Today we had the chance to visit the Akademiya Tendûristî a Rojava and to see a friend that we haven´t seen in a while. The Akademiya Tendûristî a Rojava in Qamîşlo is the second medical academy established by the Autonomous-Administration of Northeast Syria (also known as Rojava). The first one was opened in 2016 as a part of the Afrin university, but had to be closed after the Afrin war It is a very special medical school. It opened in 2018 as an alternative medical education project and recently the 3rd year of students began their studies to form a new generation of doctors who are very much needed in the region.
We were welcomed warmly by our friends heval Raman and hevala Doza, two students in their second year, who we met during our first visit to the academy at the end of September 2019. Shortly after this visit, the Turkish military invaded and attacked Rojava to occupy a so-called “safe zone” along the Turkish-Syrian border and thus a new war had started. Unfortunately and very characteristically for this region, the academy had to close for a month and a half during the initial invasion in October and November 2019 and the students all left. It is so good to see that they are alive and back to their studies!
Raman explains the situation they were facing when the war started, “The academy’s building is located very close to the Turkish border and the so-called safe-zone, and this brings the risk of direct or indirect attacks by Turkey and its proxies. Most of the students went to provide medical support at the frontlines or in the hospitals close to the them.” He himself also went to support the comrades in the areas of fighting. “One of the students got injured during an attack. Luckily he is well again and can continue his studies. But some students could not return to the academy,” he added. “Many had to support their families who were mourning losses or were displaced and needed family support to survive.”
Another change is a painful reminder of the recent war and subsequent occupation: the nursing school that belongs to the health academy was before situated in Serîkaniyê- a city which is today occupied by the Turkish military. Most of the Kurdish population were displaced or had to flee. Also the nursing school could not longer operate in occupied Serîkaniyê and moved to Qamîşlo. Now, around 50 nursing students are doing their 6 months of classroom studies in the same building as the medical students. Afterwards, they leave the academy for 6 month practical training in different health facilities.
The idea of this academy is to educate medical professionals and doctors while incorporating the revolutionary political concepts of Rojava and to meet the needs of the region, as there is not only a shortage of doctors and nurses, but also very special requirements due to the ongoing war, migration, interruption of studies, and changing demographics. Raman is talking with passion about how their medical studies are structured. “The program for the future doctors consists of 4 years of education within the academy.” He goes on to say, “The first two years start with ideological / intellectual lessons, followed by anatomy, physiology, and biochemistry. In the third year the foundation of clinical medicine is scheduled and the students start practical internships in the surrounding hospitals and health facilities. After 4 years, the students graduate from the academy and start working as trainees for 3 years in general medicine. Afterwards, they can either work as a general practitioner or start their specialization in any medical specialty.”
Doza explains what daily life in the academy looks like. “With approximately 50 students in the first two years and 27 in the last, there are 127 medical students right now studying and living together. Girls have their dormitories in the academy building and the boys stay together in a house in Qamîşlo.“ She adds that their studies do not only include medical education but also community activities, self-organization and meetings with the responsibles. Doza is also part of the media and diplomacy committee. She points out that the students take part in regular meetings and reflections and have the possibility to influence their curriculum by giving feedback about the last semester‘s classes and suggest changes in topics and time frames.
We were lucky enough to meet the academy’s reverberî (principal). He was a professor in pharmacy and has studied numerous health topics for a very a long time. He is a very warm, well-studied, and extremely interesting person. He spoke about the idea of creating an academy which offers a different approach to medicine and medical studies as well as trains medical personal especially for the work in this area. While he was speaking he was constantly attentive, smiling and involved Doza and Raman actively in the conversation. One could feel that he has a lot of hope in this new generation of medical doctors. He pointed out that he had been working on this idea for over 10 years before it was finally realized.
The curriculum is the result of many years of research about medical education and health systems all around the world as well as international and national conferences to exchange ideas between health and pedagogic professionals and the structures of the self-administration. The outcome of this intensive exchange and research is all summed up in a document which explains the philosophy of the new health system and the goals of the health academy. One of the main tenets is a holistic approach to health which includes the political, social, and philosophical aspects of the subject. Students should not only memorize anatomical structures and physiological processes by heart but also learn about the connection between society and health, diseases and lifestyle, community and individual health, ecology and capitalism. Gender equality, reflections on the ancient, natural ways of healing, and the importance of peoples’ self defense including medical treatment of combat injuries are important topics that distinguish the Akademiya Tendûristî from other medical universities inside and outside of Syria.
On a personal level I am amazed by this project and excited to see how these ideas are put into practice and how this will impact the existing health system. Raman, Doza, and the other are experiencing this by learning collectively about health and the importance of a healthy society, supporting each other in the resistance against a capitalistic and patriarchal system that currently dominates the worldwide conception of medicine and, last but not least, being able to minimize the losses and damage of the ongoing attacks by the various forces that seek to undue the accomplishments of the revolution here.
After many years of medical studies and working as a doctor in European hospitals, I have heavy critiques and feel a lot of frustration regarding the way our health system operates and the manner in which it forces its employees to work. This system, that at a first glance looks very social and advanced (in terms of insurance, medical assistance, possibilities for treatment), is very much dominated by technical achievements, the economic influence of the pharmaceutical industry and a financial competition between medical facilities that are organized as private enterprises and an increasing shortage of time and personnel to actually care for and treat patients. Health is more and more seen as a product, the patient as a costumer, and the responsibility for one’s body and well-being handed over to a “health care market”. The result is an unhealthy and uneven relationship between patients and doctors, and a decreasing understanding of the relationship between health and the way of living, the own body, nature, society and the politics of capitalism.
The way health care is implemented in many places made me unable to work according to my personal understanding of the profession. Taking time for your patient, adjusting the therapy to the individual needs and supporting the body’s self defense resources are important factors in this context. As well as encouraging the patient in taking responsibility for his/her health. It should include connecting individuals, society, and politics regarding health issues and health education. Treatment should be independent from economic influences of any industry and the financial situation of the patient. In the official health facilities, I quite often felt very lonely with my opinions and even though I tried, it seemed impossible to fight the system and to chance the structures that have been established and supported by politics and economic factors.
This picture is taken in the dark because electricity here often unpredictable.
Since I first heard about the Akademiya Tendûristî I am fascinated by the possibility of starting a new system from the ground up instead of trying to change or reform existing structures influenced by political and ideological beliefs and experiences that had been made over centuries. I truly belief this approach can be a solution for the deficiencies of modern medical education and structures.
Of course, there is a long way to go. The academy is very young, the curriculum is still in the process of development, and the political situation makes it difficult for students and teachers to focus fully on the medical education. Another problem is that it is difficult to find doctors who are willing to teach in the academy in addition to working in a hospital or clinic. And it’s crucial that they share the revolutionary views on medicine and alternative concepts of being a health professional. Finding these doctors who can be good teachers and role models is important regarding the theoretical studies as well as later on for the practical part of the education. Taking in consideration that a lot of doctors left the region during the last 9 years of war and instability and the remaining ones have to cover all open positions, one can imagine that this is not an easy task.
Another problem for the students is that their degrees will not be recognized elsewhere, because the school is run by the Autonomous-Administration of Northeast Syria- which is not internationally recognized as an “official” state.
But people here take all this just as a part of their struggle, willing to face it and try to create a better future for everyone. This institution is an important step in this direction.