a The girl slipped through the hallways of the hospital's fifth floor with her friend. The two had bright eyes and were shy. Today is her last chance to wear the shiny new shoes she bought for the party last week. Tomorrow, this 12-year-old Iraqi will have one of his legs amputated.
The surgery was scheduled two weeks ago, but the surgeon, who was trying not to cry while delivering the news that an amputation would be required, agreed to postpone it. First she wanted a chance to wear her new shoes to the party.
Her 11-year-old friend is from Yemen, and her scalp glistens with the plastic sheen of burn scars. Her arm and shoulder were also injured in the accident four years ago. A truck full of refugees fleeing an attack on a village by Saudi warplanes has collided.
They are victims of various wars and are among up to 110 war-injured patients treated by Médecins Sans Frontières (MSF). Mowasa Hospital Anytime in Amman, Jordan. Another 400 people are on the waiting list and 8,500 surgeries have already been performed.
It is a center of excellence for reconstructive and orthopedic surgery combined with physical therapy and psychological care, and the staff is dedicated to providing the best possible outcomes for those injured in war.
“Nationality reflects the wars in the region,” says hospital director Roshan Kumarasamy, a veteran of MSF operations in conflict zones around the world. “Our patients are from Syria, Iraq, Libya, Yemen, Somalia, and Gaza. Almost all of them have PTSD or some type of survivor guilt.
“There is no other surgical facility in the world like this hospital. We have a unique specialty,” he says. “This is not just MSF's life-saving frontline work; this is the quality of life in the aftermath.”
MSF is one of three charities supported in the Guardian and Observer's 2024 Conflict Victims Support Appeal, alongside War Child and Parallel Histories. This appeal has raised over £1 million so far
In Mowasa, injuries have been caused by improvised explosive devices (IEDs), flames, shrapnel, barrel bombs, rockets, bullets, sniper drones and apartment explosions.
Yemeni photographer Taha Saleh has bubble-like scars behind both ears from a bullet that pierced his head while filming in 2015. “There were a lot of people injured in the attack, so they prioritized the patients, so they left me in a heap where I expected to die,” he says.
“For nine years, I struggled to get medical treatment in Yemen. I had trouble eating. I always had a throbbing pain in my head.”
After a month of physical therapy and mental health support here at Mowasa, Saleh's skull tension and constant nightmares have eased. “Now I have hope and am happy to return to Yemen soon,” he says.
He met his friend Ahmed Jalal here. Jalal was injured in the explosion, which killed five others. His life was saved at an MSF hospital in Aden, Yemen, but he was left without specialized care in a war zone and without the use of his arm. Here he underwent bone lengthening treatment, went home to heal (while connecting with his physical therapy team over the phone), and is now back for his final surgery.
“I feel very lucky. Now I can find a job and get married,” says Jalal.
Behind every injury there are many personal stories. But that's not necessarily what orthopedic surgeon Dr. Hanna Jang-ho is looking for. “Sometimes the story starts to weigh on you,” he says. “First of all I ask, we haven't had too many injuries or incidents. Right now we're focused on injuries and what we can do.”
Jang-ho now runs a clinic, seeing patients one after another who have probably already undergone multiple surgeries, including bone grafts and mainly tendon and nerve injuries. Bullets can mess up bones, and snipers like to target the femur or pelvis.
People are referred by MSF doctors in their home countries. The team here will consider each case and those who they think can be helped will be flown to Amman.
The overwhelming commonality among Jangho's patients is a quiet sense of gratitude that their pain is relieved, their limbs can move again, their bones grow and heal again.
“Usually, you start seeing people about two years after the fighting stops,” Yangho said. “So now we have a lot of Yemenis. Some patients live in rooms on the top floor while they are being treated, and others go back to their homes.
“What's the worst we'll see? Probably after barrel bombs are dropped on the Syrian people.”
Daed Almunaid is a clinical psychologist who runs a multidisciplinary mental health team in an office decorated with artwork from past patients and scented with strong roses.
“Oh, that’s our perfume maker,” she said with a smile. “We have started vocational training and adult education alongside treatment, and patients are empowering each other. There is a lot of integration going on here.
“Especially in Arab culture, there is this idea that everyone is suffering and so they try to stay silent. To speak up is to increase the burden on others. So we need to break down the stigma and say OK. We have to teach people that they can do without it.”
This also applies to staff. Ms Almunaid said: “We worked with a 12-year-old boy who was facing amputation step by step. She was well prepared and the surgeons were very supportive.”
Mowasa Hospital was the brainchild of a group of Iraqi doctors. Dr Rashid Fakhri is one of them, and is acknowledged by many staff members as an inspiration. He said: “At MSF, it is always an urgent emergency. Wounds and acute trauma are treated and patients survive. So just two weeks after opening in Amman, we changed our standards. Needs come first. It wasn't what it was.
“Surgeons on the front lines will be able to stabilize and save lives, but patients will still have problems.” [the need for] Soft tissue, tendon, and nerve repair. No one can do anything because there is no time or place. That's what we're doing here. ”
Even in a pioneering hospital like Fakhri, Samar Ismail stands his ground. She 3D prints prosthetic limbs and works on treating burns and scars. Now she is helping Yemeni teenager Janeya Ahmad, who suffered burns to her face, fit a transparent mask to help her skin repair.
“Customized aids, finding solutions to people's problems…that means we really need to think imaginatively,” she says. “Sometimes I wake up in the middle of the night and think about some problem. We started 3D printing in 2017, so it was self-learning. If we failed, we tried again and now we We share that knowledge with others.”
She shows a square device with a pencil sharpener sealed inside. “This is a good example. There was a little boy who lost his hand, so we made him a prosthetic arm. But at school he couldn't sharpen pencils like other kids, so , he still didn't feel normal, so we designed this. He puts it on his prosthetic finger and it stays in place so he can sharpen his pencil.
“He seemed very happy,” she retorted with a smile. “That's what we're doing.”
