November 07, 2016

By McKenzie Ross

Yasser was crossing a street with his mother when he was struck. The bomb caused so much damage to the eight-year-old's leg that it had to be amputated below his knee. It also sent shrapnel flying into his face, completely removing his jaw.

Yasser was one of the first patients Julie Little worked with as a nurse activity manager with Doctors Without Borders/Médecins Sans Frontières (MSF) in Al Qa'idah, Yemen. After his initial surgery, Yasser remained unstable, suffering in the ICU from continuous infections.

"He was going into the operating room almost every day. He was eight years old, he should have been out there playing with his friends," says the nurse from Vancouver, British Columbia. "It's hard when you see a lot of young kids coming in with injuries and needing amputations, things that will totally change their lives, and it was just a result of them being in the wrong place at the wrong time."


'Everyone has a right to quality healthcare'

Little was in Yemen to help MSF provide emergency medical services to war-wounded and internally displaced Yemeni people. It was the type of work she had always wanted to do — Little became a nurse with the goal of one day working with MSF and helping people like Yasser. "I wanted to focus on working with populations that were more vulnerable; I just believe that everyone has a right to access quality healthcare," she says.

This was Little's first time working in a conflict area. Yemen has been in a civil war since March of 2015, with most of the fighting taking place in Taiz, about 20 minutes south from MSF's hospital in Al Qa'idah. Around 40 per cent of the patients who Little saw were civilians who had been hit by airstrikes, cluster bombs or crossfire as a result of the ongoing conflict.

Many of her patients also suffered from accidental gunshot wounds — a frequent risk in highly armed countries.

"The thing that amazed me the most was we had a lot of really bad gunshots — to the neck, to the abdomen, to the chest — and you know, we didn’t have a whole lot of resources to use, but most of our patients did really well. It's just amazing how resilient the body is," she says.

Although the recovery rate was high, these gunshot wounds were very challenging for Little's team because of the hospital's limited treatment capacity. "We had one general surgeon, so if someone came with a bullet wound in the head or the neck or somewhere in the chest and they needed a neurosurgeon or a thoracic surgeon, we needed to refer the patient," says Little.


Providing essential care

This need had serious impact on patients: while all MSF services are free, patients referred to the Yemeni medical system often have to pay for treatment, which many cannot afford. Little believes that it is important for MSF to be in Al Qa'idah because otherwise "there's no doubt, this community wouldn't have access to healthcare," she says.

That level of care also allows patients like Yasser to have good outcomes. Just before Little returned to Canada, the young boy was rebounding. He was free of infections and the team was preparing to send him to an MSF project in Jordan that specializes in reconstructive surgery, where he will receive facial surgery for his jaw.

"He was such a trooper," she says.


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