Surgery on the front lines of conflict
A note from Dr. Gerry Bashein
Syria 2017 © Jamal Bali
I was 64 years old—the age when many people are thinking about retirement—when I decided to take on a new professional challenge and work outside my comfort zone on my first assignment with MSF.
I set out for Monrovia, Liberia on the West African coast, not long after 15 years of civil war came to an end. Even though we were in the capital, there was no working electric power grid or piped-in water. We had to generate our own electricity and trucked in water to the hospital and our living quarters.
The hospital was housed in a private school that had closed during the war. Classrooms had been turned into patient wards and still had blackboards on the walls.
I was the anesthesiologist on the team which included a French general surgeon, an Australian obstetrician, a French pediatrician, a Japanese ward nurse, an Irish midwife, and national staff from Liberia. The workload was intense at times.
One night, I was finishing an operation when I received a call from a nurse in the intensive care unit. There was a baby with cerebral malaria having seizures who was likely to die. The nurse was unable to start an intravenous line (IV) to administer the necessary medications, and she needed my help.
I didn't work with babies ordinarily and was not likely to be of much help, but the situation was critical, so I went.
I arrived with my camping-type headlight on my head. I shone this on the baby, and the moment I did, the nurse saw a great vein and popped the IV in, solving the problem.
It’s our job to do whatever it takes to save lives. In this case, I was assisting the nurse. Together, we saved a baby’s life.
When I left the assignment, I left my headlamp in the possession of the head nurse. With no electricity from the grid and a generator that only provided poor lighting, I knew this problem would occur again.
When I got home to Seattle after this first assignment, I had lost some weight and was physically and emotionally tired, but I had an inner feeling of satisfaction and knew that I wanted to go on assignment with MSF again.
Three of my subsequent assignments involved victims of the Syrian war. I went into northern Syria in 2012 to help open a hospital in a village held by armed groups near the Turkish border, northwest of the city of Aleppo. The border was quite porous at that time and we could easily bring in all necessary equipment and supplies. Our team was lucky to find an adequate building to turn into a hospital, because almost all empty buildings had been taken over by squatters displaced from their homes in Aleppo.
MSF is still active in Syria, though security constraints amid the ongoing conflict have hampered our response. In 2020, MSF teams provide maternal health care, general health care, and treatment for noncommunicable diseases through mobile clinics. We distribute relief items and improve water and sanitation systems. We also support regular vaccination activities and help care for patients who underwent kidney transplants. In northwestern Syria, MSF runs a specialized burn unit that provides surgery, skin grafts, dressings, physiotherapy, and psychological support.
I served in several assignments after that, including one in Amman, Jordan. There, for the last decade, MSF has been running a hospital doing reconstructive surgery on victims of violence and accidents in the Middle East. Operations involve bone and joint surgery, plastic surgery, and oral and maxillofacial repair.
Over the years, I have had the privilege of working with some outstanding international medical teams, but we could not have done it without the help of the nonmedical support teams and the infrastructure that MSF provides.
My work with MSF has been the most rewarding of my entire career. I never imagined working for MSF when I first read a news article about their founding in 1971 during the Biafran civil war in Nigeria. I was a medical student at the time and had a mental image of doctors running around in a war zone with their medical kits in backpacks. I had no idea that the organization would become so large and well-known, or that MSF would be awarded the 1999 Nobel Peace Prize.
More than four decades later, I have completed 15 assignments in 10 different countries over 11 years.
I am grateful for the opportunity to share my experiences with you, and for your compassion and generosity. Thank you for standing with us, so that we can be there when we’re needed most.
Sincerely,
Dr. Gerard “Gerry” Bashein, MSF anesthesiologist
