Aaron Epstein
Bridging Health Care and Security in Iraq
A Conversation with Aaron Epstein
As a new lower looking forward to his first day of classes at Exeter, Aaron Epstein ’04 was midflight from Miami to Boston on Sept. 11, 2001, when his plane landed abruptly in New Jersey. After learning of the catastrophic events that had taken place that morning in New York, Pennsylvania, and at the Pentagon, Epstein and his parents scrambled to collect their luggage, find a rental car and make their way north on I-95, passing a blacked-out New York City along the way. They arrived without incident, but the events of that day and the ensuing wars in Afghanistan and Iraq, Epstein says, “shaped my worldview. They sparked a desire to focus on national security.”
Epstein had his first of three internships with the State Department the following summer. He later studied Arabic and focused on Middle Eastern culture while earning his bachelor’s degree in economics and international policy studies from Rice University. He also landed several national security and counterterrorism internships and worked with the White House Council of Economic Advisers, where, he says, “I learned a lot about spending and budgets and the mixing of business and intelligence.”
After graduation, Epstein worked for a major defense industry firm in its advanced systems, intelligence and electronic warfare divisions and received a master’s degree in intelligence and security studies from Georgetown School of Foreign Service. But, in that winding way in which a life’s purpose sometimes reveals itself, his trajectory took a few more turns. Volunteering as a medic revealed an avid interest in medicine. “I was relentless in asking questions of the attending ER docs. I wanted to know everything I could,” he says. A medical mission to Cambodia with a fellow paramedic furthered his interest. “I could save lives by working in the security field, but it might take a lifetime before seeing the impact.” Inspired by the possibility of helping in more immediate and tangible ways, he enrolled at Georgetown’s School of Medicine.
During his first year of med school, Epstein began reaching out to friends and former colleagues in the national security world and building on relationships he’d forged with members of the Iraqi and Kurdish military communities in his earlier career. Knowing there were troubling gaps in the medical services available in the region, he was hoping to lay groundwork for safely operating medical missions there. “I was beginning to think providing access to quality health care and medical training might be a more effective way to build lasting security in those communities,” he says.
Epstein pauses before adding: “To fortify a population, you could arm it with every weapon under the sun, but I don’t see that as a role to be taken on by humanitarians, and historically that has only led to more suffering. Governments can do that — unfortunately, there is a never-ending stream of weapons available in all parts of the world — but I don’t see that as an ethical way to alter outcomes.”
In 2014, Epstein founded the Global Surgical and Medical Support Group (GSMSG), a nonprofit organization that provides high-level medical relief and training in conflict zones, particularly in the Kurdish region of northern Iraq. Epstein says that part of the country, which has taken in massive numbers of Syrian refugees and internally displaced Iraqis fleeing ISIS, is a notably open and tolerant one. “Those qualities have drawn refugees to the area, and I believe they’ll ultimately contribute to the Kurdish community’s success and longevity,” he says. “But the ongoing crises have left the local populations and medical infrastructure overwhelmed and in desperate need.” Epstein mentions the “golden hour,” the first hour after a trauma occurs, in which immediate access to emergency medical care is critical to a good health outcome. “By providing quality EMT care and training in a region that completely lacks it, we can give the Iraqi population this golden hour,” he says.
His initial forays with GSMSG involved bringing one or two surgeons over for short medical missions, but Epstein and his crew have since built up a large network of volunteers, including 450 American veterans of the Iraq War eager to help by returning as medics and providing triage support in the region. He attributes the advocacy of early supporters — like his mentor Sister DeDe Byrne, a nun and former Army surgeon who runs a low-income clinic and teaches surgery at Georgetown — for helping the organization to also attract a roster of more than 100 physicians and surgeons from top-tier U.S. medical institutions. Byrne, who accompanied Epstein on his first medical mission to the Kurdish region of Iraq, now sits on the advisory board of GSMSG. She and the other volunteers finance their own missions, which can last anywhere from two weeks to two months.
The larger goal of GSMSG, Epstein says, is to fortify the medical system: “Because if you can survive what literally hits you, you can survive the proverbial storm. I initially went into the national security field optimistically, but I’ve seen this: Governments and established institutions can send all the Band-Aids, blankets and tents on earth, but if the people they’re trying to help don’t develop indigenous human capital to utilize what is given to them, then the fundamental problem doesn’t change. It’s just not a sustainable solution to have a population be eternally reliant on outside help. If we can bring in the expertise to train people to provide their own medical care, that will create real change.”
In addition to providing a full array of on-site medical, surgical and much-needed psychiatric care to the war-ravaged population, GSMSG experts offer crucial in-depth training in complex medical procedures, including cardiothoracic and acute-trauma resuscitation techniques, to local medical staff. Over the course of nine medical missions, volunteers have trained more than 100 surgeons and surgical professionals, 150 medical doctors and diagnostic specialists, and 750 combat medics. In addition, they work with local ministries of health, medical directors, facility managers and community leaders to prevent and manage crises and build and sustain the medical infrastructure. “We are the only group who provides such broad support and high-end instruction from U.S. board-certified physicians,” Epstein says.
Eventually, the GSMSG team would like to offer similar support in other areas of the world, but first they want to perfect the model in Iraq. Epstein lays out his long-term plans for what that could look like: “We’re hoping to set up a medical university at a fixed facility, in partnership with leading medical schools in the U.S., to provide the full spectrum of training for everyone from field medics to surgeons.”
Such an enterprise requires a great deal of funding, so Epstein has been pursuing grant opportunities through the State Department and private charities. In talks with potential donors, he says, he often discusses planned self-obsolescence for GSMSG: “We want to help change the medical system so that over a period of years, the local personnel can take over and we can phase out. That might be a bad long-term business idea, but we aren’t in it for a profit.”
Epstein, now in his fourth year of med school, with plans to specialize in trauma surgery, was named a Fulbright specialist by the State Department in January, allowing him to serve as a health care, peace-building and security consultant to foreign institutions. He was recently contacted through Fulbright by the Kurdish consulate regarding potential collaboration. No matter how much he takes on, or how his plans evolve, Epstein remains motivated by the possibility of building a more secure world: “Whether this is an unfortunate commentary on governments today, I don’t know; but I do think one person with enough drive and a large enough network can generate grassroots change on a scale that even governments can’t achieve.”
—Genny Beckman Moriarty
Editor’s note: This profile first appeared in the summer 2017 issue of The Exeter Bulletin.
