"Am I My Brother's Keeper?"

I recently attended the European Wound Management Association 2016 Conference in Bremen, Germany, May 11-13. With roughly 6000 people registered, more than 190 exhibitors showcasing their wound care products from around the world, and as many as 14 tracks of meetings going on at once, I was excited and honored when asked to present at 2 sessions and co-moderate a third. The session I co-moderated with Dr. Hubert Vuagnat from Geneva, Switzerland (“Migration, Culture, and Ethnic Skins”) was somewhat of a mystery to me. Since I had absolutely no idea what this was about, much less what I could add to any discussion, I sent out a few panicky e-mails and learned the session would discuss providing health care, especially wound care, to refugees fleeing the Middle East. I knew what I had read in the paper and seen on television about the issues but had not thought much about the provision of medical care to those people. As the session unfolded, it became an amazing experience to listen to those involved with providing for the refugees.  

One speaker, Dr. James Elliott, who works with Doctors Without Borders, discussed caring for diabetic foot ulcers of Syrian refugees who were in camps in Lebanon. They did not know how many refugees had diabetes mellitus or foot ulcers in the camps. He spoke of the problems with people living in tents inundated with water that make several inches of mud the only floor. The people were barefoot or wearing sandals — not an ideal diabetic footwear under the best of circumstances, but especially in mud. The discussion involved problems with obtaining dressings and bandages of any type and getting them to the refugees with wounds. A major issue was obtaining insulin for the patients with diabetes. Much of the insulin they could get contained impurities and most had been adulterated so the concentration on the label did not match that in the bottle. How were they going to manage these problems in the midst of all this and political issues?  

Dr. Christian Münter, a physician from Hamburg, Germany, then spoke on providing health care for refugees in the German camps, especially around Hamburg. The camps in Germany are much different than those in Lebanon in that many are enclosed structures with plumbing and electricity or nice tents with permanent floors and facilities. There is no mud in the German camps. His discussion of compassionate care for the patients and their health problems was very inspiring. In contrast to Lebanon, these people had access to medications and even hospitals if they needed them. He stressed that they were human beings and needed to be treated as such with all the help that could be provided. While this is not a popular approach due to political issues, he pointed out that we should treat these people as we would want to be treated if we were in their position. He ended his presentation with the question, “Are We Our Brother’s Keeper?” Also, a reference was made to when Jesus discussed the treatment of the poor and needy: “Whatever you did for one of the least of these brothers of mine, you did for me” (Matthew 25:40, NIV).

After these inspirational presentations, I was to present some of my experience in treating patients in under-resourced areas and make comments on the other presentations! My thoughts turned to our work of treating patients with wounds not only abroad but also in the United States. Every day we see patients with difficult circumstances, and many times we have mixed emotions about treating and trying to help them. Every day we must answer for ourselves: “Are We Our Brother’s Keeper?”