LETTER Shoulder-to-Shoulder Capacity Building with Colleagues in War-Torn Kurdistan, Iraq: An Equal Opportunity, Non-Partisan Endeavor In reply to Demirer and Colleagues Quyen D Chu, MD, MBA, Renas Zibari, BA Shreveport, LA Thai Lagraff, BA Schenectady, NY Anand Annamalai, MD, Sachin "Sunny" Jha, MD, MS Los Angeles, CA Lou Smith, MD Knoxville, TN Bharat Guthikonda, MD, Hosein Shokouh-Amiri, MD, Gazi B Zibari, MD Shreveport, LA We were quite perplexed after reading the recent letter from our distinguished colleague, Dr Seher Demirer, chair of the Turkish Surgical Society, who represents 19 Turkish medi- cal/surgical societies and federations. 1 In response to our article, "Medical capacity-building in war-torn nations: Kurdistan, Iraq as a model," 2 while the article contains more than 4,000 words, Turkey was mentioned only twice and only in the context of describing the geopolitics of cur- rent Kurdistan, Iraq. To provide the readers with an appreciation of the Kurds and the sociopolitical/economic challenges facing the region, we opted to provide a brief historical back- ground. Such background was not meant to inflame any one person or particular group of people or to push a political agenda. Throughout our paper, we made appro- priate references to historical facts, backed by accurate and reliable sources. Demirer and colleagues 1 denounced the article for making a derogatory statement against Turkey. Nowhere in our paper was such a statement made. They objected to our statement, "current Kurdistan, surrounded by neighboring states, is a byproduct of colonial powers controlling the Middle East post World War I," and suggested that we had implicated Turkey as a colonial power. Regrettably, we believe that Demirer and colleagues have entirely misread that statement. Colonial powers controlling the Middle East post World War I (WWI) apply only to the victors of WWI. Who were the victors? France and England. The great Ottoman Empire, which lasted for 600 years, suffered a ma- jor defeat in WWI when they sided with the Germans. The modern nation of Turkey was what remains after the dismantling of the Ottomans. Those who lost the war were in no position to control their own fate, much less those of others. Therefore, our irrefutable and incontrovertible statement did not apply to Turkey. Furthermore, the Wiki- pedia reference we had used showed the names and popula- tion of the neighboring states to Kurdistan; there was no reference of Turkey as a colonial power. Dr Demirer and colleagues 1 criticized us for including the Kurdistan map as a "proposed country of a political organi- zation..." Nowhere in the paper did we mention Kurdistan as a country. The legend of the map clearly states, "Historical Kurdish Areas, Proposed Kurdistan Border 1919, and Iraqi Kurdistan (Autonomous region in Iraq)." Furthermore, the Iraqi Constitution recognized the Kurdistan Regional Government (KRG). Dr Demirer and colleagues 1 expressed their displeasure with the editorial board of the Journal of the American Col- lege of Surgeons. While we cannot speak on behalf of the editorial board, we can assure Dr Demirer and colleagues that the peer reviewers had done an exceptional job critiquing our work. In fact, the paper had undergone multiple revisions, and all authors had fact-checked their sources before approving the published article. Dr Demirer and colleagues 1 additionally suggested that we had engaged in lobbying toward a political agenda. Nothing could be further from the truth. A lobbyist, as defined by the Merriam-Webster dictionary, is "one who conducts activities aimed at influencing or swaying public officials and especially members of a legislative body on legisla- tion." 3 There were and are no legislations on the table that we were aiming to influence and there were and are no public officials or members of a legislative body that we were or are trying to sway. Additionally, the authors of our article were physicians from a myriad of national backgrounds; they are Vietnamese-American, Iranian- American, Irish/French-American, South-Asian American, 1 ª 2020 by the American College of Surgeons. Published by Elsevier Inc. All rights reserved. https://doi.org/10.1016/j.jamcollsurg.2020.09.008 ISSN 1072-7515/20