Computer generated transcript

Warning!
The following transcript was generated automatically from the content and has not been checked or corrected manually.

So our next speaker is MS Atiga consultant, laparoscopic and colorectal surgeon, humanitarian advocate, and ordinary lecturer at Queen Mary University. Drawn from our experience in Gaza. Today's um MS Cogs talk humanitarian surgery in Gaza will focus on strategies to ensure access to surgical care and the severe resource uh constraints. Please join me in welcoming MS G Good morning. Thank you so much for coming this Sunday, chilly afternoon. And um yeah, so I think picture speaks itself like such a profound photograph. Um how even the healthcare workers and ambulances are short. So my name is a um I'm working in New Home and uh Saint Bart's Health Trust. The topic today is humanitarian surgery in Gaza. So we gather here today at a crucial crossroads of medicine, humanity and conflict with pressing urgency in crisis affected region. Um like Gaza, what is humanitarian surgery? It is providing care in resource limited settings. It is a surgical care provided to vulnerable populations in times of conflict, crisis or disaster to underserved populations through the charitable or disease specific mission. So these programs are often set up quickly in emergency situations which can make it challenging to ensure quality of care. And I would like to add to some extent accountability challenges in conflict zone. Um What are the challenges usual ones like access to care with movement restrictions which often hinder the ability to patients, healthcare workers to reach the facilities attacks on health care. Uh which we have seen ample examples recently on facilities, ambulances, workers uh which are frequently the target in conflicts in violation of international law and on background of all the acute injuries or uh mm things going on. There's always chronic diseases which are like um diabetes, hypertension, cardiac disease, cancer, other chronic conditions. Uh people often forget them uh in the time of acute crisis. So um how do we arrange care by um uh in Gaza amidst the current crisis? What it would require, it would require coordination with other international organization, adherence to emergency protocols, collaborate with organization like Red Cross MSF map who so secure funding and supplies. I mean, these are all the usual staples. Um Coordinate logistics uh advocate for access like pa for humanitarian pauses, corridors, pressure for ceasefire, um deploy mobile clinics and navigating cultural sensitivities and political barriers. So one would ask why Gaza because Gaza uh for last uh many years, uh more than 75 years has been one of the most densely populated areas on earth. It faced unrelenting humanitarian crisis, blockades, periodic escalations of violence and systemic resource shortages. Uh hospitals and clinics were burdened to the break point understaffed, underresourced. Um people facing displacement, trauma, psychological stress compounded by inadequate access to care and infrastructure challenges. Uh We'll see more in detail later on electricity, water, medical supply, et cetera. So what was it like working in Gaza? Nearly 2.1 million population were in dire need and almost 50% essential medications were at zero stock level. That was last year. Pre um current crisis due to restriction on leaving the country, the access to health care specialist was limited and prewar uh precurrent crisis, there was no pediatric surgeon, no radiation oncologist, no mental health support system, no screening facilities, lots of which we take for granted in uh western uh world. So what is innovation is like doing new things? Uh Despite the challenges, the resilience and in unity of the medical staff and professionals, it shines through nowhere better than in Gaza. Like we've seen how they have optimized the resource. We here have luxury of dispose like staplers, energy uh devices, equipments uh which we would throw after single use. Um I would say typical um in a Gaza setting, people would use them at least 50 times by just dipping it in a like a side solution, solar powered clinics, et cetera. Um You know, because uh typical in an operation theater during long operation, electricity would go 4 to 5 times and generators would kick in. So this would be helpful. Um Also like with the new A I technological innovations uh which will be covered later on. Uh how we can uh make it the care more accessible to remote areas with uh specialist uh uh guidance, et cetera, optimizing limited resources. So I would like to share my experiences from 2019 to 2022 on three trips uh or humanitarian missions that I undertook in Gaza. So these were entry to Gaza just uh playing a small video. Can we play, please? Well, Luke is not coming. If we go back, uh the volume, it might be difficult to go by the volume. He oppose it and do the volume we go to inflate again. Brings back a lot of, lot of memories and ready for that video. Oh, sorry. So this was Era Crossing which is like a bar electrified tunnel of one mile long. And if you would deviate um uh in, I think you would be vaporized by snipers. This is how you enter Gaza. So, on the first trip, um this was uh along with the American uh group called Med Global uh and also Palestinian American Medical Association in conjunction with that. And it was self funded. So, so proud of this group because I would call this a diverse group. There was surgeon, anesthetist, intensivist, uh medical specialist, pediatrician, a nephrologist and why there was also in faith and beliefs, there was like uh Muslim Christian, Hindu and a Jew. So uh I think uh it's not uh limited, like if you need to reach out for help, uh you know, you not need not be restricted by any of your beliefs. So we had a great time. We were treated with like a celebrity. Welcome. There was uh um this American surgeon who was uh uh hepatobiliary. So we would do uh we did a joint colorectal and metastatic liver surgery symposium. Also, we did surgeries, which I will show you share with you later. So uh first day uh typically would start with the outpatients, meeting along with the local surgeons and uh trainees who would uh also um translate with us to the patients. These are all cancer patients. And uh also in the ward, I would like to share this picture of happy I would call like uh white angels. People are admitted in the hospital or in the ward who are depressed in pain. These are patient uh going along providing psychological or what I would say, spreading joy. So just few pictures of cancer surgery in a war zone total colectomy for synchronous tumor. That's what I was saying that uh often theater would be uh electricity would go in theater and we would be left in dark till the uh generator kicked in. So proud to share this photograph. This was a lady whom we did the sigmoid resection. Next day when I would, I shared with her the photograph of the Specimen and explained to her about her surgery. She expressed gratitude through her son and through her son, she conveyed to me that she would like to be my Facebook friend. So I think the language, um universal language of love doesn't need any words. Um This was a minor 12 year old girl. We did first lap appendix in the hospital because before that, I think everything was probably open. Um The second and the third trip from uh was funded by Medical Associated Association in Palestine. And uh we completed typical activities like uh outpatient clinics. So three days of surgery ward round symposium and debrief meet. This is team Gaza, local surgeons and trainees, consultants, radiologist. In this uh photograph shows first time we took a stoma nurse and a colorectal nerve specialist making this uh entirely like a MDT experience. So this was uh at a European Gaza Hospital with the chief surgeon there. And uh we were doing a complex uh colorectal case but the pre op and POSTOP care was provided by uh the toner specialist and cancer colorectal nerve specialist, Tim Gaza. Um This photograph here is the female surgical trainee and this photograph makes me both sad and happy. Same time, this was the theater Metro. Anywhere you go in the corridor of the hospital, you see these happy places. But I don't know today uh about her whereabouts, which make me extremely sad. We would typically do live sessions from the theater uh with the team sitting outside and uh for moderator doing the live uh commentary. This was uh so taking the trainees for simple operations like a appendix and cholecystectomy as well. So you can see now the trainee being do doing the operations uh last day of uh any such mission would be like a symposium where in the whole team, the theater nurses, doctors would gather and have um nice dinner and talk. So I also took uh you know, we have the Fr CS books. So how much at liberty um or luxury we have to move if we need to attend any conference or do a workshop or get access to books. Uh It is instant, instantly uh accessible. But for us, typical surgical training in Gaza, things were not accessible then. So we took a few sets of books and uh um you can see the joys for collective sharing. Also. What does war brings war brings um collateral damage like war displaced Children. So this was Al Amal Orphanage in Gaza. Each of my trip I crowdfunded um and collected a substantial amount of fund for this orphanage which I'm so proud that uh I was a part of it and this photographs all female medical students or future surgeons in Gaza. So coming back, how do we um keep it's not just a one off mission where you go and provide do some surgery and then uh the care or the training is not sustainable. So we every two weeks along with other pathologists, radiologists, and surgeons in UK, we would do a MDT along with the surgeons there. And uh this would be where all the cases for the next two weeks would be dis discussed. So this was a true uh collaborative MDT with Gaza and UK team just wanting to share a few de uh data from math. So this was a long term capacity building of general surgery in Gaza and West Ban, wherein we took this pathway of train the trainer, basic surgical skills, basic laparoscopic skills, advanced laparoscopic and uh con um continued cancer management. So just to share a few more memories. So all in all uh roughly we trained about 200 surgeons, 200 complex cancer operations were performed and 400 cancer cases were discussed from 2016 to 2022. So what is life in Gaza? Like people would have imagined life under siege, life in conflict, life in crisis, but life goes on normal. Uh I have such beautiful happy memories. This is all pictures are from my mobile. Um In this presentation, this was from a hotel window just outside, beautiful moss. This hotel is the one we stayed in which was all built from reclaimed materials and like um mm what do you call devastated building sites? Probably all gone. Um I remember the beautiful food. How warm the welcome was. Um you know the um Baklava and uh the in center, this uh what you would call a dish Arabic dish called maloba, which means upside down. So I think in the history of me being vegetarian, they served me a vegetarian maloba. Traditionally, it is like a chicken cooked under brown. So and the world's best strawberries I found out were in Westpac. So, so much of things that, you know, you learn new things. So my zone is not just about medical treatment, it is about restoring dignity, hope and humanity. So when in Gaza, I would like to say uh there is a ancient Sanskrit phrase, um some of you may be aware of that. What what does it mean? It means world is one family. So though it is ancient, but it is still uh relevant because we need to know there is a global perspective of um collective wellbeing and shifting one's ideology from one individual, one family. It should be collective wellbeing. So just um happy memories. And I would like to dedicate this to all the medical nu- doctors and nurses uh who lost um their lives in this. Um Some of them are there probably not all in the current crisis. Thank you.