Dr. Bob Taylor is a general surgeon and the director of the Branch for International Surgery in the UBC Department of Surgery. Here is a recent blog of his work at the ICRC Hospital in Peshawar, Pakistan.
Every day and night new patients arrive at the hospital, victims of armed conflict – injuries from gun shot, landmines, bomb blasts or mortar shells. Some are combatants but often they are civilians – men, women and children shopping at a market, working in their fields, travelling along the road or attending social gatherings. Some arrive within hours of their injuries, others arrive days or weeks later. They come from both Pakistan and Afghanistan. Some recover well, others are debilitated for life.
We have been here for nearly two months and it has been very busy. Not much down time. For good reason, our activity is restricted to the hospital, our residence and travel between the two. Occasionally, we shop for groceries and supplies at a nearby market, going there and back in official Red Cross vehicles. Life in Peshawar, which is a large and historic city, looks fascinating and inviting and we are only sorry that we can’t engage in it at this time for security reasons. The regional conflict is large and Peshawar’s location puts us at the geographic centre.
We are both well. Until recently it has been very hot and dry. Day temperatures have been usually in the 40’s and occasionally into the 50’s. We are slowly adjusting. Thankfully, our bedrooms have air conditioning which means that we are sleeping. The Red Cross Hospital is also cooled, including the operating theatre, without which no one would survive.
No doubt, you have been hearing about the disastrous flooding that has hit Pakistan these past weeks. The news coverage has been extensive and there is probably not much information that I can add to what you already have heard. Something that may not have been included in the news reports is that these floods, as well as causing suffering directly, also prevent conflict injured people from getting to hospital, thus delaying treatment and increasing the death rate. One might have thought that the perpetrators of violence would step back in the face of such suffering from the flooding. Not so, the guns and bombs continue.
The Red Cross (ICRC) Hospital for the weapon wounded in Peshawar accommodates about 100 patients. The staff is both Pakistani and expatriate, with the expats coming from all over the world – Canada, Mexico, Norway, Italy, Hungary, Kenya, Sudan, Switzerland, Russia, Japan, Australia, New Zealand – there are almost as many countries as there are expats. There is a good esprit du corps and common purpose among us. Working with the Pakistani staff is a pleasure and we find them welcoming, well trained and hard working.
Nearly every patient who makes it to the hospital survives, but not all. It is always difficult to see someone die from violent trauma and particularly heart wrenching when children die. This is not the first time that we have worked in a disaster or a conflict setting, but it is the first time for such constant intensity on a daily basis. One can’t help but ask big questions.
My work schedule is rather constant, working every day and every other night. There are two surgeons so we rotate night duty in order to provide complete coverage 24/7. The cases can be very challenging as there is often so much tissue destruction from the injuries and often the patients arrive late, after infection has become established. Injuries involve every part of the body, of course, so there is also the challenge of sometimes operating in anatomy where I am less experienced than in more familiar anatomy. There is also a third surgeon on staff who is an experienced “war surgeon” and is a resource if needed. I am becoming quite familiar with the different kinds of tissue damage from low velocity bullets, high velocity bullets, landmine blasts, bomb blasts, mortar shells, etc. There seems to be no limit to the ingenious ways that humans can inflict injury on others.
We are very grateful to those of you who have emailed us, filling us in on what is happening with you and assuring us of your prayerful concern for us. Thank-you.