gms | German Medical Science

Introduction: Worldwide, the number of violence and trauma victims is increasing. Particularly, acute or chronic sequelae of hand trauma are very frequent, impacting negatively the victim's social and economic life in a long-term.

Doctors Without Borders aims to save lives, reduce suffering and enable social reintegration. In humanitarian aid highly specialized surgeons are hardly available. Therefore, acute surgery is predominately provided by general surgeons. Many surgeons lack specific knowledge in orthopedic and handsurgery which is urgently requested in these settings.

Objective: To illuminate the benefit of a needs-driven surgical training activity, when working in humanitarian conflicts

Method: Once a year a five day 'international surgical workshop' is conducted in the anatomy lab of Düsseldorf University. It consists 12 different modules, divided in 14 hours lecturing and 24 hours practical teaching on corpses and is offered to surgeons working in the humanitarian field only. It is evaluated at two different points:

1.

The 'end of course evaluation', using focus group discussions and structured questionnaires, focuses on its content;

2.

The 'field evaluation', with a semi-structured questionnaire, targets the sustainability of the course and is requested six months post-training.

Results: Since 2009 204 surgeons from 42 nationalities participated in the training. The 'end of course evaluation' reached 4.75 points out of 5. Amongst other surgical modules, participants were qualified on the most prevalent handsurgical traumata in the field of humanitarian crisis (e.g. injuries by machete, gunshot, and burn) by experienced hand surgeons. Hereby, the practical focus was set on tendon and nerve repair, infection and bone trauma management and local flaps. Handsurgery was ranked 4.9 out of 5 for its high field relevance.

After the training all surgeons returned to work in the humanitarian field. Therefore, a high degree of sustainability was achieved. The knowledge gained in hand – and reconstructive surgery, as well as external fixation was measured with the highest practical relevance and usefulness for the surgeons in the field (4.7 to 5.1 out of 6)

Conclusion: Handsurgery is essential in humanitarian surgery. A needs driven training activity, incorporating theoretical and hands-on training for humanitarian surgeons is fundamental. The training has a great benefit for the humanitarian surgeons and the victims in humanitarian crisis with a high degree of sustainability and societal impact.