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Summary

The webinar offered an insider's view into the life, experiences and humanitarian work of our keynote speaker, a renowned surgeon who has made significant contributions in the medical field and earned prestigious accolades including the star of Palestine Award. Her moving journey includes her struggles and triumphs as a woman surgeon, best known for her relentless advocacy for people who cannot express their plight. The speaker shared her insights about being a surgeon, her personal experiences working as an NHS doctor in a conflict-ridden region, and her unique perspective as a refugee on the loss, suffering and resilience she has witnessed. This interactive session provided valuable opportunity for participants to learn about the profound impact of socio-political factors on medical practice and healthcare in unstable areas. This would especially be an excellent learning opportunity for medical professionals interested in humanitarian work and global health.

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THIS IS THE EVENT PAGE FOR REGISTRARS AND CORE TRAINEES. FOR MEDICAL STUDENT AND FOUNDATION TRAINEE (PRE-MRCS) TICKETS PLEASE CLICK HERE

Moynihan Academy EGS FRCS Weekend in collaboration with ASiT, Roux Group and Duke's Club

IET Birmingham: Austin Court

Friday 1st of December and Saturday 2nd of December 2023

This is the Annual EGS and Trauma Symposium to bring together four of the UK’s largest Surgical Trainee collaborations and offer an overview of the surgical syllabus for EGS and Trauma.

The Symposium is set to be an engaging and entertaining learning experience.

This is specially aimed at those preparing for surgical exams, however we hope that surgical trainees at all levels will find this a relevant and useful educational event.

*Registrations are non-refundable, if unable to attend the day will have access to recordings and virtual vivas on the Saturday*

Learning objectives

  1. Understand the realities and impacts of geopolitical conflict, particularly in areas like Gaza, on the provision of healthcare.
  2. Explore the challenges faced by women and refugees in pursuing a career in surgery and how they can be addressed.
  3. Gain insights into the role of surgeons and healthcare providers in war and conflict zones.
  4. Analyze the importance of humanitarian work and the role of medical professionals in serving marginalized and oppressed communities.
  5. Learn about the Palestinian culture and history, and their impact on healthcare provisions in the region through personal experiences shared by the speaker.
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Computer generated transcript

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

And welcome to the second day of the eeg S weekend. We are really excited to, to have our keynote speech this morning, MS won the star of Palestine Award for service to the Palestinian people. She has been indicted into the Singapore Women's Hall of Fame. She continues to do significant humanitarian work and to champion people who cannot speak for themselves. It is an honor and a privilege to have you join us this morning. Thank you. Thank you so much, Mike and thanks everybody for being up here so early after your dinner last night. And I do apologize. II couldn't join you because the truth of, you know, you know that Gaza has been bombed again, the pause has gone. And since 7 a.m. yesterday morning, more than 200 people were killed. And I just feel that, you know, II just am in such a bad state that if I came to dinner last night, I probably upset everybody else. Michael wants me to talk about me as a woman surgeon. So this is a strange presentation because I talk about myself and I talk about what I do as an NHS doctor and what I do in my second job. So this was the figures before yesterday and you can see that after yesterday is nearly 15,000 civilians have been killed, more than half are Children and eight is not going to Gaza anymore. So there's drought, there is famine, there's death and there is a destruction of hospitals and home. Uh a bit about myself. I come to this country a long time ago and this is my current hospital which is bloo and this bit of it is about 900 years old. So or maybe 808 100 years old to be more accurate. So I am the first woman or be consultant appointed in this faces in its history since its foundation in 1133 II go to medical school in Singapore. This is Singapore University and you can see it is really a contrast because it is so modern. So I want to tell you a little bit about how I feel about being a surgeon. A surgical career is a gift. So it is not something which makes you money, it is not even a career, it is something which lives in you and becomes a part of you and a part of your patient. So it's not a day job. It's also a night job. So I arrived in this country in 1977 as a refugee. So I want to share with you how was surgical training like 46 years ago? It was very different. So I arrived as a refugee and I found myself a job in a place called he, he is famous for the Hads Wall and the cattle market. So it also run the spinal unit because all the jockeys fall off and end up with spinal injuries. So the next spinal unit was in stoke Mandible. So we are the northern bit Hexham Abbe Hexham General Hospital, which was where I worked. But of course, working as a senior House officer in Hexham will not get you anywhere to sitting your FRCS exams or getting you in a training scheme. So I had to apply for a job in London and this was my main mission hospital and I came all the way down and work in this hospital. It's no longer a hospital now it is the HIV kind of hospice S lens hospital. Also one of the hospitals close in East London to save money Hackney Hospital, which begin to be transformed into the current home, internal hospital and the mother's hospital and the Salvation Army. You can see how the hospital grew as kind of charity and homes for the destitute and slowly change in the hospital. It's very interesting because later on I tell you what happened to hospitals with the Palestinians. So I got my FRCS and that's where the trouble started. No one wants to support a woman doing orthopedics, especially a woman refugee. Well, I was offered these choices they are all very good. And in retrospect, I will gladly become any of the specialist down there. But I was very, very stubborn. I decided to do orthopedics and nobody could give me a good reason why I cannot do orthopedics. It is so insulting to the general surgeons and the plastic surgeons and pediatric surgeons are s and G people that I can't do orthopedics and therefore I should shift this way. It won't be insulting to you. You know, when you know, if you want to do orthoped, no, no, no, do general surgery. It's terrible, you know, so there is no proper reason for it. So finally, I started training in Bristol Hospital, which is part of ST Peter's. Now it was ok until they found out that it was a refugee and has got no home to go back to. So my consultants panicked because they were worried that maybe 6 to 8 years down the line, I will be jobless and unemployable. So now I'm going to talk about who are the people that matter to us, whether you are a junior surgeon, training surgeon, you know, a consultant surgeon or an elderly surgeon like me. So these are the categories of people that matters a lot and they are the ones we constantly measure how we perform and note the last in the whole lot are my junior colleagues and to me, as I grow older, they are more important because they are the people who will inherit, inherit the NHS and the future of surgery persons backs very easy. You, human being a doctor, a surgeon and you got to be very, very stubborn, no matter what anybody tells you. If you decide to do something, you go for it. Ok. But on top of all, always be true to yourself. So I was in ST Thomas Hospital by the time I was probably uh two years post Fr CS and then I took a career break. I was already five years in the UK and has worked climbing the surgical ladder which many of us in this room are doing right now. So I know exactly what the feeling is. Unfortunately, each evening when I went home, I saw a place being bombed. It was called Operation Peace for Galilee. Galilee makes sense to me because I am a Christian and I know Jesus was the man from g so it caught me among many headlines, but the devastation was terrible. It was as bad as what was happening. What is happening in Gaza now, blocks and blocks of buildings being destroyed. And this is horrible. This is called an implosion bomb or a few explosive which you see a lot in Gaza. Nowadays, something went in and the whole building just collapsed to the ground, burying everybody in it, incinerating everything. And that is a dual explosive bomb very, very destructive and buried in this heap of rubble, which is what's left of a 11 floor building are 200 bodies. So as a young surgeon, full of hope and sense of self importance, volunteering to a war torn country, this really taught me the meaning of humility. So after 10 weeks of siege, deny of water, food and medicine and also constant bombardment, a group called the P evacuated. In those days, the P was seen like the Hamas, they were called terrorists. And of course, as a Christian, I've got no affection for the PL but on the day of evacuation, I saw people putting up these banners saying goodbye through the evacuating po and I begin to wonder who are these people? Why do the people of Lebanon, Christians and Muslims alike care so much for them. They were crying, they were waving goodbye and there I think it, it begin, I begin to shift in my very strong belief that it should take everything possible to destroy the P. I think I probably sound like Netanyahu now because it is, it takes whatever destroy everything just to get them out. But with the ceasefire and evacuation, I was asked to join the Palestine Red Crescent Society which is part of the International Red Cross Movement. And this was my ID card. The first one I held and I don't know what on earth it says in Arabic. Except that I've got blood group. A you go to a, a war to country. The first thing is they, they cross match you. I was brought to hospital called Gaza Hospital. Gaza, of course, is very much in the news, but this was the Gaza Hospital in Beirut City. And of course it was built and given that name by the Palestinians to remember where they came from. So the people from Gaza found themselves in Beirut and in the refugee camps and they built hospitals named after the places they left behind like Gaza, like Hau, like Ramallah, like Naia and many many other hospital despite be officially vaccinated at the hospital of the ICRC. It was bombed, shelled. This is bombing from the top. You can see the ceiling being bombed, shell from the mountain and from the sea. This was Dr Habib's room and it overload this and it took me several days to find out what this is because I asked around and say, you know, and, and I hear in the news all the time that the camps, the camps, the Palestinian refugee camps. And I didn't realize that Gaza hospital was right in the middle of the Palestinian refugee camps of S and, and you can see how badly destroyed is. Most of the top five floors are blown up. But on the main road which is called Ro Sabra, you can see families coming back, bringing whatever possession they have on donkey cars on service, taxis, all men with young mothers with wounded Children, bringing coming back because of the ceasefire to rebuild their lives and homes. And I made friends with them and found out from them who they are and why they are in a place like that. They are part of the Palestinian refugees that were driven out of historic Palestine and found themselves refugees in the Palestinian refugee camps. There, there's no hope of going back and they continue in those camps. They built those camps, the tents became containers, became shanty towns, became towns of s and Shatila. Here Children were born, refugees, grew up refugees and died, refugees forgotten by the world, except when they are bombed and killed. I worked with Arabic staff. This particular gentleman was in charge of our A&E and basically he could do everything except operate. And of course, it took me a while to understand that his home was destroyed. Part of his family was killed, his brothers have evacuated and there's this constant anxiety of treating patients while worrying about his loved ones. I also learned more about the Palestinian people, their culture, their history. And here I show you this piece of embroidery which is done by the women. It is classical of the pin embroidery. And you can see on each, each square motive cross stitching of different different designs. And these designs always represent the village. These women come from villages which were destroyed, 600 of them were destroyed when the refugees were driven out. But through their stitching, they re recreate their heritage and the history and they educate me about what happened to the family. In the evening. I used to go down from the ninth floor of Gaza Hospital and sit with them in the broken homes where they offer me Arabic coffee and tell me the stories of how they lost their homes. They showed me keys, which they have carried for two generations hoping that they can return home. Of course, many of those homes don't exist anymore. So I had three weeks of this making friends working treating on wall wounds which are already festering and full of osteomyelitis by then. But the three weeks of this fire was cruelly broken when Israel re invaded this time on land. So far, they have only been bombing by the air. It's called a land invasion which you know, now BBC talked about it all the time. Several 100 tanks drove from south of Beirut and came rolling in Beirut City. They flatten everything in a way then shelled away through many buildings. A contingent of them broke out and sealed S and Shati which was a came, I was working in and it came closer and closer. And by the afternoon, we were surrounded by a ring of tents and nobody in the refugee camp could escape. The population of the camp was about 100,000. Then because many people came back since there was a ceasefire guarantee to rebuild their homes. Then the horrible thing happened, the BBC announced to the whole world that the po left behind 2000 fighters and they've gone in to get them. But instead, right where we were in a refugee camps, it was a broken bodies and shot up civilians like this man who taught me how to cook Arabic coffee babies. And soon many, many people who have never held a gun in their life or killed and brought to a mortuary. We operated nonstop and we inundated, we got two operating tables and we split ourselves into two teams. And in the evening, the following day, I decided to go up and look up a mother and a child. I've operated on, I found that the hospital has run out of blood. We were on to our last pack of o negative blood and the nurse wanted to give it to the mother. Both of them were in their homes and the hand grenade was thrown into it. Everybody else died except these two, our bridge and both of them. I also wanted the mother to have the blood and let the baby go. But, but the mother refused. So we gave it to the baby and she had a shot of morphine and died. Soon. This particular picture was not of the mother and baby. It was of two persons. A nurse on your left Swedish blue eyes, blonde hair, a patient on the right colored, lying flat on a trip. He just undergone a laparotomy where half of his pancreas together with a gastrectomy was carried out those days, orthopedic surgeons did laparotomy. So he was also a nurse. Unfortunately, he was a nurse from Bangladesh. He had dark skin wrong sex. So you're shot. She a Swedish knife looked after him. The hospital was filled with 2000 people sheltering to escape the massacre outside. But soon news arrived that the people who are doing the massacre and the tanks are coming near the hospital. So they all fled the following morning. The 22 of us were told to leave the hospital at gunpoint. We were desperate because we knew with 30 critically injured patients which we have just operated on in itu most of them Children, my Swedish nurse and a young medical student. Fourth year, I remember he was fourth year, refused to leave. So the 20 of us negotiated for them to stay with the patients. And today I know that those 30 patients survive because of these two individuals because they stay. The patients were not murdered. The rest of us were taken out. And as I emerged into the sunlight, we walked through the main road of the camp and I found out that while we are desperately trying to save a few lives, there are being butcher. Some of the bodies were already 23 days old blood was black. Some of them were just murdered. Last night, blood was still dark red. And for the first time I felt horrible, horrible that up to then I never knew that Palestinians existed and I never did my own research. And now they were dead because on each broken body would be a refugee identity card saying that they were from Jan, from, from northern Palestine. And that's why it's called Peace Galilee. If you kill all Palestinians, you will have peace. None of them would threaten to go home. I began to ask God what to do. It was desperate at the end of the camp was this kind of picture. I don't know whether you will have to see one real and close up in your life. It is a mass grave underneath. It was buried. 1000 bodies which was brought in and dumped there. The houses were bulldozed and destroyed and cleared. And so was brought to cover the bodies and white line strewn over them. The bodies dissolve and that's what's the mass grave. You can tell by the appearance. It's quite typical. I refuse to leave when the foreign office asked us to quit. I decided no, my life cannot end by leaving and coming back to London. I will stay when the cancer open. I went back and found that the homes, people rebuilt a few days before were again dynamited and destroyed. The paint on the walls are still fresh coffee, not drunk, but families missing everywhere. There were orphans standing before the walls where their parents were murdered, Children with no home to go to. And the Lebanese winter was approaching, that was late September going to October. And I am also now thinking of the people of Gaza with no homes to go back to because northern Gaza was completely destroyed. They have no homes to go back to. I will tell you the story of this little boy. He was the last person I operation on with my team before we had taken out at gunpoint. He was about 11 or 12 or 13. In this picture, he was shot three times and lined up with 27 members of his family. The adults were properly killed but he was small. So they missed him and the bodies fell on top of him. He survived and was brought in. We operated on him, transfused him and he survived when I return and found him in the ICRC Field Hospital. I was delighted. I decided to visit his grandmother, 70 years old in this picture who has walked 20 kilometers from another refugee camp in Lebanon when she heard of the news of the massacre and a r finding that 27 of 27 members of her family were killed. And this is what she said to me. What can I say in the memory of my Children, our doves are still here. Our carnations get fragrance and our sparrows sing their usual songs. Yet my Children are nowhere to be found. Beirut you took all I had you took my last hope in life and my heart lies dead on the streets. Apple your hair. My first born son was cruelly cut off his roots on your soil. Made the blood of whoever murdered your mingle with yours. Make your mother feel my pain. Mother says my Children come visit our grace. I go to your grave and tenderly embrace their stones. I asked the stones to make way so that you can breathe. I asked stones, please take good care of you because I've entrusted you to them. How eny those of you who are merciful enough to give my Children a drink of water. I asked every passing but to carry my love to you all and come back with your news. My calls remain unanswered. Mountains of distance are between us now, life, what life is left to us. Our hearts have died and our tears have dry for all the men and women who have died. God almighty, give us patience and my Children made my love always be alend to your path and may God show you the holy way. This was devastating. I rarely feel. You know, I'm, I'm quite robust in a way and I'm stubborn and resilient and it almost finished me off. So I walked out from this lady's house in the main road of it was a terrible scene because there were bodies lined up for identification and women crying and howling. And then suddenly a group of Children spotted me and they ran up to me and said you are the Chinese doctor. You know, it is very strange. You know, nobody believe I'm from Britain. They always call me the Chinese doctor. And whenever I say no, no, I'm from London. Yeah, I'm British. They say no, no, no. You are a very good woman. We love you, we love the Chinese. We hate the British. The British are very bad people. You know, they do terrible things to Palestine, but the Chinese are very good. Well, and then they begin to talk about what happened to them and all the things they have to face. And then suddenly they line themselves up and asked me to take a picture of them. And as I took out my pocket camera and focus, they raise their hand in a victory sign and said this to me. We are not afraid, we are not afraid of this rabies. I took this picture and then later on developed it in London. When I came home and looking at it, there were broken buildings behind and the kids live in those ruins in front of them were the bodies laid up for identification and the air was filled with a stench of decaying humans, flesh. But between death and destruction or the Palestinian Children. How dare I despair? How dare I get so depressed? So from that moment, I think I've undergone a change. My hospital is no longer functional after the incident of the massacre. So I began to speak up because as a human being, I have a voice. I still have that left. There is no hospital operates on my patients have died. I failed to save them. I've watched him being killed, but I can still tell their story. And today I'm with you to tell their story. I'm here to show you the pictures of the Palestinian Children who gave me courage to carry on. And that was 41 years ago, I gave testimony to the Israeli Kahan Commission. At that time, the Israelis were furious. Now 90% call for the destruction of Gaza. That time, 100s, in fact, half a million Israelis demonstrated in Tel Aviv demanding that the army withdrew from Lebanon, demanding an investigation into the massacre that resulted in the firing of the Defense Minister. The IGF took me to the Holocaust Museum and you can see that this is a profound saying how they should never forget. But at the same time, I will also not forget, never forget peace. Lebanon with the heavy pressure for peace from Israel with the international outcry resulting in the massacre with ap already divided and destroyed. Everybody was hoping that finally there will be peace, peace in the country called Lebanon who has seen no end of war. But there's not to be after speaking in Israel. The idea of I say you please don't go back to Lebanon. We can't protect you. Something might happen to you. And where did I go to? I came back and I've got to go back to the NHS. The NHS is like a haven to me. It not only provide me training, it not only gave me a job, it also became a home for a very destitute doctor. I again crossed the river time into the north. I returned to my day job. Ok. Um Michael, should I carry on? You want a break or not? This is ok. All right. And anybody wants a break, just feel free. So I crossed the Tame bridge to Newcastle to a royal infirmary and to meet my old friend, Professor Jack Stevens and uncle Jack says that you better get your training. You just got the FRCS and it disappeared, you know, and there's no way to continue. So he gave me a local spr job and they walked and then I stayed and I work this, this was the sac. But then before long, I have to take a second career break because the Palestinian refugees in Lebanon were again being attacked. It was 1985. They were so desperate, so desperate that they actually called me by phone about them being attacked, Gaza Hospital being burned, the nurses taking arms, taking on arms to protect the hospital and being killed. Would I come back? I don't know what I can do at that time. We've just registered our organization, Medicaid for Palestinians, we have raised 600 lbs basically to help them rebuild the sewage in Sabra can. But this is more than sewage. This was a total destruction of Gaza Hospital. So, so we began to send volunteers and of course, I was the first volunteer and we went back, there was no more Gaza Hospital because it was taken over as a military command post so that they can shoot and fire into the camp. And operation has to be done on people's so far in the kitchen under very basic condition, but we managed to walk and I saw old friends, I know who later became the chief surgeon of the ICR C. And of course, over the three years where the camps were held under siege and systematically destroyed, we had 400 medical volunteers to medical aid for Palestinians. I show you this picture because she's the oldest of the whole lot. She was 80 in this picture 80. So now I've got a problem. I'm nowhere near 80. So I've got to, I've got to continue have an eye. 1987 was vaccinated the inter International Year for the homeless. But despite all the UN resolutions or how everybody should have a shelter, this was what she looks like. And when the rains came and the winter came, all the rubble collapsed and the family fled to live in makeshift shelters like this in the underground car park. And behind each curtain, live a refugee family. Yet it was when I was doing the milk round with Mama Rita that I found out something very special. The Children were very happy that morning. They are no longer crying, they're running around and they told me that there's an uprising in the, in Palestine, their home up to then I've got no idea that there is still bits of Palestine left. So this was, they are Palestine and you can see the evolution of what happened. The map to the extreme left was Palestine before 1948 right. The green were land belonging to the indigenous people. The white were immigrant colonies in 1947. And of course, after that, you have the BEFO declaration which wants to split Palestine and there was war in 1948 Britain gave up because they couldn't handle it and handed over the mandate of Palestine to the U. And the U went on to suggest a partition of Palestine 56% to form a Jewish state and the remaining 44% to remain for the Palestinians. But instead of that happening, there was a big civil war ending on the third map. This one and this third map was where Israel conquered 78% of the total Palestine and the remaining land which is 20 22% became West Bank and Gaza. So that's how West Bank and Gaza came into existence. And a map on the extreme right was a failed negotiation. After Oslo, you can see then the plan was implemented to systematically separate and fragment the remaining of West Bank. And you can see Gaza that little bit of Gaza in the Southwest. And this way we are talking about later. So the first intifada, these were the figures was on armed Palestinians against the occupation. So these were the people who were killed, 66,000 wounded and half 100 and 20,000 in prison, half of them Children for throwing stones and long curfews. I was asked by the Bishop of Jerusalem, whether I would go to Gaza to look after the wounded and start some sort of basic orthopedic trauma care for the people of Gaza. And of course, I say yes, I'll go and this is Gaza and you can see it is the size of the isle of white to the north. You enter by s which is really controlled. There's no more s because it's the northern half of Gaza is completely bombed flat and occupied by the IDF. Now the southern half of Gaza which you talk a lot on the, on the television where all the northerners were told to go to was where can Rafah and so on is being bombed now. Ok. So the what's happening today is the 1.2 million people from the North were told to evacuate to the south and in the south, it was so crowded and now it is being bombed and pushing them to Rafah, which is bordering Egypt. And of course Egypt say no, we don't want 2.2 million refugees on our ground. Why should you know they have a home in Gaza? You give it back to them. So that's going on. But Gaza was already under blockade from the land and sea. So nobody gets in RFA into, into Gaza without Israeli permission and nobody get into Arabs into Gaza as well. This is checkpoint. But once inside Gaza, you can see this. Now, this was the first intifada when women and Children will demonstrate against Israeli armored cars, tanks and so on demanding their rights to a homeland, demanding that the occupation stop in return. Many of them were killed. I was put in this hospital, the only hospital in Gaza strip, not under Israeli occupation. So the church owns this hospital and this hospital was built before the state of Israel. It was built in 1890. It's called a Arab hospital. It was built by the the Anglican church and of course the funding came from the Baptist now and you hurt on the 17th of October, thousands of people sheltering in the car park in the front, in the courtyard of Ali Arab hospital thinking that they are safe because it is a Christian hospital and that was bombed, that was bombed and 100s were killed. And that was the one where they have lots of debate on television. As to whether Hamas actually destroyed the hospital or the Israel bombed it. I won't go into that. Now, that's not my job. I will tell you many of them were killed. But what happened? Strange, although the hospital was damaged, the ceiling of the operating theater collapsed. So many died. A week later, they managed to refurbish bits of the hospital and open 22 beds and it continued to function until 10 days ago when the tanks came in with a land invasion and ordered everybody out and also captured some of the doctors and nurses. These were my colleagues from 1988 operating in Ackley hospital. The wounded that came to us, people were shot dead by rubber bullets. And of course, for the first time people around the world begin to see what an occupation really looks like because anybody can be arrested can be put in prison. The curfews were long and the refugee camps. This is jab you heard recently. Also Jabalia camp was badly destroyed. Many killed, the sewage system will just drain freely and the Palestinian refugees. This particular picture was taken after a curfew of 30 days and 30 nights. Finally, they could leave their home to go to United Nations and fetch the restaurants. So if you want to know how Palestinian looks like under extreme deprivation and humiliation, that's how they look like. I think it is important, you look at them because these were the faces of humanity faces like you and me and they are also the Children of God and the beautiful little babies of Gaza. Now they will have grown up and I don't know what happened to them. The rubber bullets and the tear gas, the tear gas came from USA, Pennsylvania. And of course, I could not get by without showing you how beautiful Gaza is. This is the beach of Gaza, white sands, blue sea. You know, it is, it is more beautiful than Costa Del so or southern Italy. This is the sunset in Gaza. Springtime in Gaza. That was me. But when I took this picture, 340 Palestinians were shot and wounded and came into the hospital. They lined our court here, six of them died without even having an operation or treatment. You know, Gaza was never a desert. Gaza grew citrus fruit. This family grew citrus fruit and oranges for 100 and 50 years. Dates garden. This was, this was the fertile south of Gaza. I don't know if I ever get into Gaza. Now, whether it will look the same or would it be burned and destroyed while I was working in a hospital? I also wrote a lot of stuff including things for the who and reports for the United Nations and of course, I was told to leave. So back, I went to the NHS my day job. You see the NHS is a home. It's like a parent part of the reason I've got to tell you about the NHS. Normally I skip the bits of the NHS. When I give this talk is that your generation and my generation must look after the NHS is to remind me to tell you that. OK. So back to the pro and this time, sweet. You don't run away, you finish your training and get your CCT before you go. OK. Right. I did. All right. And only that, I also have to do a sub specialty. And this is the father of modern hand surgery on your left L Swanson Swanson who have all these prosthesis for wrist and fingers and so on. And two, your right, Tom W who has recently died and they both taught me hand surgery. So that's Tom, Uncle Tom and me in Grand Rapids. And that brought me finally to settle down in bars health as a consultant. And then I began to have young trainees. Many of them women who became very successful. To your left is Professor Caroline H and to your right is Kate Brown. Both of them leading orthopedic surgeons and on the council of BA and of course me, OK. And my patients who are my patients, my NHS patients are wonderful. They have got no idea where Palestine is, but whenever I come back, they will look at me and say, are you OK? MS don't be sad. You have done all you can for them, you know, this, this lady has rheumatoid arthritis. I did 19 operations on her. Did she turn around and say you are hopeless 19 operations and I'm still not right. No, she is full of gratitude. See, it is a blessing to have patients like that. You do everything you can for them. And one of my rheumatoid hand patients came back to me after I have operated on the fingers with a picture like that, she drew it. She said, I've done it. This is for you and many, many other things. So your patients are also very special. So remember if you're a surgeon, when the patient sign the consent form, it's not a small thing, you know, it means they trust you, right? And let's honor that trust. So seventh of July terrorism came to UK this after the Iraq war. So you have Islamophobia. We have anger and we have the July bombings. So London Hospital, one, not one of the biggest recipient. We have 191 casualties. So this is operating. So civilian polytrauma, we have lots of it. This one have got 1234 fractures, ok? Forearm fractures, ok. Platelet fasciotomy arterial injury. And when he was all healed, about eight months later, he made an appointment to see me. So I was worried, I said, have you done something? What happened? I thought you were ok. I said no, I want to come back and show you how fit I am. Can you take a picture of me? I said ok. Yeah, here it is ok. So it is good to be a trauma surgeon because when your patients do well, it is really the best reward in the whole world. So I had a period of peace because the Palestinian negotiated peace with the Israelis under the Oslo Accord. And from 1993 and 28, I was ok because my family in Palestine were doing ok. But suddenly we received news that Gaza was being bombed. This was, this is your generation. Many of you would be aware of that 27th of December while we were celebrating Christmas, we had operation cast and these were the damages according to wh O you know, Gaza was very crowded. It's still very crowded. This is, it's just been bombed yesterday. So if you drop a bomb, you can see how many people you were killed. So precision bombing, safeguarding of siblings are rubbish, collateral damage has to happen. If you drop a bomb in that kind of setting, phosphorus was used large fuel air explosive. See this fire ball, the northern half of Gaza which I knew so well were completely flattened. This is 2009 few explosive bearing huge blocks, melting concrete death, targeting of hospitals of ambulances in schools. This was an American school for the elite bombed four times un compound where people were sheltering. Was she with phosphorus? This was phosphorus burns just look at it in the lancet. It is a publication by a Palestinian surgeon, new form of explosive go dying. We just absolutely just cut someone's legs or torso into half. This is Shifa Hospital which you heard so much on the news recently, he was accused of being the headquarters of Hamas. These were the surgeons working trying to save life and the mortuary of hospital in the Children and whole family is being wiped out before they could scarcely recover before the wounds have healed. Another big wall Gaza 2014 operation car sled twice the number of deaths, twice the number of wounded, many more Children, un shelters, clinics, hospital homes destroyed. And yet Gaza rebuilt the tensity which they have resulted in have been rebuilt. You have seen it now on the television because this part of Gaza, there were many buildings now which are being taken down currently. So what makes the Palestinians so special? I've been asked so many times. Can't you work with some other people? Why do you stay with them? This picture probably tells it all two women sitting in a heap of rubble. Palestinians are builders. They are also rebuilder. They never take no for an answer. If you want them to die, they will die standing because they will never live on their knees. The great march of return is 2018 and I've never been on the flotilla. I don't want to go because I'm the founder of Medicaid for Palestinians. So you don't do a thing like that. Well, what is it all about? It is about the right of return and it's also about lifting the blockade on Gaza, which has happened since 2007. Gaza was under complete siege. If you look at this man, this picture was taken in 1988. No, 1989. Springtime. What's so special about it? He's a gatekeeper of Ali Arab hospital. One day he asked me for a favor and I asked him, what was it? Can you take me to show me my home? I said I was just in your house yesterday, drinking coffee. Say no, no, no, no. That is refugee camp. I have a real home and I want to see it. I said, where is your home? Oh, I can walk for 1.5 hours and reach it. I said, just walk. No, I can't because it's inside Israel. I can't go, they kill me. So I drove the hospital, ambulance put a Mohamad on my left hand side and carried a piece of paper in Arabic saying that he's a paramedic. We are going to Jerusalem to buy supplies for the hospital and the Israelis that are passed and we reached this because my home. But when we get down, we found that there was no home left because the homes and the whole village was completely destroyed and not even built over Abu Mohammad even if he has a right to return to his home now has got no home to return to. This was after an article we wrote in the BMJ, the policy was since the great march of return was totally non not an armed struggle. This shoot to main. So the wounded was horrendous 36,000. So the you know there are two ways of of conducting hospitality. If you kill a lot of people, you are very few wounded today. The death toll in Gaza is 15,000, the injured is 26,000, right? Because it is it is actually the policy of killing. So you see this one, you have lots of wounded but very little death because it shoot to main. So it lumber the hospitals with a high kind of burden. You got to deal with amputees, limb reconstruction, traumatized people. And also of course, many of the health workers were shot and five dead. So these were the pullers, these were the wounds. You want to study high velocity gunshot wounds by snipers come to Gaza special bullets which on impact just opened up. The Gaza doctors call it butterfly bullet. He struts the tissue creating this kind of horrible, horrible injuries. That's very hard to reconstruct. And while this was going on USA move its embassy from Tel Aviv into Jerusalem, you might not understand the political significance East Jerusalem was supposed to belong to the Palestinians under ceasefire agreement. If you move your embassy into Jerusalem. It is a recognition that Jerusalem no longer belongs with the Palestinians. So the Palestinians protested and more than 100 were killed in about half an hour. So it was desperate and hopes were all gone. So of course, I got to do something. I don't know what to do. So I wrote this and send it out basically expressing how I feel. And here I say I have seen Palestinians continue to rise above every tragedy. What we must do is to continue to support and stand in solidarity with them. They are a nation of builders and rebuilder are people of strength and resilience of courage and honor. May we as friends now draw inspiration from them and continue to journey with them and not be afraid and faint hearted, the dead will be buried and find peace. The wounds will heal, the strength will return. The young will grow up and lead the struggle. It is not over until justice is restored. Not over till tyranny is defeated. Not over to Palestine is free and all can live in security and dignity. Big words. So the challenge came when you come on a flo and be our me, you see if you write something, you got to live by it. So OK, yes, I went, went on a Norwegian fishing boat which was captured in international water and all of us were taken to prison upon release. I came back to London feeling really lousy, lousy is the word. And then suddenly I received this stress. The women in Gaza has made distress for me. And this dress was made in Gaza and then sent across the blockade from Gaza to Amman Jordan and from Jordan, it was flown to Lebanon and from Lebanon, it was taken to London for me and with it came a message as Palestinian, we will give you our best. Our women will give you our very best. Every state carries our history, our culture, our heritage and our residence and our steadfastness. So from then on, Gaza has been kind of attacked every year because now what happened is that they are trying to empty out West Bank and Gaza gets in the way because they shoot rockets which are very ineffective but annoying. So this is what happened to 1000 Palestinians. They stormed the mass. And so Gaza got the cheek to demand that the Israelis withdraw from the mosque by 6 p.m. 10th of May. If they refuse, you get the rockets. So the rockets fired and the bombs came. Pestinum killed 260 buildings were destroyed. Many, many these are just you can take it from the internet. 14 families are wiped out, including the head neurologist and so on. The whole families were killed and Children, even New York Times responded and of course they were accused of being anti Semitic. How dare they publish pictures of dead Palestinian Children to the mental health aspect were also horrible. Children live with depression, grief and fear, be wet. I'm able to concentrate, can talk cab workers and givers feel unhappy, helpless and hopeless. This was before the latest another assault on Gaza and yet came an article in The Guardian written by the head of mental health services and say we want our Children to remember how to laugh, look it up. So now the situation is even worse. So from where, what do we do now? I don't stone. I know we can make a difference. I know you can make a difference because it is possible and it is a blessing that we all can make a difference no matter how small I will remind you of my journey. This is the Pakistan earthquake. This was Gaza Mass Grace. But the Children of tomorrow art therapy for the Children who are traumatized mentally. What would they draw? Look at what they drew. The tanks are coming, helicopters shelling us on our building. What can we do? We will burn tires to oppose advance. We will throw stones, we will become paramedics and doctors to heal the wound. And beauty is still possible. They might be poor but they make beautiful objects in the colors of the pine flag embroidery. And somewhere the flower is still bloom for my family in Gaza. The next slot of slides is more for you to look up. If you want to find out more. These are either written by me or by friends who have influenced me. So there are about 13 of them don't have to look at it and a better end here. Ok. Thank you very much.