Surgery on the Frontlines of the Yemen Civil War

Ammar Darwish’s experience of operating and teaching in the world’s worst humanitarian crisis.

CONTAINS GRAPHIC IMAGES OF SURGERY

“The Yemeni medical staff in Marib sent a call for assistance as they have been extremely overwhelmed with injured patients from the war”

David and Ammar were called up by Syria Relief to assist the medical staff in the city of Marib, who were facing an unprecedented number of patients injured in the intensifying conflict of which the city had become an epicentre. The team left London excited to get back to their roots, operating in areas of conflict and austere environments.The team left London ready to begin the long journey to Yemen, where they would meet with Syria Relief – a charity that provides support to Syrians needing medical intervention, food, education and other necessities. The team arrived at Seiyun airport in Yemen, and travelled through the night to reach the hospital in Marib that was to be their home for the next two weeks.

Marib is just 10 or 15 kilometres from the front-line of fighting, a grim reality that was ever-present as the team arrived and changed immediately into their theatre clothes.

After meeting the local medical team David, Ammar, Mounir and Dr Asan Rafee had a quick tour and then immediately started working. For the patients at this trauma centre, there was no time to lose.

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“This is one of the first operations that we dealt with. A gunshot wound to the abdomen in a young man who was left in a state of shock. He bled a lot and we had to do a trauma laparotomy and damage control surgery. We operated on him immediately.

David is just behind me in the background. He is getting ready to go to another theatre to deal with another case.”

“This is another case. Another gunshot wound to the lower leg causing a vascular injury. You can see David operating and myself assisting in treating and sorting out these vascular injuries to the blood vessels in the leg”.
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Although the local surgeons are very experienced, they have not dealt with many of these cases before. David and Ammar spent many hours training the local surgeons, imparting their years of knowledge gained through war surgery and taking them through complex operations.

“Here, we had a gunshot wound to the chest and abdomen. The patient came almost pre-arrest (his significant blood loss was threatening to stop his heart and lungs). Immediately the team performed a resuscitative thoracotomy and a laparotomy”.

They opened the chest to stop the bleeding, performed damage control surgery and took the patient into intensive care. All the while, David and Ammar were teaching their local counterpart how to perform this procedure, and to deal with these injuries.

After 48 hours, the patient was brought back to complete the surgery as he had become more stable.

After 7 days, the patient was discharged. His life had been saved.

“This is the team after a long day of operating, dealing with different kinds of injuries. We sat down, I think it was almost 8 O’clock in the evening to break our fast after a long day of operating – I think 12 or 13 hours of operating”.

“When everything had calmed down, especially at night, we used to give teachings. David gave lectures on different kinds of injuries and how to manage those injuries. David did the main teaching, and Mounir and I helped to translate”.

The team did around 45 operations in Yemen. This ranged from life-saving trauma surgeries to complex reconstructive surgeries.

They returned home to the UK ready to deploy again as soon as possible, to wherever they are needed.

This presentation was made possible by extensive voice recordings made by Ammar Darwish, and photographs that he and the team took during this 2021 mission to Yemen.

The mission itself was organised and conducted by Syria Relief. Head to their website (https://syriarelief.org.uk/about-us/) to learn more about them.