Limb reconstruction surgery, Gaza

IDEALS trauma care programme in Gaza:

  • We have been active in Gaza since 2009; intensively since the 51 Day War in 2014.
  • Our principal objective: to improve the management of adult and paediatric trauma, including complex limb injuries, through a combination of treatment, training, capacity building and the procurement of essential equipment/consumables.
  • Subsidiary objectives: to reconnect Palestinian surgeons and allied health professionals to the wider world, excluded by siege since 2007; and to promote the ortho-plastic approach (orthopaedic and plastic/reconstructive surgeons working closely together) to the management of trauma/complex limb injuries.
  • How we do this:
    • Close coordination with the health authorities in Gaza, UN agencies (primarily the World Health Organisation (WHO)), International Committee of the Red Cross (ICRC), other international NGOs active in trauma care and clinical colleagues in Gaza’s hospitals.
    • Regular visits, up to eight per year since 2014 (interrupted only by the COVID-19 pandemic), by teams of volunteer NHS orthopaedic and plastic surgeons, nurses, physiotherapists and radiographers.
    • Visits supplemented by weekly/fortnightly videoconferences, email and WhatsApp communication.
    • Seven training fellowships for Palestinians in UK trauma/limb reconstruction centres (three surgeons, two nurses and two physiotherapists): four more planned, two imminently.
  • Our long-term support has brought about:
    • Capacity for the management of the most severely wounded where formerly there was none.
    • Reduction in the numbers of wounded transferred out of Gaza for treatment.
    • Significantly improved outcomes for patients: better quality of life; less pain; and able to do more of the routine tasks we all take for granted.
    • Acceptance and welcome by patients, clinical colleagues and health authorities alike.

Current Crisis

Hostilities began on 7th October. As of the evening of 26th November:

  • 14,800 Palestinians in Gaza have been killed by Israeli airstrikes and shelling, with more than 36,000 injured. Women and children, tragically, make up 68% of all those killed to date.
  • The north and south of Gaza have been disconnected by Israeli ground troops.
  • 25 of 36 hospitals and over two-thirds of all primary health care clinics have shut down because of damage or a lack of fuel.
  • Over 1.7 million Palestinians have been displaced from their homes, fleeing to emergency shelters or the homes of family/friends.
  • A severe water shortage, consumption of contaminated water and massive overcrowding in shelters have already resulted in a surge in communicable disease reports, with fears that major outbreaks are imminent.
  • Essential food stocks are severely depleted throughout Gaza and completely exhausted in the north.
  • Dehydration and starvation now threaten the entire population.
  • Mains electricity has been unavailable for seven weeks, with fuel supplies for emergency generators in those hospitals still functioning critically depleted.
  • Emergency drugs and supplies are almost exhausted in those hospitals caring for the injured.
  • Erez and Kerem Shalom crossings remain closed by the Israeli authorities. Following the humanitarian pause which began on 24th November, the Rafah crossing to Egypt has opened more consistently, allowing a small number of internationals and critically injured patients to leave and the delivery/distribution of significantly more aid into Gaza; but still only a fraction of the fuel, food, water and medical supplies needed.

Our immediate objectives:

  • To help respond to the current emergency, getting surgical teams and life-saving equipment into Gaza as soon as possible.
  • To simultaneously complete a thorough assessment of health care needs in Gaza to guide our subsequent work.

Medium-term objectives:

  • To continue support for the established adult/paediatric trauma and limb reconstruction services, to ensure resilience and robust succession planning.
  • To bring standards of major trauma care at the five principal hospitals up to modern international standards.

To support our vital work please donate through the link above. Thank you.

Limb reconstruction clinic, Gaza

Typical surgical instrument set

To read a case study that really highlights the value of the limb reconstruction service click here

Other Projects Completed in Gaza Over the Past 14 Years:

  • Established Primary Trauma Care courses in Gaza; delivered the initial training courses and trained local trainers within the Ministry of Health to ensure sustainability
  • Difficult airway management training - particularly important in major trauma
  • Further training in trauma care for first responders (paramedics)
  • Associated with evidence based medicine development in Gaza
  • Water quality - provided the public health service in Gaza with the equipment and training needed to monitor the quality of drinking water; both routinely and during emergencies
  • Supported improvements in theatre practice/hygiene and hospital sterilisation services
  • Supported the National Society for Rehabilitation with: an upgrade for their mobility aid repair/maintenance workshop; and the purchase of five Braille computer-speakers to allow those with visual impairment to utilise the computer laboratory
  • Funded the addition of an occupational therapist to the multidisciplinary team at Al Asdiqaa Association; a local NGO that runs a community based rehabilitation programme for persons with disability in Rafah, south Gaza