Getting to Rwanda takes ages. I don’t know why there isn’t a direct flight to Kigali from the UK but there just isn’t—which meant that my journey there took close to 24 hours (via Kenya and Burundi). I have travelled through East Africa plenty before, but this was my first trip to Rwanda. I went through customs with my hackles raised and my barriers up, ready to fight through the onslaught of taxi and hotel offers—but there were none. Forget “This is Africa”—This is Rwanda. Aside from the occasional gentle inquiry from a local about whether I was ok, I was left to my own devices as everyone went about their business. more…

The basic surgical skills course (BSS) for Palestinian surgical trainees finished today. Throughout the two days of practical sessions it seemed that time acquired an extensile quality: the tasks completed in 48 hours on the Mount of Olives would usually fill a week. The intensity is not only due to the rigour of an arduous BSS course curriculum, but also fuelled by a human response which accompanies this transplanted course in the Middle East, and the forging of enduring friendships with our Palestinian counterparts. more…

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. more…

The car journey from Tel Aviv to Jerusalem lasts about an hour. There is an enveloping warmth in the air even at 2 am and it is eerily quiet. The UN car is veering into East Jerusalem, up the Mount of Olives, and finally to our destination: Augusta Victoria Hospital (AVH).

Next week this hospital in East Jerusalem will host the second basic surgical skills (BSS) course for Palestinian surgical trainees, as endorsed by the Royal College of Surgeons of Edinburgh (RCSEd). Acquiring safe fundamental surgical skills (e.g. suturing, knots, incisions, bowel anastomosis, haemostasis, vein patches, diathermy, and laparoscopy skills) empowers Palestinian surgeons from the West Bank and Gaza to tackle emergency cases which would otherwise be delayed in transit to larger hospitals due to roadblocks and checkpoints. A year on from my previous blog, nothing seems to have changed. more…

Now that I no longer have an axe to grind (recovery from the revision surgery on last year’s failed whole hip replacement appears to be going well), I would be interested in doctors’ reactions to the argument for the introduction of temporary disabled badges.

During the six months I waited for surgery, I was in considerable pain and had increasing difficulty in both standing and walking. Many people wait longer for hip replacements and with greater disabilities. more…

“Emergency surgery patients must have higher priority in NHS hospitals.” So say the new standards from the Royal College of Surgeons of England, which highlight the wide range of complication rates following emergency surgery across the NHS. Interpreting these data is not straightforward, not least because there are no accepted standards for measuring or defining surgical complications. For example, a “wound infection” in one centre may be “minor inflammation” in another. Even definitions of death rates following surgery can vary, making comparisons of something that might seem clear cut, difficult. The use of different terms and definitions for complications after surgical procedures makes comparing outcomes between hospitals problematic. How does one know if the hospitals are truly different in their complications, or just in their ways of counting or labeling them? more…

One of the world’s most experienced fistula surgeons is illiterate. I found that out when I went to a screening of a short film called Fistula Hospital: Healing and Hope at the Frontline Club in Paddington. Her name is Mamitu Gashe, and she was a patient at the Addis Ababa Fistula hospital. After her operation she worked at the hospital, eventually assisting in operations. Over the years she has continued to learn and operate, now giving master classes to gynaecologists from all over the world.   more…

So you want to be a surgeon? As a new medical graduate do you really know what this entails? I thought I did, but quickly learnt otherwise. more…

Sarah Palin may have raised the profile of female politicians, but I’m lifting my glass to the girls who saw me through surgery last week. I did spot the odd male among the panoply of health professionals who looked after me, but they were thin on the ground. From the consultant surgeon and anaesthetist to the kindly soul who sang as she emptied rubbish sacks, mine was a female dominated “hospital episode” and none the worse for it. more…