Growing Bold and Overcoming Adversity

Article

• Refugee surgeon who has forever changed medicine fusing together man and machine

Reference

• The book ‘Walking Free’ is Munjed's extraordinary account of his journey from the brutality of Saddam Hussein's Iraq to a new life in Australia and a remarkable career at the forefront of medicine. Available to buy here.
• In his book ‘Going Back’, Munjed shares the extraordinary journey that his life-changing new surgical technique has taken him on. Through osseointegration, he implants titanium rods into the human skeleton and attaches robotic limbs, allowing patients genuine, effective and permanent mobility. Available to buy here.
• More about Osseointegration
• Saddam Hussein’s Iraq

Growing Bold and Overcoming Adversity

Welcome to the Grow Bold with Disability podcast, brought to you by Feros Care. A podcast dedicated to smashing stereotypes and talking about the things people with disability care about most. To help us live bolder, healthier, better connected lives. I’m journalist, Pete Timbs. And I’m Tristram Peters. I work for Disability Service Directory, Clickability and am a wheelchair user living with spinal muscular atrophy.

Today's episode of Grow Bold with Disability is growing bold and overcoming adversity. Our guest is Professor Munjed Al Muderis, the refugee surgeon who has changed medicine and thousands of lives.

In this episode, we'll hear how he escaped the Saddam Hussein regime in Iraq and has gone on to become a game changer in the world of orthopaedic medicine. And along the way collected the New South Wales Australian of the Year gong for 2020. Professor Al Muderis welcome to Grow Bold with Disability. Thank you very much for having me here.

As I said you were born in Iraq under the Saddam Hussein regime, and you were a second-year med student when the Gulf War started. What was it like living under that regime? So, living under the Saddam Hussein regime was a classic environment off autocratic regime where people live under a dictatorship. It's fully controlled by military, there are Marshall laws everywhere, checkpoints every kilometre or two. And people kind of must live under military control. You don't know when you go outside your house if you are ever going to go back in, there's always fear.

There's always the sense of in security when you know you lie down on your pillow at night, you wonder when someone will knock on your door and open the door and take your family away from you. And so that was a simple as I could describe it. In general terms, if you mind your own business and you don't interfere with Saddam's regime, you can live your day to day life. Baghdad was very cosmopolitan city. It was pretty much like Sydney and life was very vibrant. But there is always a sense of insecurity. There's always a sense off, you know, the big brother watching you, and you can't obviously have freedom of speech because you don't know who is recording and you don't know whether your cousin or your brother is gonna be doping you.

So what was the catalyst that forced you to flee Iraq? So, I was a junior medical officer at Baghdad University Hospital. And I never thought about leaving Iraq. I was very comfortable with the living arrangement that I had.  Especially I have my family, I have my friends. And then, believe me, despite all what I've said, people can live in these circumstances. They would prefer to live, you know, among their friends and among their family and in the environment that they grew up in because that's what they're familiar with. And no one would prefer to face the unknown and escaping for a better life.

Because it's always the what you know, even if it's evil, it's much better than the unknown, because it may be worse. So, I was similar to the majority of people living in Iraq. You know, content with what we've got and we're just happy that we can survive. But all of that changed suddenly. I was a medical doctor going to the surgical theatres and all of a sudden, I was confronted with three busloads off Army deserters escorted by Republican guards and Bath Party members.

And they ordered us to abandon the elective list and start mutilating these Army deserters by chopping their ears off. And as a result of that, everything changed. The head of the department refused openly, so they basically the Republican guards, dragged him to the car park in front of everybody. They executed him by putting a bullet in his head, and then they turned to the rest of us. And they said, Well, anyone share this man view, come forward, otherwise proceed with our orders.

So, I faced the most challenging decision in my life. Should I obey the commands and live with guilt for the rest of my life? Should I refuse and end up with a bullet in my head, or should I run away? And I decided to escape. From their own would my life changed upside down. And I moved from being a reasonably comfortable young doctor, living in Iraq to someone who's escaping for his life and running away from the authority. And if I was going to get caught, I would be executed.

Well, goodness. Tell us about that, the deal of escaping and the challenges in coming to Australia. So, when I escaped, I had no plan, obviously, and the first initial move, I had to leave the immediate danger, which is the hospital itself. And then I had to stay in the female toilets for five hours. They felt like five years in a small cubicle, and I was wondering when people come and open the doors on me and find me.

Then I went to the outskirts of Baghdad in a farm in the western part of Iraq and had to hide there for several days until my family managed to prepare a passport for me, which to date I don't know whether it was legitimate or fake, and they gathered significant amount of money and basically they smuggled me through the borders to Jordan.

Jordan was not safe, and the only place that would give an Iraqi national with half decent passport a visa was Malaysia. And Malaysia would give Iraqi nationals 14 days visa to enter a course of English language. So, I took that trip, and then sequence of events led me to end up on a leaky boat that's not seaworthy bound to Christmas Island in Australia.

And I think from there you ended up at the Curtin Detention Centre in Western Australia for about 10 months. Is that correct? Yes. So, I spend five days in Christmas Island under the control of the federal police and then from there we were taken by chartered planes to Derby to Curtain Detention Centre, which is a RAF base. Basically, the minute we entered the Detention Centre everything changed.

The first thing that happened to me I was stripped of my human identity. I was marked with a permanent marker on my shoulder with a number 982. That's the name that I carry till the day I was released from the Detention Centre. Um, I was treated like an animal basically. We were locked behind barbed wire in small compounds within the main compound. We were head counted four times a day, and obviously I was very outspoken. I couldn't shut up, so I caused a lot of problems and as a result of that, I was singled out to be a troublemaker and ringleader.

And because of that I had to spend significant time in prison in many Western Australian jails, including maximum security prison. And I tell you something, just to give you a prospect of how bad was the Detention Centre comparing the Detention Centre to the jail? The jail was like heaven compared to hell, and the jail system was brilliant. I was treated like a human being. I was fed very well. I had access to a telephone, and I was treated with dignity.

And how did you know lose hope during this time? What kept you going? What focused did you have? Look, I must admit, I mean, there were some tough times and I talk about the wheel of fortune and your position on the wheel changes from day to day. Hey one day you may be on top and another day you may be at the bottom. And at some stage I was really down, especially when the Department of Immigration decided to put me in the solitary confinement which was called them the hotel.

I spent 40 days in a box, 2.5 by 1.5-meter mattress on the floor. No pillow, no sheet so I don't hang up my myself or suffocate myself. A hole in the door of 20 cent piece I can see the outside environment, which is the main compound detention centre. And I was locked in for 22 hours. And I could go outside that box for two hours, basically, in the day. It's something that you cannot imagine that could happen inside a country like Australia. But it did happen to me. And that time was tough because every time I asked the guards when they bring food, which is basically a colourless noodle and a mincemeat in a plastic container. Every time I asked them “What am I doing here?” And they say, “we're rehabilitating you”.

I read many kinds of psychology books, and I've never seen this kind of rehabilitation ever mentioned. But these times, were really tough days, and I thought, is this going to end? Especially when my name miraculously dropped, or my number dropped from the list and I didn't get any legal representation. So, the whole detention centre detainees were processed and I was waiting there.

But eventually I mean, things changed. I had to go on a hunger strike to ask them to release my only companion that I brought with me, which is the anatomy book. The Last Anatomy. And they gave it to me then returned to break my hunger strike. And I looked at the bright side, in everything there is a bright side and that I’m stuck there inside this box for 22 hours, I might as well use time to study. And I tell you what, I read this book from cover to cover again and again. And as soon as I was released from the detention centre, I sat my qualification exam and I passed with very high marks in anatomy so you can get something out of it.

The hard way to learn that was for sure. But it wasn't all smooth sailing once you got out, you applied for over 100 jobs. Is that correct? Well, I applied for more than 100 job and basically, I started knocking on doors as soon as I was released of every hospital I could find. And I used to get the same rejection you know, go and learn English, sit the exams and recognize your qualification. And then we may employ you.

But I never lost hope. I went to this place called the Centrelink on and I told the officials there that I'm looking for a job and they said to me well you have to write a CV and that's how you do it. So, I figured out that this is the way to do it in this country and I learned how to tick the right boxes, and I did that. And within a very short period, I managed to finally employment. I mean, the first job I did in Australia was toilet cleaning, and I enjoyed it. I didn't have any problems with that. And then I thought I would do try to work in what I know better, which is medicine. So, I managed to get a job in the medical field, and I can tell you, I felt very bad that I spend taxpayer's money. I was released on the 26 of August 2000 and I received my first page a paycheck as a doctor on the first of November 2000. So, with my first paycheck, I took it back to the Centrelink, and I wanted to give it back to the government. And they thought that I'm an idiot.

I think you paid it all back. So, there you go. I mean, I started climbing on the ladder very quickly, and to be honest the last thing I wanted is to remember the past, and I just wanted to move on. I wanted to start a new life. I wanted to forget about everything in the past and you know, people that come on a boat and get called queue jumpers and asylum seekers and you name it, they get traumatized. And they feel ashamed off this stigma that they get attached to them. And I was one of them. But then I had this wakeup call because I just wanted to move on and didn't want to remember anything.

But then, you know all doors opened in front of me and started climbing the ladder very quickly. And I thought that everything becoming pink and all of a sudden had this wakeup call when in my welcome dinner to join the most prestigious training program in Australia, which is orthopaedic surgery, to my face two off my colleagues who joined the training program at the same time, they said it to me that isn't it a shame that the Australian training program in orthopaedic surgery had dropped their standards so low to allow a refugee to be one of us.

And there was a turning point in my life where I thought that, you know, there is no room for this kind of people. There is no room for hate. There is no room for discrimination. And I decided that I turned my back again to the past and face the past and basically work as hard as possible to fight for people, dignity and tolerance and acceptance.

And it's such an amazing job you've done at doing that. Can you explain to us what an osseointegration, prosthetic limb is and how it works? So people when they lose a limb, whether it's an arm or leg, they historically since 1529 used to be fitted with a bucket or a socket mounted prosthesis, which is just something that wraps around the limb and you have to walk with it. It’s attached to a prosthesis – it's like Captain Feather in Hook. And it basically hasn't changed for all that time.

Osseointegration surgery is a completely revolutionary technique or technology. And that's by integrating the body with a robotic arm or leg. And the way we do it is by inserting a high tensile strength titanium implant into the residual bone and skeletally attaching the human body with my electric prosthesis or computer, robotic arm or leg through a small opening in the skin. And reorganizing the muscles and the nerves to operate this, my electric prosthesis.

It is creating what's very similar to the Terminator or Robo Cop basically.

So, you’ve worked in all the medical fields, obviously working up through the ranks. Why the passion for orthopaedics? Look, I always grew up in a war torn region where I've seen a lot of disabled people, a lot of people who when they lose a limb or an arm and they get deformity or significant trauma to the extremity, they become deformed and they become disabled.

And that leads to a significant impairment in their capacity to live, work, earn living and integrate with society. So, I always wanted to do reconstructive work to build these people back again and give them the capacity to function. So, function is life. Mobility is life, and that's why I wanted to do reconstructive surgery. The only way to do it is through doing orthopaedic surgery basically. I mean, I could have done plastic surgery, but that's very limited to the hand area. Or with all due respect, I don't mean to discount plastic surgery. But you know, we have to go through a lot of, there is a reconstructive part as well as the cosmetic part. And then I thought that with orthopaedic surgery, it's more involved in integrating the bone, the muscles and the tendons and nerves. So, it's more inclusive basically.

Right. And as an orthopaedic surgeon, you could have lived quite comfortable in Australia working here but you've chosen to go back to Iraq, travelled to the Middle East, Southeast Asia, helping several people. Why that drive to go back and travel the world, helping people. To be very, very clear I do live very comfortably here in Australia, and I do have a very good living here and I earn, well used to earn, now with the coronavirus we’re shut. But I used to earn very high income and very good living in a lot of the work I do here in Australia involved joint replacement surgery like hip replacement, knee replacement. Believe me, it's boring like batshit. But it pays the bills so I'm no way denying that. But as I said to you, I decided that I’d dedicate a significant portion of my time, which is more than third to giving back. And giving back doesn't mean going only to Iraq or the Middle East or Southeast Asia, given back means giving back everywhere, including here in Australia.

So, I do a lot of pro bono work here in Australia. I do a lot of charity work here and for people who cannot afford surgeries and a significant portion of my work here in in Sydney is for people who are in financial difficulty and who have significant disability in the community. And unfortunately, and sadly I could say that we do have people who are not capable of paying for the bills. Even here in Australia. I do work in developing countries and I do work in developed countries. I help British soldiers. I helped Germans, Dutch, Swiss, South African and I do work in developing countries or what you call them, semi developing countries like America. That's a joke by the way.

And I do enjoy working in places where people need the service most and like Southeast Asia and in places like Cambodia, Vietnam, where they have a lot of land mines. Iraq is another place where I can function to the max because I can relate to the people. I can speak the language and that gives me a huge advantage off maximizing my output. But people say sometimes are you wanting to go back to your homeland? I don't discriminate. I don't differentiate. I treat everybody as human being, and I've been to places like Lebanon, Israel, Jordan. I was invited to go to Syria, but it's very unsafe there. At the same time, I was invited to go to Iran and Saudi Arabia, and you can see they all contrast countries, they all are fighting with each other.

So, I don't discriminate. Human beings are human beings, and if they need help, they all equal to be honest. So, I quite enjoy it. But at the same time, I do enjoy flying first class, and I do enjoy the many luxuries of life and I have a big boat and I have a fancy car, but I pay for that from my own pocket, and I don't take money from anybody else. So, it is what it is. I work hard.

Fair enough. Now we’ve spoken about osseointegration. What's next in the world of prosthetic limbs? Are we going to be seeing sensory touchpads and so forth? Look, we're working very, very heavily on new technology, which is not just hooking up the robot, but giving people sensation and feeling back in the prosthesis, and there is a new technological target muscle Innovation, where you kind of make these robots mind control prosthesis and give them the feedback where people can touch the object and can feel it. That's one area. The other area is that which is a field that I will work on in the future. I am working on now and started doing a couple of cases already where people who are wheelchair bound due to spinal injuries and people who are paraplegics and quadriplegics to give them the mobility back.

And I managed to get the first t four paraplegic the ability to walk again by giving them this technology and by working with endo skeletons and exoskeletons. And this is a field that it's massive and can transform a lot of people's lives and especially working with neurological disorders, not just injuries. And so that's another field that we're working on.

But unfortunately, the world is facing this disaster with the virus and that put everything on hold. And so I'm back now moved from doing all this work to, you know, being a foot soldier and fighting this virus, where we just do ordinary trauma work and back to doing fractures and things like that, which I enjoy as well. Work is work, and it's respectful regardless of what you do.

And you touched on mobility there, briefly on my power chair using myself. And the idea of being able to walk again is just mind blowing to me. What was that gentleman, the T4 paraplegic? What was his response to being able to walk again? What was his reaction? Well, look, it's very interesting. He's one of our and heroes. One of our soldiers and he had an injury as a result of parachuting accidents and unfortunately, he lost the ability to walk and he is paralyzed from the T4 down. And when he came to me, he said, I want to run. And I said, look, all I can do for you is to take your legs off, give you these two prosthesis and make you easier to manage to transfer and for hygiene, and never thought that this can expand.

And then from there we started working together on possibilities and re innovation and things like that. And, um and he proved me wrong and he started walking and we opened this kind of horizon that we were completely oblivious to. And I mean, it's way outside the box. And you know, the idea off amputating someone to let them walk is completely wrong. And I mean, it can be seen as, you know, a maverick work. But, you know, I look at the bright side of it is that he wouldn't lose much because he's not going to use these legs anyway. And if he gets any mobility from it and he is much better functionally. He hasn't run yet. But he put himself up for the Invictus game, and I have five of my patients that are competing. They competed in the last in Invictus Games, and I have several of my patients were supposed to be competing in The Hague Invictus Games, which, unfortunately was cancelled. Incredible.

Well the technology is all there. Munjed, this podcast is called Grow Bold with Disability as you know. What does living a bold life mean to you? Look, I get bored very quickly and I don't know. It's in my nature that I always live on the edge. But one thing I learned from my father is that as long as you have a calculated risk, and as long as you do your own research and you surround yourself by people who are expert in the field that risk and pushing the boundaries can make a huge positive impact on the society. Because you doing productive work, you're not doing something that is destructive.

And so, you know you need people. I strongly believe that you need people who are crazy like myself to push the boundaries further. And otherwise we will still be, you know, riding horses until now. And, you know, like bold moves like, I call bold like the Wright brothers taking the first flight. That's a bold move because, you know, these people, you know, they deserve the gratitude for all humankind because they made things that were impossible possible for us. And I don't claim that I'm one of them, but I do my best to help in pushing the boundaries and keeping the wheel off development going. But as I said, as long as you do it in a measured way and in a way that can benefit people rather than cause harm.

Well, you might not be making people fly but you are making them walk again. So, it’s as close to the Wright brothers that you are going to get I think.

Thanks so much for joining us today on Grow Bold with Disability brought to you by Feros Care. And our listeners can find out more about Professor Al Muderis’ work and his amazing books, check these out, “walking free” and “going back”.

All the links are provided in today's episode show notes where you can find those amazing books and more details about the professor. Thanks again joining us today. Thanks very much.

Thank you for listening. And if you have enjoyed today's episode that make sure you subscribe to the podcast grow bold with disability. And if you like what you heard, please take a few moments to pop over iTunes and give our a podcast, a quick rating so we can continue these conversations and encourage people to grow bold.

This podcast is brought to you by Feros Care, an NDIS partner delivering local area coordination services in Queensland, South Australia and ACT. Feros Care is a people care organization committed to helping people live bolder lives. We call it growing bold. And for over 25 years, Feros has been making it real for both older Australians and those living with disability. To find our more head over to www.feroscare.com.au

The content and views discussed in this podcast series are those of the individuals involved. They are not necessarily condoned by, or, are the views of Feros Care or its employees.