 The decree was issued by the Ottoman Sultan Mehmed VI and was confirmed in Elias' visit to Constantinople in 1919, during which he also received the Ismania medal.Elias travelled extensively in 1919 to visit surviving Syriac Orthodox communities in the Middle East in the aftermath of the Assyrian genocide.As a result of the end of the Turkish War of Independence in 1922, Elias was forced to flee the traditional patriarchal residence at the Monastery of Mor Hananyo to Jerusalem where he resided for three months.