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Inverness surgeon on 'survivor guilt' leaving Gaza and casualties being mostly children

By Rachel Smart

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Andy Kent in the hospital.
Andy Kent in the hospital.

Warning: Readers may find some of the details, pictures and videos below distressing.

A surgeon from Inverness has spent the last four weeks working as part of a specialised surgical team in Gaza.

Andy Kent (60), a trauma and orthopaedic surgeon based at Raigmore Hospital, is a volunteer member of medical charity UK-Med which is responding to the urgent needs in Gaza as the pressure on local healthcare services intensifies amid the Israel-Hamas war.

He’d been working at Al-Aqsa Hospital, in the central area of Gaza and returned to Inverness on Friday. Having previously operated in Ukraine, Mr Kent said that it is nothing compared to what he saw during his time in Gaza.

Sharing his experience, Mr Kent said: “I’m feeling mixed emotions about coming home. It’s been a tough four weeks, but very rewarding. It’s great to be back, but I feel a bit of ‘survivor guilt’ leaving the guys behind, particularly with the way things are looking just now.

“When we arrived through Egypt, we travelled for five hours through the Sinai Desert, then were hit by the crossing into Rafah, where there were literally thousands of trucks queueing to get into Gaza.

“When we made it through, the drive through Rafah was just crazy. The population has been kettled into the south of Gaza, living in makeshift tents.

“Having been to Ukraine, I can honestly say it was nothing compared to what I saw in Gaza. Every night, it felt like we were surrounded by gunfire and explosions."

Andy Kent in the hospital.
Andy Kent in the hospital.

For Mr Kent, the first thing that struck him when he was going through the displaced camps was how young everyone is. About 50 per cent of the population in Gaza are under 18.

He continued: “We had to drive an hour north along the coastal road to Al-Aqsa every day from the guest house where we were staying. It became apparent a lot of the population were encamped on the beaches on both sides of the road. It was surreal – thousands of people in makeshift tents.

“The casualty load at Al-Aqsa was heavily weighted towards children. That was traumatic for the local staff – and really palpable for the international medics like myself. When working in international conflict zones, I’m used to mainly dealing with adult men.

“However, most of the patients we dealt with were women and children, the vast majority of whom were suffering from explosive blast injuries, often involving shrapnel. Very few patients, I’d say less than five per cent, had high-velocity gunshot wounds.

“The majority of the patients we treated had big chunks taken out of them, or fractures. The makeshift tents they’re living in offer next to no protection."

Since January 10, and at the request of the World Health Organization, the UK-Med specialised surgical team has been working alongside local health staff who have been operating in 'horrendous conditions' according to Mr Kent – one of three Raigmore Hospital surgeons who have been working in Gaza, another of whom is Professor Angus Watson.

“The local surgical staff are very experienced – they’ve been exposed to these sort of injuries for many years, but not in the volume they’re having to deal with at the moment," said Mr Kent, who was named hero of heroes at Highland Heroes 2023.

"They’re operating in horrendous conditions, with very limited resources and equipment. Like their patients, they’re also living in tents. One of the guys out there has six children and a wife, living in a makeshift tent, cooking on an open fire and coming to work every day. It beggars belief when you see how little they’ve got.

“The main thing we’ve brought through UK-Med’s deployment is a boost to the morale of the Gaza medics. We’ve been able to advise on surgical work for specific injuries. For example, I’ve offered advice on amputations and how to manage limb injuries. The number of limbs being amputated from young children due to the volume of patients and lack of equipment has been horrendous, but we’ve been able to salvage many of those limbs that may have been lost before our arrival.

“We’ve been involved in life-saving surgery involving shrapnel injuries to patients’ chests. Sadly, however, some of the patients we’ve operated on have not survived. It’s very, very hard to take when we find children have passed away – it’s just devastating.

“Conversely, we operated on a 20-year-old lady who spoke great English in an American accent just from watching movies. Her femur had been fractured back in October. It’d been fixed, but the metal work had failed. We operated on her on Monday (February 19). Afterwards, she was lying in a bed in the car park in the sun the following day. I was able to advise and take on the surgery to help it be successful."

Mr Kent said that despite the incredible resilience of the people of Gaza, he feels that their hope is starting to wane.

Andy Kent in the hospital.
Andy Kent in the hospital.

He concluded: “The hospital grounds have become a massive camp and when you arrive, literally dozens of kids are running around, smiling and happy, despite the devastation of what’s happening to them. They’re always ready for banter when you get out of the car. It’s incredible. The people of Gaza are so resilient, but I do feel they’re beginning to lose hope – they just can’t predict what’s going to happen.

“I’d say there are four main problems we’re facing in dealing with the crisis in Gaza. Firstly, there’ll be ongoing trauma cases. The casualties will keep coming. There’s that problem of volume. Secondly, there’s no secondary healthcare, so a lot of patients with critical illness are now receiving next to no treatment. That includes renal dialysis, as well as diabetic and epileptic treatment – and we’re seeing the consequences.

"Thirdly, in the longer term, all those patients with chronic limb and head injuries are going to need rehabilitation, surgery and physiotherapy. They’re getting none of that now. Finally, there’s the psychological trauma. It’s going to have a massive knock-on effect. That includes the staff in the hospitals.”

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