Kurdish Mountain Chai is a locally owned and operated business based out of Louisville, Kentucky.
Their commitment? To brew the best cup of tea you’ve ever had and to save lives while doing it.
For every pack of tea Kurdish Mountain Chai sells, a dollar goes toward another lifesaving heart surgery in Iraq.
Now, who wouldn’t toast to that?
We at the Preemptive Love Coalition are partial towards charitable businesses. After all, it’s how we first started saving lives with Buy Shoes. Save Lives. back in 2007.
A pair of handmade shoes. A glass of well-brewed tea. Another business that cares. These are some of the reasons we’re able to save another life this month.
Have a charitable business idea of your own? Write us at info[@]preemptivelove.org and let us know how we can partner with you!
June 19, 2012 by Jeremy · Comments Off
The only bad failure
is the one from which we fail to learn.
Most organizations put a premium on celebrating successes at the end of every year—we certainly do!
But we also believe that we have a great deal to learn from our failures, so we endeavor to share them and the lessons we’ve learned in hopes of avoiding those same mistakes in the future.
When seeking to tackle intractable problems in an environment like Iraq, missed opportunities, missteps, false starts, and failures are par-for-the-course. There will be no improvement in the political situation in Iraq, in the economy, in healthcare, or in the pursuit of peace without a number of flops and failures along the journey. If we already knew what worked, we all would’ve implemented it by now and moved on.
The truth is, neither the American government nor the Iraqi—neither international nor local NGOs—truly know what works in Iraq. Most of us are making educated guesses and seeking to rightly adapt programs and principles that have proven successful at other times in Iraq or in other parts of the world.
From this point forward, I want to provide you with an annual (and sometimes real-time) assessment of our failures. In absence of such previous reports, I will use a few minutes to highlight our most meaningful setbacks, failures and lessons learned to date.
The three major failures of 2011, to be covered in this report are:
Failure #2: High-mortality Remedy Missions in February/March 2011 (Read about Failure #2 here)
Failure #3: The Loss of Our Sulaymaniyah, Iraq Surgery Site as a Major Developmental Partner; Lack of Surgical Capacity Increase As a Result of Remedy Missions Conducted
Let’s get started…
Failure #3: The Loss of Our Sulaymaniyah, Iraq Surgery Site as a Major Developmental Partner
Unfortunately, it became obvious in May 2011, after completing two Remedy Missions to the Sulaymaniyah Center for Heart Disease, that local organizations and hospital leadership were not committed to the partnership. In-fighting over child selection, credit sharing and cost sharing dogged the nascent partnership from day one.
We struggled for one year to make the partnership work. But ultimately, we failed to keep it all together. What we deemed to be petty lines in the sand gave us deep concerns over the ability of local players to see our program through to the 5-year completion that we had all discussed and envisioned.
Our March 2011 Remedy Mission IV was a huge disappointment in many ways. We went back to the drawing board and made a few required upgrades before our international team would agree to work again in the hospital.
By May 2011, as we tried to put the final touches on our next mission to the center, the local hospital had failed to made requisite upgrades in hardware, medications and supplies.
In consultation with our international partners, we ultimately issued a vote of “no confidence” and cancelled the pending mission.
In many ways this felt like a waste—a waste of nearly 8,000 of cumulative training hours; a waste of financial resources on a program that apparently lacked the willpower to see commitments through to the end, etc. All we had to show for our two missions in the city were 42 operations—including a few ground-breaking, inspirational cases; some amazing stories of peace and reconciliation; and eight deaths.
Within six months, we heard that the heart center was moving forward with an Italian team along a contract similar to the one we had originally proposed. The Italian mission in the Fall 2011 was deemed a success, and many surgeries were performed, but after the mission was completed rumors again circulated about local politics and an apparent inability to mobilize the center toward a long-term contract with the Italian team.
In a January 2012 meeting with the Director of Health for the province, we inquired about the number of surgeries that had been performed since our team and the Italian team had conducted three surgical missions to the city. To our great disappointment, the health director laughed and asked if we were joking, saying that the hospital’s surgical capacity had not improved in the previous year, in spite of the three missions. He laid the blame at the feet of local staff and the politics and health and not at the feet of the international teams that had attempted to help.
I’m not entirely sure we’ve learned all there is to learn from this yet. Our inability to woo or influence the hospital leadership into making the necessary upgrades was frustrating, but it is still unclear how we could have sweetened the deal or foreseen it coming prior to the May 2011 deadline that we set.
I am grateful that we made the decision to pull the plug on the program rather than continue to invest valuable resources (from all parties) into a stagnate program. The cumulative work done by international teams in the Center over the course of one year should have led to a measurable increase in surgical capacity. That is how our programs are designed and we are seeing an increase in capacity in other cities.
One question that we have contemplated is the idea of exclusivity in our contracts with a hospital. Should we insist on exclusive rights to train in a hospital, in an effort to increase commitment, decrease the opportunity for communication breakdowns and competing interests, etc? In the southern cities of Iraq where we work (where security risks are a much greater concern and where development is further behind the northern cities), we do not have competing interests. This appears to have created a greater loyalty and a healthier trust between our international and local teams than anything we were able to achieve in Sulaymaniyah. Our inclination continues to be against such exclusivity demands, but the question has come up as we seek to understand what went wrong and how we can avoid it in the future.
We cut our losses before running a mission in a dangerous environment. Perhaps most importantly, we cut our losses on a program that showed little organizational leadership and, in the words of the health director himself, zero increase in surgical output resulting from our educational, material, and infrastructural inputs. While the loss itself is a huge disappointment and I feel a personal sense of failure for my inability to cobble together a solution, it could have been so much worse.
It has been an exhilarating year in so many ways. But the above failures have been sobering. Yes, children are alive that may not be if we had not intervened. But it is undoubtedly true that children have died because we intervened. If our mandate is primum non nocere—first, do no harm—then it is cleared that we have failed on that front at least a few times this year. At least one was related to indecisiveness—a leadership failure on my part. Some of the other deaths were to be expected given the risks that were clearly communicated to the family. But we do not only seek to “do no harm.” We have another object in view: we seek to do good. And we did not attain the good that we desired in our now defunct partnership. For reasons to which we are not privy, they have failed to increase their surgical output as a result of our efforts. We made the right decision walking away from the partnership for the time being. We will remain open to reengaging in the future if local conditions change.
I am most impressed and proud of our team’s willingness to confront and respond to failure on a trip-by-trip basis. When it became obvious that a mission could not run without an international cardiologist, we responded. When the local conditions required staggering the deployment of extra nursing staff so that ICU care could extend in a professional manner beyond the duration of the official trip itself, we responded. And when we were urged to move ahead with a mission in spite of conditions that we believed to be unsafe, we responded by canceling the trip.
There are at least a few viable philosophies as to how one should develop a pediatric cardiac care program. Some progressive; some conservative. Some are boring and more predictable; others are inspiring and innovative. We are proud to work with professionals who employ different methodologies and adhere to different philosophies of development. We will no doubt continue to face difficult days as we face down death and attempt to eradicate the backlog of Iraqi children waiting in line for lifesaving heart surgery. But we envision a day in the future when every child across the country has access to the care they need within a 3 hour car ride. And we will continue to labor toward that end.
If you have any questions or concerns about this report, the decisions we’ve made, or the direction we are going, please email me at your convenience. I would love to hear from you.
Nearly two years ago, we began our first Remedy Mission with the International Children’s Heart Foundation and Living Light International. For us it was a great risk to take. We had only sent children out of the country and, all-in-all, that model was proven. It was safe.
But thanks to your support, we were able to begin training doctors and treating children inside Iraq. And we were able to serve a little girl named Iman (along with 23 other children). Now, just under two years later, here she is:
Iman is from Dohuk where our partner doctor, Dr. Kirk Milhoan, and his team screened newborns for heart defects. Now Iman is happy and healthy, able to enjoy playing games with her friends, learning in school, and spending time with her family.
Safe at last from her childhood disease, Iman’s life is full of potential. Thank you for giving these children a future!
Grandmothers; they’ll pinch you, they’ll squeeze you, and they’ll always hold you tight.
Our recent screening mission in Dohuk saw a constant stream of grandmothers caring for their newborn grandchild as the weary mothers rested. And for that, I salute them. They are truly fantastic women!
A Kurdish grandmother poses with her grandchild after learning the child was free of any heart defects.
A Kurdish Yazidi grandmother rewraps her grandchild after the child’s screening—no heart defect found!
These grandmothers were incredible at caring for the newborns. This one kept her grandchild distracted during the screening.
March 23, 2012 by Behar Godani · Comments Off
For millions of immigrants in America,
a sense of belonging and successfully handling their dual cultural identity is one of the most difficult and challenging of tasks. On the one hand, your heart is tied back to a land that was once your home—as is the case with my parents—or at least a place that feels a lot like home—as is the case with my siblings and I.
Yet no matter how many times we go back there or insist that we want to spend the rest of our days here, there never seems to be a perfect fit. There moved right past my parents and the memories they could have made had they not been forced to leave thirty years ago, and here feels much more familiar.
As a result, we’re stuck between here and there, never completely belonging anywhere.
But perhaps the beauty in the limbo that so many immigrant families find themselves in is that they are able to understand and exist in both places at once.
And perhaps that’s where the secret to truly co-existing beside one another lies as well.
There are immigrants who have walked in our shoes, but there are plenty more back there—in Iraq—who, like my parents, were forced to leave and if they survived were likely to be internally displaced. And that’s where so much of the current resentment lies. It was never truly an ‘us’ vs. ‘them’ mentality in the sense that entire groups of people became alienated from one another. No matter how bad things became in Iraq, there was always a recognition that the majority of its citizens were good people.
Now, many wonder if the country and its people—in light of recent political developments—will ever live up to the potential that so many of its own politicians boast about and so many in the West had initially hoped for.
The key lies not in government policies, per se—which I yield, can at times favor one group over another and further disenfranchise other groups who already don’t feel welcome in the political system—but in all-natural and real human connections. When people can put a face on families affected by violence, when a doctor from a different faith or ethnicity saves a child’s life, when a Muslim breaks bread with a Christian who’s just as Iraqi as anyone else, the concept of “preemptive strikes” and bombings will become just as foreign and distant a concept as they were all those years ago. Then “preemptive love” and a true sense of commitment to the success and prosperity of the Iraqi state for the sake of its people will begin to emerge.
No more will bureaucrats, insurgencies, or fringe groups attempt to dominate the hearts and minds of the people as much as they have in the past because the people, like my parents, will come to learn the importance of existing in the now. They’ll learn that yes, you may have been displaced and you may have lost loved ones like so many innocent Iraqis have, but our humanity and our hopes for a better future must transcend the easy way out which often involves blaming an entire people or religious group for why things are currently the way they are.
Most immigrants face the challenge of simply reconciling their ethnic identities with their American ones, but families who hail from conflict zones—both those who had an opportunity to escape and those who were forced to stay behind—face the added difficulty of not only staying true to the identity that various groups have tried to wipe out, but also of keeping the anger and sadness in their hearts from ultimately skewing how they view “the other.” That of course can only happen with social projects and movements that focus on bringing different groups together so that individuals can begin to put a face on “that religion” or “that ethnic group.”
Eventually, they’ll come to find—as we all eventually must come to find as human beings—that religion, ethnic identity, the types of clothes a person wears, or the color they choose to dye their hair quickly falls away once that connection is made and “that” person becomes a friend.
March 16, 2012 by Cody · Comments Off
On this day in 1988 the war between Iraq and Iran had just entered its eighth deadly year. In the middle of the fight stood Halabja, a Kurdish city of 50,000 just eight miles from the Iranian border.
Halabja shook under the relentless air and artillery bombardment by the Iraqi military. Then when the night fell, Iraqi helicopters and bombers dropped chemical bombs from the sky. The survivors’ stories tell the rest:
A father named Kherwan remembers, “Artillery rounds began to explode…and planes began dropping bombs on the town…so we ran and hid in our basement. Then it started with a strange noise that sounded like bombs exploding, and a man came running into our house shouting, ‘Gas! Gas!’ Later, I smelled an aroma that reminded me of apples and I lost consciousness. Sometime later, I discovered that the Iraqi air force had bombed Halabja with chemical weapons.”
Nouri Hama Ali recalled, “Many of the women and children began to die. The chemical clouds were on the ground. They were heavy. Many children were left on the ground, by the side of the road. Old people as well. They were running, then they would stop breathing and die.”
At the end of the day, some 5,000 Iraqi Kurdish men, women, and children were dead. Another 10,000 were maimed and blinded. Halabja’s soil, food, and water supplies were contaminated and the survivors began to witness an enormous increase in cancers, respiratory disease, miscarriages, infertility and congenital heart defects.
This attack took its place in Saddam Hussein’s deadly Anfal Campaign which aimed at killing and displacing the Kurds in Northern Iraq. Human Rights Watch concluded in 1994 that this campaign resulted in as many as 100,000 deaths.
Every year, on this day, there are hundreds of articles, posts, and statuses drawing our attention to Halabja.
Some use it as a time to draw attention to the fact that Hablabja’s infrastructure is still in shambles—24 years later. Others still call for justice to be served to all those involved in the genocide. Some condemn the countries that supplied Saddam with the chemicals he needed to create these weapons. Others call us simply to pause and remember.
All of these are right and we honor Halabja by advocating in these ways.
But working toward a Halabja with paved streets, running water, and constant electricity is not the best we can do. We can turn Halabja into a Dubai or a Manhattan, but if we still haven’t addressed why the bombing of Halabja happened in the first place, we continue to dishonor those who died there.
That’s why we believe in remaking the world through healing—not just through bricks and mortar.
We believe that where forgiveness is freely given, reconciliation can happen and where reconciliation happens, there is freedom; freedom from the past; freedom from always being labeled the “victim” or the “aggressor;” freedom to live life the way it was meant to be lived—in restored relationship.
So I’m taking time today to stop and remember Halabja and to encourage those I know who were affected by it. And I’m also taking time to stop and remember that reconciliation is the way forward.
Photo by Julie Adnan
March 8, 2012 by matt · Comments Off
A week ago today our friend Jeremiah Small was killed in his classroom. His own student pulled a gun on him. If you haven’t read about it, see more here.
It happened in the city of Sulaymaniyah, and the entire community is still recovering from the shock of it all. Of course, the shock is about the violent death of an American in the oft-touted “other Iraq” region, to be sure, but the shock is also about much more than that.
When the community heard that Small’s family was coming to bury their son, rumors started to fly. Some thought they were coming for financial compensation, others for revenge. And in an eye-for-an-eye culture like this one, rumors like that aren’t crazy. If someone hurts you, you hurt them back. And that’s more than cultural, it’s human nature.
But that isn’t preemptive love.
Until someone is willing to absorb the pain rather than pass it on, violence will only continue to beget violence. Pain has to go somewhere.
So when Jeremiah’s family arrived and began blessing everyone they met, people were amazed! They were grief-stricken, to be sure, but through their great love the Small family proved to be bigger than anything most people had ever seen—they blessed rather than cursed, they sang rather than screamed; their love was furious. They even wore traditional clothing in order to show solidarity with the culture.
This was their way of living out preemptive love. Just as Jeremiah worked to love his students first—no questions asked—his family came and loved preemptively. They were remaking a broken world by choosing to forgive rather than to yield to the endless downward spiral of hate and violence.
Perhaps the most compelling example of this love was at the funeral when both the family of Jeremiah and the family of the boy who killed him embraced (pictured above). They absorbed the pain—shared it even—rather than lashing out at each other.
This is preemptive love. This is the lifestyle we believe everyone can (and should) live by. This is the better way, and the Small family used Jeremiah’s death to show us that.
December 7, 2011 by matt · Comments Off
Haka ta nazani, chava da jeerani.
Translation: “If you don’t know, look to your neighbor.”
Photo by Jamal Penjweny
Whenever someone hears about our kids or reads about our work they almost always arrive at the same question: “How did Iraq get this way?” “What caused this?” “Who’s to blame?”
Well, after 4 years of working throughout this country we believe we can provide you with a concise answer to that incredibly complex question. This isn’t about guilting anyone or pointing the finger (there’s already too much of that going around), but it is a hard look at the answer to your question.
Based on Iraq’s history, here are 5 ways to destroy a nation’s healthcare system:
1. Limit a country’s ability to operate politically and economically
In 1990 the UN Security Council passed Resolution 661, which imposed broad, restrictive regulations upon Iraq. In a nutshell, these regulations stipulated that no country in the UN could import or receive any goods from the country.
Unfortunately, the sanctions did more than impede the political and military action of the Iraqi aggressors. The Iraqi economy, that had been so dependent upon oil exports and foreign trade, crashed as a direct result of the Resolution 661.
In 1989 Iraq’s gross domestic profit was over $66 billion. Just seven years later it was estimated as being $10.8 billion. In 1989, annual income per household was $3,510, and by 1996 had fallen to less than $500. Before the sanctions, 93% of the population had ready access to healthcare institutions, which were staffed primarily by physicians who had been trained in Europe or the United States.
This economic collapse primed the country for the health crisis it is in today, a health crisis that has lead to the death of inestimable millions over the last two decades.
2. Slash governmental healthcare funding
In the 1990′s Saddam Hussein cut spending on healthcare by 90%. Continued education, supplies of necessary equipment, and valuable public health programs all suffered without adequate funding research.
Without funding and governmental support, the healthcare system deteriorated.
3. Reduce the number of medical professionals in the country
In some areas, insurgents made it a practice of targeting medical professionals. Although many doctors were not individually targeted, they were still in danger. Ambulances were frequently robbed of their medical supplies, and it was not uncommon for gunmen to enter hospitals and force doctors to care for their injured family members or comrades.
Another blow was dealt to the stability of Iraq’s healthcare when many doctors and nurses, who were lucky enough to escape death, fled the country in a mass exodus, further damaging the quality of the Iraqi healthcare system.
The murder and exodus of Iraqi healthcare professionals is tragic. It has left many families broken and many patients without the care that they need. But the negative effects extend beyond their families and the patients they left behind. Without their mentor-ship, expertise, and knowledge, generations of students from universities and teaching hospitals will continue to have insubstantial educations.
4. Destroy physical healthcare infrastructure
In 2003 American and Coalition forces destroyed two primary public health laboratories and an estimated 12% of hospitals. While speaking about the state of the nation’s healthcare infrastructure, former Minister of Health of Iraq, Khudair Abbas, explained that of the remaining primary care centers, “15% have been looted. Even though 80% remain intact, 40% need extensive repairs…13% do not have clean water and one third are staffed primarily by paramedics rather than physicians”.
During the Gulf War, American and coalition forces destroyed key elements of Iraq’s infrastructure. “Bridges, communications, electricity supplies, water and sewage systems, weapons factories, healthcare facilities, administrative centers, warehouses” and homes were destroyed. While this may have been a strategy aimed at ceasing Iraq’s ability to make war, this strategy did far more than defeat the Iraqi military.
5. Overburden the healthcare system by creating too many patients
The above contributing factors deal primarily with political, structural, organizational, or educational deficits. Ultimately, however, it is the population of patients that compose the largest component of any healthcare system. And, regrettably, there is a vast population of patients in Iraq.
The demolition of water and sewage treatment plants lead to outbreaks of typhoid and cholera. In 1989, there were no cases of cholera per 100,000 people; just 5 years later there were 1,344 cases per 100,000 people.
According to studies, by 1996 31% of children under five were chronically malnourished. Just a year later, there were a million children under the age of five who were malnourished, and a year after that 70% of women were suffering from anemia. Another study, consistent with the information on malnutrition, found widespread, chronic stunting in school children as an indication of long-term malnutrition.
Poverty’s wide-spread negatively affects the livelihood of the Iraqi people. Low socioeconomic status is associated with lower levels of education, poorer nutritional intake, and higher risk of congenital heart defects.
Research shows that poor diet contributes to far more negative effects than weight loss, anemia, nutritional deficiency, and compromised immune system. Without the funds to afford healthier food, mothers with higher intake of saturated fats and lower intake of nicotinamide (vitamin B3) have increased risk of giving birth to children with congenital heart defects. 5, 8 Furthermore, low dietary intake levels of folic acid (vitamin B9) around the time of conception have been linked to higher risk of neural tube disorders.
But nutrition and education are not the sole arbiters of death and ill health. Many parts of the country still suffer from the chemical and biological attacks perpetrated by Saddam Hussein. Not only are individuals suffering from primary exposure, but research supports that children of those who were exposed suffer secondary effects in the form of birth defects.
The list of health problems and their contributing factors continues ad nauseam, and the patient-load continues to overwhelm doctors.
The evidence shows that the state of Iraq’s healthcare system has been nearly two decades in the making. The downward spiral began with sanctions in the 1990’s by making the nation more susceptible to economic collapse. It continued with a multitude of factors including military action by the US and Coalition forces, violence wrought by religious extremists, and a vast backlog of patients.
The question remains, is it too late for Iraqis to rebuild their healthcare system?
Is Iraq too far gone?
Of course not! The restoration of Iraq’s medical infrastructure is happening now!
This November 5th will be our biggest surgical mission yet–lives will be saved, doctors will be trained and Iraq will be one big step closer to restoring what was broken!
July 24, 2011 by Ryan · Comments Off
1: Dressing up isn’t only about looking good
For the most part, in America, men don’t dress up to impress their platonic male friends in social settings. When going out somewhere, whether it’s a sporting event, coffee shop, fast food joint or just hanging out somewhere, men typically don’t dress to impress their male friends. We just don’t. If I showed up to have lunch with a friend wearing slacks, dress shoes and a button down shirt, he’d almost be sure to ask where I was coming from or where I was going, that required such attire.
Would you press your shirt and throw on a tie for an all-guys backyard barbecue? Would you shine your shoes and put on slacks to go watch a ball game at a friends house?
Let’s be honest. The answer is no, you wouldn’t.
But the Kurds do. Every weekend in the bazaar, at tea shops or just walking in the street I see Kurdish men wearing slacks, button-down shirts and the shiniest shoes I’ve ever seen in the dustiest place I’ve ever been. Here in Sulaymaniyah, dressing up is not all about looking good. It’s an expression of respect to the people around you as well as to the friend you are meeting for tea. Dressing up isn’t about demonstrating how dapper you can look. It’s about wordlessly saying, “The time I spend with you is a special occasion, and that is worth dressing up for.”
2: Hospitality isn’t just refilling the bowl of potato chips
I always try to be a good host when people come over. I’ve got the basics down – offer them food, offer them drinks, “is there anything I can get you?” – you know, the usual. But since coming to Kurdistan, I’m realizing that hospitality isn’t just refilling the bowl of potato chips; my hospitality should not be confined to guests at my house.
While being here, so many Kurds have gone to great lengths to show me hospitality: from physically leading me to my destination when I’m lost (despite it being in the opposite direction of their destination) to spending entire afternoons with me drinking tea, playing backgammon, teaching me Kurdish and talking about life. When was the last time you spent an afternoon with a stranger, let alone an acquaintence, just to show them a good time?
3: We all yearn for reconciliation
I entered Kurdistan harboring misunderstandings. Besides some brief reading of Kurdish’s history, most of my opinions of Kurdistan were shaped by mainstream media and ignorance. Let me tell you, that was a mistake. My Kurdish friends laughed as I explained the common perceptions of Iraq and Muslims in general, and grimaced soberly as they explained that Osama Bin Laden wasn’t a real Muslim because of the way he perverted, corrupted and twisted the teachings of Islam for violence and hatred.
My Kurdish friends laughed as I told them that not all Americans are like the people on Jersey Shore and that our nation isn’t entirely filled with debaucherous hedonists. They nodded disapprovingly as I spoke about the Westboro Baptist Church and their hateful and irreverent propaganda, and nodded in agreement as I said that we reject them as true representations of Christian theology and culture.
Many things became clear through these conversations, but the most profound epiphany I experienced was that we all yearn for reconciliation. We spoke about TV and culture, but what we were doing was reaching for common ground, understanding, and reconciliation. In discussing our differences and our misunderstandings, we found a common desire for peace between our cultures.