It’s the last day. Several times a year MSF teams – composed of surgeons, theatre nurses and anaesthetists – do these short surgical assignments in Gaza, in close cooperation with medical teams working in Palestinian hospitals. As part of this surgical team, we gather dozens of patients and carry out multiple operations in a short period of time.
In four weeks we have finished 53 procedures on 34 patients. They’ll all heal well. I stared as the bandages went back around a hand, clean, firm, taped. A hand repair. Probably looked at a few times by now, making sure that it’s forward motion from here. They kids ages ranged from 5-16 years old approximately. The parents are strong. Their children get injections so that they are calm because the dressings would be very painful otherwise.
It’s not long after and all the stock is being pulled into bins to take them home, boxes, trolleys and the operating room is dismantled and moved into a van to be moved back to the offices. Our Operating Theatre (OT) manages the demolition too. When I am back at the office patting myself on the back and calling my wife on my job-well-done, he’s running around with paperwork. He has a wide smile for me, has a busy look otherwise.
"In four weeks we have finished 53 procedures on 34 patients. They’ll all heal well."
You can’t run it without them because they know if a patient’s name is a girl’s or a boy’s, is second or third on the list, is here or not, if their parents are near or far and if they are going to this clinic or that. You couldn’t do it because all the stuff that you need Arabic for is taken away from you when you don’t speak it but they do. You wouldn’t want to because you know the only way you can convince a family that an operation is optional or urgent, to communicate your understanding that their expectation is high – informed consent – relies on this person’s ability to understand you and understand them. And what does he say to me? “How is your assignment?” Good, I say. “This is your first assignment?” Yes, it is, I reply. “This is the first time you are a chief?” Yes, it’s my first time in charge, running my side of the ship. “You are doing well,” he says.
This surgical assignment finishes today. Over the next few weeks the patients will be seen by the dressings clinics. There are three in Gaza. The theatre staff will resume roles in the clinics along with a team of nurses, physiotherapists and OT nurses. The patients have been having their wounds reviewed and monitored and complications detected. Planning for the next assignment later this year has already commenced.
"This surgical assignment finishes today. Over the next few weeks the patients will be seen by the dressings clinics. There are three in Gaza."
For any anaesthetist wanting to join:
- Go on! If you are interested, and the provided information has not yet put you off, then there is only one way to find out if it is for you.
- You will work hard
- This particular assignment I understand was particularly well resourced in terms of not just equipment but in well trained personnel and restricted to elective surgery. It may not be representative of the serious contexts in which MSF does a large proportion of its work.
- Take it slowly. There is a lot to take in and the anaesthesia here has been the easiest part of the assignment. It’s all the stuff around it that has made it complex.