© Juan Carlos Tomasi/MSF
08 Jan 19
Eve BruceEve BruceAmericanClinical DirectorJordan

‘I am far from home for Christmas again. But I am not alone’

This content originally appeared in The Irish Independent

Last Christmas I was in Gaza. This is my 13th mission with MSF, the longest and a very different position. For the first time in my almost 35-year professional life I am not in the operating theatre. I am in Amman, Jordan, as the clinical director of a large tertiary care rehabilitation hospital for war-wounded patients from all over the Middle East.

The mission was begun in 2006 in response to the large number of crippled patients coming out of the Iraq war who needed further treatment and had nowhere to go. At the time, no one imagined that the needs in the region would grow and grow.

Currently, our patients are mostly from Yemen, Syria, and - yes - still from Iraq. We provide staged reconstructive orthopaedic, plastic and maxillofacial surgery as well as intensive physiotherapy, occupational therapy and psychosocial therapy.

Our average length of stay is four months, many staying much longer, and most returning for additional stages in their lengthy rehabilitative quest to return to, if not their pre-war life, at least a more functional life.

As clinical director I am responsible for maintaining quality medical care in this remarkable and unusually high-resource MSF project.

My days are filled, challenging, but in the end rewarding as I manage a continual flow of traumatised patients towards their hope of a better life.

The emotional toll of the arriving patients' stories about the horrors of war, followed by extended periods of painful surgery and rehabilitation, is balanced by the many success stories. The wheelchair-bound patients leaving independently walking; or the children physically and emotionally scarred leaving with smiles; or the families finding hope far from their destroyed homes.

One of our patients is Fatima, a nine-year-old Iraqi girl who was burned severely on her head and both arms and hands when she was two years old. She was in a burns unit for over a month. She has been coming to our hospital for years for multiple operations involving release of burn scar contractures of both arms and hands and reconstruction of her scalp. We know her for her contagious smiles and her many fun hats which she wears at all times to hide the burn scars and hair loss, as well as the multiple surgical tissue expanders.

Only six months into my mission I have been challenged over and over, and yet I am so grateful and proud of my mostly local national team and our successes - implementing total hip replacement in war-wounded patients, an expanded and effective mental health department including a Syrian peer counsellor, improved nutrition and pain management, enhanced paediatric preoperative sedation, 3D printing of arm and hand prostheses for amputees. I could go on and on.

Yes, once again I am far from home for Christmas. But I am not alone. Every single one of our more than 200 patients are also far from their homes and for this healing opportunity they are filled with gratitude, as am I.


Dr Eve Bruce, lives in Dingle, Co Kerry. Dr Bruce spent Christmas in Amman, Jordan, where she is hospital director of a reconstructive surgery project run by Médecins Sans Frontières.

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