Surgeons working in the occupied West Bank have been compelled to learn new skills to cope with the realities of providing emergency care in an worsening conflict zone.
To save more lives, surgeons of all specialities are being taught the fundamentals of trauma operations, because the injuries suffered by Palestinians become more severe and the practicalities of treating them are more difficult.
The David Nott Foundation (DNF), a charity training frontline doctors in conflict zones, organised a course to train 60 Palestinian surgeons across a variety of medical disciplines. If an orthopaedic specialist has to deal with a severe head injury, they will now have an understanding of the steps required to keep the patient alive.
The course, with the help of the World Health Organisation, trained the surgeons trained over five days last month. The main goal of the training was to ensure doctors can keep patients alive so they can be moved to specialist medical centres.
“In the hospitals, you could have just one surgeon on duty and when a case comes in, regardless of whether they're a vascular or an orthopaedic surgeon, they may have to deal with that specific trauma,” said Hetty Cane, who organised the programme for the DNF. “This is a real problem in West Bank because the checkpoints often mean that you can't transport ambulances through them.”
The doctors, some with 20 years of surgery experience, were taught skills from ballistics, damage control, vascular surgery, head and maxillofacial trauma, plastic surgery and paediatrics. “It’s essentially an all-round course, supporting skilled surgeons to deal with every field of trauma surgery,” Ms Cane added.
The latest UN figures show 10,712 Palestinians in the West Bank have been injured, including almost 3,000 wounded by live ammunition, since September 2023. The violence committed by ultranationalist Israeli settlers has also reached an average of four attacks every day.
One doctor told The National they once treated light injuries, but people are now being severely injured or killed in clashes with the Israeli security forces or illegal settlers.
“They're aiming to cause more casualties, not just to scare people away like before,” the surgeon said. “We're not seeing more numbers, but we are witnessing a lot more advanced and more difficult cases.”
The doctor said general surgeons are doing much more than they used to as a result of the increasingly deadly operations. “Brain surgery is not something I would like to do, but if I am alone in a hospital and the city is closed and I can’t get the patient into another hospital safely, I would have to operate," the surgeon explained.
“We are preparing for the worst, and that's why most of the training that we're having is just to build more expertise to deal with mass casualties and very bad advanced injuries.”
With major chest injuries, general surgeons at times have had to “just open up the chest and operate in the ER”, but they had “very good success stories based on the training with the David Nott Foundation", she added.
The training course was developed as medical staff witnessed a sharp increase in major trauma injuries in the wake of the atrocities of October 7, 2023, as Israeli security forces launched a series of operations across Palestinian residential areas.
Air strikes on towns have caused life-threatening blast injuries, as well as deaths. The effort to save lives is also threatened by the huge increase in Israeli checkpoints, with vast queues meaning a 35km journey from Jericho Hospital to Ramallah can now take up to four hours.
The National has not named the surgeon interviewed for this article due to security concerns.
