Ideals

Gaza

IDEALS was invited to become involved in Gaza during 2008 because concern was expressed that some amputees were not receiving prostheses. This proved to be incorrect but it resulted in our involvement with the charity Medical Aid for Palestine (MAP) who expressed an interest in the work conducted in Southern Asia and Bosnia and especially our involvement with Primary Trauma Care UK. It was agreed that PTC would be introduced into Gaza initially as a hospital based system and subsequently extended to the local non medical population who are the usual “first responders” to major incidents such as bombing. In August 2009 Sir Terence English and John Beavis visited Gaza and met the senior members of the medical community who agreed to the courses beginning based at Shiva Hospital Human Resource Development (HRD). A very successful initial set of courses took place in November 2009 led by Dr James De Courcey and a team from the UK.

This event was fully reported in “World Anaesthesia” March 2010 -- www.nda.ox.ac.uk/wfsa/html/acrobat/wan/wa1103.pdf.  

Subsequently, over many months, the PTC project was extended with the establishment of the PTC (Gaza) Faculty and a gradual progress towards independence fully supported by MAP(UK) in all ways. This involved numerous visits by John Beavis who also assessed the other ways IDEALS could be involved in the medical needs of Gaza. It is hoped that with the training of a full complement of “Trainers” in January 2011 the next phase will begin of training non medical first responder personnel throughout Gaza. One of the most exciting aspects of this was training medical students from the Islamic Medical School Gaza

Dr Andy Ferguson, who is a trained PTC Instructor, accompanied John Beavis in advance of the main party in November and undertook an assessment of the care of individuals in the area disabled by problems such, for instance, as cerebral palsy and polio which occur independently of war and are often neglected as a result of attention to major trauma and its complications. Dr Ferguson will work with MAP to try to redress these problems as far as possible.

Within a short time of visiting Gaza it became obvious that medical equipment was in short supply. IDEALS provided equipment for treating chronic pain (a common complication of major trauma) and colostomy bags (used after large bowel surgery and absolutely essential).

We were greatly helped in our endeavours by a group of intrepid individuals who had heard about IDEALS volunteered to drive from the Taj Mahal to Trafalgar Square in small (Nano) cars and to advertise for sponsorship to support our work in Gaza. The Nano Challenge 2010 raised a sum of over £11,000 was raised which has been used for various projects of a technical and educational nature.

1.    At the request of Nasser R. Abu Shabaan FRCSI, Director General of HRD and Chairman of PTC(Gaza) Faculty, a fibre optic laryngoscope was purchased to assist with anaesthesia in difficult situations such as head and neck surgery and major trauma. Our Trustee, Dr Eamon McCoy, who is an acknowledged international expert in such matters, visited Gaza in November 2010 and undertook a work shop in the use of the instrument. He will return in January 2011 to demonstrate the instrument on patients in the operating theatre.

2.    The Nano Challenge donations were used to finance the attendance of Dr Khamis Elessi, Director of Al Wafa Rehabilitation Hospital Gaza, to attend courses on Evidence Based Medicine and Medical Statistics in Oxford in September 2010. His accommodation in Oxford was at the home of Sir Iain and Lady Holmes and in London in the home of Dr Jeanne Frossard who has been a very active participant in PTC training in Gaza – and elsewhere. Sir Iain has a long association with Gaza and established the system of Evidence Based medicine there with a workshop in July 2010.

3.    IDEALS will support Dr Nasser Abu Shabaan attending a course in minimally invasive surgery at the ICENI Centre in Colchester and for clinical Experience in Oxford at a time to be arranged early in 2011

4.    IDEALS provided equipment to Al Wafa hospital for the treatment of chronic pain which is a common complication of major limb injuries.

During his visit in July 2010 John Beavis assisted in inspecting possible places for the new Burns Unit for Southern Gaza and was involved in the process of deciding where it should be sited.

It became a regular part of John Beavis’s visits that on each occasion he gave several lectures of a medical nature to the Palestinian Surgical Society and his fellow visitors also joined in. In March 2010 Dr Ruth Spencer and Dr Deborah Harris from Frenchay Hospital Bristol gave talks on The Management of Burns and Head Injuries which were very well received and Dr Eamon McCoy gave a lecture on Difficult Airways in November 2010.

Bosnia 

IDEALS gave assistance with general post war medical reconstruction with major specific projects:-

• Training was given in modern techniques that had lapsed during the conflict. This work included minimally invasive (keyhole) techniques and joint replacement and limb reconstructive surgery. IDEALS financially sponsored work and education in the UK for Bosnian surgeons.
• Research into and treatment of massive war wound infections.
• Purchase of ultrasound equipment for the detection of developmental displacement of infants' hips. IDEALS organised training in the UK and the visit of a world expert to Sarajevo, (Professor Graf), to undertake two full certificated courses in methods of diagnosis and treatment. This established a full clinical trial of the condition in Sarajevo.
• IDEALS sponsored a research programme at Imperial College London to investigate the biomechanics of an external fracture fixator (Sarafix) designed and used during the war. This work is now demonstrated in the Hunterian Museum of the Royal College of Surgeons of England.
• IDEALS fully supported a general surgeon form Sarajevo to attend two courses – primary and advanced –in minimally invasive surgery at the Royal College of Surgeons in London
• On various occasion the Surgeons and anaesthetists form Sarajevo were brought to the UK to deliver lectures on their war experience and helped in the preparation of the research papers related to  this work including a mastership thesis.

Pakistan 

Introduction of Primary Trauma Care training in to Peshawar in 2003 to improve initial care of injured patients in the border areas with Afghanistan. IDEALS sponsored this training programme with subsequent progress to the southern area of Sindh -- around Karachi - and then to Lahore and Quetta in Baluchistan. Hundreds of medical staff have been trained and formed a fellowship across Pakistan.

In May 2004 the Pakistan Military requested that we should extend the training to senior medical service personnel and this was accomplished with a three day course in Rawalpindi.

At the time of the earthquake in October 2005 the "fellowship" united to assist the injured in the North West Frontier Province and Kashmir.

In association with the Peshawar based NGO, Community Appraisal and Motivation Programme (CAMP), and assisted by Ghandara University immediate aid was given to victims. This consisted of bedding, water, food and medicines transported to remote villages.

An appraisal of injured patients in various hospitals showed that many patients needed expertise plastic surgical treatment for the terrible wounds that had occurred. IDEALS paid for two teams of Plastic Surgeons and theatre staff (one from Oxford and the other from Morriston Hospital Swansea) to visit Pakistan in December 2005 in order to undertake numerous complex and essential procedures. Ties between the two countries were strengthened by establishing teaching and research links in this speciality (see Burns Research Fellowship)

IDEALS stayed on after the early massive publicity had died down and united with CAMP to continue assisting the villagers of Bedadi in the North West Frontier Province. IDEALS paid for the resettlement of the destitute population of Bedadi (60 families) into a temporary tent village of high quality that allowed them to survive the succeeding winter with a high standard of living that was disease free and allowed them to thrive. The children's education was also attended to with a temporary school.

In September 2006 IDEALS paid for CAMP to purchase new land for the families that frees them from a feudal dependence on landlords. This permanent resettlement has been described by the United Nations High Commission for Refugees as a unique venture. A legal trust between IDEALS and Camp has been drawn up that will eventually allow the families to own the land. The families moved in on October 17th 2006. The project was delayed due to administrative hold ups in planning but initial work began on water ad sewage installation began in August 2007 and was completed by Autumn 2009. The families now own their houses and cannot be prey to unscrupulous landlords. Skills which were learned during the building of the village are now used to gain employment and support the community.

In the post earthquake period IDEALS, with its special knowledge of the region, assisted the Cambridge University Department of Architecture and Cambridge Architecture Research Ltd to examine the relationship between the geographical sites of the quake, the building damage and the injuries sustained. In collaboration with the University of Peshawar department of Geography this project has yielded interesting results that will certainly assist in future planning of buildings in earthquake zones.

IDEALS, with support from Old Varndeanian Association, created a Fellowship to allow Professor Shariq Ali, Director of the Burns Unit at Dow Medical College Karachi, to spend six weeks working in Morriston Hospital Swansea during the summer of 2006. Prof Shariq was instructed in the most modern methods of burns care and began a teaching and research association that will benefit Pakistani patients in the future.

North West Frontier Area of Pakistan

In association with CAMP a survey of land mine injured survivors and other seriously disabled by all forms of injury was completed. It was hoped that this will lead to rehabilitation programmes including provision of prostheses, physical aids and re-training for work.

In December 2007 a training programme for doctors in the Afghan Border area began for the management of major trauma. During this training it became apparent that there was a paucity of equipment in the hospitals on the Afghan Pakistan border and so IDEALS fully financed supplying many hospitals with the basic tools to allow high standard Primary Trauma Care and emergency resuscitation of other critically ill patients.

The major problems of FATA were recognised by the Trustees and in particular the dreadful complications of childbirth with a massive maternal and infant mortality. There was no formal training of Community Midwives for the area and so in 2009 to 2010 IDEALS established a course for 15 young women from the FATA region which was so well received that it will now be continued by the local heath authority.

 Sri Lanka

Following the devastating Tsunami of December 2004 IDEALS became active in southern Sri Lanka. Substantial support was giving in regeneration of the economy of a small town Tangalle on the south coast of the island. In addition the local school for Blind and Deaf children benefited from a large donation for food and a contribution towards a new water supply and kitchen. In Tangalle the school wall was damaged and dangerous so IDEALS paid for its reconstruction. In addition various businesses were given assistance to return to normal activity and these included supplying cattle, fishing nets and building reconstruction. A deep sea trawler was purchased by IDEALS to replace one that was destroyed in the Tsunami. This allowed the crew of ten to be employed and for their families to be supported - up to one hundred people in total. The administrative cost for the entire Tsunami project was estimated as £1.80 per £1000 spent directly on the victims.

India 

IDEALS financially supported the first Primary Trauma Care course in Delhi at the Apollo Hospital in September 2005. This was the first of such courses that had taken place with a Pakistani teaching faculty, Indian doctors and IDEALS Chairman, John Beavis. It confirmed that warm friendship can exist between the two countries when political differences are forgotten and was entirely within the founding ethos of the Charity.

Azerbaijan 

Provision of neonatal infant incubators for the hospitals in Baku

IDEALS paid for the evacuation of a severely burned child, with his father, from Baku refugee camp for reconstructive surgery at Stoke Mandeville Hospital

Donation to Leonard Cheshire Centre for Conflict Recovery for its work in the fast track surgical programme for refugees.

Sierra Leone 

Support for work to manufacture locally made limb prostheses