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Chechen Doctor Is Nearly Killed for Upholding Hippocratic Oath - 2004-01-30


The Hippocratic Oath is one of the oldest documents in the world. Every doctor who pledges to it is bound to assist all of those in need of medical help without discrimination. During the Chechen-Russian wars, a Chechen surgeon faced great risk in upholding the oath by treating the wounded on both sides of the conflict. VOA's Brent Hurd has this report on Dr. Baiev's first-hand account of war and the challenges he faced as a doctor on the front lines.

Chechen surgeon Khassan Baiev says his only crime was saving lives. That's exactly what he did for nearly six years during the Chechen-Russian wars in the 1990s. He said “I am a doctor. I treated all wounded people who are brought to my hospital, including Chechen fighters, Russian soldiers and civilians. A majority were children, women and elderly people.”

Although he mostly treated peaceful civilians, Dr. Baiev also cared for injured Chechen and Russian fighters, never allowing politics or personal bias to interfere with his commitment to the Hippocratic Oath. This vow almost cost him his life when he was targeted for assassination by Chechen extremists and the Russian military, both of which considered him a traitor to their cause.

In 1994, Russian troops attacked Chechen separatists who had declared independence from Moscow. After fighting erupted, Dr. Baiev left a promising medical practice in Moscow to return home to the front lines of the conflict. He opened a hospital in Alkhan-Kala, a village on the western edge of the Chechen capital city Grozny. He was the only doctor for tens of thousands of people.

His new book, The Oath: A Surgeon Under Fire, details his experience of operating on wounded civilians and soldiers in rugged conditions. He worked mostly without electricity or running water as artillery shells sometimes crashed into the hospital. When supplies ran out, he dressed wounds with egg yolks and donated his own blood for surgeries. During the most trying times, he amputated scores of limbs with only local anesthetics.

Dr. Baiev says his pledge to the Hippocratic Oath was put to the test when both injured Russians and Chechens needed treatment at the same time. “There were many terrible moments in the course of the war. This was particularly true when the two conflicting sides confronted each other in my town. It was exceptionally difficult when Chechen fighters and Russian soldiers were brought to my hospital at the same time.”

Dr. Baiev treated those with the most life threatening injuries first. Sometimes he traveled on armed personnel carriers to bring wounded Russian troops under his care back to their side. The local population of Alkhan-Kala knew that Dr. Baiev was treating some Russian soldiers. Many of the Chechen elders -- who are highly regarded in Chechen society -- supported him and made it clear to the townsfolk that no scores would be settled with the wounded Russians in his hospital. But not everyone felt this way.

Nicholas Daniloff, former Moscow Bureau Chief for US News and World Report, helped translate and write Dr. Baiev's book. He describes a time when Dr. Baiev was nearly executed by Chechen warlord Arbi Barayev who considered him Baiev a traitor: “He stood next to field commander Arbi Barayev, who said that it was his intention to execute Dr. Baiev for operating on Russian soldiers. And as he pronounced those words, a Russian artillery bombardment began and more wounded were brought in, including wounded who were under the command of Barayev. Barayev then said, alright, we won't execute you right now. You treat my wounded first, and then we'll kill you. In the end, the bombardment became so heavy that Barayev and those with his force that were still alive disappeared. So that death sentence evaporated.”

Ironically, Dr. Baiev had saved Arbi Barayev's life by removing a bullet from his neck four years earlier. The doctor was targeted by Russian forces for aiding Barayev and other Chechens. Mr. Daniloff explains why he took such risks. “Dr. Baiev believes very deeply in the Hippocratic Oath and he was challenged in a most serious way by both sides. He likes to say he does not belong to one side or the other -- the side he belongs to is the side of the wounded.”

Howard Markel, a doctor and historian of medicine at the University of Michigan, says “the essence of the Hippocratic oath is that this is a calling. We are taking an oath of conduct that is above and beyond what the average person must do. It is not that we are better human beings, but that we have very significant social responsibilities. It is articulated in the oath that if you find someone who is ailing, it is your responsibility to take care of that person, whether they are the enemy or not -- as in this case. You are here to treat people. You don't judge them on their politics, race, creed, religion, or even their social beliefs. That's not part of the bargain. They have an illness and you are supposed to treat it. That's what doctors do.”

Hippocrates was an ancient Greek physician who founded one of the first medical schools in the fifth century BC. Dr. Markel says he recognized that natural human bias could compromise a doctor's ability to perform his or her practice. So he developed an oath of medical ethics. It states that a doctor will do no harm, treat anyone in need, share medical knowledge and honor patient privacy. The 1948 Geneva Convention reflects the spirit of the Hippocratic Oath by stating that when combatants are wounded, they are no longer part of the fighting force, but in need of protection and care.

Dr. Baiev concedes there were moments when he considered taking up arms against the Russians, especially after they had arrested and beaten him. But he continued to treat the wounded at his hospital. He describes one of his worst moments when 300 wounded Chechens arrived at his hospital in late January 2000. They had run across a snow-covered minefield while fleeing Russian forces closing in on Grozny. “I operated for 48 hours and during that time I lost consciousness twice,” he says. “I was taken outside and my nurses rubbed my face with snow until I came to. Then I went back and continued operating. And I knew that every minute, every second was going to cost the life of someone. And there was just no other way of doing this because I wanted to save these people.”

By the end of the second day, Dr. Baiev had performed 67 amputations and seven brain surgeries, before his strength gave out.

Weeks later, the Russian army placed a bounty on him for treating a wounded Chechen warlord. Dr. Baiev realized he had to leave to save his life. With the help of human rights groups, he fled Chechnya for the United States, where he was granted political asylum in February 2000. He now lives in Boston with his wife and six children.

Reflecting on his experiences, Dr. Baiev says war is hell and ordinary people caught in the crossfire are the real victims. He often discusses the plight of the Chechen people with US government officials but remains frustrated that Chechens are stereotyped as international terrorists. Dr. Baiev believes the Russian government is using the war on terrorism as a justification for committing atrocities in Chechnya. But he says he does not regret saving those Russian lives.

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