#106 Saving Lives and Survival with Dr Waheed Arian

Dr Rupy: Today you will listen to one of the most incredible stories. So much so that it genuinely sounds as unbelievable as the plot of a Hollywood movie. Such is the journey of my friend and colleague, Dr Wahid Arian. He was born and raised in Afghanistan, and Wahid's childhood was spent fleeing from conflict. And as early as the age of five, he and his family fled their hometown in Kabul for the refugee camps of Pakistan, taking the treacherous journey through the harsh terrain, all whilst dodging bombs and the Taliban. Once reaching the camps, his family had to do further battles with malaria, TB, all without access to medicine and proper healthcare. His childhood is littered with these experiences and, fearing for his life, Wahid actually managed to escape Afghanistan, leaving his family in Kabul at the age of 15, just before he would have been conscripted by the Taliban to fight. He managed to find safety in the UK, and he actually started working multiple low-wage jobs in the London area, sending all of his earnings back to support his family in the war zones. But he also decided to formally learn English and complete his A and AS levels. And this is where the story gets even more astonishing. He applied to medicine, and through sheer determination, he managed to achieve a place at Cambridge. He completed his clinical work at Imperial, and this is where myself and Wahid actually crossed paths in the same year group, and did an elective at Harvard. And if none of this was impressive enough, Wahid went on to start radiology training and founded his pioneering charity, Arian Teleheal. And this works directly with clinicians on the ground and provides governments and global organisations with a blueprint for delivering innovative healthcare and education. So through a network of volunteers in the UK, doctors across Afghanistan have access to highly skilled and trained clinicians via encrypted social media platforms. Wahid has since been recognised as a UNESCO Global Hope Hero, a UN Global Goals goalkeeper, and he was appointed to the WHO roster of digital health experts in 2019. In the UK, he's been awarded the Rotary International Peace Award and the Prime Minister's Points of Light Award. He was also working throughout the pandemic in A&E in his hometown and has not stopped working on his charity ambitions ever since. And we talk about a number of things today, largely centred around Wahid's story and how the seed of ambition was planted actually by a doctor that treated him for TB when he was just six. And we also talk about how refugees are important and why it's critical to fight for their rights. The legendary BBC reporter John Simpson has actually told his story in a BBC documentary called Wahid's Wars. The link to which is all on the show notes at thedoctorskitchen.com, as is a link to his latest book, In the Wars, which is available in all good book stores and online. And I highly, highly recommend you read Wahid's book. It is quite simply one of the most inspirational stories I've ever read, and it has touched me deeply. It has helped me in my gratitude practice immensely. The sounds of today's podcast changes around an hour in. We had a few audio difficulties, but nothing that should dissuade you from listening throughout the whole podcast and right to the end. And I have one ask, that you support Wahid, you go follow him on socials. And also, if you're enjoying the show, please do rate, review, and do send this to a friend who needs to hear it because it is quite simply one of the most incredible stories. You can also join the doctorskitchen.com newsletter where I give you suggestions on what you should eat, listen, or watch every week. And something that I believe is important for health and wellbeing, and hopefully it will give you some impetus every single week to do something new and something that helps your mental wellbeing. Anyway, that is enough from me for this intro. I really hope you enjoy Wahid's story and enjoy our chat. I'm basically just going to ask you a bunch of questions and just let you talk and just tell your story because it's, and I mean this, man, it's so powerful for a number of reasons for people who want to go into medicine, who feel that they need a step up, who need motivation, who might be refugees themselves, there's just so many elements of your story and the way it's been written and put together, it's just incredible. So I want to give you as much time to talk through it, and we can talk about obviously the charity, ways to support, and anything else that you want to talk about as well. So, so yeah, man, this is, this is really just your chance to speak to my audience and I want to try and promote it as much and as much as possible.

Dr Wahid Arian: That's very kind of you, Rupy. That's, I think that what I'll do is I'll go chronologically from the beginning, the start, and there will be themes that will come out that I would like to summarise, for example, hope, dreams, mental health issues, refugee camps, situations. So I think that way we wouldn't miss anything. But anything you want to focus more, you can stop me and then we can kind of discuss, for example, PTSD. We're talking about, I've made a note here of as well that how, for example, I had late night food habits, food comfort. Yeah, I had that. So for example, that's a topic relevant here that we can discuss the connection between the mind and the nutrition and exercise and my coping mechanism for mental health as well of how I was using that. So we'll go through them.

Dr Rupy: Yeah, definitely. Okay. Because it seemed like exercise, particularly Taekwondo, was a really good avenue for you to try and help you get through your PTSD and.

Dr Wahid Arian: It was, Taekwondo was. I learned actually kicks and some of the moves from Jackie Chan movies as well as Bruce Lee. I learned some of really, some of the kicks later on that when I was being trained properly, they were looking at some of my kicks, they were weird. Some of them were wonderful, but some of them were weird. And the instructor, he was like, who taught you that kick?

Dr Rupy: Did you say Jackie Chan?

Dr Wahid Arian: Yeah, because I would just see that he could do that move, you know, go on the wall and then flip back and I was like, I can do it too. And then I was just obviously I'd bash my head, I will fall on the floor and then my mom will get annoyed, you know, what's this noise coming from and the pillows everywhere, but kind of, but I learned some, some really cool tricks and some not really cool. I had to relearn some of the kicks, the techniques back and so on. But that's I think one of the mechanisms as well that during wartime, we didn't have access to playing, we didn't have access to outside, we were not going to school much. So we had to find something to entertain ourselves with and at home, that was one of the things that kind of we're watching movies, staying at home and then kind of create this imaginary world where everything was okay, everything was fine for us to separate what was going on on the outside.

Dr Rupy: Yeah. Do you see, do you think that still happens today? Whenever you see children on the news and my position is obviously from my sheltered home watching it on TV, and I see children in during famine, in conflict zones, and a lot of, some, obviously not the atrocities and the apocalyptic scenes, but sometimes you see kids and they are laughing and smiling and jumping around in front of the camera and stuff like that. And they seem very, very happy. Do you see that as like a coping mechanism? Is it just like the way children are? They can, they can imagine and visualise their own environment?

Dr Wahid Arian: That's a very good point actually. I think it also applies, obviously it applies to conflict zones, but if you go to some parts where there's extreme poverty, for example, some parts in Africa, some parts in India, you actually see that those people have got a huge smile on them on their faces. They will still interact with you, they'll be happy to receive you, they'll be happy to tell you about their lives, tell you about what they are going on to do and so on. One, I think consciously, I'm not sure if it is one of their coping mechanisms, but subconsciously, they, one, they're born into that reality, whether it's poverty, whether it's conflict. So for them to see somebody else coming as a guest or for them to see to find pleasure or to find comfort in the small things that we take for granted in life is actually what it's all about for them. So for us, we didn't know when the fighting would end or start. Usually we would be in the cellars hiding from the daily rockets and the bombs. But some days when the fighting wasn't there, that was really a good day for us. So we would be smiling, we would be happy. But in the grand scheme of things, if you look at it from the outside, you would be saying, why are you happy about? You know, the conflict is still ongoing. But from day to day, we would find a burst of times where we could find comfort in each other, we find humour in small things, we would make jokes about small things. And that's how actually what one of the subconscious coping mechanisms that humans have actually. The one thing I've later on on reflection I've realised is that humans have got so much potential in so many avenues. They've got so much resilience that if need be, if you're pushed, we can actually tap into them, we can use that resilience. And I think that's something that I brought with me back when I came to the UK, which I'll talk about later on is that the idea of not to give up, the idea of always to keep pushing that there will be better days is actually stemming from that of not having hope, not having anything, but then the next day there will be a hope of so on. So having talked about that, then I was born in 1983 during the Afghan-Soviet conflict in Afghanistan. So I was born into war. I didn't have any other reality. That was my reality when I was born into. And the first five years, I remember hiding with our family members in one room or another or in cellars from the rockets, from the shelling, and also from the tanks that were kind of making noise outside for the helicopters, gunships and the planes, the Soviet jets making noises in the air. I had no clue what was going on, so I would usually ask my mom, what's happening? And she would say, oh, it's just fireworks outside. It's nothing. So that was another way that how they would try, parents would try to comfort us. And they did an amazing job for us. And that's usually when we see parents trying to protect their families in conflict zones, I'm absolutely blown away by the sheer resilience they have, by the sheer kindness, they use and their compassion and passion they use to protect their children and to provide for them in the extreme conditions. We didn't have a lot of things. Usually my mother, she would go out and find jackets on the street or some clothes that were exported from Europe or exported from Russia or from some other country where kind of it's redundant here, but obviously in those countries, that's exactly what we used to wear. They would be holes here or tears and so on, but that didn't matter. What mattered for us was, were we actually warm in winter when winter the temperatures go beyond freezing. And also we didn't have a lot of food. Obviously what was given to us was completely below standard, but that's what kept us going. And parents again play a huge part in that, making sure that we get the nutrition as much as possible whilst starving themselves. So after about five years, we decided all of us to go back to Pakistan. And the reason for that was because my father was fleeing from the military service. He couldn't be with the family. So we had to go and meet in a location, a hidden location, which was another province. So we were living in Kabul in a capital, and my father was in hiding in Logar province, quite a few kilometres away from Kabul, and he would go back and forth to Pakistan to make some money, bring that money back during summertime when the heat was too much, give that money to my mom so she would support us and he would go back in hiding. And finally, they decided that it was too much for everybody. So we had to go to Pakistan to live together. And that's where most of the refugees at that time went. Millions of refugees they fled Afghanistan because of the ongoing conflict. So we took a very dangerous route because we couldn't go through the usual border. The usual border was closed. The families were not allowed to flee to Pakistan. So we had to use very dangerous routes from mountains, through rivers, and the journey was actually at night. And the reason for that was that any movement that was seen during the day, the helicopter gunships and the planes would come in and attack and destroy with the families, children, that was the same route used by the rebels at the time as well. So they wouldn't discriminate necessarily whether it was a rebel or whether it was a family that was trying to flee conflict there. And it took about seven days, seven nights. We came under the attack about three times. Miraculously, we survived those attacks along the way, and we made it to Pakistan to a refugee camp. And that's when we arrived, the rockets and the bombs and the shelling stopped, but the horrendous conditions in the refugee camp actually started. They were far worse than the conditions beyond conflict that we had seen in Afghanistan. So many families, they would be using one or two tents for the entire family. Again, lack of nutrition, lack of sanitation, no clean water for them. And they had to make use of whatever they had. They brought very few clothes with them from with their families from Afghanistan, and but what they would usually bring with them is that hope, that dream that, you know, we've survived war now, we're safe in Pakistan. Let's make our lives better. So they wouldn't kind of say that, oh my God, we've come to these conditions. What do we do now? So they would always seem to think positively, and that was the attitude my parents had as well. They would tell us that, come on, although the conditions are really bad here, but at least we are safe. The bombs are not here. So that's kind of like changing a negative situation into positive by hanging on to the small threads of hope here and there, but also using the small things, the day-to-day things that we usually take for granted actually here.

Dr Rupy: Because in the, in the book, you describe your father as having this irrepressible, optimistic attitude. And I wonder if that was something that was distinct for him as a person, or is this something that you've noticed in other families in the refugee camps and other people in general who who've experienced the conflict zones in Afghanistan?

Dr Wahid Arian: That's a good point. I think it was pretty distinct for my father, but also I've seen that trend actually in many people who lived through conflict, who lived through really adverse conditions. They do develop that sense of optimism, trying not to give up. One, they may not have any other choice, because either it's that or death or completely giving up on their families. Or alternatively, it's it's something that kind of they've been pushed to build that attitude because of the environment, the conditions. But my dad seems to have that, he had that from a younger age, I think. And he still has that with him. Whenever I consult him, I still do consult him for things as well. He's got a very optimistic attitude to him, telling me that everything will be okay. One day there will be peace. Afghanistan is still in war for more than four decades. And he usually would listen to a radio, a small radio, telling us that he's heard some good news. Despite listening to it for an hour, listening to bad news, but he would still try to find that one bit of good news on the radio and tell us that, oh, there is hope that we might be able to go back to Kabul, to Afghanistan, and there would be peace. So back in the refugee camp, when we were living there, as a huge family of eight in one muddy room, and the conditions, temperatures rising up to 45 degrees centigrade with little food, lack of sanitation, no clean water. And some rations that were given to us by the UN refugee agency, that was what was kept us going. But again, I think despite all those conditions, what on reflection, I find amazing is the hospitality of the local people. That's I think where humanity matters as well. They felt, they knew that we were suffering back in Afghanistan and we had fled war. So they did show us compassion. Our neighbours didn't have much. The local Pakistani people didn't have much, but whatever they had, they would try to share with us. For example, we didn't have electricity in when we moved from a refugee camp to another area called Badabera. And the reason for that was because I contracted tuberculosis, so we had to relocate. So I remember our neighbour gave us electricity, so there was a fan for us because we couldn't afford electricity and there was no electricity there. They would also allow us to use some of the clean water they had, or many other things. These are the small things that I'm mentioning here, but how the refugees obviously integrated back in Pakistan, they started giving back to the local communities, they built shops, they built businesses, but also the people, local people from whatever city people were living at, they would be welcoming refugees, they would be trying to make them as comfortable as possible. And ultimately, they became sort of a community that you wouldn't be able to distinguish too much. Of course, one from Afghanistan, the other from Pakistan, but they had a lot of things in common in that sense, the basic human universal human values, I would say.

Dr Rupy: It's incredible, isn't it? That you in the middle of conflict, you see both the worst and the best of human nature. You see abhorrent fighting and apocalyptic scenes, but at the same time, you see incredible gestures of humanity, like you just described there. And I just want to zoom in on the fact that you got TB as well, because I believe you were about six at the time, and you'd obviously being in a refugee camp, there's medication shortages, you know, there's conditions that are unsanitary. I mean, what was that experience like for you, if you can remember?

Dr Wahid Arian: Soon after arrival, most of my family members and I, we suffered from malaria first, actually, because of the lack of sanitation, the huge number of mosquitoes, especially in refugee camps. We didn't know what it was, but it was soon we started suffering from high and low temperatures, vomiting, body aches. And the people knew locally that that's actually these are the symptoms for malaria. We would go to a local pharmacist and they would give us just medicine. There were no proper treatments for malaria, but most people would survive and some people wouldn't survive. We don't know exactly what the death toll was from that. But after suffering from that, I think a few months that we were living in the refugee camp, I started developing a cough, which went on for quite a while. It wouldn't settle. And it was a cough that actually with that cough, I started losing weight. I had night sweats with it. And after about a few weeks, I started bringing up some blood with it as well. And that was a very worrying sign for my parents. We went to, he took me to, my parents took me to a local doctor in the refugee camp. And when I saw that there was a huge queue waiting for that doctor, for thousands of refugees, there's just one doctor in a muddy room sitting there and trying to examine, trying to help people. But I still saw actually a smile on his face. I saw that he was still being very kind to people. He wasn't feeling tired. And that kind of made me very curious that why is this person so happy despite being so, he should be tired. But he was still, and then he, when he examined me, he told my dad that he had to take me to a pulmonologist, to a chest specialist, because he suspected that it would be something serious. He didn't spell it out what it would be, but he said that it is, I think it's something serious and you need to go to see a lung specialist. But whilst that experience was something that actually slowly made me curious about medicine, the power of medicine of how it can actually heal people and the effects that it has on the people who are practicing it. So that was kind of the first seeds. But then I was suffering so badly that my dad took me to the pulmonologist in Khyber Bazaar in Peshawar city. We went there and when I saw the chest specialist, again, I saw a lot of kindness in his eyes and his touch when he was examining my chest, he was listening to my chest. He asked my dad to go to the local shop there to get my x-ray. So that's how the x-rays are done. You're seen in one room and then the next room you go and then you pay for your x-ray, your x-ray is taken, you bring back the x-ray, you put it up on a white screen and that's how he examined the x-ray and he checked my weight. Then he asked me to go out to another room whilst he was chatting with my dad. I could just listen to what he was talking about a little bit as well. And he told my dad that there's quite a high chance of losing your son if we don't treat him now, probably 60-70%. But because the condition actually is really bad, he has lost a lot of weight, he doesn't have a lot of body nutrition or nutrients in his body to fight actually on his own. So he definitely needs to take the medicine and also get all the relevant nutrients for it as well. When my dad came out, I didn't know what was going on, but I saw the doctor was really kind to me and he said, I'll see you soon in a few weeks time. I'd like to you to make sure that you take all the medicine that dad gives you, take all the milk and the meat that dad is going to buy you, and I would like to ask you these questions. So that's kind of the start of interaction between me and that doctor. But when we came back to the house, everybody was crying. I had no idea why they were crying. Of course, they had it from me and later on I found out that they knew that there was 60-70% of chance of dying. And many other children died. So miraculously I survived. It's because my parents put a lot of effort into treating me, giving me the medicine, taking me back and forth to the doctor, giving me the nutrients that I needed, but many children died. They do still in villages, in areas where they don't have access to good healthcare, they don't have access to good nutrition. I'm sure you know this better than I do that how important nutrition is in when especially when people are suffering from acute conditions to to enable their bodies to fight back. It's not just the medicine, we also need good nutrition for it as well. And that's what kept me going and miraculously I survived that. But that second interaction that I had with the doctor, which kept on and on because I had to keep going every month or every two months to be weighed. We had discussions about what medicine was, what he was doing, what he was, he had, he was using a stethoscope to listen to my lungs and I would ask him what's that tube? He would let me listen to him, to himself and my dad. Then one day when I went in, he gave me a stethoscope. He had bought me actually from the local shop, a stethoscope. He said, you can keep listening to your dad now. He also gave me an old black and white book with a lot of images, pictures. He said, this is going to be your medical book, that's your stethoscope, and your dad will get you some syringes as well that you can play with. So they actually became, they actually became my toys because in the refugee camp, we didn't have any toys. We couldn't just go out to play freely. It's one, we didn't know many people around. Secondly, that it's everybody is suffering in one way or another. People are completely coming from a shock of conflict, having lost family members, having lost everything. So they can't just build, rebuild their lives so easily. They come in with so much mental trauma, with so much suffering that they're just content with staying indoors and kind of surviving and and in some ways reliving the trauma in their minds as well, what exactly happened. So that was actually when I became inspired to become a doctor to see the healing that I saw the power of the healing of how he treated me, how he saved my life and how those doctors can actually save the lives of many other people who are suffering even more than we did.

Dr Rupy: Yeah, that's it's incredible. I I remember in the book you you wrote that was the pivotal change, the seed of ambition that was planted by that those doctors. Um, at such a young tender age and and it seems like you've held on to that ambition and that dream of being a doctor throughout your journey that thus far, right?

Dr Wahid Arian: Absolutely. I hung on to it. Subconsciously I was inspired, but there were so many challenges ahead. After we went back to Afghanistan from the refugee camps staying for about two and a half years there, we went and my dad was above the age of military service, so he could go back, we could all go back to Kabul. But within a year, the civil war broke out inside. And from 92 all the way till 99, that civil war carried on. And it was a really bloody fight, street from from one street to another amongst so many rebel groups that we didn't know who was fighting who, but all we had to do was again to hide in the cellars from the daily rockets, the bombs. But then we had to also flee from one part of the city to another because one day one part of the city was calm, the next day it wasn't. So the fighting was going on in that part. And so many people died, so many people lost their their relatives, their friends. And and for us to be able to find safety, just to survive was the key important point. Actually, the crucial point was for us just to be stay alive. Then we internally displaced, we went back to Logar province to other areas in Afghanistan to survive. And we went back to.

Dr Rupy: How were you moving moving about throughout those different areas of Afghanistan? What where would you stay? Where would you sleep when you had to move from one conflict zone to the next?

Dr Wahid Arian: Well, that's something that I'm glad you've mentioned that usually in during wartime, the main objective is to stay alive. Everything else becomes secondary. Whether you find a house, whether you find a tent, whether you find a relative's house or or you find an unknown person who just welcomes you. Again, compassion, people show compassion, people show kindness in those desperate times. People will just go and knock on the door like I've come from that part of the city, can you just give me shelter? People will welcome them in their houses, not having known them at all. But they knew that the fighting is ongoing and they need support. So nobody would shut their doors on anybody. Um, and the primary objective obviously was to stay alive, to to dodge the bullets or dodge the bomb. And it was how my dad would used to listen to the radio to find out anything from the news that who was fighting who, where the fighting might come. So it was a lot of guessing game as well that the fighting is getting closer here and another area is a bit calmer. And they would just go out, the men would talk amongst each other and then they would decide the next day that, okay, we have to now move from this part, go somewhere else. And we had very little with us as well. Um, very few clothes that we would carry. We knew what the bags were. We didn't have huge cartons or boxes and everything for moving out the way we do here, for example. And that's it. You get your bags, you move from that part which is under fire, go somewhere else just to be able to survive. And that's exactly what's going on at the moment in conflict zones. And that's why refugees flee. They flee primarily for their safety, primarily for to to be able to live. They don't actually leave their houses, their belongings that they've worked so hard for. They don't leave just their friends, their family members to go somewhere else to have a better life. It's not the case. As we discussed earlier on, many people are happy where they're born, many people are happy to be surrounded by friends, family members that they've known all their lives. That's actually what good living is. It's not about having the everything that or a lot of the things, materialistic things that they may not necessarily need. It's actually the meaningful stuff, the stuff that actually what makes us humans. But they leave everything behind for one reason, for safety, to flee war, to flee persecution, to find safety. And that's what exactly we did internally, whether we when we displaced in Afghanistan or later on when we migrated to Pakistan, and finally when I left Afghanistan to come to the UK, again, it was to flee war and and to find safety in the first instance and then secondly, to follow my ambition of to find actually if I could achieve my dream.

Dr Rupy: Yeah. And I'm glad we're talking about this because I think particularly in this country, there is a rhetoric around immigration, migrants that they come to the UK for a better life monetarily or we have a welfare system that they can utilise to their advantage, etc, etc. And I think, you know, just by virtue of you telling your story about how you went to Pakistan and then back to Afghanistan, even though you knew that there was still some, um, you know, sensitivities around conflict and stuff, that's where you're from, that's where you wanted to be. People don't leave those areas because of a better life in the UK. You know, there's so much more to life and community and where you are and friendships that that's what what grounds people.

Dr Wahid Arian: Absolutely. Exactly what you've mentioned, it's actually family members, it's the community, it's the friends that you've known all your life that actually what makes living enjoyable, what living is about, that you see happiness on each other's faces and you use the little you have to make a good life for yourself where you belong. But they don't leave all that to come somewhere else to find a better life. Some people do, so I don't disagree with that. Some people they do, but for us to find out who's actually fleeing persecution, fleeing war, or somebody else who is fleeing not persecution or war, but they're just coming to have a better life. That requires a proper assessment. That requires safeguards. That requires systems which are robust to make sure that it doesn't infringe upon the human rights of the many people, the thousands upon thousands of people who actually flee war. So we can't label everybody as having fled to come to the UK or another country for a better life and vice versa as well. I fully agree that there has to be a discrimination with that. But for us in order for us to do that, we can't create umbrella systems to brand something or to say that from now on nobody can cross the channel because it's going to deter human traffickers. That's sort of using an umbrella statement never works. We're humans. Each one of these people who are taking these very dangerous journeys to come here, they do it for a reason. And that's what we need to find. We need to find out exactly their life stories, exactly that you're talking to me, finding about my life story. Every refugee has a story. And and the only way for us to tell that is that if we have a good application system, a good, a humane system where they can be treated as humans, they can be looked after mentally, physically, and and socially. And that's actually the basis of their health as well in the first place. Then we would be able to tell, you know, who requires support, what sort of support they require, and amongst them, if there are some who are not really, shouldn't be here, then fair enough, they could be given protection, given safeguards, and and and all that, they could be returned back to places where they're safe. But not everybody, we can't label everybody.

Dr Rupy: Yeah, yeah, exactly. I want to get on to the part in the book now where you make the decision to come to the UK. What what spurred that decision on and how did you get about doing that? Because it just seems so far removed to even be able to have the opportunity to to to come here.

Dr Wahid Arian: So before making that decision, we um, during the internal war, when we went back to Kabul, Afghanistan, the civil war that started, we migrated again to Pakistan. We went back to the refugee camp because the war was so bad. And back in the refugee camp, because I was old enough at that time to look for education, to look for some sort that I could do something with my life. I know subconsciously I wanted to become a doctor, but I had no clue where to go about it. The schools in Afghanistan were shut. Usually we would when whenever we had a chance to come in, we would talk with each other to find out who had lost family members, who had lost friends, and the teacher would be telling us stories about conflict. It was not about math, science or um any of that. So most of my education did happen during conflict. It was in cellars. Whatever books I could find on the streets, I would just grab them or my dad would grab them for me and I would just start reading them at nighttime, um, whether when the bombing was not there, we would go upstairs into a room and when the bombing was there, we would go into the cellar with a lamp to read whatever I could under a desk. So that was when I became so inspired to find ways so I can educate myself, opportunities. And I was absolutely thirsty for those opportunities. So when we back to, when we went to Pakistan to refugee camp again, I looked for those opportunities where I could study. And there was a a center, an institute, they call it the Islamic university. It wasn't actually a proper university. So it was an institute where you could go and get educated. So I started reading, preparing for that. It had an entrance exam. I went to a local school and I told them that, yes, I've done my schooling in Kabul, Afghanistan. I just wanted to bypass the whole thing. And they asked me, okay, the exam is in two months time. I had to prepare for the school matriculation exam. Actually, they passed almost everybody because they just wanted to sell the certificate. So they gave me a certificate as well. I went into this institute. It's was supposed to be a medical school, but it wasn't a medical school, but it was mainly teaching us right from the start of how a cell works, the basics of biology, the basics of chemistry, maths and so on. And that's actually one and a half year that I remember that I had good education over there, which was the equivalent of GCSE, but the rest of my education was all over the place. So I learned a lot of things the wrong way and many things the right way. But during that one, one and a half year, when I got the foundation of the science, I equipped myself with that. But then I had to give it up. I had to give it up because I didn't find the reason for me to continue for another five years learning at this Islamic university because the certificate was not useful anywhere. It was not even acceptable in Pakistan to practice as a doctor. So it was only acceptable in the refugee camp. Even it was not acceptable back in war-torn Afghanistan. So I had to abandon that and kind of my hopes got smashed completely to pieces, not being able to find a way to study medicine. I went back to Kabul, the Taliban were in power at that time. And I was helping my dad drive his taxi as well from time to time. I had no license, but there was hardly anybody on the streets. And it was the Taliban that we had to take from one part of the city to another and they would be paying us. And back there I realised that there was a threat to my life soon that I would be recruited to fight on the front line and not being able to achieve my dream to become a doctor because the universities were shut. There was hardly any education. So the combination of trying to survive one and then being able to find somewhere that I can educate myself was the motivation for me to flee Afghanistan. But we didn't know how to do it. There was no way, there was no easy way to do it. You can't just go to an embassy. And that's exactly the point I really would like to emphasize here as well. There are no legal routes for refugees to flee conflict zone. I know I'm talking about my story here, but the case is still present. I talk to my family members in Afghanistan, I talk to people in conflict zones through our charity, International Telemedicine charity that we do. There are no proper resettlement routes available. Now we they're talking about resettling, for example, the interpreters who had worked with the British army, who had worked with the American forces. But such systems were not available at those at that time. And how about the millions of other people or the thousands of other people who need to survive? There are no legal routes for them. We didn't have any route. So we had to find, ask local people how they managed to flee the country. And one of the people who I was studying with in Shamshato camp in the refugee camp in Pakistan, I had heard about him, his name is Hakim, that he had fled to the UK. I spoke with him on the phone and he told me, yes, life is um, in the UK, they're very hospitable, they're very compassionate and they allow me to work and they um, and I asked him, can you study? He said, yeah, I can study. I'm not studying, but yes, you can study. So for me, that was at the back of my mind, two things. One, it's safe that I can flee conflict. Secondly, there was an opportunity for me to study. So that was something I really aspired to do to flee the country. But then we had to find ways to do it and I had to find people which later on turned out to be human smugglers to which asked for a lot of money. Initially, they sold the concept to us saying that you will be, we're going to get you a refugee status visa all the way from one of the countries, which would be UK, Germany or America. But it will cost you a lot of money and it will cost you some time as well because they will assess you and all that. So and that brings me to another point is that refugees don't really necessarily understand the parts they take, the routes they take. They're so desperate to flee conflict that they would take any route. It's the alternative is dying. So from that, any other route goes. Hence, a lot of people they take these really dangerous journeys, whether through sea, through air, to flee conflict and to find safety. And that's what happened with me that we paid a lot of money, thinking that the visa that was given to me was actually a refugee status from the UK. It later on it turned out not to be a refugee status. It was a fake passport that was given to me by the human smuggler, and he was a human smuggler. And but it got me to the UK here. And that's back in the UK, I found that out that how much of a risk I had taken by my parents selling the house to to selling everything they had to get that visa for me in order for me to flee the country for my safety and then to be able to pursue my dreams here.

Dr Rupy: Yeah, yeah. I think any family listening to this would do exactly the same thing. And to give some context, you know, the reason why initially your family fled Afghanistan was because your father was of conscription age and you only returned until he was past that age and you were coming up to the same issue, that red flag of of, you know, you being conscripted to work, to to be part of the military. Um, and it's uh, it's incredible that, you know, your family made such sacrifices to do that. But like I said, it's something that everyone would want to do and aspire to do if they had the chance to do so. And when you got into the UK, what was your experience? Because I I imagine pretty much immediately they recognized that you had a fake passport.

Dr Wahid Arian: It was, it's a long story there. Um, it's uh, when I arrived back here, they I was um, handcuffed, I was taken by the police. There was an incident on the plane where I was traveling with two other refugees from Afghanistan. We were given instructions to destroy our passports upon landing here, but two other refugees, they went and tried to burn their passports in the toilet on the lavatory on the plane. When I tried to do the same thing, there was already smoke from the other two passports and then they realised that they might be burning the whole plane down or something like that. So they called for a police force to arrive. When we arrived in Heathrow, we were welcomed by so many police cars. We were handcuffed, we were taken to a cell, um, and interrogated. But the interrogation mainly actually went on for a couple of things. That was for having the fake passport. That was the main one there that although I was telling them, you know, I've fled Afghanistan, you know, I've been given a refugee status, you should actually check your records. This is exactly what the people told us. He said, no, this is actually a fake passport that was given to you and we are charging you for it. And I don't know what charging means at that time. But then, you know, whenever we talk about adversity, we talk about human compassion as well. I was very lucky to find Hakim again, my friend Hakim. He found, I found his number, I called him from Feltham, which I was locked up in Feltham there. Um, and I told him that this is where I am. He was absolutely bemused. He's like, what on earth are you doing there? I told him the story what had happened. He came, and then he found me a solicitor. He found me a solicitor which later on sent a barrister to fight my corner in the court. And he did an amazing job and I'm still in touch with that barrister still. He he actually was the one who took me to Cambridge University years later to to take my equipment and everything that I had with me to move me back there. Again, my point here is that the kindness that was shown by Hakim, my friend, then by the barrister to fight on my corner, then he gave me his card as well. He told me he knew I was so vulnerable. I was 15 years old. I was absolutely over the moon because I was safe. You know, I didn't care about anything else. I was just safe here. But he knew that I had a lot of other challenges to go through. He gave me the card and he asked me to contact him whenever I wanted to, if I needed help. And then when I continued my aspiration or my kind of my search for education, I went on to work during the day and at nighttime I started studying and finally when I got my AS level results, A grades at my AS level results, I called the barrister and I told him the good news. He couldn't believe me that I had achieved that.

Dr Rupy: Because I mean, you you hardly spoke English at that point, right? I'm assuming your education in English would have been from TV or VHS videos at the time, because this is pre-2001, so this is, you know, pre all the checks on the planes and and all the rest of it and and quite early in technology uh uh standpoint as well.

Dr Wahid Arian: Yeah, absolutely. So I had my grammatical English wasn't bad, um, because I'd learned from books. So I knew kind of my grammar, but my spoken English was not good. Um, so I had, it was really, really patchy. Um, and I had to quickly learn my English. I was practicing my English when I was working in shops on Edgeware Road with customers. And I was also working as a kitchen porter as well. So I would use any opportunity to practice my English, but behind all that, my aim was to get to university. And I had soon found out about ways to get into university. First, I asked the local refugees how I could actually become a doctor. Within a few weeks, well, first of all, what I did was that I was so desperate to find a job because my family was still suffering back in Afghanistan. We had a huge family. The Taliban was still in control. So I had to find means to pay for their expenses as well, as well as for the large amount of money that I took for me to to come here to the UK. So within a week, I went to find a job on Edgeware Road. Again, you know, I saw kindness in the eyes of this Irish man who gave me a job within me having any sort of documents or anything else. He took mercy on me and on and it was my persistence as well, even though he was pushing like he wasn't sure I was too young, I'll be able to work. But I sold it to him that I could actually sell his perfumes, his the cards that he had. I told him that I could speak Urdu, Hindi and Arabic languages. So he was taken by that and then he gave me the job. So I started working within a week and that and then I started working at the kitchen porter and did some cleaning jobs around as well. So that was how I used daytime, seven days a week to literally be able to pay for my expenses, as well as for the expenses back in Afghanistan. But I soon turned my attention to education. I asked the local refugees who I found out from one another through Hakim. And I asked him how I could educate myself. And they actually all advised me against it. Most of them, they advised me against it. They said, well, we know where we're coming from. We hardly been educated. So they didn't mean any harm, but what they were trying to tell me is that for me to be smart about using my time, because in Afghanistan, so many families depended on us. So they said, why don't you just keep working hard to make sure that you are able to support yourself, your family members. You can work in a chicken shop, then you can start to become a taxi driver and then one day you will become the owner of a chicken shop. So for them, that was kind of the cycle that they were used to. That was the vision that they had coming here. And of course, these are all hard working jobs. I really admire them very, very hardly, but you know, to become a chicken wing specialist was not something that was my vision. For me, it was more to become a doctor, to heal, to heal my family, to heal the people who I had seen so much suffering amongst them.

Dr Rupy: Yeah, yeah. I mean, reading your story when you when you got to, how old were you when you arrived?

Dr Wahid Arian: 15.

Dr Rupy: 15. Okay. So you're a mid-teens, you come here, you move into Portobello Road, I believe it is, um, with some other refugees, uh, all sleeping around, you know, in a in a place that's far too small for you guys. And you're working at Edgeware Road, you're working a number of different jobs to make ends meet and to send money back home as well to support yourself. And on top of that, you decide to do your AS levels and A levels to chase your dream of being a doctor. Which university did you go to, uh, college did you go to during that time?

Dr Wahid Arian: So I, first 99 until 2001, uh, sorry, 2000, I was purely working and I was trying to polish my English first, to read up on my English, and I also did GCSEs actually on my own on way to to work on the buses, on on return journey from buses late at night. And I love those journeys. The London buses, when I see look at them now still, I remember I used to like sitting right at the front and that would give me a sense of freedom that I'm finally free from conflict. I'm finally free that I can actually breathe. Um, that would make me so happy those small instances, but that's when I used to study as well, my English as well as for GCSE subjects. Then from 2001 to 2003, that's when again, I was working during the day and at nighttime I was studying. And that education went in three colleges because I was not allowed to work for more than 16 hours in one single college because I was at the time also on paying, getting housing benefit, which I couldn't afford to pay for Portobello rent at that time, huge rent and I had to save money for myself and pay for expenses back at home as well. So the three colleges were Made of Vale, Westminster, Kingsway in King's Cross and Hammersmith College. And I had to juggle between various subjects and and try to make a way out of it.

Dr Rupy: Yeah. And you had this instance where you're applying for medical schools and you got some advice from um, a college tutor about which medical schools you wanted to apply to. And you mentioned Cambridge. Um, what was their reaction when you said that?

Dr Wahid Arian: Well, I to first of all, actually about Cambridge, um, applying to Cambridge was not my idea. Um, I was working for British Gas as a salesman at that time. That was another job later on that I found. But through that, um, I came across a graduate student from Cambridge University. Um, when I saw him, he asked me what grades I had at AS level. I told him I got all A's and he encouraged me to apply to Cambridge. Then he took me on a tour to Cambridge. I was absolutely blown away. I was so inspired. Um, and I went on um, there were some open days as well and the Trinity Hall College, the admissions tutor, Professor Bradley, he was very welcoming. That really inspired me to apply. Then I came back to my college, which was in Westminster, Kingsway. And I told my tutor, I told him that I wanted to apply to Cambridge and they kind of the huge bemusement on their face and said, well, you know, are you sure you want to do this? Because you're going to burn one of your UCAS places. You're only allowed to apply to four medical colleges, so you're going to burn. So that was not very encouraging. And then when I insisted that I wanted to do that, um, to apply and I needed some help with my application as well as with my interview, then they referred me to somebody who was locally known as as one of the tutors who would prepare students for interviews. Again, when I went into that preparation room with him, he focused mainly on all the things I didn't have to apply to Cambridge. For example, not having GCSEs, not being white, not coming going, coming from from a private school. Um, and everything he could find negative, he just put it in front of me. He said, this is exactly what's wrong and why we don't want you to burn one of your places. I think he didn't mean harm there, but he was just so pessimistic about everything there that I actually I just wanted to get out of that room. I came out of that room, I burst out crying and I was really heartbroken that nobody was trying to take me seriously in that sense. But I gathered my thoughts and actually that's how I use my self CBT as well, the coping technique that I've used all my life, trying to hang on to small bits of successes. And for me, I just told myself that, hang on, I've actually survived the bombs in Afghanistan. I've made it on my own to this country. My family is still alive. I'm so thankful for all these things. I'm so thankful to be able to breathe, to be able to have a roof over my head, to be able to to eat, which I didn't have these opportunities to have good nutrition. So what is it? You know, I lose one place, so be it. I don't care about that. So if the Soviet helicopter gunships didn't take me down, I don't care about not applying to Cambridge. And that's sort of the attitude I had built at those times that kept pushing me towards actually getting my good grades at AS and A levels as well because I was competing with people whose English was absolutely amazing, the writing, everything was really top notch. So I had to put actually double hard work. It wasn't that kind of like I came in with so much educational background that I could rely on. So I really worked double. I I bought the past papers for so many years. And instead of one or two years as somebody told me that if you work through past papers for one or two years, you will succeed. I actually bought five years worth of past papers because I didn't want to take any chances. So whatever I didn't have actually for my background, I actually made up for it through my sheer dedication, through my sheer hard work. And I remember coming to the UK with $100 in my pocket, but that sheer determination, that steel-like will to be able to succeed continued with me and that kept pushing me as well. But it was quite complex the situation for me on the other hand was that I started having these nightmares. I started having these flashbacks as well, which was something I did not know what it was. And that was again, I was using the tested mechanisms and the coping techniques that I've built, for example, doing exercise, um, to to cope with my loneliness, um, using self CBT, and also the gratitude that I was using plenty of that as well and my faith to to never give up on hope. There's always hope. And for that, for me to be able to serve my family was one of the greatest honors. And that kept giving me that more reward internally as well. But those sort of instances kept coming that whenever I was standing near a tube, the sound of the tube coming past near me would just make me jump. And I didn't know what it was. Or for example, when I was walking on the street in London, I would just suddenly see a tank coming towards me and trying to fire at me. That sort of flashback and those nightmares, they kept coming. Sometimes they would go away, but whenever I spoke with my family, they would come back. And later on, I realised that they were actually symptoms and signs of the post-traumatic stress disorder that many people living through conflict zone, they suffer from it. There's a very high proportion of people who when they leave conflict, they come with that mental trauma.

Dr Rupy: You talk about having this vision for your reality, these four walls, education, an idea of where you were heading and that's essentially what you manifested when you went to Cambridge and I remember you describing the four walls of your accommodation and the lawn outside and being in this incredible institution. I imagine the culture shock of first going from Afghanistan to London and now London to Cambridge must have been huge. And then also you had the PTSD flashbacks to to to come and deal with as well when you're at Cambridge. How was that?

Dr Wahid Arian: So at Cambridge actually, the social isolation came a lot more to the forefront because I was running on pure adrenaline for such a long time that I didn't have time to reflect on what had happened. In a way that I had boxed my old life, the years that I'd lived behind me in conflict zone in a box and I thought that for me starting a new life is just like that, it's so easy. But I realised soon in Cambridge that I was actually at an extreme disadvantage. One, socially I didn't have anybody. There would be families who would come in every month or so, they would bring him food, they would see the young kids growing up and adjusting to the university system. I didn't have anybody with me. Secondly, I would struggle actually financially as well because I was still trying to pay for my own expenses, my younger brother who came, my younger brother who came in as well, I was looking after him, but also I was paying for family expenses as well there. And I had to hide all that from the tutors because we were not allowed to work. But also what happened was that it was a shock for me as well, not having a good educational background backfired here. I didn't know how to actually study. For A levels for me it was a bit easier, not easier but on the easier in comparison to Cambridge because I relied on past papers, I relied on putting everything into my memory but at Cambridge it didn't work. So I struggled the first year and the first couple of years I struggled and I had to figure out how to learn. I had to figure out how to compete with all those students who are coming in top of their classes from so many amazing places that they would be just absolutely fluent in everything. I wasn't fluent. But again, I didn't give up and I knew that I was at a disadvantage. I was struggling socially, financially and mentally as well. And I think that affected me even more at that time that I realised that I was actually a proper outsider. Although I was now safe, the conflict wasn't there. I had all these amazing things that I never had, but I was very lonely and mentally it wasn't in a great place, but I kept going and I still kept using the same coping mechanisms which was my faith, having being able to look at the positives, to to have gratitude for the smaller things at nighttime, early morning. Exercise was a huge thing for me. And slowly I paid attention to my nutrition as well because at that time it was all over the place. I was young but I slowly found out more about nutrition, how nutrition actually worked, not in a lot of detail but even on a macro level, you know, I need to have my vegetables, I need to have my fruits rather than spending hours and hours on Red Bull trying to, which was actually the case. It was I was running on pure adrenaline, completely on on sleepless nights when I was doing my A levels but at university I had to readjust things and I had to look at things a lot more in that sense.

Dr Rupy: Yeah, no, it's incredible. It's an amazing campus and uh, you're right, it's an incredible opportunity to to to study at a world-class institution. Uh, our experience of medical school, just hearing your journey was just so vastly different and I can understand why you might have had some issues, particularly in your first year at Cambridge of integrating into that medical sort of fraternity, sorority, whatever we call it these days. Um, and you ended up going to uh, Basildon, um, which also was the university, which is the uh, district general hospital that I ended up working at as well in my F1. Yeah, so I remember those long corridors and those nights as well and like the incredible staff there as well, like uh, Dr. Remon, who was the um, endocrinologist there. Um, we got on really well. And I remember the radiologist who, you know, you've obviously worked with an incredible amount since then. I forget his name now. You mentioned him in the book. Um, gentleman.

Dr Wahid Arian: Dr. Sameer Khan.

Dr Rupy: That's it. Yes, Dr. Sameer Khan. I remember as an F1, uh, having to go and speak to him about a CT request and I had no idea what I was doing. And he was the nicest man, the nicest man, because for the listeners who don't understand the context, you know, when you go and speak to the consultant radiologist, it's a bit of a grilling, you know, it's a precious resource that we have in terms of radiology and the use of um, imagery. And so you have to present your case, almost like selling it to them. And I had no idea what I was talking about. I had no idea what I was there. So yeah, no, he's a lovely, lovely guy.

Dr Wahid Arian: He is, he's uh, actually he's one of the trustees for our charity, uh, for the Teleheal International Telemedicine charity and I keep in touch with him on a daily basis. He reports our scans now internationally coming from Afghanistan, from Syria, from Africa, and he advises actually on the education as well. So he's absolutely an amazing guy. And that's actually when I got inspired to become a radiologist. So first when I was at Basildon, when I started my foundation year one training, um, I met up like yourself, I had to go and ask him questions to get approval for one of the scans. Um, but prior to meeting Dr. Sameer Khan, I met Dr. Kaiser Malik, uh, who is another good friend. He's a radiologist. He introduced me to Dr. Sameer Khan and he told me that Dr. Sameer Khan, he really likes teaching. So I went to one of his teaching and he asked me questions what I wanted to do with my life. I had set my eyes on cardiology or general surgery. So I was torn between the two. And then he convinced me that I should do radiology. And I saw that radiology was central and pivotal to so many things in hospital setting. So by the end of my foundation year one training, I decided that I wanted to do and I did some audits with him as well. He allowed me to do write some papers. So I wrote some poster presentations as well, which I gave in Liverpool and some other conferences to build up my CV towards going for my interviews in radiology training. And I came back to um, in London to complete my foundation year two training in London. And after that, I went back to Basildon because I took a couple of years um, before I got into radiology training. And I used that time to do a bit of the equivalent of core surgical training as a trust grade doctor. So I acquired a bit more skills in that department and then in 2014, I started radiology training up north.

Dr Rupy: Yeah, yeah. No, it's an incredible journey. And I guess um, just before we talk about um, your your tele health charity and and the ideas that that sparked that. Um, you mentioned about integration and how uh, you struggled with identity, were you Afghani, were you British, were you both? Um, and I guess that came to a head when your your family and and as is the case in a lot of um, cultures from that region were sort of asking you questions about marriage and settling down. Uh, how did you, how did you deal with that? And obviously, you know, married and got kids now and very, very settled. Um, but what was that journey like for you?

Dr Wahid Arian: I think those experiences can be pretty personal as well. Um, I don't think I can generalise in that sense because people's experiences coming at what age they leave the country, what age they're settled, uh, the people they meet, some people might come across people that they've left um, a similar country, they're coming from a similar background, they might find it easier to talk about their backgrounds and they may have a lot in common with, but in my particular case, that wasn't the case. I hadn't met many Afghanis in London. I had met a few sporadically, but not people who are potentially that I could get look at as as life partners. And my idea was that, you know, one day I'll go back to Afghanistan, I'll get married there and it would have been easier in that sense that because the way I was looking at it is that I wasn't sure whether I would spend my entire life back in the UK or not. That was another issue for me. So I wasn't certain what was happening. But I also had the blessing of my family who told me that whatever made me happy that I should stick with that regardless of where that person is coming from. It's about love, it's about kindness, it's about life partnership for life that I should be able to find that person. And I was lucky later on to find my wife Divina, to meet her. But prior to that, I had a lot of conflicting thoughts in my head as well. Um, and for the reasons I mentioned, and kept going back and forth to Afghanistan to figure out if I had actually a future back in Afghanistan or back here. It wouldn't have been fair on if I got married back in the UK and then I deciding that, oh, I have to go back to Afghanistan. Sadly, when I went to Afghanistan on several occasions, I realised soon that my future was back in the UK. I had worked so hard and I knew that from the UK, I could actually help better in Afghanistan rather than me coming to Afghanistan and staying there. Although the Afghanistan reconstruction had started, the rebuilding had started, but there was a sense amongst everybody knew knowing the political system, knowing the building of Afghanistan wouldn't be that easy. And sadly, that's the case now that the war has intensified. There's a lot of war ongoing at the moment. Um, but coming to my own personal life, I made a decision that I wanted to stay back in the UK and that's when I started looking for a potential wife as well and got on a dating scene and finally met my wife Divina in 2011 and we're happily married. We've got two children now.

Dr Rupy: Yeah. Oh, I'll save that romantic story for the book because it's uh, it's very well told as well, uh, about how initially you you were thought of as a a geezer from uh, Essex. I I we met in Barkley um, hotel where Divina was working as a supervisor there. I had actually met there with my friend Mark who um, we were going to have a catch up and I met Divina and I was blown away by Divina. I wanted to make a conversation with her. So I managed to find her phone number and then when I texted her for a coffee, then she discussed the possibility of meeting me for a coffee with her friends. And when I told her that, oh, I'm living in Basildon, you know, I'm a doctor in Basildon, that's when everybody thought that I was a geezer from Basildon, maybe a gangster there or something, somebody else. Obviously, not everybody in Basildon is.

Dr Rupy: No, of course not. But for some reason it has a bit of that reputation. Yeah, totally. Um, so you you mentioned there about how you you came to the realization you'd be able to help Afghanistan in a much bigger capacity from the UK and from your position here. When did you come across the idea for the tele health organization that you now uh, run, um, and uh, and what were the foundations for that?

Dr Wahid Arian: So the idea first for me, when as soon as I became a doctor in 2010, I started looking back into my initial vision that one day I would become a doctor and I'll start healing people. And that obviously at in the NHS, we heal people, we help people. But for me that I'd seen so much suffering around my own family, my own life, but also so many other people, that was my vision to be able to give back in some way that I could. I kept going back and forth to Afghanistan every few months during my leave and I went to hospitals, I asked them how I could help and to university as well. But I soon realised that actually on my own, I wouldn't be able to help too much. And for me to make that huge difference that I wanted to make, it wouldn't be through my personal experiences alone. And I also realised that there were so many other people in the NHS that they wanted to help. I would tell them stories about conflict, about Afghanistan, that how people they need support and they said, how can I help? But there was no way for them to take a leave. It wasn't safe for them to go to Afghanistan, and financially it wouldn't have been, they wouldn't have been able to do that as well so readily. So that made me think of finding a way to be able to connect healthcare professionals living in the UK, in first in the UK, now we've got volunteers from across the globe. But how people from the NHS could be able to help people back in Afghanistan, medical colleagues in Afghanistan. It took about four years. Initially that from me trying to help and then trying to recruit people to come with me, that didn't succeed. And until finally I came across the idea of telemedicine. MSF was doing it at the time. It's not something I invented, but MSF was doing it in the capacity in the store forward that they were sending cases not in a live too much live emergency but more in a store forward sense that in a non-emergency scenario. And I also saw that in Afghanistan, in the villages, back in hospitals, everybody was using smartphones. They had really good smartphones with good cameras and they were using social media as well. And that was the light bulb moment for me to find out how we could actually tap into mobile phones and social media to be able to connect healthcare professionals from the NHS to healthcare professionals on the ground in Afghanistan. I didn't know how, I didn't know if it would be possible, but as soon as I looked into that idea, I actually started pursuing it more. And I discussed back with the medical professionals back there. I started collecting their phone numbers. I even told them that I've got a huge pool of volunteers sitting back in the UK who wants to help. And that wasn't the case. But I was visualizing in my mind that that would be the case. And convinced that side, then I convinced the hospital chiefs of the hospital to allow us to do something like that. And I came back to the UK. When I came back to the UK, I it wasn't too difficult for me to sell the concept because people are compassionate, people are giving inherently, almost everybody has that ability in them to give, to be kind. And for me, it was just telling those stories of what's happening on the ground, the resources, the medical colleagues are struggling with, the lack of expertise on the ground and for them not being able to go to conferences to upgrade their education of how much valuable all this could be if they're connected. But then the politics come into into this as well, dealing with Afghanistan politics is absolutely can be a nightmare. So I had to convince people in the government to allow me to connect because there's a lot of governance issues involved here. There's data transfer, there's clinical governance, there's political issues, and we had to take that permission from the Ministry of Public Health. But luckily the government agreed to that, um, and they allowed us to pilot with five hospitals in Kabul, Afghanistan first. And that pilot survey that we did around that showed that many lives were saved and the doctors had a lot of good things to say about the education, about their education that was enhanced through this partnership. That they allowed us to roll the entire Teleheal system to throughout Afghanistan. And we signed an MOU, a memorandum of understanding with the Ministry of Public Health and they let us get connected to 14 emergency departments and ICU departments throughout the country. So in summary, um, Arian Teleheal, which is the name of the International Telemedicine charity that I lead, was founded in 2015. Now we have more than 150 volunteers coming from the various specialties, but mainly we support emergency departments, as well as mental health front in Afghanistan, in Syria, in parts of Africa. But we also now enable other international organizations. So one, it's our own volunteers from the NHS, from US, Canada and Australia, who dedicate, who allow their time very kindly to be used by medical colleagues on the ground. And they use a system called what we call as reverse innovation as well. So through that, a lot of learning that happens, a lot of the experiences that happen on the ground are absorbed by our colleagues here. We on our system, we do have the registrars as well who keep learning from those experiences. So we help the NHS, our colleagues who have never been, who would never be able to see a very extreme case of tuberculosis, for example, they would never be able to see a bomb blast on a regular basis that happens in Afghanistan or the trauma as a result of that, they see it on their smartphones. And they allow that to happen in their free time, whether it's at home, whether they're sitting on a sofa, whether they're having a coffee in hospital, they just look at their phones on their secure social media and that's how they're connected to medical colleagues thousands of miles away. They say hello to each other, they learn from each other, they save lives, but also it promotes dialogue, it promotes peace amongst them. And that's I think dialogue, misunderstanding to to remove that misunderstanding through dialogue is a key to peace and that's actually the long-term vision for our charity is to be able to keep enhancing that dialogue across the globe in a very neutral format, in a very compassionate, in a very giving format, that's medicine. And our charity also enables other organizations to operate similarly. So we kind of giving our blueprint to organizations and governments and that includes to World Health Organization for which I'm also serve as a digital health expert. Um, and we have given it to MSF, um, we've also given it to Health Education England to support some of the fellows who travel to Africa, South Africa or other parts of India on a six-monthly rotation. Now we've got an amazing partnership that's going on with the British Association of Physicians of Indian origin. So within the space of one month in response to the COVID pandemic, they managed to recruit more than 650 volunteers um, from across all the specialties. And as we speak now, the cases are ongoing on the phone, I can see them. So they these volunteers are connected using a very similar format to the Teleheal. So we are one of the partners, so we're giving them the blueprint, but they're now using it and they're giving advice to junior doctors or colleagues back in these hospitals in India. And at the same time, they're learning from them as well, you know, to see exactly how they're dealing with these devastating effects of COVID in in various part of India. So they show solidarity, they exchange knowledge with each other, they exchange experiences with each other. And this is something so rewarding that I see it on my phone that Teleheal has now expanded to such an extent that now what we save lives, our volunteers save lives themselves, but then we allow other organizations to do it as well.

Dr Rupy: Yeah. I mean, I know you're a very humble person, um, and the way I keep on describing your your story is incredible, but you know, to coordinate uh, the inception of a charity during your radiology training as well, I mean, that must have been quite a feat. And just for the listeners, because um, a lot of the listeners aren't aren't medics, can you give an example of how uh, Arian Teleheal will coordinate a dialogue between a physician in the UK or somewhere somewhere else with a physician in an ICU or an accident and emergency uh, doctor in in Kabul or or another area of Afghanistan?

Dr Wahid Arian: So for example, um, a case could come from an emergency department in Afghanistan. Um, this case could be um, a road traffic accident, somebody has been struck by a car, they come to the emergency department. Then the doctor who's dealing with that case goes through procedures to stabilize that patient. First of all, make sure that the patient is survived that the immediate impact of the trauma by lying him down, by making sure that the neck is secure, and they take some x-rays. Those x-rays images or the CT scan if available, those images and x-rays are all sent to us on smartphones. They use WhatsApp. So they use WhatsApp, they take pictures of those images, the CT x-ray scan, the lab results, they summarize the case, the history of it and what they find on the by examining the patient, they send it all to us to one of the coordinators in Afghanistan, it's myself still. And that coordinator then looks at the case as a whole to see what specialists are required for this case. For example, a radiologist is required to report the x-ray or CT scan. Then you need an orthopedic surgeon to comment on what's happening with if there is a fracture. If a neurosurgeon is required, for example, if there is a bleed, then we send that case to a neurosurgeon as well. So various specialties now are involved in this case, but all surrounding that case which is an emergency to deal with, they give their opinion of what is happening and what should be done next to the medical colleague in Afghanistan. And the coordinator takes all that advice back. In this case, it's all live. So the chat is going live between the medical colleagues on both ends. Um, and that patient actually does survive because the advice that's given of what to do next on how what steps should be taken after the initial management, whether it's four hours later, six hours later or or a day later. We had a similar case that came from Syria. It wasn't a road traffic accident, but a similar emergency case that a young child who had diabetes, born with diabetes, had diabetes, but was in a coma and they didn't know what the management of that child would be because it's such a specialist area. That case came in at night when I was just finishing my emergency department shift. The case came in when I looked at it, I immediately sent it to one of our pediatricians, child specialist. That pediatrician immediately coordinated and advised on exactly what fluid management that child should have. Even the fluid management for children is so complex that even if you ask me off top of my head, I'm an emergency medicine physician now, I couldn't tell you. I have to look it up. So you can imagine how doctors actually in conflict zones with very few resources have to struggle to figure out what to do and what not to do. They send us a video of that child, exactly how much fluid were they on, what they're taken, what medication she was on. And this pediatrician actually from Basildon, Dr. Sanjay Rao, he's my tutor, so he signed up for Teleheal as well. He's still one of our kind volunteers. He was on it and the whole night he was advising. There was another colleague of mine, colleague of ours actually for Teleheal advising from Canada as well, another pediatrician. So they were both advising on that case and the next day they sent us a video of that child walking with a cucumber in her hand. And in many instances, a case like this would have ended absolutely in disastrous consequences. For us, we were lucky that we had a specialist who could advise on that case. And we've got similar cases coming with COVID as well. Patients coming in, for example, in hospitals in India with severe cases of COVID pneumonitis, the whole lung is taken by the virus and but superseded actually by other bacterial infection as well. So very complex cases and all that is now discussed with our acute physicians from the British Association of Physicians of Indian origin, BAPIO, and they give advice. They also now provide virtual ward rounds as well. Every day of the week, we have virtual ward rounds. They collect the cases and one day, one of our specialist volunteers, he goes live on Zoom and a colleague from one of the hospitals, they ask them all these questions they have collected around all these cases. So whatever question they fire at them thousands of miles away here, that doctor tries to answer them or vice versa, if that doctor is educated by the colleagues on the ground as well. So that's how the reverse innovation happens and it keeps happening and the lives are being saved at the same time.

Dr Rupy: When you look back, um, and you think about you as that six-year-old child in the middle of a refugee camp, um, who was fighting malaria and then TB, and your journey thus far to now coordinating and having started an international organization that is providing life-saving treatment and advice, facilitating reverse education, um, being invited to the Global Hope coalition, doing trips to New York City and being in the presence of uh, UN leaders and celebrities, having BBC programs about your life and and the incredible work that you're doing with Arian Teleheal. What do you think?

Dr Wahid Arian: It's it's really difficult to put it into words. I think one thing I would say is that um, for me it's about the mission. For me it's never about actually my own life. And I think that's something that keeps me going is that the mission is not accomplished. Personally, yes, it was about me to get education and that's something that I treasure all my life that I managed to escape conflict, I managed to come find safety and then get education. And with my first salary, I bought watches actually for my parents and that was something that, okay, this is me done now. I bought gifts for my, especially coming from an Asian family, you have to buy something for your parents with your own salary so they can feel that you have provided. Regardless of all the help, the money I was sending throughout my early teens and all that, that didn't matter. What mattered was that I was a doctor, I was earning a salary and I was with that salary I bought those watches. So that was for me personal satisfaction. But beyond that, everything else was about the bigger vision. And if that's something that I could advocate to to listeners here as well is that the larger the vision, the more inspired you will become, the more fire there will be in your belly every morning that you wake up that you could do something with your talents, you could do something with the amazing network of professionals, of colleagues or friends that you have. We can't do it on our own as well. That's another lesson that I've learned throughout my life is that it's actually with the power of compassion that so many other human beings have. If we tap into it, we can actually solve so many big problems in the world. It's not just about the money, it's not about technology. Yes, I am the one of the World Health Organization digital health expert, but I hardly talk about technology. That comes quite at the at the end of it. It's actually about solving a problem and having that fire in us to be able to solve that problem. I mean, passion. And the bigger that problem, the bigger our vision. So that's the simple formula for innovation for myself, which you're doing as well, Rupy. I know you're doing amazing work that I'd love to hear about your nonprofit organization. And you're a fellow NHS clinical entrepreneur. So I would love to know how you've used innovation as well to do that. But to summarize all that for me would be that having that fire that was built or that I got in refugee time, I was lucky to have that early on to have that seed of passion in me to become a doctor one day to be able to heal. And now I keep making that vision bigger, bigger, bigger every day. But the principles are the same. Some days which I have, you know, I'm disappointed, some things don't work out and so on. All I do is just I look through some of the pictures of the refugee time or some people who are suffering from conditions. I look at the reports and it just starts burning that fire back that I can't give up. You know, I can't, there's so many people who are suffering, not just in conflict zone and low resource countries, back here in the UK as well. There's a lot of inequality when we look at it from inequality in access to mental health, for example. You know, so many people are suffering as a result of the pandemic, they've suffered. They don't have access. We see it on the tipic end, they come into emergency departments with full-blown crises. We see them trying to, very sadly, to take their lives, taking overdoses, self-harm. And and that's really heartbreaking for me and that's something that I'm putting a lot of efforts into now how to be able to find a solution for that. And unfortunately, the NHS doesn't have the capacity to deal with all these mental health problems that existed before and especially after the COVID pandemic, the mental health issues, that's a parallel pandemic that we probably are underestimating at the moment. But that is coming to a point that we need to address it. And that's something that keeps me awake at late at night as well that how I could actually use a similar system to Teleheal, which I've founded now, the Arian Wellbeing, to be able to connect the mental health experts across the country and maybe later on across the globe to be able to address this mental health issue. It's not easy, but it's something, it's a huge problem. And coming back to my initial point is that the bigger the problem, the more inspired one can become. But it's small steps. It's small steps every day that we take, whether it's speaking to one expert, to recruiting one person, doing one email or that, this all can be very rewarding, but as long as we are looking at the problem in a bigger scale in a few years time that we are going to solve.

Dr Rupy: Mate, that's uh, it's it's that's I'm just sort of blown away by your your vision, your tenacity throughout your life, you know, it's uh, it's incredible. And it's it's an absolute privilege to to have you on the show and and talk about your journey. Um, there's so many elements of your story that we just didn't have the time to talk about, but everything's in in the book and uh, I just wish you the biggest success with uh, both Teleheal and uh, the wellbeing uh, elements as well. And uh, oh, my um, my puppy has come to say hi. This is uh, Nutmeg. She's just, she's called Nutmeg. She's very cheeky. Yeah, Nutmeg.

Dr Wahid Arian: She's very. We have two Chihuahuas. We had two Chihuahuas. One was Louis and Pushkin. Louis, Louis died last year, so we have Pushkin. Nutmeg is absolutely gorgeous.

Dr Rupy: Yeah, she's a she's a cavapoo and she's um, she's very uh, cheeky and naughty. She shouldn't be in here. She just pushed open the door and so she just came in.

Dr Wahid Arian: They always push the door open, no matter where you are. You know, they they show so much love.

Dr Rupy: I was really against actually getting a dog, um, but uh, my my girlfriend uh, managed to convince me last year and I think it's just the best addition to our household. So I'm very lucky.