This morning we left the peaceful lutheran guesthouse in the grounds of the Augusta Victoria Hospital (AVH) to start set-up for the first day of the basic surgical skills course (BSS) for Palestinian surgical trainees in the hospital. The morning sun was glaring and a haze lingered over distant views of the Dead Sea as we entered via the back entrance of the hospital, carrying boxes of course materials. David Sedgwick—course convenor for the Royal College of Surgeons in Edinburgh, Ruth McKee, Ian Wallace, John Anderson, Robin and Magdalena Kincaid, Sarah Sholl—manager of the Royal College of Surgeons Edinburgh surgical skills laboratory, and surgeons from all parts of the UK (Fort William, Glasgow, Edinburgh, Truro) are the UK team running the course.
Working as part of a team with a spirit of a common purpose makes all the tasks seem a tad more achievable. Once again this year the UK team and the Palestinian course co-ordinators experienced (possibly the most unusual) bonding exercises. Relentless attention to detail generated good quality “abscesses,” by filling glove-finger tips with mayonnaise and then tying up the filled tip into a small ball and tunnelling them under the skin of the turkey leg. The “abscess” then left a proud bump for the candidates to dissect. Banter (in a mix of Arabic and English) eased the workflow, as the exercise was repeated 21 times. The turkey legs were then prepared for the “traumatic wound” debridement—beads, gravel, and turmeric were used to create the “infected wound” look. Military drill precision returned in the making of “sebaceous cysts” using toothpaste filled glove fingertips pushed under the skin of shaven goat legs (yes, really). They were ready, only to be excised by trainees.
It felt like a family occasion despite the incongruous sight of the preparation tables; blame it on the addictive warmth of friendship, if you will. My very basic level of Arabic only got slightly better, though.
Whenever we need something, someone from the AVH theatre or sterilization unit always finds it for us, or knows a person who can. Being surrounded by such helpful people makes life unexpectedly good.
The registration session in the AVH cloisters was a chance to meet the candidates pre-course. Only four surgeons from Gaza were allowed to attend—the other two were refused entry this morning.
Candidates seemed curious about the animal tissue—a novelty in the Middle East. There were many eager young faces, open and cordial, and a lot of smiling and expectation in the room. Often before we had a chance to say “Ahlan wa sahlan” (“welcome” in Arabic), they said it to us instead.
The practical part of the course starts tomorrow. It is only the first step, but the right one. As life journeys go here, it is no mean feat.
Magdalena Kincaid graduated from the University of Dundee and did her surgical training in Scotland.