Developing surgical and trauma care skills in Gaza

Wafa Kanan, MAP’s Project Officer in Gaza, and Rasha Al Moghany, MAP’s Medical Training Officer in Gaza, report on two medical missions supported by Medical Aid for Palestinians (MAP) in Gaza in November.

The ongoing closure and movement restrictions imposed on Gaza’s population present serious challenges to the ability of medical professionals to access the training and professional development they need to provide quality care to their patients.

MAP has been working for many years to bridge this gap and ensure Gaza’s health workers can stay connected to updates and technical developments in the outside world. Where medical professionals struggle to get out for training, we bring training opportunities into Gaza instead, with the aim of sustainably improving the capacity and self-reliance of Gaza’s health system.

The final week in November was a busy time at MAP’s Gaza office, as we were supporting two visiting medical missions in parallel. The first focused on core surgical skills training, and the latter on the creation of national ‘trauma protocols’ for Emergency Departments in Gaza’s hospitals.

Core Surgical Skills Training

Trainers from the UK’s Royal College of Surgeons (RCS) travelled to Gaza for the third time since March 2017. This time, they were helping to ensure that Gaza’s health system can sustainably deliver surgical skills training to local medics in line with the RCS’ standards.

The team joined MAP to evaluate the training capacity of the Ministry of Health Human Resources and Development Department’s ‘Simulation Centre’, in order to enable its accreditation by the RCS as an internationally-recognised Core Surgical Skills Training Centre. This accreditation will enable the centre to provide high quality courses in Basic Surgical Skills (BSS) and Core Surgical Laparoscopic Skills (CSLS).

During the visit, these training courses were completed for the third time in Gaza, delivered by a local Palestinian faculty of nine consultant surgeons who received the RCS ‘Training for Trainers’ course last year as part of MAP’s Core Surgical Skills training project. The latest cohort comprised 34 general, orthopedic, obstetrics and gynecology surgeons.

“I’m so satisfied with the first day of the course, it’s amazing to have the chance to learn things from A to Z in such a practical manner, especially at this early stage of my career in surgery”. Dr. Tayseer, R1, General Surgery.

“The strongest point in this course is that the faculty as supervisors guided us and were there for us all the time, telling us what our mistakes were and making it easier for us to learn.” Dr. Sara, R2, General Surgery.

Sadly, two medics from the visiting RCS team did not receive their permits from the Israeli authorities on time, and so were unable to reach Gaza. This meant that the accreditation process could not be performed locally, but will instead be completed in the UK on approval from the RCS.

Trauma Protocols

The month’s trauma mission was also a great success. Teams from the Emergency Departments of Al Shifa and Indonesian hospitals in Gaza were able to develop and finalise 17 ‘trauma protocols’ for their hospitals. These protocols are essential guidelines to enable staff working in busy Emergency Departments to know how patients with specific types of traumatic injuries should be treated, and the responsibilities of different members of the team in delivering this care.

The two teams worked alongside Grant O’Keefe, Consultant Trauma and General Surgeon visiting from the University of Washington Medical Centre.  They used trauma protocols from Harborview Medical Center (HMC) in USA to guide them, as well as their real-life experiences of treating patients in Gaza.

By the end of the week, nine trauma protocols were finalised by team at Al Shifa, while four more protocols were drafted, ready to be finalised and sent to MAP. At the Indonesian Hospital, eight protocols were finalised by the team, and four other protocols were drafted and sent to MAP.

 “It is really interesting to learn how to create a protocol. It is the first time that we as Junior surgeons got the opportunity to do such type of learning”, R3 General Surgeon working at Al Shifa Hospital.

With both teams in town together, MAP also held a joint educational symposium on General Surgery and Trauma Care, attended by approximately 70 general surgeons and Emergency Department staff . This is the first time that MAP conducted such an event. The cases of four trauma patients injured by Israeli forces at the “Great March of Return” were presented and discussed, in addition to one general surgery case too. The discussion panel included MAP’s delegation of consultants: Dr. Grant O’Keefe from the University of Washington Medical Centre; and Dr. Bijendra Patel and Dr. Nickolas Markham from the RCS.

On their last day in Gaza, the visiting teams attended the first part of the 6th Conference of Surgery in Palestine. Dr. O’Keefe gave a presentation on “Trauma System Development” while Dr. Patel delivered a presentation about “Reducing Bile Duct Injury”.

MAP would like to thank the visiting experts for their time and energy.

Please donate today to help MAP continue to support training and development for Palestinian medical professionals in Gaza.

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