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Médecins Sans Frontières anaesthetists are required for the increasing number of surgical missions in the field many of which are in conflict ridden countries . Anaesthetists need to be flexible to be able to work with limited resources, and with a varied patient load from trauma victims to women requiring emergency Caesarian Sections. Because anaesthetists are often part of an emergency program they are frequently required to leave at short notice. Often these emergency missions are less than the usual 6 month first mission given the nature of emergency intervention and the fact that we realise the difficulties of anaesthetists taking an extended length of time away from their practice.
STORIES FROM THE FIELD :: Graeme Murrell I arrived on Mannar Island in the north of Sri Lanka after a 12-hour journey out to sea and back again – just to avoid the Tamil Sea Tigers and to obey the Government’s edicts. I was searched yet again (a different set of criteria applying to each search). After circumnavigating the danger and the red tape, I’d finally made it to my destination. The reception from the local community made it more than worthwhile: they couldn’t have been more warm and welcoming. Once a prosperous and self-sufficient town, Mannar was now isolated, intimidated and abandoned. The professionals had fled, the medical teams had been evacuated to safer areas. It was time for Médecins Sans Frontières to step in. I was sent with a surgeon to provide anaesthetic and surgical (particularly, obstetric) care to this forgotten community. Supplies were often held up by the Army so we had to do a lot with very little. It was an incredible challenge but we managed... most days. One night a soldier with self-inflicted grenade wounds was rushed to the hospital. We went to work quickly. The precious bottled gases flowed through the anaesthetic machine and scarce supplies of muscle relaxant were consumed. The endotracheal tube was inserted into his one good lung, and, just when we thought we might be able to save him, we were advised that there would be reprisals if he died at the hospital. He had to be sent back to the Army base. The evacuating helicopter took far too long to come for him, and he died in my arms. To cope with failures and losses in the field, I found that I had to look forward and not back. The very next day we were back to delivering babies, draining abscesses and setting bones. And so we did what we could and provided a little hope in a dark time for this beautiful country. ESSENTIAL CRITERIA ALSO DESIRABLE
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