’They looked like they were coming out of a concentration camp’: British surgeon treats Aleppo’s wounded

’They looked like they were coming out of a concentration camp’: British surgeon treats Aleppo’s wounded
For fifteen hours a day, the flow of wounded men, women and children from the remains of Syria’s largest city did not stop.

Aleppo residents - evacuated to the safety of the countryside after a six-month siege - came with bones jutting through their skin, limbs succumbing to gangrene and shrapnel still buried in their wounds.

“They looked almost like they were coming out of a concentration camp,” said David Nott, a British surgeon who returned to Britain last week after spending eight days in Syria’s Idlib province treating the injured.

Dr Nott works in operating theaters across three London hospitals but has made repeated medical trips into Syria since fighting started in 2011.

He trained many of the doctors who worked in east Aleppo’s makeshift hospitals throughout the Assad regime siege and Russian bombardment and wanted to be there to help when 30,000 civilians and fighters finally left the city in early December under the terms of a ceasefire deal.

Over the course of a frenetic week of surgery, he operated on 90 people, including 30 children.      

“The patients were really in desperate state” after months with little food and harrowing journey out of the city through snow and freezing temperatures, Dr Nott said.

“They were coming in not just injured but dehydrated, malnourished, and psychologically traumatized.”

Doctors in Aleppo focused on saving “lives not limbs” and performed hundreds of rapid amputations with only valium and ketamine to offer their patients for the pain.

With no way of sterilizing the wounds, the injuries became infected and Dr Nott and his colleagues were sometimes forced to amputate a second time in order to keep people alive.

“They would have amputated below the knee but all these wounds were infected and so we had to perform amputations above the knee to get less infection,” he said.

Dr Nott said he knew that he was probably seeing the strongest of the Aleppo survivors. Many elderly people and children would have died of their wounds weeks ago before they were able to get out of the city.

“What we were seeing was probably the tip of iceberg,” he said.

Dr Nott has spent time in war and disaster zones before but said the operations in Aleppo posed a particular challenge of trying to clean up old wounds after hasty surgeries done inside the city.

One case stuck out for him among the sea of injured: a four-month-old baby girl who arrived with two broken legs and a fractured arm. Both her parents had been killed inside Aleppo.

“She was just on her own and it was really pitiful,” Dr Nott said. “I treated her and had to to leave her and hope that she gets through to Turkey. She’s a beautiful little baby but she’s not eating and not drinking and will be dead in a week if she doesn’t get treatment.”

Dr Nott left Syria on December 24 and was back in Britain for Christmas Day. But he carried the memories of the displaced people of Aleppo with him. “I think about them all the time,” he said.

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