Friendship leads to ophthalmic outreach mission in Kurdistan

The first American ophthalmologist to visit Duhok, Kurdistan, brought new treatments and equipment to an appreciative community.

John A. Hovanesian

Phillips Kirk Labor, MD, met Gazi B. Zibari, MD, FACS, FICS, when both were attending medical school at Louisiana State University. Dr. Labor was a medical student; Dr. Zibari was a surgical resident.

Dr. Labor did not know that their friendship would lead him, some 20 years later, to a medical mission in Kurdistan in northern Iraq, or that it would bring him not only a sense of accomplishment, but also a new understanding of his country and profession.

“I don’t really see myself as doing that great a thing, as there are so many great ophthalmologists in this country,” Dr. Labor said. “There are people that are much better than I am. I’m not diminishing my skill, but because I’m surrounded by it all the time, I don’t really appreciate it. … But when you go over there, I had never been treated like that as a physician, anywhere. It’s just amazing. It’s a real eye-opener, not just from the standpoint of helping others, but it’s also an eye-opener in terms of the opportunities that we have in this country that we take for granted every day. It really changes your perspective.”

The friendship

Dr. Zibari is a native of Kurdistan, an autonomous region within Iraq. He had to leave the country in 1975 during an expulsion of thousands of Kurds by the Iraqi government.

“He has a very interesting story about how he was forced to walk out of Kurdistan to Iran and then ended up in the United States in the mid-’70s,” Dr. Labor told Ocular Surgery News. “[He] basically worked his way into medicine and through medical school, and that’s how he ended up being a resident when I saw him. He’s probably one of the most industrious people I’ve ever met.”

Phillips Kirk Labor, MD, performed surgery at the Azadi Hospital in Duhok, Kurdistan. Image: Labor PK

In the late 1980s, an estimated 50,000 to 100,000 Kurds died when the Anfal genocide was carried out by the Iraqi government, according to human rights groups. Dr. Labor followed the Kurds’ plight in the news and discussed the situation with Dr. Zibari when they were at Louisiana State University, Shreveport.

“I told him back then, I felt sort of a — I don’t know if ‘kinship’ is the right word, but a duty to help these people who had been very pro-American in the Middle East and … if the opportunity ever arose, I’d like to go over there and help,” Dr. Labor said.

Time passed, and Dr. Labor became an ophthalmologist, while Dr. Zibari became a general surgeon. They lost touch, Dr. Labor said, but met again 3 years ago by chance.

This year, the Kurdistan region was safe enough for Dr. Zibari to travel there with foreign physicians. In April, on a medical mission sponsored by the charity Operation Hope and the International College of Surgeons, Dr. Labor kept his promise to the Kurdish people.

He traveled with Dr. Zibari to Azadi Hospital in Duhok, Kurdistan, for a 1-week ophthalmic outreach stay.

Outreach

Dr. Labor was the first American ophthalmologist to work in Duhok, Dr. Zibari told OSN, and the first ophthalmologist to perform phacoemulsification in the area. Dr. Labor’s outreach work was beneficial to the Kurdish people in multiple ways, Dr. Zibari said.

“[Dr. Labor] took great care of many patients, both at the clinic and in the operating room,” he said. “He gave lectures and educated local ophthalmologists, residents and students, in addition [to] introducing new technologies to that medical community for the first time. Dr. Labor donated operating … equipment and suture materials.”

Dr. Labor reached out to Kurdish ophthalmologists who did not have access to new medical techniques for more than 20 years, in addition to providing a phaco unit, Dr. Zibari said.

“I have been going to Iraqi Kurdistan since the first Gulf War for medical mission work,” Dr. Zibari said. “This trip with Kirk and other colleagues was very fun, and yet it was extremely productive. We need more physicians like Kirk in this world, who are very warm, caring and compassionate.”

Dr. Labor said that he felt relatively safe when traveling in Kurdistan with Dr. Zibari and others, and was surprised by the region’s stability. He was also surprised by how many people awaited his arrival.

“The clinic was absolutely jam-packed with people,” he said. “I could have sat there until midnight seeing patients all day. Even though I specialize in doing LASIK and cataract surgery, they brought everything to me. People that had blast injuries who were old to infants with corneal disease. Everything.”

He examined patients in the morning, followed by operations with one of the hospital’s two “beat-up” slit lamps, indirect ophthalmoscope and the newly donated equipment. During the examinations, if the hospital door between the waiting room and examining room was not guarded, when it opened, “the room would just flood. It felt like I was working in a sea of black because of all the people in there, all the women in burqas, and they would crowd right up to the slit lamps,” he said.

Conditions

Patients’ records and ophthalmologists’ equipment showed evidence of the conflicts in the country, Dr. Labor said. There were no medical documents or eye charts, and patients had only scraps of paper with information written in Kurdish.

Ophthalmologists in the region performed extracapsular cataract extractions under air, a technique not used often in Western medicine since the 1970s, Dr. Labor said. Because intravenous sedation was not available, all patients – including children – underwent surgery with only peribulbar or retrobulbar blocks.

“They were absolutely the toughest people I have ever seen,” he said. “They did not complain at all.”

Leading ophthalmic companies donated key equipment to the hospital, but more ophthalmic supplies and equipment are needed to help the Kurdish people, he said.

“There’s a world of work that could be done there by anybody doing any medicine,” Dr. Labor said. “The people there are very, very appreciative for what we do there.” – by Erin L. Boyle

• Phillips Kirk Labor, MD, can be reached at Eye Consultants of Texas, Southlake/Grapevine, 1643 Lancaster Drive, Suite 305, Grapevine, TX 76051; 817-410-2030; e-mail: plabor@eyecontx.com.
• Gazi B. Zibari, MD, FACS, FICS, can be reached at LSU Health Sciences Center, 1501 Kings Highway, Shreveport, LA 71130; 318-675-6405; fax: 318-675-6358; e-mail: gzibari@lsuhsc.edu.
• For more information about donating supplies or equipment to the Kurdish people, contact Dr. Labor at plabor@eyecontx.com or Dr. Zibari at gzibari@lsuhsc.edu.