On a mission

For nine months a year, Steiger runs a high-end aesthetic surgery clinic in Zurich performing tummy tucks, facelifts, and other enhancement for some of the world’s wealthiest people. But for decades, he has also been taking sabbaticals to join humanitarian missions for the International Committee of the Red Cross (ICRC), the United Nations, and others.

Starting out in Namibia, then South-West Africa, Steiger has also worked in Bosnia, Kosovo, Somalia, Rwanda, Sierra Leone, Liberia, Pakistan, and Afghanistan.

In early 2014, he was helping to set up a reconstructive surgery programme in Tripoli, Lebanon, for a large international NGO when Covid-19 hit, leading to the project being cancelled. Frustrated, Steiger decided to go it alone and Swisscross was born.

“All these big organisations have become too risk adverse, in my opinion. They hide behind walls and have lost touch with people on the ground,” he explains. “I had an idea to do something different. I wanted to deliver humanitarian aid for the 21^st century, where we can use our expertise to help patients, yes, but also to empower and train local healthcare workers.”

Steiger also wanted to find a way to do ensure humanitarian doctors, who have become increasingly at risk in conflict zones, to deliver care off the battlefield. 

Swisscross embarked on its first medical mission in 2021, taking a small pool of volunteer doctors into Zheen International Hospital in Erbil, the capital of the Kurdish region of Iraq, to deliver complex reconstructive surgery. This is not frontline work and Swisscross doctors are not operating in war zones.

But their work is no less important as they deliver highly specialised procedures otherwise almost impossible to access in countries like Iraq, where decades of conflict and an underfunded and poorly managed health infrastructure mean this sort of tertiary care is typically either not available or only via long waiting lists that can take years for refugees and those on low incomes.

In its first 18 months, Swisscross, which is registered as a nonprofit foundation in Zurich, received more than 1,250 patient referrals and during five missions performed more than 250 complex orthopaedic, maxillofacial and plastic surgical interventions, half of which related to burns, and 70 percent involved children.

Swisscross works with several NGOs based in Iraq, including the Barzani Foundation, and Nadia’s Initiative as well as international organisations like Médecins Sans Frontières (MSF) to receive patient referrals.

It has also developed its own mobile application to help referring agencies collect and share information about prospective patients outside of Swisscross missions.

This grassroots referral system is vital to ensure the time of the visiting surgeons is used efficiently and guarantees proper post-operative follow up care for the patients.

Unlike other medical charities, Swisscross has no permanent facilities in Iraq, and instead books bed days and theatre space in local hospitals. “Building something new would be a waste of our donors’ money,” explains Steiger. “There’s no need and it’s not in the spirit of our organisation which is trying to be as flexible and nimble as possible.”

Swisscross is a lean organisation. There is CEO, Dr Ian Furst, a Canadian oral and maxillofacial surgeon and its lead surgeon is Dr Walter Kunzi, like Steiger from Switzerland, who is qualified in neurosurgery, plastic and reconstructive surgery, hand surgery, general surgery and trauma surgery.

They are supported by two field officers, Dr Sarezh Saber and Dr Lass Azad, both new graduates from the University of Hawler Medical School in Erbil, and a handful of other staff working alongside a revolving pool of international volunteers.

In addition to performing the surgeries in Iraq, Steiger also wants to pass on the group’s skills. Swisscross doctors have been working with local universities and local surgeons to do just this. “We’re not here to compete with the local medical community,” he says. “We want to share the burden and also exchange knowledge and experience.”

Most of the patients seen by Swisscross are refugees or internally displaced, many are Syrian, and there is also a sizeable number of Yazidis from the west of Iraq. Their injuries vary from third degree burns preventing limb movement and untreated or badly managed fractures that have left people immobile, to limb loss due landmines, gunshot wounds, or other explosions.

Some require corrective surgery, such as limbs being shortened, others need skin muscle flaps, or other forms of complex plastic surgery to restore their movement as well as rebuild their confidence.

CEO Furst, who is usually based at the Coronation Dental Specialty Group in Ontario, Canada, recalls one man who was hit by an Islamic State car bomb at a checkpoint. 

“His face was very severely injured in the explosion and although he had already been through two or three surgeries before we saw him, he had a bad infection in the jaw, which meant he couldn’t move his tongue. He was in a bad way.”

Two surgeries later and the man is now able to talk, eat and, crucially, is no longer in pain.

Another patient that stands out for Furst is a Syrian who was knocked down by a car in a refugee camp shortly after coming to Iraq. “He arrived in a wheelchair and had had a broken thighbone for nine years, since he was 14 years old, despite more than 20 surgeries.”

Dr Sarkhill Radha, a UK-based trauma surgeon volunteering with Swisscross operated on the young man and after three months of healing and lots of rehabilitation, he was back on his feet. “Taking his crutch away and seeing a 23-year-old walk after nine years of a being in wheelchair was just amazing,” says Furst.

Then there is the boy from Sinjar whose face was peppered with shrapnel after being caught up in an explosion. And of course, little Ahmad from Syria.

“Honestly, there are so many, and they are all so different,” he says. “It's not the type or the mechanism of injury that is important to me. People find themselves in these situations because resources are so scarce so the fact that we are there and even seeing them at all, gives them hope.

“This part of the work is very meaningful to me. I want people to experience hope and to know that the rest of the world is watching and does want to help.”

Steiger set up Swisscross with his personal funds, supported by contributions from patients and friends. The NGO’s operations in Iraq were made possible thanks to a 2021 donation from the government of the United Arab Emirates (UAE).

This partnership with UAE Aid came about when a close friend of Steiger introduced him to Mohammed Al Shaibani, the director general of the Ruler's Court of the Government of Dubai, who then connected him to Reem al Hashimy, the UAE’s Minister of State for International Co-operation.

“HE Reem al Hashimy is very knowledgeable and engaged and she has a deep understanding of humanitarian work, so it didn’t take me long to convince her to support Swisscross," Steiger explains. "Thanks to her, we have been able to start our work in Iraq.”

The UAE Aid money has been an important springboard for Swisscross, but the organisation is keen to expand its funding pool to find support from other governments as well as philanthropic donors. Steiger said he had been encouraged by interest from several private Kurdish donors who wanted to pay to take Swisscross to other cities, including Sulaymaniyah.

“We’re trying to find people that understand the contexts we’re working in, and who see the value of addressing disability and what the long-term impact of that can be,” explains Furst.

“If we can help someone to be able to walk again, then the economic multiplier of that for their family and their community is huge. Not only can they earn their own livelihood, but their family is also relieved of the burden of caring for them. It’s a small upfront cost for a long-term benefit.”

Steiger has big plans for his model of specialised but agile care. “Erbil is the proof of concept,” he says. “But we don’t want to stop there. We want to see if we can share what we’re doing to inspire a new generation of humanitarians.”

Part of his vision includes creating a humanitarian training hub [for the MENA region] somewhere central like the UAE to bring doctors in from places like Iraq, Somalia, Afghanistan, Ethiopia, and Palestine, and give them the tools to deliver specialised healthcare in fragile environments with limited resources.

“I want to use Swisscross as a catalyst to bring together a community of organisations to exchange ideas and work out how we can all work together with organisations like ICRC, the UN, and other NGOs, to maximise our joint potential effort in an environment always stuck with limited resources and ultimately help more people.” - PA