{"id":29539,"date":"2013-10-17T11:09:16","date_gmt":"2013-10-17T10:09:16","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=29539"},"modified":"2013-10-17T11:09:16","modified_gmt":"2013-10-17T10:09:16","slug":"sophie-reshamwalla-the-bomb-blast-injury-boys-of-pakistan","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2013\/10\/17\/sophie-reshamwalla-the-bomb-blast-injury-boys-of-pakistan\/","title":{"rendered":"Sophie Reshamwalla: The bomb blast injury boys of Pakistan"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/2013\/10\/17\/sophie-reshamwalla-the-bomb-blast-injury-boys-of-pakistan\/sophie_reshamwalla2\/\" rel=\"attachment wp-att-29546\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-29546\" alt=\"sophie_reshamwalla2\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2013\/10\/sophie_reshamwalla2.jpg\" width=\"160\" height=\"140\" \/><\/a>My mobile rings. It is a nurse from the Emergency Room (ER):<\/p>\n<p>\u201cDr Sophie, we have a boy whose legs have come off. Please could you come to help?\u201d<\/p>\n<p>I shout \u201cI\u2019m coming!\u201d before hanging up and starting the laborious task of correctly putting on my hijab, along with pulling on my shalwar kameez, making sure that I don\u2019t need an umbrella for an erratic hail storm, and run over to the ER in my flip flops.<!--more--><\/p>\n<p>This is far removed from anything I\u2019ve experienced in the UK, and it is exactly why I wanted to work for MSF (M\u00e9decins Sans Fronti\u00e8res or Doctors Without Borders). To provide care for people in extremis, regardless of race, religion, colour, creed, or political persuasion\u2014mostly the same reasons that we become doctors in the first place.<\/p>\n<p>The case above is one of many, unfortunately. Is there anything worse than going out to play and having your legs blown off?\u00a0 I\u2019ve been faced with this question on an almost weekly basis since arriving in the rural Khyber Pakhtunkhwa (KPK) province in Pakistan six weeks ago and I\u2019m struggling to find something worse than losing your dignity, childhood, and innocence, all with one regrettable footstep. I am of course referring to IEDs (improvised explosive devices) and the collateral damage they cause to their (often unwitting) victims\u2014curious little boys who go out to play.<\/p>\n<p>The injuries are severe, and disgusting. We unravel the homemade bandages that someone has wrapped around this boy\u2019s legs, and reveal severed bones surrounded by a mangled twisted carnage of unrecognisable muscles, tendons, and blood vessels all hanging limply from where the knees should be. The boy himself is awake and stunned as the IEDs are often designed to injure rather than kill\u2014forcing further logistical and medical burden on the enemy combatant\u2014it\u2019s hard to accept this \u201crationale\u201d when you are faced with a child who is unlikely to ever walk again.<\/p>\n<p>What we are able do for these boys is to ease their pain and tidy them up in the operating room as best we can. I do not yet have a grasp on what types of rehabilitation services there are available in rural Pakistan, but I\u2019m guessing the options are limited. People here are dirt poor and expensive things like prostheses and rehabilitation are usually the reserve of the rich. So who knows what life is like after they leave our facility?<\/p>\n<p>I have seen many young boys in this ER, with all the naughty injuries that little boys get up to in any setting\u2014swallowing coins, trying to catch pigeons, falling off bicycles, and many more\u2014and what they all have in common is that they cry like babies and they all want their mothers.\u00a0 The exception to this rule is the case above, and those like him. Surrounded by their hysterical relatives, these BBI (bomb blast injury) boys are grim-faced and stoic. They simply watch, as the bandages are unravelled, noting which parts of them are missing, and they do not shed a tear or ask for any help.\u00a0 They keep their heads while all about them are losing theirs\u2026and never breathe a word about their loss.<\/p>\n<p>Kipling\u2019s \u201c<a href=\"http:\/\/www.poetryfoundation.org\/poem\/175772\"><em>If<\/em><\/a>\u201d may be reminiscent here\u2026..but there is nothing poetic about this injustice.<\/p>\n<p><em><strong>Sophie Reshamwalla<\/strong> worked in London as a surgical registrar before completing a Master\u2019s degree and the DTM&amp;H at the London School of Hygiene and Tropical Medicine. She has worked for THET (Tropical Health and Education Trust) and Lifebox Foundation and currently works as the ER supervisor for one of the MSF projects in Pakistan.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>My mobile rings. It is a nurse from the Emergency Room (ER): \u201cDr Sophie, we have a boy whose legs have come off. Please could you come to help?\u201d I [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2013\/10\/17\/sophie-reshamwalla-the-bomb-blast-injury-boys-of-pakistan\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[750],"tags":[],"class_list":["post-29539","post","type-post","status-publish","format-standard","hentry","category-msf"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Sophie Reshamwalla: The bomb blast injury boys of Pakistan - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2013\/10\/17\/sophie-reshamwalla-the-bomb-blast-injury-boys-of-pakistan\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Sophie Reshamwalla: The bomb blast injury boys of Pakistan - The BMJ\" \/>\n<meta property=\"og:description\" content=\"My mobile rings. 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