Intensive caring for Iraqi war-wounded with Medécins san Frontières

Nikki Blackwell,1,2 Xavier Lassalle 1

1 Medécins Sans Frontières, Paris, France

2 Prince Charles Hospital, Brisbane, QLD

The war in Iraq has led to an overwhelming humanitarian catastrophe with more than 650 000 civilian deaths, 1.5 million internally displaced people and untold thousands of orphans. Baghdad is the most dangerous place in the world. It is the scene of the worst of the fighting and the highest toll of casualties. The three major public hospitals in Baghdadr eport receiving more than 100 severely injured casualties per day. There is no reliable provision of water or electricity. Basic medical supplies and medications are unavailable. Medical equipment has not been serviced since the war began, and many machines have broken down and are out of service. Experienced, highly trained medical specialists have fled or been murdered. The most junior medical staff, who are unable to leave, are required to run the health service.

Medécins Sans Frontières has been attempting to provide humanitarian aid in Iraq. The conditions have required us to devise creative solutions. The development of a perioperative care program to support a sophisticated reconstructive surgery program for Iraqi war-wounded adults and children will be described. Conditions treated include burns from blast injury, complex maxillofacial trauma after bullet and blast injuries, and orthopaedic injuries from “ieds” (improvised explosive devices), bombs and bullet wounds. Other initiatives to deliver aid directly to critically ill patients in Baghdad, many of which are in evolution, will also be discussed.