Call to service: Truckee woman aids Kosovo refugees
The day after she found out she was pregnant with her first child, Truckee resident Leora Sapir agreed to work overseas as a nurse practitioner in a refugee camp in Macedonia.
Working 12- to 16-hour days, Sapir spent five of the first six months of her pregnancy training Albanian physicians to provide prenatal care to the refugees of the Kosovo conflict. Two months after returning home, Sapir’s daughter Ella was born.
“The organization called me and I really wanted to go,” Sapir said. “I’ve been doing this type of work for years. They called the day after I found out I was pregnant and I realized it was my last chance for a little while. So I said yes, I would go.”
Within a week of receiving the phone call from Medicine Sans Frontiers, known in the United States as Doctors Without Borders, Sapir was working in a refugee camp of 23,000, thousands of miles from her husband, Ron Barzel.
“We’d been apart before for 10 months,” Sapir said. “This time we had email. We had more contact than ever before.”
Having the convenience of email was not always convenient, though. The smoky Internet Cafe where computer access was available had very poor connections, Sapir said, and at times, the wait for a terminal was more than four hours. But waiting was often worth Sapir’s time.
“I was able to hear from people and get support from family and friends,” she said.
Not only email made Sapir’s mission in Macedonia different from her previous four missions, she said. During her previous missions in India, Burma, Vietnam and Africa, conditions in medical facilities were much more primitive than in Macedonia, which was her first emergency mission.
“It’s Europe,” Sapir said. “It’s not like being in Paris or Berlin, but we had a nice house and good food. Everyone lived pretty well. For most of us who have done this type of work, it wasn’t the toughest work we’ve done.”
Sapir described the typical Macedonian refugee as “in extraordinarily good health,” stating that this was the first of her missions in which she did not need to give iron supplements to pregnant women.
As Europeans, the refugees had educational, social, cultural and economic backgrounds similar to Sapir’s and other United States citizens, she said. Because of this, practicing medicine in Macedonia was much more like practicing at home than on previous missions, but she saw many more severe mental health problems among the Macedonian refugees.
“The horror stories were in fact true,” Sapir said.
As a result of war-time atrocities, refugees in large numbers suffered immediate post-traumatic stress syndrome, Sapir said, demonstrating such symptoms as extreme panic attacks, seizures and anorexia.
Anorexia was not uncommon, she said, because in some places in Kosovo, food supplies had been poisoned, leaving many people afraid to eat again.
Despite her proximity to a war-torn area, Sapir said she never felt herself in danger.
“It was pretty safe,” she said. “You didn’t hear the bombing but you’d hear the planes breaking through the sound barrier. It was insane – the air traffic. And Kosovo was a mess. I went in there a few times. That was quite startling.”
President Clinton’s visit to the refugee camp was as equally exciting as Kosovo was startling, Sapir said. But because a threat had been placed against the president, the original plan for the president to visit casually among workers and refugees was changed.
Security was heightened and Sapir, along with others, was informed that she would not have the opportunity to meet the president.
While Sapir hung back, honoring the requests of security personnel, several members of her staff made their way toward the president and eventually shook his hand. Sapir appreciated her staff members’ excitement, but as the only United States citizen working at the camp, she felt somewhat disappointed that she had not also been able to meet the president.
“I wanted to see my president,” Sapir said. “I got to see his head and caught glimpses of him, but that was all. My staff, they were very happy, though. It was very good for them.”
The president came and went with a great deal of fanfare, in a matter of hours. The refugee situation, however, remained the same. Tensions among different ethnic groups were often a concern and domestic violence cases were not uncommon, Sapir said. A whole new set of medical problems directly related to life in a refugee camp arose.
Burn victims were among those topping the list of casualties, Sapir said, because people accustomed to modern conveniences were suddenly living in very close quarters and made to cook over fire within those quarters. Young and old alike stumbled into cooking fires after tripping over cords securing tents or other debris littering the tight spaces.
Just as refugees were required to learn new living skills, and though Sapir described the refugee camp as much more modern than other places she has served, medical personnel too needed to adjust their skills to the situation at hand.
Some days, refugees arrived by the thousands. At times, 700 people or more would be waiting in line to receive medical attention and crowd control became an issue. As the summer wore on, the heat in the tents became excruciating, Sapir said, and temperatures approached those of the Central Valley. The pay was minimal and the hours long.
Local staff needed to be trained that prescribing Valium for every ailment is not necessarily good medicine. Creating shade became a medical priority as dehydration cases increased.
“The challenges of this work are completely different,” Sapir said. “The question is, How can you make modern medicine work in primitive conditions?”
Another question one might ask is: Why would a pregnant woman want to try?
“I could imagine my work overseas much easier than I could imagine being a mother,” Sapir said. “I love doing this work. It’s what makes me tick.”
Ella Barzel was born in good health to Leora Sapir and Ron Barzel two months after Leora Sapir returned to the United States.
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