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Chile: an ICRC surgeon shares his experience with doctors going on peacekeeping missions

18-11-2007 Interview

Mexican doctor Víctor Uranga was one of the ICRC specialists leading the recent war surgery seminar run by the Chilean defence headquarters and ministry of defence. The aims of the seminar were to update military doctors going on UN peacekeeping missions and to share with them the experience acquired by ICRC surgeons.

 Why is the ICRC taking part in this seminar?  

The ICRC has acquired many years’ experience in the field of war surgery. The organization is keen to share its experience with doctors taking part in UN peacekeeping missions, as this can have a direct effect on the people they treat.

  Dr Víctor Uranga    
    The seminar in Chile allowed doctors from the Argentine, Brazilian, Chilean, Paraguayan and Uruguayan armies to hone their surgical skills and, above all, to work on organizational aspects. As a result, they will be well prepared to respond immediately, both in conflict situations and in case of disaster.

 What is war surgery?  

There are a number of differences between war surgery and the “normal” surgery that a surgeon is trained to perform. One difference lies in the types of wound to be treated – bullet wounds, lacerations caused by knives or bayonets and burns caused by explosives, such as mortars and mines.

Battlefield wounds display are much more badly contaminated. Wounds in a civilian context don’t normally require such extensive or radical cleaning as do war wounds. When I say “cleaning,” I’m not just talking about washing. I mean removing all the devitalized tissue around the wound. And it’s normal to leave such wounds open for around five days, to prevent infection.

Knowing these techniques, and others, can enable a surgeon to save an organ, or even a life.

 Does this knowledge improve the patient’s long-term prospects?  

Certainly, it’s the future of the patient that’s at stake here. We have to bear in mind the population with which the surgeon is dealing. Most of his patients will be combatants, young people. These people don’t just need to have their wounds treated. They require long-term physical rehabilitation. The ICRC is one of the humanitarian agencies doing the most in the area of rehabilitation.

 What has your work with the ICRC involved?  

  Dr Uranga and the other members of the ICRC’s mobile medical unit operate in a ramshackle building in Sudan.    
    I was a member of the mobile surgical unit that the ICRC deployed to Sudan. The unit consisted of an anaesthetist, two nurses and me. Its role is to undertake rapid deployment to wherever it’s needed in Darfur. The fighting there makes it impossible to treat casualties any other way.

We carried 400 kg of equipment, including sterile preparations and instruments, medicines, intravenous solutions, a generator and anaesthetics equipment. We were able to set up a complete operating theatre and conduct major surgery anywhere in Darfur.

I’ve also worked in Liberia, Eritrea and Afghanistan. It was in Liberia that I had the experience which made the biggest impression on me. I was asked to treat a young man of 19 who had had both his hands chopped off with a machete. He arrived in a state of shock, naked, on a stretcher. He wasn’t moving, and his hands were dangling from his wrists by pieces of skin. All we could do was complete the amputation. We couldn’t attempt any kind of reconstruction. We kept him alive, but for the rest of his life this young man will be dependent on others for the most basic of everyday activities – dressing, washing, going to the toilet, and so forth. We often witness tragedies like that. But in isolated regions where we were the only doctors, I also had the opportunity to take part in complicated births and save the lives of mothers and their babies. Those are the things that make it worthwhile. Saving a life, saving an arm or a leg, doing something that will enable a person to rebuild their life once the fighting ends.