Interview with MSF surgeon Dr Stefan Krieger

Hand surgeon Dr Stefan Krieger spent three weeks on a Médecins Sans Frontières (MSF) mission in Gaza. He treated burn injuries and shared skills with the local surgical teams at the Nasser hospital in Khan Yunis.

For Dr Krieger, this mission provided an opportunity to address the lack of specialised medical care in the Gaza Strip.
He shares his experience with us:

Inflatable hospital

"The MSF team is operating in the MSF mobile field hospital set up last August to address the lack of space available at Nasser hospital due to its on-going rehabilitation.

Due to heavy rain in the preceding week, the MSF inflatable hospital had to be reconstructed and the ground of the tent elevated by using a wood construction.

A further hygienic and noisy challenge was the fact that just outside of our tent the hospital road was rebuilt, with a lot of dust and construction machines passing by every five minutes.

But all the material I needed was available. Hygiene and sterilisation were also highly satisfying. 

Two hundred and twenty patients had been identified in advance by the teams. Consultations started on the 23rd of November and were undertaken together with Dr Hassan Hamdan, the head of the burn unit of Nasser Hospital.

Out of these 220 patients, and according the inclusion criteria, we chose 56 for surgery. Eighty percent of the cases were post burn constructions, followed by congenital deformities in hands and one tumor case.

Eighty nine percent of the patients who had been operated on were children under 18 years old; 36 percent were females.

Experienced team

We had in total nine days to operate. We could undertake four to five operations per day, ending up with 35 operations in total.

The MSF anaesthetist was very experienced. Even anaesthesia on very young children was possible.

Organisation of the daily logistics and communication with the patients were very well managed by local staff, all the operation theatre (OT) logistics were done by the MSF OT nurse in a highly qualified way.

Satisfying results

The functional results we have followed up so far were fully satisfying.

Furthermore we had no infection, hygiene protocols are strictly followed and the preparation and cleaning of the patients by the team is of high standard.

Hand surgical cases we mostly followed up in the MSF Gaza rehabilitation clinic: dressing and physiotherapy including splinting are provided under the supervision of doctors and physiotherapists.

I think there is future surgical work for MSF, especially in hand surgery and flap coverage of burn sequelae.

The team spirit was very motivating.

In between the operations we could frequently do dressings or consultations of new cases. Cooperation with Dr Hamdan of Nasser Hospital is very good as he is interested in gaining new techniques.

We had very good surgical discussions and I left him my textbooks electronically for further reading.

Security was fine during my whole mission, we could move and work every day, still there were incidents reported during the night. This did never affect our own security.

I had a very good and challenging mission in this field.”

Future collaboration

Dr Krieger was very satisfied with his mission and is willing to come back or to recommend it to other surgeons.

Three more surgeons are expected to arrive before the end of the year to finish the rest of the planned surgeries.

Such operations provide an opportunity for MSF and Palestinian experts to exchange medical techniques and surgical procedures related to elective reconstructive hand surgery and anesthetic procedures, including those of young children.

Specialised surgery in Gaza

In July 2010, MSF signed an agreement with local health authorities and opened a specialised surgery program in the Nasser hospital, in Khan Yunis, in southern Gaza Strip. 

Several times a year, MSF teams – composed of surgeons, operating room nurses and anaesthetists – carry out missions, working closely with Nasser teams. 

As with MSF's other activities in Gaza, the goal of our surgical program is to rehabilitate trauma patients, to help them to regain optimal use of their limbs.