Dr Javid Abdelmoneim is a specialist in emergency medicine at Médecins Sans Frontières (MSF). He was invited by Cambridge Friends of MSF to speak about his experiences working in Basra, Iraq and Cité Soleil, Haiti. Dr Abdelmoneim gave his talk at King’s College on Wednesday 9th February.
Dr Abdelmoneim’s Basra expedition, which began in October 2009, involved just him and another doctor in a small-scale consultancy placement. The risks and restraints of working in a politically unstable region were clear from the outset: death threats received by the team forced them to retreat to Jordan for a frustrating two months before beginning the project.
Dr. Abdelmoneim stressed that once they returned, it was skills rather than material resources that were lacking in Basra. The MSF team were tasked with bringing order to an emergency department with no triage (system for determining the order and priority of patients’ treatment), trauma processes or basic resuscitation methods. But they were able to make important connections and secure funding from the Iraqi Ministry of Health to accomplish their work.
Dr. Abdelmoneim’s pictures illustrated vividly how the turnaround was accomplished. While taking all the hospital employees through basic and advanced trauma life support training, the team purchased trolleys for the hospital and introduced a records system. Dr. Abdelmoneim was pleased with the progress made in Basra, where there are now new MSF workers continuing the project. He predicted that MSF will look to carry out further Emergency Room projects on a similar model.
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After only a six-month turnaround period, Dr. Abdelmoneim set out for an expedition of a very different kind in Haiti. The team was based at MSF’s Choscal hospital in Cité Soleil, a slum of Port-au-Prince and one of the most deprived areas in the Western Hemisphere.
Dr. Abdelmoneim said that while the doctors were better trained than in Iraq, here they were faced with a critical lack of medical resources. Everything in Choscal is provided by MSF, right down to the cooking pans, rubbish bins and fly-nets. The experience was a gruelling one, with no diagnostic equipment available in the hospital, and a mortality rate reaching 50% in some months. An already dire situation was made worse in October 2010 when the cholera epidemic hit the country. Daily intake rose from 30 patients a day to 230. The team’s logisticians had to immediately provide enough beds and 300 extra staff were recruited to deal with the surplus. The team managed to positively combat the epidemic and transport surviving patients to a treatment centre. But with huge numbers of people dying every day and logistics disasters always imminent, Dr. Abdelmoneim described the experience as very difficult and much more emotionally taxing than the project in Iraq.
The detailed and moving talk was followed by a number of questions about the psychological hardship involved in contributing to such an expedition. Dr. Abdelmoneim emphasised that the social support from his colleagues at MSF was an important and necessary counterbalance to the difficulties.
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By Robbie Stern ~ 17 February 2011
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Links
Médecins Sans Frontières: www.msf.org.uk
Cambridge University Friends of MSF: www.srcf.ucam.org/cufmsf
French and Arabic speakers needed to work with MSF
