Posts tagged surgery

Photo: People who have fled shelling are living in precarious conditions without access to medical care. Syria 2012 © MSF

Wounded and Sick Trapped in War-Torn Syrian City

Tens of thousands of people, many of them wounded, are trapped by intense fighting and bombing in Deir Azzour, a city in eastern Syria. MSF called for the evacuation of the injured and sick to safety and for international medical teams be allowed to work in the war-torn city.

An MSF team unofficially visited Deir Azzour governorate in late November to evaluate needs in the isolated, war-ravaged region. It was too dangerous for the team to enter the city of Deir Azzour, home to a reported 600,000 people prior to the conflict. Local residents reported that tens of thousands of people remain trapped in the city, which is shelled and bombed daily. Those remaining are predominantly poor and elderly, unable or unwilling to leave and now extremely vulnerable. Despite support from an organization of Syrian doctors, it is virtually impossible to obtain medical supplies in Deir Azzour.

“Deir Azzour now has just one makeshift hospital with only four doctors working there,” said Patrick Wieland, an MSF coordinator who recently returned from Syria. “The doctors are completely exhausted after six months of working in a combat zone. But they refuse to leave the city and are continuing to treat the wounded around the clock.”

Evacuating patients on stretchers is particularly risky because of aerial bombings and sniper fire.

MSF teams are working in three hospitals in northern and northwestern Syria, in areas controlled by armed opposition groups. MSF provides emergency medical care, including surgery. Since late June 2012, MSF teams have treated more than 2,500 patients and carried out more than 550 surgeries. In Jordan, Lebanon, and Iraq, MSF has been providing medical care to Syrian refugees and its teams are prepared to address additional needs arising from the conflict in Syria

Photo: MSF surgeons operate on a patient in a hospital in northern Syria. Syria 2012 © Rachael Craven

Treating the Wounded in Syria

Inside Syria, MSF teams are striving to meet the needs of people caught up in the conflict, but restrictions and insecurity prevent the teams from extending our work or gaining an overview of the humanitarian and medical needs in all the affected regions.

Fighting has also displaced people from their homes. The population in one Syrian town where MSF is working has increased to 30,000 people over the last few months. Many of the displaced families are sheltering in schools and public buildings. In one site, MSF teams are providing people with clean water and are evaluating additional relief activities.

In response to the increasing medical needs in Syria and an overall lack of medical supplies, MSF has donated tons of medical and relief items to field hospitals and clinics in Homs, Idlib, Hama, and Deraa governorates and to the Syrian Red Crescent in Damascus.

Syria: Safety of Wounded and Medical Workers Must be Prioritized

Wounded people and medical workers remain targeted and threatened in parts of Syria, preventing people from receiving life-saving emergency medical care MSF said today, following recent visits to parts of Syria by MSF medical teams.

After reaching the governorates of Homs and later Idlib, MSF teams found patients and doctors at risk of attack and arrest. MSF first reported in early February on the abuse of health facilities and the targeting of patients and medical workers. All parties to the conflict must fully respect the safety and integrity of wounded people, doctors, and healthcare facilities, MSF said.

“Being caught with patients is like being caught with a weapon,” said an orthopedic surgeon whom MSF met in a village in Idlib governorate. “The atmosphere in most medical facilities is extremely tense; health care workers send wounded patients home and provide only first aid so that facilities can be evacuated quickly in the event of a military operation.”

Photo:A burned out medical center in Idlib.
Syria 2012 © MSF

Performing Reconstructive Surgery in the Gaza Strip

My name is Mateja Stare. I’m 38 and I am from Slovenia. In Ljubljana, the capital, I work in the country’s largest hospital. I am an operating room nurse. I’ve just come back from the Gaza Strip, where I spent a month on mission with MSF.

To say that you want “to help people in need” can sound a little superficial, and even frivolous, but it’s also true. I really believe that after you’ve organized your life and everything is going well, the time comes when you need to share your expertise and your experience with other people—with people who haven’t had the same luck. So why not join up with a humanitarian organization?

I worked as the operating room supervising nurse in Gaza. I managed, directed, trained, evaluated, coordinated, organized, and planned everything in coordination with the surgical activities. We worked in an MSF field hospital, in tents set up in front of Nasser Hospital in Khan Yunis, a city 20 kilometers south of Gaza City, where MSF has its office and house.

Because of the events, we were only able to operate during for four days of that month-long mission, but we decided to do the maximum number of operations per day. There are posters hanging all across the Gaza Strip with information about this program inviting potential patients to consult our teams. The day before the surgeries began, the surgeons—both Palestinian and expatriate—carefully examined 200 patients. In the end, we operated on 25 people and dressed the wounds of two additional sedated patients.

Read the rest of Mateja Stare’s account from the his time in the Gaza Strip.

Photo: Palestinian Territories 2012 © Mateja Stare/MSF An MSF staff member tends to a young burn victim.

MSF Blogs: Yin A Mat Po? (Are You Happy?)

The woman came to us with no living children. She had been pregnant twice before, but both pregnancies resulted in stillbirths. In the first pregnancy, she had labored for days, and the baby died during labor, but delivered vaginally. In the second pregnancy, she had pushed and pushed, but the baby did not deliver. A C-section was done, but the baby died anyway.

I cannot imagine what that must feel like. In the United States, a stillbirth at term is a huge event. Privacy is paramount. A subtle sign is placed on the patient’s door so that the staff knows not to enter unnecessarily. A sympathetic nurse is chosen, one who will comfort the patient. Aggressive pain control is offered, because pain can only make grief worse. And the woman carries that loss with her for the rest of her life.

In South Sudan, it is unusual for a woman not to have lost at least one child. They die in childbirth, or they die later of malnutrition, malaria, infection, unexplained illness. I have seen women who have delivered seven children, only to have three of them die; or delivered four children but having only one living child. When a woman comes to us, the first question asked is “How many children have you had?” The second question is, “How many are alive?”

Read the rest of the blog from Veronica Ades here.

Photo: South Sudan 2012 © Lisa Jones MSF OB-GYN Veronica Ades examines a patient.

Emergency Response Scaled Up as Violence Continues in South Sudan

Tensions and hostilities continue unabated between South Sudan and its northern neighbor Sudan, and MSF is scaling up its emergency response by treating people injured in the latest violence, giving material and staff support to local clinics and hospitals, and providing relief to people displaced by the fighting.

MSF currently provides life-saving surgery in Aweil and Agok for patients wounded in the recent violence. The organization also reinforced its surgical response capacity in case of a general degradation of the situation.

MSF has also donated medicines and medical supplies to local hospitals in Abiemnom and Bentiu in Unity State, both of which have received high numbers of wounded from the recent clashes. Two of MSF’s medical staff have been temporarily seconded to support the Bentiu hospital.

Photo: South Sudan 2012 © Robin Meldrum/MSF Refugees from Blue Nile State in Jamam refugee camp

Haiti: MSF Opens New Surgical Center in Port-au-Prince

Work on the 107-bed center began in 2011 and was completed in February, 2012. The center treats victims of accidental trauma, such as falls and road accidents, and victims of violence who have suffered beatings, assaults, and gunshot wounds.

“MSF is now supporting the Ministry of Public Health and Population with 600 hospital beds in Haiti for emergency care,” said Drossart. “This is still far from adequate, but is nevertheless an advance.” In a country where 75 percent of the population lives below the poverty line, and where referral facilities are vastly inadequate, MSF’s new center will improve access to surgical care for the population of Port-au-Prince’s metropolitan area.

Haiti 2012 © Yann Libessart/MSF
The entrance to MSF’s new surgical center in Tabarre.

The Avoidable Crisis of Maternal Death

MSF makes it a priority to provide lifesaving, emergency obstetric care in both acute and chronic humanitarian crises. MSF teams strive to address the five main causes of maternal death: hemorrhage, sepsis, unsafe abortion, hypertensive disorders, and obstructed labour.

In a conflict or crisis, pregnant women are even more vulnerable because health services have collapsed, are inadequate, or are totally non-existent. But these women need access to quality emergency obstetric care whether they live in a conflict zone, in a refugee camp, or under plastic sheeting after a devastating earthquake.

In fact, they need the same help that all pregnant women facing a complication need: access to appropriate medical assistance—skilled medical staff, drugs, and equipment—to save their life and the life of their baby.

Conflict, epidemics, natural disasters, or the complete breakdown of a country’s health system are crises faced by MSF’s millions of patients around the world every day. But a maternal death: that’s the avoidable crisis.

Infographic by Will Owen