Saving life and limb: The NHS super surgeons reconstructing the war wounded in Ukraine

As fighting intensifies, plastic surgeons James and Ahmed treat the victims of war in an emergency hospital in Western Ukraine.

NHS surgeons James Henderson and Ahmed Emam are part of an important surgical mission to deliver life and limb-saving trauma surgery in West Ukraine following a request for help from an under-strain hospital. The surgeons are offering the best chance of life to the war-wounded, swapping their NHS clinics for the operating theatres of an emergency hospital in Ukraine.

Ukraine’s war-torn health system has been under intense pressure, with an estimated 1000 casualties a day. As the flow of war wounded continues, so does the number of those needing the expertise of plastic surgeons.

“Everyone knows the way to the emergency theatre since war broke out,” explains surgeon James.

The hospital theatre, more used to treating everyday surgical procedures is now dealing with bullet wounds, shrapnel, loss of limbs and wounds only seen in battlefield.

Left: Plastic Surgeon James, who travelled from his hometown of Bristol to provide surgical support in Western Ukraine. Right: James and Ahmed pictured with health staff in Ukraine.

Medical evacuation train

Patients arrive at the hospital from the casualty train, a fully equipped medical train which evacuates critically injured civilians from the embattled frontline regions to safer health facilities in the west. Paramedics meet the train at the local station and transport the injured to the hospital where they will be treated.   

The journey is not easy says James “Patients are transported from the frontlines on casualty trains with old wounds contaminated with dirt, fragments and clothing, sometimes with no dressings”. This leads to infections which can spread to the limbs and require amputation. 

Treating the victims of war

In recent weeks, the surgeons have been treating a range of injuries from bullet wounds, cluster bombs and landmines. “We are treating patients of all ages, from 7 year olds to 70 year olds” says Ahmed “Patients arrive in waves. The first two days we had no cases, by day two we are seeing two to four cases a day”.  

In the corridors outside the theatre, the wards are full of recovering patients and many will have months of operations and rehabilitation to come. Patients like ‘Volo’, a 20 year old who stood on a landmine. He arrived at the hospital with a one-week old wound, badly infected. He was operated on by Ahmed and James and after 3 weeks on the ward is ready to be discharged. In gratitude for the treatment he received, he has bought a specially made cake for the staff who treated him.  

“Without the operation the infection could have spread to his bone requiring amputation” explains Ahmed.   

UK-Med members have performed over 70 surgeries since the Ukraine response began.

In Ukraine, supplies are scarce and the environment challenging

North Bristol surgeon, James says “Resources are scarce, there are not enough operating theatres and staff to treat the wounds as quickly as needed.  

Without the basic plastic surgery equipment, the work is incredibly challenging.  

“The equipment here is about Second World War era and we’re using the kind of techniques used in those times” explains James.  Lack of supplies is also a major issue for the hospital and surgeons. “There’s a huge supply shortage in terms of dressings, theatre disposable items like sutures and lack of surgical instruments” explains Ahmed.  

“We’re a British war time speciality”

Delivering pioneering treatments in the most challenging circumstances, the plastic surgeons are reconstructing the war wounded using ‘Ortho-plastic’ techniques born of the battlefields of WW1.  

James explains “We’re a British war time speciality, many of our techniques were developed on injured soldiers and airmen during the war”. 

Life before limb, was the guiding principle of surgery before the development of Ortho-plastics. The elite surgeons promote saving limbs and avoid limb amputation where possible. Working alongside Ukraine colleagues they are training and upskilling surgeons in Ortho-plastic techniques.  

The road ahead

As we move into the eleventh month of the war, the strain on the health system will only increase.  

How do the surgeons feel about the challenges ahead? “This is my passion to help with trauma surgery” says Ahmed. “We will do as much as we can” adds James “We’ll be here for however long we’re needed”.  

 The surgical programme is funded by The Randal Charitable Foundation which has a mission to directly save and significantly improve over 1 million lives in the UK and globally.

The Randal Charitable Foundation was founded by Dr Nik Kotecha OBE and his family in 2017. Its focus is to support issues connected to health, mental health, poverty and education. The Trustees’ aspiration is to directly save the lives of over 1 million people globally. To find out more visit www.randalfoundation.org.uk

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