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The Birth of Hope and Purpose in Adversity

The Birth of Hope and Purpose in Adversity

 Guest post by Reem S. Abu-Rustum, MD, FACOG, FACS

Purpose. It is what keeps us going in life. What drives us to fight adversity. What instills courage and resilience within us humans in general, and women in particular, to keep going on, irrespective of how dark the world around us may be and how helpless we may feel…

As a human being, I am forever in awe of “her”, the most delicate of living creatures, who has been entrusted to bear the gift of life, and whose noble role as the bearer, nurturer and protector of this life is the main purpose of her existence. She withstands the ultimate pain in bringing this life to life and she guards it with her life. In many parts of the world, she is still victimized, abused, neglected and unaccounted for. Nonetheless, she fights with resilience and courage, carries on with purpose and compassion and serves as the example of utter selflessness to humanity. For me, an obstetrician, it is the greatest privilege and honor to accompany “her” in her purposeful journey, and to witness the miraculous life she carries from conception to birth.

My story takes you to the Middle East, to Lebanon, to a country with much natural magnificence that has suffered never-ending wars and strife in its fight against extremism. Its noble purpose has been to serve as the example of coexistence of 17 religious sects. In addition, our women are amidst a never-ending battle to secure their basic and equal rights, and our mothers are still deprived of their basic human right of being able to naturalize their own offspring.

Today, Lebanon is housing not only its Lebanese, but it is also home to Palestinian, Iraqi and Syrian refugees. It is estimated that the Syrian refugees account for over 1/3 of the Lebanese population, the majority of which are women, living well below poverty levels, housed by the neediest Lebanese families, in the most impoverished areas of Lebanon.

IMG_8819As tragic as death and loss may be, as instigating as they are once the shock subsides, they give as a renewed sense of purpose to pick up and carry on with our mission in life, using birth as the most effective weapon with which to combat death. I have seen this phenomenon countless times in life in general, and amidst my patients, who have suffered a loss, in particular. Conception and reproduction become the central driving force in their lives giving them renewed purpose and strength.

In 2004, a lovely human being, Dr. Sana Elias, who was at the peak of her mothering (with a 2 year old and a 4 month old daughter), and a rising star neonatologist, whose sole professional purpose was to guard the tiniest of humans who were prematurely forced to leave the security of the womb, was prematurely stolen from us by death. She was robbed of her purpose and dreams, her family of a mother and daughter, and her community of a most humane giving physician.

The impact was catastrophic and tremendous, however, after 7 years, in 2011, I, together with her closest family and colleagues found a renewed purpose to carry on with dear Sana’s medical mission in life, and SANA Medical NGO was born. Ever since my residency training where I had the unique opportunity to work in the “Florida Outreach”, I had always dreamt of a “mobile clinic” in the Lebanese Outreach in order to deliver the urgently needed medical care to those with no means of transportation or financial capabilities. Dear Sana provided me with the opportunity and purpose to pursue this dream in her name and honor…

SANA is modeled after the ISUOG Outreach Program ( and SANA’s motto is: sustain, aid, nurture and assist. SANA’s primary goals are first, to provide comprehensive obstetrical care and education to??????????????????????????????? the underserved mothers in the Lebanese Outreach setting which, with the Syrian Crisis, is quite unique since it encompasses both Lebanese as well as Syrian refugees. Second, SANA aims to empower the local health care providers by enhancing their education in prenatal care and by providing them with sonographic training. Obstetrical sonography is the “window to the womb”. The minute the ultrasound transducer is placed on the maternal abdomen, there is an immediate transcendence into a miraculous world pulsating with life, hope and purpose. Nonetheless, it is a threatened world that may have deleterious effects on the lives of both mothers as well as their budding fruit.

Since its birth, SANA sole purpose has been to leave the greatest possible impact in our neediest areas of North Lebanon. This has been no easy task with our pre-existing Lebanese challenges now compounded by the mounting challenges of the Syrian crisis. The refugee numbers are increasing by the minute: when faced by death, there is a renewed purpose in reproduction. What could be more hopeful than a new life? As such, the rates of pregnancies in the refugee population are at concerning high levels, contraception is not a welcome option, and SANA is currently taking care of expectant mothers many of whom are on their second or third pregnancy while displaced in Lebanon. Couple this displacement with pregnancy, poverty, inaccessibility to good healthcare, and the disastrous state we are in clarifies.

As hopeless as our state is, as distraught as SANA’s Team is at the end of each medical mission having been faced with so many heart-breaking stories, as empowered as the team feels. There is a renewed sense of purpose to have been able to be part of the lives of these stoic, resilient, courageous mothers. On our long trips into the impoverished Lebanese outreach, we encounter the most amazing human beings: children, women and men, each with a unique sense of purpose, each with a unique role and value to the community, each with an inspiring uplifting story, no matter how tragic.

There are priceless images imprinted in my and SANA’s team’s brain: from the faces of our appreciative patients grateful for knowledge about their bodies and thankful for reassurance about their babies, to our diligent dedicated SANA volunteers and partners, to our empowered trainees with enhanced self confidence and pride. Not to forget our brief encounters with the women incessantly tackling the impossible goal of trying to provide a clean and healthy environment for their families by performing simple tasks such as sweeping the dust outside their tents or proudly displaying their laundry lines hanging to dry; add to that unforgettable images of the children bathing in the rain-created pond by their tent, the priceless smiles on children’s faces at the notion of a photograph, the dreamy girl lying tent-top gazing out to sea, the toddler watering the plants, the laborer in the field hunched over by the crates he is carrying, the shepherd with his perfectly united herd, the twinkle-eyed cotton candy seller who spreads such joy, Adel bearing a white rose for his pregnant mother on mother’s day, Abdulaziz helping us communicate with his deaf-mute pregnant mother, to the woman bearing the weight of the world on her head, all with such purpose and drive.

IMG_8824This brings me back to purpose. I would like to impart a few words to our future budding generation. I have a teenage daughter, and I am gynecologist who is privileged to be able to help our young girls deal with their most intimate concerning issues and insecurities, especially in our male-dominated part of the world. I tell them no matter how dark the world may appear at times, look within your souls, identify the resilient amazing beings that you are with all the limitless potential that you have each been blessed with. Believe in yourselves and the gifts within and you can never go wrong. Your purpose and path in life shall clarify. Life is a beautiful journey, albeit with many challenging roads and valleys that only make us stronger once we emerge, for it is only after the deepest plummet that the rise commences…

My memory is replete with priceless stories and images that have so enriched my life. My privileged interactions with all the amazing women and their families are a never-ending source of hope. Their own sense of purpose fuels my existence with such a sense of purpose. For that, I am forever grateful…

Reem S. Abu-Rustum, MD, FACOG, FACS. She received her medical degree at the University of Florida in 1993 and completed her residency training in Ob/Gyn at the University of Florida in 1997. She is certified by the American Board of Obstetrics and Gynecology and is a fellow of the American College of Surgeons. She serves on the Board of Governors of the American Institute of Ultrasound in Medicine and is an ISUOG Ambassador for Lebanon and Outreach in the Middle East. She has authored the text “A Practical Guide to 3D Ultrasound”. She is co-founder and president of SANA Medical NGO and the director of the Center For Advanced Fetal Care in Tripoli, Lebanon. Age 46. Lebanon.
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