RAMTHA, Jordan – The wound in the middle of the man’s arm is a large circle of ribbed red blood and tendon, the edges of the flesh curving up and out like petals. Metal prongs inserted into the skin on either side of the wound hold his arm in place; his chest rises and falls with each breath.
To observe surgery up close is at first disorienting and surreal, like watching a perfectly shot film in the cinema and then walking through the screen to realize there is no such thing – only machines and people creating the images that were streaming as reality before you. I do not normally see bodies in disrepair that are being painstakingly stitched back together; I feel like I’m trespassing on something sacred.
The Médecins sans Frontières (Doctors Without Borders) trauma hospital in Ramtha, Jordan, is located 3 miles (5km) from the Syrian border. From the roof of MSF’s house, where its international staff live, you can see the blue-green hills that demarcate the border, stretching between the two countries like a gentle wave. Once you could have strolled in those hills, or laid down in the grass and daydreamed.
At night on the roof the lights of nearby Irbid glitter, some of them marking the apartments where thousands of urban refugees dwell, waiting for the war to end, for resettlement or for the chance to try to make their way across the ocean to Europe. Everyone is waiting – to see whether the fragile cease-fire matters and whether the E.U. will continue to turn its back on the men, women and children drowning in its seas. In Ramtha, they are waiting for a medical outcome.
As a humanitarian affairs officer with MSF, part of my job is to understand and construct here in Jordan how MSF practices temoignage – the act of witnessing. Since MSF’s inception, witnessing has been intertwined with the organization’s medical activities, which often occur in contexts where MSF is one of the only organizations to see at first hand the effects of conflict and disaster. It is what always set MSF apart for me from other organizations; although I know witnessing can be an imperfect offering, it at least implies responsibility.
To witness the effects of war is to witness what you cannot change; it is to observe mutilated bodies and sense the dislocation that comes with forced exile. It is to reflect on what meaning you can make in life when you are here, alive, and so many others are dead. For years I did not want to do an MSF mission because I thought it was not the real world, that it would change me in ways I did not want, but now I know that was fear. On the other side of fear is the world; it is still there, whether you choose to look at it or not.
In Ramtha, you cannot fix a war-wounded patient when they arrive; you perform a surgery to keep them alive, you salvage body parts, you fight with time to prevent infection from unraveling from an open wound down the length of a body. Doctors monitor medical charts and heart monitors to assess probabilities, but sometimes they are no more than scanning the horizon, looking for a sign.
After the first surgery, the person often needs intensive care, further surgeries, new legs or arms. They recover in Ramtha and are often discharged to another MSF facility in Zaatari refugee camp, where their stitches are cleaned and they are taught how to use a wheelchair.
Counselors begin the delicate process of trying to help each person make sense of their missing pieces. A handwritten sign in a counseling room in Ramtha reads: “finally all the painful memories will go away like the dry leaves and nothing lasts except the lovely flower trauma made for you.” I do not know if that is true, if there are memories you can bury. I think the memories must be more like blood, always running through you.
A small boy with tufts of black hair needs to be reunited with his parents but cannot be because they are still in a part of Syria where fiery metal falls from the sky like rain.
A woman who stepped on a landmine and has shrapnel coating her arms like sleeves must be informed that her husband – who drove her to the border, who lifted her body into an ambulance so she could be transported into Jordan to receive treatment, who promised to speak to her in the morning when she awoke alone in a metal bed – was struck by a rocket driving home and died, his body engulfed in flames.
You go to sleep and someone is alive, you wake up and that person is dead; the boundary shifts, the numbers are updated, the news spits out another record of the war.
To witness is to stare at this reality and not look away, to record these stories, to sometimes speak about unspeakable things. But maybe witnessing is also to refuse to accept this is the whole world. It is to remember what existed before the war and what could exist after; to someday hike in the hills near Ramtha along the arbitrary border of two lands.
The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Refugees Deeply.