Dr. Elizabeth Weinstein: “It is meaningful for us to take care of any child and family who needs us here in Indiana, whether they’ve been here for generations or they just arrived weeks ago.”
By Maureen Gilmer, IU Health senior journalist, mgilmer1@iuhealth.org
In a playroom on the eighth floor of Riley Hospital for Children, a man and a boy sit on a table facing the window. They look out at the unfamiliar city below them and talk quietly in a language few here understand.
They could be any father and son seeking a reprieve from the stress of a hospital room. While they may feel like strangers in a strange land, they have been welcomed here.
Around them, they see the face of hope.
That’s what team members at Riley want to be for this family and so many others who have come from Afghanistan to start a new life in a new country.
It doesn’t matter that they don’t speak the same language. A smile, a reassuring touch, a gesture of welcome says what words cannot.
“You are safe.” “We want to help.”
That has been IU Health’s guiding principle ever since more than 6,000 Afghan men, women and children who fled their country after the Taliban takeover were temporarily resettled at a military base about 40 miles south of Indianapolis last month.
Camp Atterbury, a training base for the Indiana National Guard, is serving as one of nine temporary refugee resettlement posts in the United States.
DOING GOOD WORK
Dr. Michele Saysana, chief quality and safety officer for IU Health and a pediatric hospitalist at Riley, has been coordinating Riley and IU Health’s response to the Afghans’ needs.
She comes to this work from both a professional and a personal interest. Her husband is Dr. Chan Saysana, a pediatric anesthesiologist at Riley and a former refugee from Laos. He and his siblings and parents fled that war-ravaged country in 1976 and came to America.
Dr. Saysana serves on the board of Exodus Refugee Immigration in Indianapolis, which has a long history of welcoming refugees to Central Indiana.
Because of that association, she knew that a large number of Afghan refugees would be arriving at Camp Atterbury, but she didn’t know that nearly half of them would be children. In addition, there were at least 100 pregnant women.
One of the first things she was able to arrange, with help from IU Health team members Kieran Tansy, Matt Simpson and Joe Meyer, was the donation of an ultrasound machine to the camp so doctors there could do prenatal ultrasounds.
Beyond that, it became evident rather quickly that many children needed the kind of care only Riley could provide.
So, Riley leadership and team members stepped up to provide that care.
“I think it’s a cool example of how we just go and do good work,” said Dr. Saysana. “Whoever is in front of us we help, no matter what. That’s what medicine is all about; that’s what we’re supposed to do.”
It’s also a way to support the military, she said, adding that she has a brother in the service, so it’s important to her on many levels.
“THIS IS WHY I WORK WHERE I WORK”
Dr. Elizabeth Weinstein, pediatric emergency medicine division chief, has the same philosophy. She led Riley’s response when it came to emergency medicine.
“In short order, it became clear that while the military was doing a really extraordinary job building these processes from the ground up, there are reasons that a children’s hospital exists,” she said.
Several children were brought to the ED beginning Labor Day weekend with emergent needs, Dr. Weinstein said. Some were suffering from dehydration and malnourishment, while others had longstanding chronic illnesses or congenital abnormalities, requiring inpatient care.
“We were happy to have those kids and those families with us, but we also realized quickly that we didn’t have much insight into where they were coming from – what we were discharging them home to – and we needed a better sense of the camp, their process and what we could provide to families.”
They worked with camp personnel to smooth out some of those processes, while continuing to do their best for the Afghan children.
“It is meaningful for us to take care of any child and family who needs us here in Indiana, whether they’ve been here for generations or they just arrived a couple of weeks ago,” she said.
“No matter how beaten down and tired we get with all the things happening on the healthcare front, there are these moments when you just very clearly think to yourself, this is why I work where I work,” Dr. Weinstein said.
SPEAKING FROM THE HEART
Dr. Rachel Peterson, a Riley hospitalist, has been seeing patients admitted to Riley for a host of illnesses. One of the obvious challenges for her and others has been the language barrier.
Sometimes Camp Atterbury has sent interpreters with families, but often the hospital relies on phone and video-based online interpreting services to translate Pashto and the variety of dialects the Afghan people speak.
Martti, an interpreter on wheels, has been a crucial member of the team, Dr. Peterson said. The video language service can translate in real time.
“We would be lost without it,” she said.
Like others on the team though, she has learned a few words from her patients and their parents. The one she hears the most?
Manana – thank you.
“Caring for these patients has been so wonderful,” she said. “We have a global health doctor on our team, Dr. Laura Ruhl, who runs the pediatric portion of our global health department in Kenya. She works here part of the year on our hospitalist team. With her help we’ve been able to address some refugee care issues that I didn’t know as much about.”
Dr. Peterson said she is glad to be in a position to help the Afghan people.
“I’ve felt honored to help. It’s the right thing to do.”
She can’t shake the images she saw on television in August of Afghans desperate to board planes in Kabul, traveling with just the clothes on their backs and their personal documents.
“To meet them in person, it gives me chills to talk about it,” she said. “It’s been such a privilege to carry this out at Riley, to show our Hoosier hospitality to people who are escaping a very scary situation.”
Despite the burdens of the pandemic, which have seemed never-ending to many in healthcare, Dr. Peterson said this humanitarian mission feels different.
“We can welcome them, we can take care of those who need it, and we can partner with our teams. It’s been cool to see,” she said.
STEPPING UP
Advanced practice provider Stayce Woodburn spends most of her time caring for cancer patients, but she stepped up to help when Riley hospitalists and ED team members were overwhelmed by the number of patients.
“I can tell you that the patients and their families have been so kind and so gracious to all the care providers here,” Woodburn said last week.
“For me, it’s just been a really good experience, to be able to help these families through a difficult situation and navigate clinically through whatever is going on and empower them to help get their child better and reunite them with their families at camp.”
The past 19 months have taught healthcare workers to be flexible and resilient. Caring for the Afghan people requires those same skills, as well as a healthy dose of humility, Woodburn said.
Dr. Saysana agrees. Despite the challenges, the work has been a privilege, she said.
“It’s what we do when we know there are people in need. We want them to have a better life.”
Humans caring for other humans, Woodburn said. That’s what it’s all about. That’s what she and her colleagues are called to do, whether it’s COVID or cancer or the chaos of mass evacuations from a troubled country.
“You can’t plan for when things happen, but when people need you, that’s when you have to step up. It makes me even more proud to work where we work.”
MEMORIES OF ANOTHER CHILD
Robin Wilson is a case manager on 8 East who has been busy coordinating resources for families who are inpatient and arranging progression of care as they move on to new homes away from the camp.
Many years ago, Wilson took care of an Afghan child who came to Riley for heart surgery as part of a humanitarian mission with Rotary International.
“I was really glad to be a part of it,” she said, recalling that the boy’s father spoke English, so she learned a great deal about the Afghan culture. She was struck by the man’s generosity and kindness.
Wilson sees those same traits in the Afghan guests today, when they let down their guard. “They’ve been through so much.”
TEAM APPROACH
Dr. Weinstein, who said the ED was seeing anywhere from four to 14 Afghan children a day last month, credits the entire Riley team for coming together to help.
From Dr. Saysana, whom she describes as “top-notch,” to Riley Chief Medical Officer Dr. Elaine Cox to Dr. John Christenson and his infectious disease team … she could go on.
“We are learning as we go, but we are grateful for our partners,” the emergency department physician said. “Care management has been extraordinary. Our pharmacy team has been amazing. It really has been a collective extraordinary effort to make sure we are zigging and zagging with all the new challenges associated with the care we can provide for these families.”
In a pediatric emergency department, it’s expected that healthcare workers will be seeing children and families who are struggling amid extremely challenging circumstances. In fact, it’s one of the things that makes pediatric emergency medicine special, Dr. Weinstein said, the opportunity to help families in those moments.
Riley’s Afghan guests, however, have survived experiences that not many can relate to, she said.
As for that language barrier?
“I think there are things you can do that don’t necessarily need an interpreter,” Dr. Weinstein said. “I think people feel it when you are welcoming. I think they feel kindness and compassion during a time that I’m sure is chaotic and frightening.
“Those are things that come through, at least I hope they do. I hope that is an environment we create for all of our families. It shouldn’t matter what language you speak.”
It’s pretty simple, she said, when she looks into the eyes of Afghan moms and dads.
“I see parents who love their children and want what is best for them.”
Photos submitted and by Mike Dickbernd, IU Health visual journalist, mdickbernd@iuhealth.org