Surgical Life in the Surgical Life in the FieldField

YEMEN Mission YEMEN Mission (20-4-09 to 2-6-09)(20-4-09 to 2-6-09)

Dr AU Yiu KaiDr AU Yiu Kai

ContextContext:: Armed conflict in Sa’ada Armed conflict in Sa’ada Governorate, YemenGovernorate, Yemen

MSF presenceMSF presence: : from July 1997 to 2003 with Aden from July 1997 to 2003 with Aden project in the South. project in the South. Return in July 2007Return in July 2007

Number of projectsNumber of projects:: 2 projects: Al Talh & Razeh2 projects: Al Talh & Razeh

Other MSF sectionsOther MSF sections:: MSF-SpainMSF-Spain

• Population of more than 18 million peoplePopulation of more than 18 million people• Surrounded by the Saudi Arabia, the Golf of Surrounded by the Saudi Arabia, the Golf of

Aden, the Red Sea and Oman.Aden, the Red Sea and Oman.• Yemen is the only republic of the gulf.Yemen is the only republic of the gulf.• Complex picture of tribalism, social tensions, Complex picture of tribalism, social tensions,

economical crisis, conflict in the north and economical crisis, conflict in the north and international terrorism.international terrorism.

The Context of YemenThe Context of YemenLocated in the Southwest of the Arabian Located in the Southwest of the Arabian peninsulapeninsula

(A)(A) Al Talh Project (started April 08)Al Talh Project (started April 08)(cooperated project with MOH, (cooperated project with MOH, Yemen)Yemen)

(a)(a)Nutrition Programme & Nutrition Programme & Immunization ProgrammeImmunization Programme

(b)(b)Al Talh HospitalAl Talh Hospital(i) Emergency Room(i) Emergency Room(ii) IPD(ii) IPD - 11 male, 11 female IPD - 11 male, 11 female IPD bedsbeds

- 8 ICU beds - 8 ICU beds (Paediatric/Nutrition)(Paediatric/Nutrition)(iii) Maternity(iii) Maternity(iv) OPD(iv) OPD(v) Surgical Activities(v) Surgical Activities(c)(c) Out Reach Programme - DahyanOut Reach Programme - Dahyan

(B)(B) Razeh ProjectRazeh Project(a)(a) Nutrition & Immunization Nutrition & Immunization

ProgrammeProgramme(b)(b) (i) Emergency Room(i) Emergency Room

(ii) IPD(ii) IPD

(iii) Maternity(iii) Maternity

(iv) OPD(iv) OPD

(no Surgical activities, (no Surgical activities,

surgical patients need to be surgical patients need to be transferred to Al transferred to Al

Talh Hospital, which takes 4½ hrs Talh Hospital, which takes 4½ hrs drive cross the mountainous drive cross the mountainous and conflict area)and conflict area)

Recent conflict escalating, Recent conflict escalating, international staffs have to international staffs have to be evacuatedbe evacuated

Human ResourcesHuman Resources (Al Talh (Al Talh Project)Project)

(a)(a) International Staff International Staff 77(including 1 Surgeon, (including 1 Surgeon,

1 1 Anaesthesiologist, Anaesthesiologist,

1 Nurse 1 Nurse Supervisor, Supervisor,

1 Out-reach 1 Out-reach doctor doctor

co-ordinator) co-ordinator)

(b)(b)National Staff –National Staff – HR HR National 77National 77

HR HR Incentive33 -medical Incentive33 -medical doctors, medical assistants, doctors, medical assistants, nursesnurses

Surgical Surgical ActivitiesActivities

• Dr Au Yiu Kai mission period Dr Au Yiu Kai mission period 23.4.09 to 31.5.0923.4.09 to 31.5.09

• Total operations – 102 Total operations – 102 • estimated estimated

- 40% - war wound- 40% - war wound

- 40% - accident- 40% - accident- 15% pathology - 15% pathology Photo for HKCCM ASMPhoto for HKCCM ASM

- 5% Obstetric- 5% Obstetric

Surgeon in the FieldSurgeon in the Field

• At least twenty surgeons in oneAt least twenty surgeons in one• Not just a surgeon, also a physician, Not just a surgeon, also a physician,

paediatrician, emergency doctor paediatrician, emergency doctor • Take up role of surgeon, nurse, therapistTake up role of surgeon, nurse, therapist• Basic clinical skills Basic clinical skills –– most reliable most reliable• Personal touch and care Personal touch and care –– most important most important

in patient carein patient care

• Holistic ApproachHolistic Approach

Thank YouThank You