The politics of war wounds

Regrettably, we can only repair bodies.

Saudi artillerymen at the border with Yemen fire at Houthi positions (photo credit: REUTERS)
Saudi artillerymen at the border with Yemen fire at Houthi positions
(photo credit: REUTERS)
The stench of blood and burned human flesh is etched in my memory. Snapshots of adults and children with horrifying wounds are omnipresent in my dreams.
I am a war surgeon. For over 20 years, I have been piecing together people torn apart by mines and bombs, or riddled with bullets.
Uganda, Somalia, Afghanistan, Libya, Syria and Yemen are part of the long list of war-torn countries I have worked in.
In all of them, I have operated on a steady stream of war-wounded patients. From head to toe. I have done so in the most austere environments and as bombs were falling.
Keeping in mind the high energy that bombs, mines and bullets carry, they generate terrible harm within the human body. The damage caused requires special medical expertise that is not taught in most medical faculties. This expertise is referred to as “war surgery” or “war-trauma care.”
With the sharp increase of armed conflicts in the region, young doctors and nurses are increasingly faced with war-related wounds early on into their tenure. A 30-year-old doctor working at a leading hospital in Israel or in Gaza has already experienced a mass influx of casualties and dealt with a series of horrific wounds, such as blast wounds and multi-limb amputations.
War-trauma care must be an integral part of the curriculum of all medical faculties across conflict-affected countries. It improves our chances as doctors to save a war-wounded patient’s life.
Our profession can be extremely disheartening, even more so when played out against the shadow of armed conflict. There are times when controlling a patient’s pain is the best we can do, allowing them to die in dignity. But war has often already taken away a person’s dignity.
Armed conflicts excel at taking away people’s dignity. They start by eating away at people’s livelihoods and the various services they depend on, and then go on to steal away their lives and those of their loved ones.
Leaving them at times as fragments of who they once were.

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Entire generations have been permanently scarred. Regrettably, many more men, women and children are destined to join their ranks. Without global and local political action, the fate of these men and women remains grim.
Occasionally, and as I stand in the emergency theater, operating on patients riddled with bullets or torn apart by explosions, I wish a handful of lead politicians in war-torn countries could join me. Would their decisions be different if faced, on a day-to-day basis, with the human cost of war, in its most raw manifestation? A piece of meat. The remnants of a human being.
The tragedies I have seen so far in my career have left deep scars within me. Unlike many of my patients, my scars are invisible.
Twenty years into my career, I muster up the courage to say, “it does not have to be this way.”
As a war surgeon, I vow to keep doing the best I can to piece people back together and to attend to their wounds. I fear however that my efforts, along with those of my fellow doctors and nurses, remain futile.
Regrettably, we can only repair bodies.
We are sadly unable to prevent casualties.
The author is a senior war surgeon who has been working for the International Committee of the Red Cross (ICRC) for about 20 years. He visited Gaza end of February 2017 within the framework of ICRC’s quest to include war-surgery related modules into the curriculum of select Gaza universities.