How is it possible that a student in his second year of medical school at Georgetown arranged three trips to Kurdistan in northern Iraq, bringing surgeons and physicians to treat injured and abused war refugees?

To understand the answer is to know Aaron Epstein (SOM ‘18), founder of the Global Surgical and Medical Support Group (GSMSG). Like Medecins Sans Frontieres (Doctors Without Borders), GSMSG aims to provide medical attention to those in war-torn regions, but all GSMSG physicians are trained in the U.S., providing a qualitative advantage.

Epstein previously planned to make a difference in the world by developing expertise in national security. In fact, he spent years pursuing this goal, working for the U.S. State Department, various think tanks and defense contracting companies.

In 2012, Epstein graduated with a masters degree in intelligence and security studies from the Georgetown University School of Foreign Service. He has been to a number of conflict zones prior to Iraq, including Hezbollah-controlled areas of Lebanon and other parts of the Middle East.

“I always had an interest in national security and defense. It seemed an ideal position from which to help people,” Epstein says.

With his experience, his degree and his contacts, Epstein was all set to pursue a life-long career in counter-terrorism through the intelligence community, foreign service or private organizations.

But he chose medicine.

“Doing counterterrorism research in Lebanon, I came to the realization that even if I did somehow become secretary of state and managed to miraculously broker peace in the Middle East, what would be the point if the region falls apart the next day, as it has over and over again with so many casualties?” Epstein says.

“While there is certainly value in service through our national security system, the truth is that security is a vague goal,” Epstein adds. “A person could spend their entire life in the nation’s defense and security apparatus without making a significant impact. Even if they did, they may never even know it, due to the compartmentalization of that world.”

In the midst of his journeys in warring locales, Epstein realized that one profession was, indeed, quietly making a difference, one individual at a time — the physician, working diligently, passionately, saving lives.

Staffing the ICU at a Cambodian Hospital

With medicine in mind, Epstein started working as a volunteer medic with the Fairfax County Fire Department when he returned from his last overseas assignment. “I wanted to know what it was all about and I was getting a total kick out of emergency medicine — still having the adrenaline rush I got from the security world, but this was from helping, rescuing people in need,” he says.

Epstein invariably tried to follow the progress of the patients he sped to the hospital, and would ask the doctors in charge what he could have done differently, as well as what they were going to do. At one point, a physician got frustrated and said, “Just apply to med school!”

Interested, Epstein connected with Frank Duggan, MD, SOM ‘95, an internist in Arlington, Va., who founded Health Care Volunteers International (HCVI), a nonprofit organization that facilitates and implements health care projects in developing countries.

Epstein signed on with HCVI and soon, he, Duggan and another paramedic from Epstein’s fire station were in Cambodia, running the Khmer Soviet Hospital in Phnom Penh. “We three essentially took over the hospital and were running the intensive care unit,” Epstein says. “We were able to do more for the population there than were the 30 people said to be doctors, but who had not been adequately trained.”

Epstein was hooked.

Treating and Training

Shortly after starting classes at Georgetown University School of Medicine, Epstein set up his organization (www.gsmsg.org). In January 2015, he conducted his first medical mission in Kurdistan, an area that has taken in hundreds of thousands of refugees fleeing war. After arranging the trip with appropriate Iraqi and Kurdish officials and ensuring that the destination was secure, Epstein invited surgeons and physicians from south Florida, who he knew growing up, as well as surgeons from Georgetown, to come along. “Nothing unexpected was going to happen to these physicians,” he says.

So far, Epstein has done three medical trips, scheduling them around breaks, and has had little problem filling physician slots, which usually include several senior-level attending physicians and junior medical staff. “After the first mission, it has all been word of mouth,” he says. Interested medical professionals may apply for upcoming volunteer positions at the GSMSG website.

Because GSMSG uses existing medical infrastructure and resources in Kurdistan, what they bring to the table is intellectual capital. “There are huge Christian aid organizations that have helped build clinics and excellent facilities, which are very well set up. They just don’t have the people to run them,” he says.

On all three trips, the GSMSG group, which has included board certified surgeons, neuropsychiatrists and medics, treated both the sick and wounded. They also treated the worried well who lined up for a health check offered by American doctors. “Peace of mind is half of medicine,” Epstein says.

The group also trained a significant number of local physicians and doctors on location from other NGOs.

“The idea is that GSMSG will not only provide the best medicine available — the best physicians in the world coming to the worst places in the world — it will also teach local physicians the newest techniques,” Epstein says. “Our footprint will be multiplied by the fact we provide training. That gives us the ability to have a significant effect both now and in the future.”

Charting a Course

The work of the group has been noticed in Kurdistan.

“Earlier this year, Aaron Epstein came to Erbil to see first-hand the suffering of tens of thousands of Christians. These innocent thousands fled the persecution and destruction brought on by the spread of ISIS. While we have tried our best to accommodate the needs of the population, our medical system has become overwhelmed,” says Janan-Zora, MD, regional representative for Health Outreach to the Middle East (HOME) in Kurdistan/Iraq.

Janan-Zora endorses the work of GSMSG and Epstein. “We believe his unique background, and the goodness and charity of the people he interacts with, will be able to help see our population through some of the hardest times.”

Epstein says the next step for GSMSG will be to establish mobile medical clinics to treat communities that have little access to the health care infrastructure currently in place. He believes these efforts will lead to the development of a stable medical infrastructure in northern Iraq.

He also has charted his own course — Epstein aims to become a trauma surgeon working in the most austere and extreme environments where few skilled medical personnel practice.

When asked to summarize “Why such extreme locations?” Epstein replied with a quote from Herman Melville’s Moby-Dick: “As for me, I am tormented with an everlasting itch for things remote. I love to sail forbidden seas, and land on barbarous coasts.”

MDs interested in learning more about GSMSG can contact Aaron Epstein at [email protected] or visit http://www.gsmsg.org.