ALEXANDRIA, Egypt — the city of learned philosophers and a once-great library, named after Alexander the Great— I head west toward Borg el-Arab to meet Dr. Mohammed Elgazzar, who could be considered a torch bearer for the legacy of Alexandrian medicine.
My car passes numerous pick-ups going in both directions, carrying bovine burdens.
Today is Eid al-Adha— the feast of the sacrifice— and these are the chosen beasts for ritual slaughter. Remembering the story of how God commanded Ibrahim to sacrifice his son Ismail as a test of faith, Muslims slaughter an animal on Eid al-Adha, recalling Ibrahim’s sacrifice and the importance of submission to the will of God.
It is hard to count how many cows I see on my 45-minute drive, but I estimate around 60. My driver, Ahmed, tells me that a cow costs around 55 Egyptian pounds (around $3.25 USD) per kilogram.
I arrive in Borg al-Arab and join Elgazzar and his two sons there to sacrifice their family’s cow and have it butchered for fattah — a traditional dish of rice, pita, and beef. According to the Sunnah— the life and traditions of the prophet Muhammed— one-third of the animal goes to families who paid for it, another third goes to those less fortunate, and the final third to friends, extended family and neighbors.
The Elgazzar cow, presently fighting the group of men seeking to subdue it before slaughter, cost around 26,235 EGP (about $1,583 USD), split between seven families.
Elgazzar makes his way to the front of the pressing crowd with the head butcher and three assistants. They stretch the cow’s neck out with a blindfold over its eyes and its appendages pulled aside by ropes. With a single move and an exclamation of “Allahu Akbar!” the butcher and Elgazzar make the deadly cut.
The slice is silent, swift and the blood spills out quickly. It looks like a poorly made corn-syrup concoction from a 1950s American war movie. Unreal and yet, visceral. Elgazzar appears unaffected by the process.
After a few minutes, the cow breathes its last and hangs from a chain, to be butchered over several hours.
Elgazzar comments on the anatomy of the beast with the precise eye of a doctor and gives suggestions to the butchers as they make their cuts.
Tiring of the butchering process, we both step outside for some fresh air. As the heat of the day intensifies, I ask Elgazzar about the ironic juxtaposition of wielding a knife to take a life, compared to his usual use of knives to save them.
“These are completely different,” he says sternly, “But I would always prefer to save the life, always.”
Disciplined, dignified and driven by a resonant desire to save those on the brink of death, Elgazzar—whose surname ironically means “the butcher” in Arabic—first thought of medicine as a means to save his mother from a terminal illness. Not able to save his mother, he went on to save countless more lives as a renowned and award-winning war surgeon on both sides of conflicts in Yemen, Syria, Sierra Leone and South Sudan.
Adventure stories and chicken surgeries
In many ways, Elgazzar was a normal Alexandrian child. He liked playing football, he read adventure stories and listened to the radio.
In other ways, he stood out.
Mr. Mohammed Rashad, one of his childhood teachers, told me, “he was always exploring, asking questions, and reading more than he needed to.”
Elgazzar saved money to buy books and magazines to create a library for himself and his friends. His favorite books were adventure stories: Rin Tin Tin, Mickey Mouse and the local Egyptian favorite “King Adventure.”
By primary school, Elgazzar began to explore the possibility of practicing medicine, reading books with titles like, “human beings, microbes and disease,” he said.
Two pivotal moments would cement this burgeoning desire for future medical service.
While just six years old, Elgazzar’s mother fell sick with colon cancer. Able to do little to stop it, she appealed to the young Elgazzar to become a doctor and save her life.
There was not enough time. Elgazzar’s mother eventually died. This “put into my mind that I have to be a good doctor and a good surgeon,” he said.
Thus motivated, at just eight years old, Elgazzar performed his first surgery.
“We were raising chickens and ducks. One day, I found one of the young chickens lying down on the ground and crying. The intestines were spilled out on the floor.”
Feeling sympathy for the chick, he said, “I ran inside, brought needle and thread, and sat down to hold it in my hand. I pushed the intestines back inside and stitched the skin back together. I put it on the ground, and it started to run normally, as if nothing happened.”
However, while his books had motivated him toward medicine, he had yet to study peritonitis. Peritonitis, the inflammation of the membrane that lines the abdominal cavity, is typically caused by bacterial infection.
“I returned after one or two hours and the chick had died,” said Elgazzar, “I did not know the reason at the time. But later, when I studied medicine, I learned what it was.”
“I vowed then, never again,” he said. At that moment, at eight years old, Elgazzar decided to become a surgeon, to save lives instead of watching them slip through his hands.
Fighting corruption along the Upper Nile
Egyptian medical schools tend to follow the “French model,” which is made up of six years of undergraduate medical education, followed by a full-year internship program before graduates obtain a license to practice as general practitioners. There is also a compulsory period of “national service.”
Most top students choose to serve in the city they trained in, pick the best hospitals and strive to stay on track for later post-graduate specialty training. As his professors talked to him about which hospital in Alexandria he might serve in, Elgazzar had another idea.
He wanted to go to Abu Simbel, a frontier town on the border with Sudan in the province of Aswan. Lying some 1,400 kilometers from Alexandria, Abu Simbel is literally on the other end of the country, just about as far up the Nile as any Egyptian could go for “national service.”
Elgazzar’s professors and mentors tried to dissuade him, urging him to avoid the city, renowned at the time for corruption and crime. Undeterred, Elgazzar made his way to Abu Simbel via a 24-hour train ride winding its way parallel to the Nile.
Why did he want to go? Perhaps motivated by the exploits of the childhood heroes he read about in books and magazines. “I liked adventure,” he said.
“I wanted to see other communities, to see how they are living, how they are working. I did not want an easy time, I was interested to face struggles and to solve them, to discover another part of the world.”
At first, things went relatively well. Put in charge of a large hospital at the age of 25, Elgazzar was pleased to lead — to have the opportunity to make a difference and work with a team.
It did not take long, however, for Elgazzar to meet resistance.
Within the first month, Elgazzar was asked to sign off on the destruction of a large amount of beef that was supposed to be delivered to the local Land Reclamation Company. Sniffing more than spoilt beef, Elgazzar investigated the situation. What he discovered was that the beef had not been purchased and the company was getting paid for beef, and its destruction, that never existed in the first place.
Elgazzar refused to sign. Then the pressure piled on. The local health inspector, hospital staff, advisors and friends all encouraged him to sign the paper and continue with the good work he was doing at the hospital.
But Elgazzar stuck his feet in the Upper Egyptian sands and refused to budge. “In the end, I found myself fighting alone,” he said.
He soon discovered that saving lives in places like Abu Simbel sometimes meant being more than a doctor.
Increasingly under pressure and fearing for his career, Elgazzar decided to go back to Alexandria to finish his national service.
“Whoever saves a life, it is as if he had saved all mankind.”
After a stint in Alexandria as a private surgeon and some time working on the border between Libya and Egypt, Elgazzar found himself tired of day-in, day-out medical work in his hometown. Wary of the difficulties he faced in Abu Simbel, he still yearned for adventure.
In 1994, Elgazzar got his chance.
Two-and-a-half months before wrapping up his residency in Egypt, the Arab Medical Union (AMU) called him to serve one month in Yemen, where there was an ongoing civil war. Elgazzar immediately accepted.
The youngest of the team, Elgazzar not only got the adventure he desired, but experiential wisdom from older colleagues from Jordan, Syria and Egypt. The fighting was intense and brutal. Performing trauma surgery in a conflict zone for the first time, the learning curve was steep.
“When you work in emergency, it’s different from working with cold cases. You receive a casualty and he is about to lose his life or not depending on your maneuvers. If you do it for him, you save his life. If not, you lose it,” said Elgazzar.
Elgazzar found the work immensely rewarding, much more so than any financial gain he could earn in Egypt.
Solidifying this sentiment was a religious rationale he received from one of his senior surgeons. A colleague shared a verse from Surah Al-Ma’idah in the Quran to him: “whoever saves [a life], it is as if he had saved mankind entirely.”
This, Elgazzar said, was a critical turning point in his life. It was the beginning of his humanitarian work. And he was hooked.
Of malaria and machetes in Sierra Leone
While his fellow residents were polishing their resumes and preparing to apply for top hospitals in Egypt, Elgazzar packed his bags and departed for West Africa with his newlywed wife, Rahab. Their mission was to serve in the town of Makeni, Sierra Leone, another country in the midst of civil war.
After an attempted coup in 1991, various factions in Sierra Leone fought for control. The conflict lasted eleven years and left over 50,000 dead.
Elgazzar arrived in January 1996 with Rahab, just months before a new government was to be formed, to serve as a general practitioner, surgeon and gynecologist.
They met misfortune as soon as they arrived. Elgazzar fell sick with malaria, there were rumors about spirits living in their home, and then, there were complications with Rahab’s surprise pregnancy and their child died. The Elgazzars were devastated.
And yet, between sickness, speculation, and their own personal suffering, the mission was successful. Tumors were removed, babies delivered, and the community stood in awe of the work that Elgazzar was doing. He was respected by patients and colleagues alike.
Then, in May 1997, looting, rape, and murder swept over the country in the vacuum of power left after years of fighting.
Elgazzar’s community was not spared. Not willing to take their chances, they fled through the bush across the border to Conakry, the capital of Guinea. There, their first child was born— Omar.
Returning to Sierra Leone after six months, Elgazzar was now a father, a husband and a respected community surgeon. Despite a difficult start, things seemed to be coming together and the humanitarian life he always dreamed of coming to fruition.
“We spent about four months safely without any troubles. We lived normally,” said Elgazzar, “Then, all of a sudden, the national army collapsed and the rebels attacked our hospital.”
It was chaos. But with dispassionate efficiency, Elgazzar grabbed their passports, the keys to their Land Rover, and a machete, one of the weapons of choice by the very rebels he sought to escape from. At the gate of their complex, the rebels confronted them and demanded their vehicles, money and identification.
With a gun to his head, Elgazzar attempted to negotiate with them. As he hashed things out, he recognized the leader of the rebels, a man he treated just weeks before.
“I told him, ‘I saved you, why are you doing this to us?’” said Elgazzar.
With that, they dragged Elgazzar back to the home and abandoned him there with his loved ones, a fellow Arab family, and his machete. Now, instead of wielding a surgeon’s knife, he clung to the “cutlass” in his hand as the only means of saving the lives of his wife, neighbors and child.
Elgazzar, the butcher, the surgeon, the father, the humanitarian. In that moment, it was a confusing mix of a doctor’s oath and a father’s commitment, conflict and chaos, life and death.
Still, Elgazzar remained laser-focused on protecting his family. Like a surgeon treating a trauma patient on the gurney before him, Elgazzar judged the situation dispassionately and did what he had to do.
“Even when the bullets passed next to me, I didn’t feel anything,” he said, “and then I told myself, I have to be the hero, to solve it.”
Tearing through the bush for two straight days, Elgazzar and his family finally made it to the Guinean border. Fifty others fled along with them.
Out of money, lacking documentation, physically decimated and emotionally debilitated, the Elgazzars boarded a plane back to Egypt.
On the flight home, his wife continued to suffer. “When the captain turned on the microphone to make an announcement, she would jump. During sleep, when the air-conditioning turned on, she screamed,” he said.
Elgazzar’s wife was suffering from PTSD—post-traumatic stress disorder.
After two-and-a-half harrowing years in Sierra Leone, Elgazzar was not sure he was up to the life of humanitarian work. He wondered if his wife would ever fully recover. He wondered if his son would be permanently scarred. He wondered if he would ever have the heart to leave Egypt and serve again.
Healing on the hajj
Upon their return, Elgazzar went back to work to try and rebuild their lives in Alexandria. His wife, however, could not return to “normal.”
He turned to Allah and begged him to cure the both of them.
Just three weeks after they returned to Egypt, Elgazzar bought tickets to go with his wife on the hajj pilgrimage, a once-in-a-lifetime obligation for all Muslims who are physically and financially able to undertake it.
“I was thinking how to fix the situation, how to cure it, like a spiritual surgeon,” said Elgazzar.
Since he was a little child, Elgazzar had taken a disciplined, measured, and surgical approach to life and its obstacles. See a problem, treat the problem. Malaria? Get the right medicine. Death and chaos all around you? Find a way out.
Whatever the situation, there was always a way that Elgazzar could solve the problem.
Yet, as he watched his wife perform the peregrinations of the pilgrimage, pray with abandon in the desert, and receive the soul-healing balm that they believed only submission to Allah could give, he came to appreciate the limit of his own capabilities.
“You have to know your limits,” he said, “just as I realized I could not save my mother or that chicken, I realized I could not clinically treat people in certain circumstances. They need something more, some spiritual support.”
He concluded, “sometimes, all you can do is pray to Allah.”
It would be almost two decades before he was able to apply those lessons in the field of humanitarian medical work again.
Saving lives on all sides in Syria
Following Sierra Leone, Elgazzar took a 15-year break from international humanitarian work and medical missions. He opened his own clinic in Alexandria, worked in the community, served at hospitals in the Persian Gulf, and continued to serve the people of his own community. “I had a very good salary, very good position,” said Elgazzar.
“But,” he said, “I wanted to go back again.”
Then, when Syria devolved into conflict, the Arab Medical Union called on Elgazzar to serve from 2013-2014. Later, he worked with the International Committee of the Red Cross (ICRC) in 2015 in South Sudan and then in southern Syria and Jordan, offering training to doctors, medics and volunteers working in cities such as Damascus and Aleppo. From 2016-2018, Elgazzar worked with the United Nations and World Health Organization in Gaziantep in southern Turkey to offer guidance to Syrian surgeons and doctors on trauma operations and chemical warfare.
In 2013, he arrived at the Arab Medical Union field hospital in the north of Syria. While trying to evacuate the wounded from Aleppo to their field hospital, Elgazzar risked his own life yet again. This time it was not machetes and small arms fire, but a carpet-bombing. “Bombs came from everywhere in the sky, all around us, there was nothing we could do, nowhere we could go.”
During the course of his service in Syria he lost two colleagues: one driver and one nurse.
Regardless of the threat to their lives, Elgazzar and his team treated Syrian soldiers and rebels of all stripes. “We would have two or three from the regime side, some from the opposition,” he said, “but we showed no discrimination.”
“We would come from the hot zone with [the] wounded— abdomen, chest, ears, vascular, brain surgery, every kind of trauma— we would operate on them, sometimes up to ten hours. It did not matter who they were,” Elgazzar said.
“It does not matter if they are ‘good’ or ‘bad’ people, we have to continue in all the communities, all countries, all the lives. You can’t just treat the ‘good,’ because the bad keep showing up too.”
Elgazzar had taken his time to heal, two decades worth. In that time he had come to a place of peace about those he treated. Regardless of religion, nationality or deeds done, Elgazzar believes they should be given proper medical treatment.
“Everyone should live, everyone should be helped— it does not matter who they are or what they have done. If I can save a life, I will save it.”
Between home and the “hot zone”
For all his success, Elgazzar also faced more than his fair share of adversity.
He relayed to me stories of fighting off bats and stints of loneliness while serving with the Red Cross in South Sudan, discrimination from a colleague because of his Egyptian background and Islamic faith and ongoing tension over serving in the field versus settling with his family in Egypt, where he knows they want him to be.
The travel, uncertainty and danger to their husband and father has all taken its toll on Rahab and their children.
“One time I came home on leave and as I was walking out the door, my son Omar held on to my hand and cried, ‘Please don’t go back,’” Elgazzar said. “And another time, ‘Baba, stop. We want to be with you. We are feeling alone.’”
His son, Omar, does not remember these feelings of fear and of hanging on to his father’s hand. Nor does he remember the trauma of Sierra Leone, where he was only four months old at his father and mother’s side during the rebel attack. Instead, he remembers pride.
“I am proud of him. He inspires me. He inspires others,” Omar told me at the dental clinic in Alexandria he opened with his father’s help. “He is an example to us. To serve those who need help. To save lives no matter what. What I do today, I do because of him.”
The call “between home and ‘hot zone’” pulls Elgazzar in multiple directions.
“Sometimes I miss my family,” he said, “And when I get home, with my family, I am happy again. But then the next opportunity that comes, I am called to go.”
Above all, Elgazzar feels called by Allah.
“He gave me the body that moves. He gave me the brain that received the medical education. He gave me a strong heart that is never afraid and can perform under fire,” he said.
For Elgazzar, this is the sum total of his religion. “The Quran is not coming from Allah just to be read,” he said. “Religion is your behavior. It’s not just theory, not just for reading. It’s your life.”
“It is not enough to see pain and feel sad. You have to do something about it,” he said. “That is my religion.”
Looking back on his service in Egypt, Yemen, Sierra Leone, Syria and South Sudan, Elgazzar applies the very lesson that he now hands down to his students at Yeditepe University in Istanbul, Turkey, where he is a professor of anatomy.
“I never planned on doing ‘humanitarian’ work,” Elgazzar said, “I found the chance to do it, saw people in need, and decided to do it. I believe I will be rewarded from Allah [for] that. I have need of nothing else.”
Without hesitation, he said, he would do it all again.
“Even sometimes my wife asks me, ‘If it is repeated, would you accept it all again?’” he said, “and I always answer, ‘Yes, I would accept it.’ At the end of the story, I am still alive. And so are many others.”
Click here to read the story on religionunplugged.com.
Ken Chitwood is an affiliate with the USC Center for Religion and Civic Culture.