Salim and Monty
After suffering serious injury in Libya's civil war in 2011, Salim Elmajbri (R) came to UHN for treatment through the Libyan Medical Evacuee Project, where he first met Monty Al-Rubayee, the project coordinator. The two are now clinical colleagues at UHN. (Photo: UHN)

When he saw the scrubs, Monty Al-Rubayee couldn't believe his eyes.

"I was happy, confused … ," says the ward clerk in Toronto Western Hospital's (TWH) Emergency Department (ED), trying to find words for his surprise. "It was the best news ever!"

The "news" was standing in front of him in the form of Salim Elmajbri, a newly-hired patient care assistant (PCA) in General Internal Medicine (GIM) who had been looking for Monty, a connection he had made long ago, under completely different circumstances.

Ten years ago, Salim was living in his home country of Libya and studying to become a doctor when civil war broke out. As revolutionaries mounted an attack across the country to oust Libyan dictator Muammar Gaddafi, Salim joined the war effort as a medic to show support for and help his country.

"It was a very scary time during the war, there was fear of death, fear of so many things," he recalls. "But I was excited to help treat my people."

Six months into the fighting, Salim was severely injured when the ambulance he was travelling in was bombed near Tripoli. Salim was the only member of the ambulance crew to survive the blast, sustaining serious damage to his left hand and ankle.

Project helped young Libyan men overcome serious injuries

Lacking the necessary resources in Libya to get treatment, the injuries soon became infected and Salim eventually couldn't walk properly without significant pain. The new Libyan government, implemented after Gaddafi's removal, reached out to other countries to get medical help for the many fighters wounded in the war.

Assessments through European programs recommended amputation for Salim's injuries: above the elbow for his hand and above the knee for his leg. Salim thought this would be his only option until he heard about a program being offered in Canada.

Enter UHN's Libyan Medical Evacuee Project, designed to provide medically and culturally appropriate care to treat war-related wounds, injuries and disabilities.

As war raged across the north-African country, a group of Libyan-born Canadian physicians sprang into action to help their countrymen. The group formed the Libyan Medical Committee of Canada (LMCC) and partnered with UHN to bring wounded Libyan fighters to UHN to treat their devastating injuries.

"The intent of the project was to help a whole generation of young men, who had serious injuries to overcome, and give them the ability to return home to live successful lives," says Marlene Borenstein, an occupational therapist (OT) who supported the project as both a therapist and project coordinator, helping the patients navigate their care.

Supported by funds from the Libyan government, LMCC coordinated with boots on the ground in Libya to find appropriate patients for the project, funded their treatment, provided cultural support during their stay in Canada, while UHN – guided by orthopedic surgeon, Dr. Nizar Mohamed, who designed the project – provided the medical resources and expertise for their treatment through Altum Health.

"This initiative really helped take Altum Health's care global for the first time," Marlene says. "The project ran from 2012 until the end of 2015, and we helped over 85 patients."

‘Now I am running!'

One of the project's first patients was Salim. His first contact upon arrival in Canada was Monty, who had started at UHN as a liaison with the Libya project.

"I was an interpreter, coordinated their transport, accommodation, all their treatment and recovery – the patients called me for every issue," Monty recalls fondly. "The project was really a beautiful achievement of UHN, lives were saved and it brought new life to people."

New life indeed. Though it took two-and-a-half years until he was completely recovered, the project was life-changing for Salim. TWH orthopedic surgeon Dr. Johnny Lau performed an ankle replacement to save his infected leg. Though four of his fingers needed to be amputated, a procedure done by TWH's hand surgeon Dr. Herb von Schroeder, he retained his left hand and thumb and was provided with a prosthetic.

"My hope when I arrived was just to be able to walk to the bathroom," he says, reflecting on his recovery. "But now I am running!"

Once discharged from the project, Salim no longer felt he could return to Libya. The political situation continued to be unstable and he feared for his safety. He began the necessary steps to stay in Canada and, with that, relaunched his dream to work in healthcare.

"Salim was very interested in the hospital and how it worked, we had many conversations about that," says Marlene, who had worked with Salim on setting goals for his recovery as his OT. "But he also had a significant injury, there was uncertainty whether he would return to the medical field in the same capacity as he had been before."

Undeterred, Salim – who had once been on the cusp of becoming a doctor in Libya – started over again, taking any opportunity to work in the health system in any capacity.

"In 2017, I started working at Sunnybrook Health Sciences Centre and SickKids Hospital in Environmental Services so I could save money to pay for training as a personal support worker (PSW)," he says.

"I just wanted to be close to medicine again."

‘He's like family'

When the pandemic hit in 2020, Salim had earned his certification and knew exactly what he wanted to do. He applied to work on the COVID units at UHN.

"It was a different kind of war," he says.

As Wave Three of the pandemic receded, Salim was able to stay on working part-time as a PCA in GIM and the ED. Now on the clinical side, he went in search of his old friend.

The reunion was "bittersweet" – with COVID-19 restrictions in place, the two couldn't hug – but it was nonetheless emotional.

"Monty is my first connection in Canada," Salim exclaims. "He's like family."

Salim loves working at UHN and is so proud to be part of the team. But he wants to take his career further and has applied to the University of Toronto to become a physician assistant. More importantly, after his long ordeal, he feels safer and is ecstatic to be reunited with the people who got him back on his feet.

"I'm so proud of him," says Marlene. "It's just fascinating how, people whose worlds have been completely torn out, what they decide to do. 

"Salim is living proof of how you can have a bad thing happen to you, and turn it into something good."

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