Of your top 10 international travel destinations, where does Kurdistan rank? It wasn’t initially on my list at all. After all, who would want to spend their own money to travel to a war-torn country with Islamic extremists just waiting to harm someone from the United States? At least that is what I surmised after following years of international news. Trying to understand the complexity of the Islamic State of Iraq and Syria (ISIS), Syria, Syrian rebels, Turkey, Russia, and the United States, all with their own agendas fighting in a very concentrated area of the world, is a challenge when only familiar with the U.S. perspective.

In the middle of all this enter John Miller and One Vision International. Even while the war was active against ISIS in northern Iraq, he would travel, usually alone, and coordinate humanitarian-aid shipments of water filters, coats for the cold winters, shoes, children’s clothes, wheelchairs, and crutches to help everyone displaced from the war. Through these experiences, he witnessed the need for a medical mission trip. 

I traveled with John and One Vision International multiple times to Haiti and the Dominican Republic. On some of these trips, one of my best friends from residency, Greg Jacobs, DO, came along. When John approached me about a trip to Kurdistan in northern Iraq, I said no multiple times for the reasons listed above. After each of his trips, he would provide me with an update, and I learned more and more about the kind and welcoming people there who were in need. After multiple invitations and a retreating ISIS, I finally said yes in mid-2018, and we started planning. One conversation later, Greg was on board.

The Trip

Dr. Balentine teaching peripheral IV access with ultrasound to attendings and residents.
Credit: Bryan Balentine

Day 1: We visited a military base and treated 100 soldiers for various medical problems. Several of these individuals had fought against ISIS in the recent past. They were extremely kind and appreciative of our time and efforts. We joined them in the “mess hall” and ate good-quality food, better than expected, on the typical metal tray often seen on television.

Day 2: John mentioned beforehand that his local hospital had requested Greg and I provide a lecture for their physicians. We would be speaking to their EM residents and attendings, with the goal of decreasing complications of central line placement by teaching them how to perform the procedure with ultrasound. The lecture also included peripheral IV placement with ultrasound to allow them to more successfully place peripheral IVs on patients with difficult anatomy.

In my limited experience, most international hospitals have ultrasound in the facility, but ED-provider utilization varies. Dr. Ben Smith from the University of Tennessee at Chattanooga graciously loaned me an excellent vascular access lecture. Greg and I tag-teamed the delivery and it was well-received.