It was with emotion and a sense of accomplishment that Carlos Ferreira , Hospital da Luz Lisboa surgeon and International Red Cross war surgeon, launched a book where he describes clinical cases and reports the learning and the personal and medical experience acquired in the various missions he did over recent years, in the world worst war scenarios: South Sudan, Republic of Congo, Iraq, Yemen, Ukraine and Gaza Strip. In all of those places, as he describes in “War surgery and humanitarian medicine” , he found hell and discovered inspiring people. The book launch happened on April 16, at Hospital da Luz Lisboa, with a presentation by the author about his latest mission with the International Red Cross in Rafah, Gaza Strip, precisely a year ago, when war on that territory had already affected thousands of people. An impressive and clinical account of an experience developed under extremely hard and hostile conditions but saving lives day after day. "There are presently over 120 armed conflicts in the world, affecting about 35 countries. The number of wars has tripled since 2000 and today war is considered a public health issue, with all that it entails in terms of basic care disruption, disease, famine … This happens mostly in poorer countries, where what exists is already the minimum." "The first victim of war is the health system. Hospitals in Gaza have even been hit by bombings. Most infrastructures no longer exist. Neither equipment nor management. Staff works in extremely harsh conditions. Those who survive in Gaza, experience hell on earth. This is a population prisoner in a territory, suffering from hunger, lacking water, lacking medical care. This is an emergent humanitarian crisis." " The mission I integrated was led by the International Red Cross Committee for the European Gaza Hospital – a differentiated hospital with 232 beds that, before the war, served a population of about 400 thousand people." "The hospital being a safe zone, when I was there, there were between 30 to 40 thousand people within the perimeter of the hospital, and about 7 thousand inside the building. They were living in tents and in extremely rough conditions, cooking inside, all sleeping in the same hospital bed… Every single day the hospital was surveyed by drones. Bombings happened daily. The hospital building was shaken every day. The very Hamas launched rockets from the inside. " " Some 700 patients arrived at the hospital daily. My surgical team treated the most severe cases, and then there were a few non-native mobile teams that stayed for two or three days to help in the hospital ward." "My team comprised 10 to 12 people. We slept in a corridor of the hospital with one single bathroom. With 30 thousand people living inside the premises, the nights were filled with deafening noise. It was complicated to rest in such conditions." "The whole operating theatre of the emergency service and the postoperative ward were under our responsibility. And bear in mind: 700 people arrived every day. That was the hardest part. Because we had to triage patients. In such context, triaging meant deciding who to operate – we operated around 15 to 20 people daily – and who to leave aside. " "All wars are wars against children. Children are the main victims and, unfortunately, in Gaza, the number of children I had to treat was much higher than expected – almost half of my patients were children." "To be a war surgeon, one obviously must have the surgical competences to handle any situation we are faced with and save as many people as possible. But we are not remotely equipped nor trained for what comes up. These are surgeries with numerous challenges but highly successful saving lives. In a sense, helping these people recover, having the privilege of giving them a better live and above all meeting such inspiring people, is gratifying." "As surgeons, as doctors, we must try to offer a better life. Being a surgeon is a mission: teach, cure, help. But being a war surgeon is an intense and often frightening challenge. Is something that pushes us beyond our limits. A huge challenge, triggering unique feelings, making us experience unique moments." "The practice of medicine is a commitment to our patients, the team, the hospital, to all the people we practice our activity with. At the end of every mission, we sometimes feel frustrated, because we return home leaving there patients, colleagues… But, at the same time, knowing that they acknowledge what we did and the grateful way they treat us, is an extraordinary feeling quite difficult to describe in words." “It is a privilege to have you in our team” Jorge Paulino , director of the surgery service of Hospital da Luz Lisboa, made a summary of the book – where the author also gives a brief historical outline of medicine and war surgery, from Ancient Egypt and Roman civilization to this day – then highlighting a few personal and clinical stories described by Carlos Ferreira in his work. Paulo Simões, president of the Portuguese Medical Association, South Section, and special guest at this launch, pointed out, on its turn, the creation by this association of a bureau to support physicians who are involved in situations of war. Isabel Vaz, the Luz Saúde CEO, and Rui Maio , clinical director of Hospital da Luz Lisboa, also took the floor to thank for the dedication and work of Carlos Ferreira, stressing the fact that he is the most experienced surgeon in the area in Portugal. “It is a privilege to have you in our team”, concluded Rui Maio. Na foto em baixo, Rui Maio, Carlos Ferreira, Jorge Paulino e Paulo Simões.
