“Adapting to save lives is what we do well”
Doctor Elma Wong introduces the MSF Conflict Appeal
You’re in a hospital tent, close to the frontlines of a brutal conflict. You’re treating trauma patients with life-threatening blast injuries...
Then a pregnant woman arrives. She’s in labour. Bleeding heavily.
What do you do? You think fast. You adapt.
My name is Elma Wong. I’m a doctor and anaesthetist from Birmingham in the UK.
I work with Médecins Sans Frontières / Doctors Without Borders (MSF) in conflict zones and complex humanitarian crises around the world.
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could help provide pain relief for seven patients for one day could help pay for five stethoscopes to help diagnose patients' medical conditions could help pay for masks to resuscitate four newborn babies could help pay for a disposable sterile dressing set to treat wounded patients could help pay for a blood transfusion kit for use in surgery could help pay for four safe delivery kits to assist women giving birth could pay for seven splints to immobilise injured limbs could help cover the cost of an MSF doctor working in a hospital for one day could help pay for a collapsible wheelchair for patients who are unable to walk could help provide two foldable stretchers for transporting injured patients could help provide a warming blanket for a newborn baby could pay for six blood transfusion kits used in surgery could help cover the cost of an MSF doctor working in a hospital for one week could help pay for three basic surgery sets for MSF hospitals could help buy a portable ultrasound device to monitor the health of pregnant women and their babies could help pay for 11 collapsible wheelchairs for patients who are unable to walk could help pay for 10 sustenance kits to help mothers provide babies with essential nutrition could help pay for a refrigerator to store blood for use in surgery could help cover the cost of an MSF doctor working in a hospital for 10 weeks could help pay for 20 basic surgery sets for MSF hospitals could help buy an emergency health kit containing enough medical supplies to treat 10,000 people for three months could help cover the cost of a doctor working in a field hospital for four months could help pay for a ventilator for patients in intensive care units could help pay for 50 sustenance kits to help mothers provide babies with essential nutrition could help buy for an emergency health kit containing enough medical supplies to treat 10,000 people for six monthsDonate now
Working in conflict zones, the biggest obstacle we face is the struggle with resources – not always having enough equipment, enough staff to work with, or access to enough drugs. All because of the situation.
“Within two weeks of opening our trauma hospital, we had pregnant women turning up just desperate with nowhere to go. Word had spread.”
This is a challenge, particularly in places where there are a lot of explosives and you might face a ‘mass casualty' event at any moment.
This is a rush of critical patients arriving at the hospital. You have to treat multiple patients at once with limited resources, and it's hard to see so many people this way. It's equally hard afterwards – you witness things that will stay with you for some time.
As a team, you need to work well and work strongly together. You get through it with the people around you.
I’ve now worked with MSF in Yemen five times in five years. Once, I was working in Hodeidah, a city on the coast, where we would see entire families devastated by the landmines that covered the region.
Multiple members of the same family could arrive together. Some might not have survived the explosion, some you could still treat or operate on, and some you may need to stabilise and transfer to a bigger MSF Hospital that was hours away by ambulance.
I remember we had two brothers come in – a five-year-old and an 11-year-old. We did manage to treat the younger boy and get the older one to care at the bigger hospital. But both their father and their uncle had died at the scene. It was such a difficult situation for so many reasons.
Doing this job, that's the side of war you see that's hugely unjust. The indiscriminate acts of violence that just wipe out innocent people for no reason.
More than trauma patients
However, providing medical care in a conflict zone is about much more than injuries caused by violence.
People living through war often have to deal with many health problems, chronic diseases and ‘everyday’ conditions, all without a functioning healthcare system.
Each time I return to Yemen, I see a system that is increasingly broken and down to basics. Meaning MSF has to support more and more services to help save lives.
At one of our medical projects, we set up a hospital in tents near the frontline, focusing on treating the casualties of war caused by airstrikes, mines and gunfire.
But, within two weeks of opening our trauma hospital, we had pregnant women turning up just desperate with nowhere to go. Word had spread.
The local hospitals were emptied of doctors, nurses and supplies. There was nothing in the area and definitely no maternity services. The nearest options were about six hours away… for a pregnant woman, bleeding with a baby that she's scared of losing?
Adapting to save lives
In this scenario, we as MSF do what we do well. We think fast and adapt.
We transformed a tent into a maternity unit. I turned a trauma table from our intense care unit into an area for the babies born into this conflict.
“I’ve seen outbreaks of cholera, diphtheria and measles in war. So, MSF adapts and sets up vaccination teams.”
It was a hugely rewarding process to be able to provide a much-needed service and change our project to meet the immediate needs of people.
In fact, in every conflict zone, MSF – and the people like me who work for MSF – have to adapt to meet the needs of people.
We know that women and children will be the first to lose out on medical services. So, we’ll set up paediatric wards and maternity centres.
We’ll quickly and efficiently set up therapeutic feeding centres and nutritional camps. This is because child malnutrition often increases in conflict zones as there might be insufficient access to food or proper nutrition.
Infectious diseases are another threat. Conflict can stop routine vaccination programmes and people might be crowded together into displacement camps or with poor living conditions. I’ve seen outbreaks of cholera, diphtheria and measles in war. So, MSF adapts and sets up vaccination teams in local communities.
Beyond the frontlines
MSF must work to provide a range of vital medical services in conflict zones.
Violence can destroy a healthcare system, and from what I’ve seen in countries like Syria, Yemen and Iraq, that means there’s just no access to basic healthcare – for women, for children, for anyone.
To really support people, we have to go beyond the frontlines.
I can tell you, from my own experience, if MSF didn't do this work, I genuinely don't know what would happen to some people. It is so important – saving lives, returning some dignity, and supporting people who are broken.
Please donate so we can continue to do this much-needed work.
MSF Conflict Appeal
MSF teams are working around the clock and across the globe in dangerous conflict zones.
We triage trauma patients, carry out emergency surgery and deliver mental health support for people caught in airstrikes, shootings and indiscriminate attacks. But violence isn't the only threat to life.
Conflict cripples a healthcare system, cutting people off from the vital services they need – medication for a chronic illness, vaccination against a childhood virus, maternity care for a young mother.