Dr. Chris Giannou

By Pat McDonnell Twair

Few people, including Palestinians, hue experienced the Palestinian tragedy since 1980 as has Dr. Chris Giannou. Born in Toronto in 1948 of Greek immigrant parents, the Canadian surgeon was director of a Palestine Red Crescent Society (PRSC) hospital in the Ein Helwah refugee camp near Sidon in Lebanon when he was taken prisoner by the Israelis during the 1982 invasion of Lebanon. During that war, he witnessed Palestinian prisoners beaten to death by Israelis and described what he had seen later in testimony before a House subcommittee on foreign affairs.

It was just one of many such experiences for Giannou, who, when he was 10 years old, decided not only that he wanted to be a medical doctor, but also that he wanted to practice medicine in the Third World.

He returned in 1983 to Lebanon, where he set up a PRCS hospital in Tripoli. That same year, when Syrian-armed and directed Palestinian puppet groups supported by Syrian artillery drove PLO fighters loyal to Yasser Arafat out of northern Lebanon, Dr. Giannou was evacuated with the wounded on an International Red Cross ship to Cyprus. From there he traveled to Cairo, where he directed a Palestinian hospital in 1984, and to Sanaa in North Yemen, where he set up PRCS medical facilities. He returned to Lebanon during the long siege of the Palestinian camps conducted at the direction of Syria by the Amal militia of Nabih Berri. It was one of the most tragic chapters of the long and so far futile struggle by Syrian President Hafez Al-Assad to replace Yasser Arafat as leader of the Palestine Liberation Organization with Palestinians who would take orders from Syria. Dr. Giannou stayed in the camps for the duration of the siege, which was finally abandoned by Amal.

Dr. Giannou's whole life seemed the ideal preparation for just such experiences. Although he received premedical training at McGill University, he chose to take his medical degree in Algeria, where he could do his internship in a Third World setting. Before going to work with the Palestine Red Crescent Society, he had also taught medicine at the University of Cairo.

Commenting that the Western world was unaware of the Palestinian people in 1967 when he was a premedical student at McGill University, Dr. Giannou said that since the outbreak of the intifadah and Yasser Arafat's endorsement of a two-state solution to the Palestinian-Israeli conflict, the world has realized that it can no longer ignore the Palestinians. "Dec. 9, 1987, wasn't the first time Palestinians threw stones or Israelis shot into crowds of Palestinians, but something new happened when the Palestinians launched massive strikes."

Harking back to the 28 months he was confined in the beleaguered Shatila camp—an area the size of three football fields—Dr. Giannou said there was no question of surrender, which would have meant a certain massacre.

Survival in the Palestinian Refugee Camps

"Starvation and deprivation were rife, but after the cease-fire, the Palestinians of Shatila walked with their heads held high. It was clear the people of Shatila preferred to die on their feet rather than on their knees. And, after all, human dignity is what the Palestinian struggle is all about."

Dr. Giannou is writing his memoirs on the war of the camps and siege of Shatila, where he was director and surgeon of the Palestine Red Crescent Society hospital he established there. He also is preparing a technical manual on war surgery and the logistics of setting up a field hospital under emergency anesthetic conditions, including the absence of electricity, water, sterilization, and adequate anesthetic supplies.

Emergency Surgery in Field Hospital Conditions

"There's not much new I can add to the techniques of war surgery, but I did innovate new methods of anesthesia," he explained. As the only surgeon in a camp where evacuation of the wounded was impossible, he handled orthopedics, neural surgery, head wounds, and even caesarian sections.

"We conducted 45 head operations and about 30 survived. When it came to eye surgery, the only thing I could do was try to prevent complications ... At times, we had only one and a half hours of electricity per day. We sterilized over wood fires; our final operations were performed under the light of kerosene lamps.”

When supplies of oxygen and other anesthetics were exhausted, Dr. Giannou devised a form of anesthesia through injections.

"We didn't need oxygen, we simply used this as a muscle relaxant and pumped away and ventilated the patient," he said. "It's very simple, and it worked.”

Dr. Giannou's proficiency in the operating theater was enhanced by his fluent Arabic, learned on the job since he first arrived in Lebanon in 1980.

The people of Shatila provided his blood supply for transfusions. He utilized four adjacent houses of the camp for his field hospital. These were transformed into an emergency and outpatient room and pharmacy, a 12-bed inpatient facility, and a laboratory whose basement was the operating theater. The-fourth building was the kitchen.

"During a three-week period when 250,000 shells were being lobbed into Shatila, we simply dug tunnels underground and covered them with boards because we knew the household rubble, when the buildings overhead collapsed, would cover our subterranean rooms," Dr. Giannou explained. During the heaviest six-month siege, 650 of the wounded he treated survived; another 110 died.

At that time, he witnessed a phenomenal reversal in sex roles in the besieged Palestinian camp in Lebanon similar to that taking place now among Palestinians under Israeli occupation. "Whenever the shooting subsided, it was women who had contact with the outside world. It was women who faced security probes, who set up fortifications, filled sandbags, and found food. Likewise, as in the case of the intifadah, during which 12,000 Palestinian men have been imprisoned, women have been catapulted into leadership roles.

Dr. Giannou lost more than 40 pounds during the camp war. At times, he and his staff survived on less than 1,000 calories a day. Breakfast was a glass of milk; lunch was yogurt; dinner consisted of cracked wheat, tomato sauce, a half loaf of pita bread, and three cups of tea, one with sugar. In the final days, five people shared a tin of sardines for a full meal.

Dr. Giannou says that many of the besieging Lebanese Shi'ite militiamen did not agree with the policy of the Amal militia and that many of its fighters complained that they had been turned into stooges to Syrian policy.

"Many Lebanese—including Shi'ites—were inside defending Shatila. Sadly, in Lebanon, many individuals fight proxy wars as a way to make money. It seems to me many of the Amal were happy when the siege was lifted," he said. "in fact, we couldn't have survived the siege if some Amal fighters weren't cooperating in smuggling arms into the camp.

"I don't like to make stereotypes regarding factions in Lebanon—there has been too much suffering and hate to do this," he continued. "I'm an inveterate optimist. Being a surgeon, I must be an optimist. I kept working on men who should have been dead, but they survived. When they did, I congratulated myself on cheating death."

It is sad then, that Dr. Giannou will not be returning to Lebanon where he has saved so many lives. "Too many people have me targeted," he explained. "The Israelis, the Phalange. It's too easy to die from an anonymous bullet."

His next destination is Mozambique.

Pat McDonnell Twair is a free-lance writer based in California.