Lebanon: Restoring faces and dignity

Severely burned in an explosion in 2014, Moussa was unable to speak or eat properly and his injuries caused him much suffering. Now, following a long and arduous operation by surgeon Dr Enrique Steiger, Moussa has been given the chance to resume a normal life.

Caution: Some of the images are graphic and may be disturbing.

In October, Moussa was one of ten patients who underwent maxillofacial surgery at Tripoli's Weapon Traumatology and Training Centre (WTTC) run by the ICRC. The operations were performed by Dr Enrique Steiger, a specialist in maxillofacial surgery which treats injuries to the head, neck, jaws and facial areas.

Could you tell us more about Moussa, the patient you operated on?

Moussa is a 52-year-old man who was injured during last year's clashes in Tripoli. He was severely burned when a projectile exploded near a gasoline tank and the gasoline splashed over his face the upper part of his body. He received superficial treatment several times previously but it didn't help him much. Also he could no longer afford it, so some people he knew and who had been treated at the WTTC recommended that he go the centre.

Because of the injury his lip was contracted downwards, causing drooling and exposing his teeth, which would sooner or later fall out. He could neither eat properly, nor function normally and was obviously suffering to a great extent.

This is generally the problem with people with facial injuries; they suffer both physically and psychologically.

We hope that Moussa will soon be able to chew and eat normally and eventually resume a normal life.

As a surgeon restoring the faces of the wounded, I am able to give them back their dignity and the possibility to get on with their lives again.

What is maxillofacial surgery all about?

It's quite a specialized and complex type of surgery, requiring very precise and meticulous work on the bone structure and the skin of the face. This is particularly true when it comes to weapon-inflicted injuries.

One of the difficulties – as in Moussa's case – is that most of the wounds are not fresh. They can be several weeks or several months old, and many have not been treated properly in the past.

Moussa's operation needed seven to eight hours to fix his facial bones with plates and screws and to replace the damaged skin on his neck with healthy skin from other parts of his body.

You came to Lebanon for just a week to perform this and other operations. What do you think about Tripoli's Weapon Traumatology and Training Centre?

I think it was an excellent idea to open this centre. Nowadays it's getting more and more difficult to get close to conflict zones for security reasons, as in Syria for example.

Many such zones are virtually inaccessible for humanitarian organizations providing health care. Local doctors tending the weapon-wounded are not always specialists and often can't ensure proper emergency and follow-up treatment, no matter how hard they try. As a result, patients develop complications which are much more difficult to treat.

However, our goal is not to substitute. Our ultimate goal is to train local medical personnel in weapon wounded surgery, be it facial, hand or orthopaedic surgery, so that they can take care of most of the cases on their own, with our support when necessary. They speak the language of their patients. They know their cultural and other specificities, which is so important for successful treatment.

The WTTC was set up in September 2014 to provide surgical treatment, including reconstructive surgery and physical rehabilitation, to weapon-wounded patients. It also serves to transfer the ICRC's know-how in surgery and rehabilitation to surgeons and other health professionals. The services are all free of charge and accessible to all weapon-wounded people, regardless of their nationality and background.