Outside is a calm suburban street. Inside is a scene straight from a war-zone field hospital. Young men with amputated legs or severe bullet wounds share cigarettes by the door. Children with bandaged limbs and facial burns chase each other around the concourse while medics move briskly along the corridors.
From the relative tranquillity of Jordan's capital, Amman, a recently upgraded reconstructive surgery hospital operated by Médecins Sans Frontières (MSF) affords a rare view of the turmoil in the Middle East. Since it opened, in 2006, the facility has provided treatment for war victims from across the region. Its case list for the past decade, broken down by country of origin, reads like a timeline of the region's upheavals: Iraq, Lebanon, Libya, Egypt, Gaza, the West Bank, Syria, Yemen.
Orthopaedics account for the largest share of the hospital’s work, but it also specialises in plastic and maxillofacial surgery (injuries to the head, neck and face).
"On the orthopaedic side, most of the cases are bullet injuries, blast injuries, fractures," says Dr Santanu Sanyal, the medical director. Among the average of 50 new patients taken in each month, cases of limb loss are common, as are cases of nerve damage and severe burns, often accompanied by signs of psychological trauma and shock, which are treated at a dedicated psychosocial unit.
War injuries
Today, about 60 per cent of the hospital’s patients are Syrians who have crossed into
Jordan
with serious war injuries.
“Most of the Syrian cases are orthopaedic: blast injuries, bullet injuries, walls falling, people who are travelling in cars when bombs explode nearby,” says Sanyal. “We also have a lot of burn cases coming in for plastic surgery.”
Sitting on his bed in a quiet upstairs ward, Ghassan Ahmed Hussein (47) recalls the incident that led him to lose both his legs, one testicle and his hearing on one side.
Hussein remained in his home town, Homs, as the city was destroyed early in the war. He says he was at home one day, in March 2012, when he went up on the roof of his building to water his plants. “All of a sudden a bomb fell on to the roof. There were big pillars on the roof, and one of them fell on me. I didn’t feel anything until I woke up in hospital.”
He was looked after by a neighbour and a priest from a nearby church (the priest was later shot dead, he says) until he had enough strength to travel south to Jordan. Since 2012 he has undergone seven operations. “A prick from a thorn can cause a lot of pain. You can imagine what it’s like to lose two legs, a testicle and the ability to hear in one ear,” he says.
As conflicts evolve, so do the types of injuries the MSF hospital is called on to treat. The frequency of car bombs in Iraq in 2006-07, many of which targeted busy markets, brought a steady flow of patients "with a deformity in every part of the body: the face, the limbs, everything", says Dr Ashraf Al Bustanji, a maxillofacial surgeon. "With time, the car bombings decreased. Now we see more bullet injuries."
The early intake from Yemen was also dominated by patients with bullet wounds, but the recent air bombardment and artillery fire means the hospital is braced for a surge of Yemeni war victims with a wider range of injuries over coming months, according to Jean-Paul Tohme, project coordinator at the hospital. “We know that in Yemen we will have a huge waiting list,” he says.
A small number of the hospital’s beds are taken by patients whose injuries are not directly linked to conflict but who were found by MSF teams on the ground. Waddah Sinan (21), who lives near the Yemeni city of Sanaa, suffered a severely smashed jaw when he fell aged five. As a result of the accident he couldn’t open his mouth, meaning he could not speak or eat solid food.
An MSF field worker came across him five years ago and referred him to the Amman hospital, where several operations to reconstruct his jaw have allowed him to open his mouth for the first time in almost 15 years.
“I’m so happy,” he says, sitting on his bed watching television. “I was extremely thin, and now I can eat rice and meat. There’s no comparison. I’m eating, I’m talking.”
Waiting list
By offering long-term specialist care, the MSF hospital in Amman is a unique operation for an organisation that normally provides emergency care to victims in war and disaster zones. Hospital officials say their criteria for selecting patients are related only to medical need and capacity.
The facility has 144 beds and access to 50 more beds at a nearby hotel, but there are currently 800 names on the waiting list and, with the Syrian war showing no sign of edging towards a resolution, staff expect that list to lengthen.
Among the recently admitted Syrians is Mahmoud Hamadi (27) from the southern city of Deraa, an ex-taxi driver who was fighting with the Free Syrian Army two years ago when he was shot in the leg and put in prison for two months. His lack of treatment for that period worsened his injury considerably and left him at risk of septicaemia, medics say, which could have been fatal.
Like many Syrians in Jordan, Hamadi dreams of returning home. “I’d rather be bombed in Syria with my family than here. I’m constantly thinking of them.” Would he cross the border tomorrow if he could? Hamadi glances at his crutch and smiles: “I’d run back if I could.”
