1. Surgical Life in the Field YEMEN Mission (20-4-09 to 2-6-09) Dr AU Yiu Kai

2. Context: Armed conflict in Sa’ada Governorate, Yemen MSF presence: from July 1997 to 2003 with Aden project in the South. Return in July 2007 Number of projects: 2 projects: Al Talh & Razeh Other MSF sections: MSF-Spain

3. Population of more than 18 million peoplePopulation of more than 18 million people Surrounded by the Saudi Arabia, the Golf of Aden, the Red Sea and Oman.Surrounded by the Saudi Arabia, the Golf of Aden, the Red Sea and Oman. Yemen is the only republic of the gulf.Yemen is the only republic of the gulf. Complex picture of tribalism, social tensions, economical crisis, conflict in the north and international terrorism.Complex picture of tribalism, social tensions, economical crisis, conflict in the north and international terrorism. The Context of Yemen Located in the Southwest of the Arabian peninsula

4. (A)Al Talh Project (started April 08) (cooperated project with MOH, Yemen) (a)Nutrition Programme & Immunization Programme (b)Al Talh Hospital (i) Emergency Room (ii) IPD- 11 male, 11 female IPD beds - 8 ICU beds (Paediatric/Nutrition) (iii) Maternity (iv) OPD (v) Surgical Activities (c)Out Reach Programme - Dahyan

5. (B)Razeh Project (a)Nutrition & Immunization Programme (b)(i) Emergency Room (ii) IPD (iii) Maternity (iv) OPD (no Surgical activities, surgical patients need to be transferred to Al Talh Hospital, which takes 4½ hrs drive cross the mountainous and conflict area) Recent conflict escalating, international staffs have to be evacuated

6. Human Resources (Al Talh Project) Human Resources (Al Talh Project) (a)International Staff 7 (including 1 Surgeon, 1 Anaesthesiologist, 1 Anaesthesiologist, 1 Nurse Supervisor, 1 Nurse Supervisor, 1 Out-reach doctor 1 Out-reach doctor co-ordinator) co-ordinator) (b)National Staff –HR National 77 HR Incentive33 - medical doctors, medical assistants, nurses HR Incentive33 - medical doctors, medical assistants, nurses

7. Surgical Activities Dr Au Yiu Kai mission period 23.4.09 to 31.5.09Dr Au Yiu Kai mission period 23.4.09 to 31.5.09 Total operations – 102Total operations – 102 estimatedestimated - 40% - war wound - 40% - accident - 15% pathology Photo for HKCCM ASM Photo for HKCCM ASM Photo for HKCCM ASM - 5% Obstetric

8. Surgeon in the Field At least twenty surgeons in oneAt least twenty surgeons in one Not just a surgeon, also a physician, paediatrician, emergency doctorNot just a surgeon, also a physician, paediatrician, emergency doctor Take up role of surgeon, nurse, therapistTake up role of surgeon, nurse, therapist Basic clinical skills – most reliableBasic clinical skills – most reliable Personal touch and care – most important in patient carePersonal touch and care – most important in patient care Holistic ApproachHolistic Approach

10. Thank You