Trauma Care
16 December 2009
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Primary Trauma Care in Gaza
Every year tens of thousands of people die a violent death. Amongst the 18-25 age bracket it is the second biggest killer behind AIDS. Primary Trauma Care (PTC) is a system for training front-line staff in hospital trauma management, aimed at preventing death and disability in seriously injured patients.
The Primary Trauma Care Foundation is a UK organisation set up in the early 1990s to increase the rates of survival of victims of trauma. The foundation focuses on the design and presentation of such medical training courses for developing countries or countries suffering from war, and has run the course in 46 countries to date.
MAP and the Primary Trauma Care Foundation (PTCF) are launching a joint project in Gaza to provide an Instructor Course Programme designed to empower local surgeons and anesthetists in injury prevention strategies, as well as in the management of severe trauma at the district hospital level.
The course is based on straightforward clinical practice, and does not require the practitioner to have access to high-tech facilities. In Gaza, where the blockade has prevented the most basic drugs and equipment from getting to hospitals, this course is practical and realistic.
The attacks on Gaza were responsible for a massive loss of life with nearly 1,400 Palestinian killed and more than 5,300 injured. Many of those hurt were unable to reach the nearest hospital and, with the Gaza Strip dissected by the military invasion, were unable to access the most basic emergency treatment. Each hospital was operating well over capacity, with departments receiving over 100 patients a day. In the first week of the attacks, Israel launched over 3,000 air strikes against the defenceless territory. Blast injuries from these bombs are devastating whether from the pressure shockwave, the kinetic power of the blast itself, smoke and shrapnel, the effect of being thrown through the air and the delays of reaching people trapped under rubble.
In a recent meeting about the launch of a PTC programme in Gaza, representatives from the World Health Organisation stated with certainty that "after the recent experience of the war on Gaza, this course is vital".
John Beavis, an Orthopaedic Consultant and Trustee of PTCF stresses that "many deaths from injury are actually avoidable if professionals are trained in PTC and can intervene at an early stage. A patient is 8-9 times more likely to die if treated in a country not comprehensively trained in PTC." The PTC course allows medical practitioners to better address the vital 'golden hour' following the initial injury in which good practice saves lives.
Mr Beavis spoke to MAP following his latest visit to Gaza where he witnessed how quickly the course was being taken up. With 44 doctors and nurses already trained, he proudly spoke of how they will "develop their own systems and own schemes" of how through love and enthusiasm they were becoming a "fellowship" whose knowledge "will cascade beyond the initial project itself".
There is little doubt about the great challenge that still exists in Gaza. Mr Beavis spoke of how the trauma that worries him the most is that which "mutilates peoples minds when they're young. There is a lack of all sorts of kit and certain drugs. Also communication between other doctors elsewhere in the world is severely restricted, leaving health professionals marooned in Gaza".
