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Jordan: "Seeing a patient in a wheelchair walk by himself is an amazing feeling"
Mudhafar Abdulwahid Khaleefa was injured when armed men stormed into his office building.
During the attack, the 43-year-old fell from the third floor. He suffered an injury to his spine, as well as multiple fractures to his leg and hip.
Over the following year, he had seven rounds of surgery at a hospital in the Iraqi capital, Baghdad - but his bone fractures failed to heal.
“In the end, the doctors [in Iraq] recommended amputation above the knee,” says Mudhafar. “The bone in my leg was infected and it wouldn’t heal. I was starting to feel very bad emotionally.
"However, soon I was put in contact with Médecins Sans Frontières/Doctors Without Borders (MSF). After a medical assessment, I was accepted for treatment and transferred to their hospital in Amman, Jordan.
"Over four months, [MSF staff] operated on my leg several times, first to treat the infection and then to progressively restore functionality.
"Now I don’t need the wheelchair anymore and can walk with crutches.”
Care for Iraq war survivors
The need for reconstructive surgery in Iraq is huge, due to the continuous conflict that has ravaged the country since 2003.
Alongside the violence, this has put the nation under great financial strain.
At our hospital for reconstructive surgery in Amman, Jordan, war-wounded patients from Iraq receive a range of treatment for complex injuries, including: specialised surgery, physiotherapy and psychosocial support.
We established the project in 2006, when it became clear that no such care existed for victims of the war in Iraq.
Since opening, we have treated around 4,500 patients and performed nearly 10,000 surgeries. Over half of these patients have been Iraqi citizens.
Bombs, shells and explosions
Our Iraqi patients present injuries indicative of violent warfare: shattered bones, servere burns, and damage to the face which makes eating or breathing difficult.
In a country where bombs, explosions and shells are a daily reality, these injuries are sadly not uncommon.
Many patients have lost mobility in parts of their body; some have undergone amputations. Most need advanced reconstructive surgery, often over many months and even years.
In some cases, patients referred to our hospital in Amman have already undergone multiple rounds of surgery, and received courses of various antibiotics to prevent infection.
Some develop resistance to the drugs, and face having their limbs amputated.
Finding patients in need
Our Iraqi patients are referred to us from hospitals in Baghdad, and other parts of the country, through a network of doctors, MSF offices and other organisations.
The criteria for referrals is strict: they only include patients whose abilities can be improved with surgery. Aesthetics are considered secondary.
Working at the MSF hospital in Amman since 2014, Dr Omar Adil Alani manages patients referrals from Baghdad.
"While patients may receive initial care for their wounds, they don't usually have access to specialised surgical procedures in Iraq," says Dr Omar. "Through this project we can treat complications that have a serious impact on their recovery."
Treating the injury is not enough
After successful surgery, patients move on to physiotherapy and psychosocial support.
Every year, our staff conduct almost 2,000 physiotherapy sessions, while around 22 percent of patients receive mental health support.
"The psychological support I had in Amman was very important for my phsyical recovery," says Mudhafar, now able to walk with crutches after falling from the third floor of his office building.
Patients' emotional wounds are not visible but are often deep, resulting from extremely distressing and traumatic experiences.
This can have a major impact on their lives and ability to recover.
"I remember a patient who was pregnant on a street in Baghdad when a car bomb exploded," says Dr Omar. "She was severely burnt over most of her body and lost her baby.
"When she came to us [in Amman] she was very depressed.
"She had divorced her husband and wanted to commit suicide.
"Because of the burns on her face she had difficulties speaking and breathing.
"She has now had multiple surgeries in Amman and is making good progress."
In Baghdad, Dr Omar and his team plan to expand their work so that they have a permanent presence in Iraqi Kurdistan.
This will increase their ability to find patients whose lives could be changed by specialised surgery.
"The situation here in Iraq is very difficult and many patients who need specialised treatment don't have access to it," says Dr Omar. "I'm very happy to be in this position, because it allows me to help fellow Iraqis.
"To see a patient who was in a wheelchair for a long time come back from Amman walking by himself - now that is an amazing feeling."