American University of Beirut

After the political uprising in Syria in 2011, health workers were targeted by the Syrian regime. “Many of my colleagues were arrested and some tortured to death”, recalls surgeon Fouad M Fouad who worked in the city of Aleppo at the time. The following year, militia linked to the regime began kidnapping prominent professionals for ransom. “It was scary, especially because they started kidnapping the children of professionals.” Fearing the worst, Fouad fled Syria with his wife and two children and resettled in Beirut, Lebanon. A decision “not only about yourself…it’s also about your family”, he explains.

In Beirut, Fouad’s life and career continued to be affected by circumstances out of his control. Most Syrian refugees and other displaced people were not allowed to work in the country under Lebanese regulations, so he could not practise as a surgeon. A situation that “reshaped my entire career”, he reflects. He was eventually recruited as an Assistant Research Professor at the American University of Beirut (AUB), Lebanon. There, he became interested in chronic diseases in refugees and issues around forced displacement, and secured a grant from Columbia University, New York, NY, USA, to study non-communicable diseases (NCDs) in Syrian refugees. “That was really the beginning of working on refugees more than any other issue, and that actually shaped my entire interest at AUB to focus on forced displacement and health, especially in protracted crises”, he explains.

As Associate Professor of Public Health Practice and Co-Director of the Refugees Health Program in the Global Health Institute at AUB, Fouad’s work explores the “chronicity of chronic conditions, so not just chronic diseases but also wellbeing and transgenerational and health system issues”, he says. His contributions include helping to shift the dominant concept of refugee health from responding to emergencies to addressing protracted crises. “Up until 2013, the focus was on addressing basic needs and people inside camps more than thinking about long-term response and integrating refugees health in the national health system, and the issue of chronic disease.” He and others “worked hard to shift the narrative from refugees being a burden to refugees being assets to contribute to their own health”, says Fouad, who is also Chair of the Forced Displacement Program in the Middle East at AUB and a Senior Research Fellow at King’s College London (KCL), UK. Since then, his research has focused on the weaponisation of health care, health systems in fragile settings and protracted crises, and the political economy of health in humanitarian settings. Paul Spiegel, Director of the Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, credits Fouad’s “inquisitive” nature and “passion for social justice”, noting he “thinks much broader than public health. His interests span culture, politics, literature and poetry, and health—and his research reflects this depth and breadth”.

Fouad’s life started in a peaceful Aleppo as one of five children. For his parents from non medical backgrounds, “it was a dream, if one of their kids became a doctor…and they were very proud when I entered medical school”, he recalls. Earning his MD from the University of Aleppo, Fouad specialised in general surgery and went on to run his own practice. In the early 1990s, he was recruited by the Syrian Ministry of Health to work on establishing various health programmes, including the country’s first National AIDS Program. After the success of the programme, he was selected to lead the Primary Health Care Department in northern Syria. “That was my big entry to public health”, he says. There, he focused on addressing NCDs and related risk factors before leaving Syria for Lebanon.

Fouad will leave his roles at AUB and KCL and move once again in the early summer of 2024, when he takes up the position of Professor of Global Health and Social Sciences at the Liverpool School of Tropical Medicine in Liverpool, UK. He has several goals for his new role. The first is to work on establishing a centre on displacement and health, which he hopes will “enrich the existing scope of health and social sciences”. Bringing “Global South voices into UK universities” is another aim, and he is planning to make connections with experts in Africa, South Asia, South America, and the Middle East. Fouad will also continue his work on health systems in fragile settings. “My hope is to go beyond that paradigm of a national health system to suggest a cross-border regional or global health system to address the needs of people on the move”, he says. Recognising that internally displaced people (IDPs) make up more than 60% of the forcibly displaced population globally, they will be another priority for Fouad. “IDPs are a major issue, but very little actual research focus has been on them”, he points out. And “given that IDPs are not just moving inside the national system, sometimes they cross the power border, what system could address their needs?”

Alongside refugee health, Fouad’s other passion is poetry. “My entire life, I always thought poetry is a second half of my life. Inside, there’s another person who looks at the world from an art lens.” He has published six books of poetry, and writes on topics such as medicine and his experiences in the Syrian war. Once Upon a Time in Aleppo is his latest book. “As public health people, we all speak about wellbeing, and this is the same for art. I don’t feel any paradox or conflict between writing poetry and writing an academic paper. Both for me involve engaging in that big question about the human being, and how we can serve the wellbeing of people”, he says.

Udani Samarasekera