JERUSALEM/GAZA – The International Committee of the Red Cross (ICRC) held a three-day seminar on war surgery in the Gaza Strip from 11-13 March for 55 Palestinian medics, with lessons ranging from international humanitarian law to basic management of war wounded, and more specific topics like head and stomach injuries.
"[War wounds] have to be managed in a way not usually taught at medical school," said Marco Baldan, the ICRC head surgeon, because more damage is caused than in other types of injuries and they are more prone to infection.
Apart from teaching new surgical techniques, part of the course focused on identifying specific problems the surgeons face.
"For example, when there is a large influx of people," Harald Veen from the ICRC explained, like during the recent Israeli operation in northern Gaza which left over 120 people dead.
"Sometimes I don’t have enough beds, and I have to discharge patients as soon as we finish the main operations," said Nabil a-Shawa, an orthopaedic surgeon at Gaza’s main Shifa hospital, recalling the recent events still fresh in his mind.
"I release them early and treat them through the outpatient clinic," he said.
He and Veen agreed there was a problem of continuity in the care of patients during conflict as the main focus was keeping beds open for incoming trauma cases.
Another issue is the guns. An injured militant’s armed colleagues may follow him into surgery or linger around the hospital. Tense gunmen in a tense surgical theatre combine to make an unhealthy situation, doctors said.
Also, it is not uncommon for family members to huddle around a physician as he works.
"It’s a small society, and everyone knows everyone," explained one doctor, noting that this led to families placing pressure on physicians to refer their loved ones to hospitals in Egypt or Israel, even when the local services were adequate.
"The hospitals must control the amount of people and weapons present, so patients get proper assessments and treatment," said Veen, adding that this was part of an overall administrative reform Gaza’s hospitals required.
For Shifa hospital’s a-Shawa, the blockade on Gaza was a major concern.
"Last week, the last of our three X-ray machines in the operating theatre stopped working," he said. "I had to stop surgeries that need X-rays during the surgery and find alternatives or send them abroad."
But he remained an optimist: "In the future things will get better. The system will be better. We have a good staff, especially in trauma. We just need to have better communication with each other," a-Shawa said.
He and Veen agreed on the importance of doctors keeping in touch and learning from each other, especially when travelling to seminars abroad was not an option in part due to Israeli restrictions on the Strip.