Development of a Limb Reconstruction Service

Since 2012 IDEALS has been supporting the development of a local limb reconstruction service in Gaza. Training fellowships at Kings College Hospital (KCH), London, for three orthopaedic surgeons, were followed by training fellowships for nurses and physiotherapists; helping to establish the multidisciplinary team required to provide such complex, long-term care. Specialists from KCH also visited Gaza to work alongside local colleagues, continue the training process and provide clinical care for patients.

Surgery
Limb reconstruction surgery, Gaza

In 2014 IDEALS began a hugely productive partnership with Medical Aid for Palestinians; a partnership that has continued to support the Ministry of Health limb reconstruction service in Gaza. Regular missions have been conducted, with orthopaedic and plastic surgeons, radiographers, nurses and physiotherapists from the UK visiting Gaza to help assess, operate on and follow-up patients with severe limb injuries, and provide on-the-job training for local teams.

Clinic
Limb reconstruction clinic, Gaza

With significant funding provided by MAP and IDEALS' technical expertise, millions of pounds of essential surgical equipment, specialist frames (to stabilise and remodel complex limb injuries) and consumables have been provided for the service in Gaza.

Set
Typical surgical instrument set

When the “Great March of Return” began in March 2018, the preponderance of devastating gunshot wounds caused by Israel’s use of live ammunition against protesters placed this service in high demand. Since then IDEALS and MAP have conducted 12 missions to Gaza, and a total of 675 limb reconstruction surgeries have been performed by the local service. Not only have patients been able
to recover functioning in their damaged limbs, they have reported increased mobility, lower pain and less anxiety following their treatment.
But many are still undergoing treatment, with many of those wounded at the protests still requiring surgeries, in addition to those newly injured through industrial and road traffic accidents.

Dr Mahmoud Matar, senior orthopaedic surgeon in the Gaza service, recently highlighted the continued importance of this project: “Firstly, Gaza is continuously a hot zone for conflicts. In 2018, when Gaza was still healing from previous wars and escalations in the conflict, the “Great March of Return” started and caused a huge influx of patients and complex injuries that the health system was not ready to address. Secondly, we continue to lack necessary resources and equipment. Without those items, we cannot help our patients heal and thus cannot prevent subsequent disabilities.” To read a case study that also highlights the value of this service click here

Despite the suspension of missions for over a year due to the COVID-19 pandemic this project has continued to serve injured Palestinians. UK specialists have maintained their relationships with local specialists through weekly video calls where they discuss clinical cases and decide on
treatment plans for patients.

We now hope we'll be able to resume missions in late May 2021 and build on the great progress made to date.

Projects Completed in the Past 10 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