Carlo Pacitti is nearing the end of his assignment in Nigeria. He shares his impressions after working as an ICRC surgeon in the northern part of the country for the last six months.
What have you been doing in Nigeria?
The ICRC is providing hospitals in the northern states of Bauchi, Kaduna and Plateau with expertise, training, equipment and supplies.
I’ve been leading a surgical team that also includes an anaesthetist, three nurses and a physiotherapist. Together, we’ve been training surgeons and staff at four hospitals to deal with sudden influxes of mass casualties.
The ICRC team works with hospital staff to enhance their knowledge of triage, increase their ability to deal with mass influxes of patients and develop contingency plans.
Why did the ICRC start working in these Nigerian hospitals?
On Christmas Day 2011, a suicide bomber blew himself up in a church in Madallah, near Abuja. Dozens of people were killed and many more were injured. Our nurse went to the National Hospital in Abuja with wound-dressing materials, and the hospital director asked him whether the ICRC could provide additional personnel to help cope with the influx of casualties.
The same day, the ICRC decided to send a surgical team and to launch a comprehensive programme to support health facilities in violence-prone areas of Nigeria.
In January 2012, in agreement with the Federal Ministry of Health, the ICRC held its first training course for Nigerian surgeons, predominantly from the north of the country. Since then, some 75 surgeons have undergone training.
The ICRC is also training Nigerian Red Cross Society emergency first-aid teams in the pre-hospital management of casualties.
Finally, our team can deploy within hours to any hospital in the country that is struggling to cope with a major influx of casualties resulting from violence.
How were the hospitals selected that received this support, and what challenges are they facing?
Northern parts of Nigeria have seen an upsurge in armed violence and inter-community clashes since 2010. Increasingly, hospitals in these areas are having to deal with sudden influxes of casualties. They have also been grappling with a shortage of nurses and doctors qualified to treat victims of violence, and with a lack of equipment and infrastructure.
The four hospitals currently involved in the on-the-job training programme were chosen following an in-depth assessment that took into consideration the hospitals' infrastructure, equipment and, above all, surgical expertise in treating patients with weapon-related injuries. The four hospitals consist of one private, one federal and two state facilities.
We received assurances – and could see for ourselves – that all four hospitals provide treatment for patients on the basis of medical need, irrespective of the patients' religious beliefs, sex or social background.
How was it to work alongside Nigerian surgical teams?
The hospital staff were always happy to see our team arrive. They made us feel very welcome. During joint ward rounds in hospitals, I was often asked for advice not only on trauma cases but also on others; this shows how much we were accepted and trusted.
It was a learning experience for me too. I was impressed with the knowledge and general surgical skills of my counterparts and, most of all, with their ability to work in difficult conditions – for example, with little or no light, or without certain instruments.
I have years of experience as a surgeon, both in my native Italy and with the ICRC, but this was the first time that I had been involved in such a comprehensive programme to support medical facilities. I found it really interesting!
I was happy to share with Nigerian colleagues my experience with basic surgical techniques for the treatment of weapon-wounded patients and general trauma cases that I acquired while working for the ICRC in Afghanistan.