Under siege, Syria doctors forced to improvise care
DOUMA: Surgical consultations via Facebook, reused sutures and gloves, and half-doses of expired drugs: doctors in a besieged opposition enclave near Syria’s capital are improvising to cope with shortages. Blood and skid marks stain the floor of a dimly lit operating room in Douma, a rebel-held town in the Eastern Ghouta region, where a surgeon was hard at work extracting medical sutures from a patient. “After we finish with the thread, we wash it and sterilize it again” for use on another patient, says 23-year-old nurse Anas Daher.
With the operation over, Daher removes his surgical gloves and, instead of disposing of them, scrubs them with water and soap and tosses them into a red basket full of other pairs. They are taken into an adjacent room, powdered and placed into a sealed jar with sterilization tablets for 24 hours so they can be used again.
“We doctors in Eastern Ghouta are taking steps that are medically undesirable,” says Mohammed Al-Omar, the head of the surgical department at the Damascus Countryside Specialized Hospital.
“We are re-sterilizing most of our surgical equipment, from gloves to tubes and even the surgical blades and sutures-even if it’s for a single stitch, and just one centimeter long.” Omar said he and his team are aware the materials are meant for a single patient, but they had no choice. The United Nations warned on Thursday that some 400 civilians are in urgent need of evacuation from Eastern Ghouta, including 29 who would die unless they were allowed to leave immediately. Since 2013, Syrian government troops have imposed a devastating siege on Eastern Ghouta, leading to rampant food and medical shortages and skyrocketing prices for whatever is available.
Facebook live, for surgery Residents of the rebel enclave have found creative ways to secure their everyday needs, including burning plastic to generate crude fuel and using solar panels to power water pumps. Eastern Ghouta’s doctors, too, have had to make do with whatever is readily at hand. They ration medication, giving patients half the required dose of drugs or expired medication, Omar says.
Hospitals limit operations to emergency surgery and the few remaining surgeons are forced to conduct procedures outside of their specialities. For guidance, they have turned to the internet to carry out real-time consultations with specialists. Hussam Adnan, a 44-year-old surgeon, was one of four doctors who, in October, operated on an infant with an esophageal deformation. —AFP