World-Class Burn Surgeon Helps Reconstruct Iraq

By Kimberley Sevcik

Car bombs and roadside explosives are a tragically common occurrence in Iraq. Often, they leave their victims with severe second-and-third-degree burns. To help treat survivors, IMC initiated a burn management training program in August. Its aim: to teach Iraqi doctors the most advanced burn treatments available to equip them with the skills to operate on complicated cases.

Due to the extreme instability in Iraq, many experienced doctors have left the country to seek opportunities in safer countries. Those who remain tend to be younger or less experienced, without the expertise to manage severe burn cases or use surgical interventions. They are eager to help burn victims, but lack the training to do so.

Photo: IMC

Dr. Randy Sherman instructs a group of Iraqi doctors in state-of-the-art burn treatment techniques. Here, he operates on a woman whose lower leg was destroyed by an explosive device.

Finding a surgeon willing to risk his life to conduct the course was a tremendous challenge. IMC’s Iraq team was lucky enough to work with one of the world’s most gifted reconstructive surgeons, Dr. Randy Sherman, who traveled from Los Angeles to Iraq to lead the course. Sherman has long been dedicated to improving health care in Iraq. In 2003, he developed a training program for Iraqi medical professionals which brought them to Los Angeles’ U.S.C. campus for four to five months, where Sherman taught them state-of-the-art surgical techniques.

Sherman recognized that going to Iraq to conduct the course with IMC might be the best way to continue his mission to help strengthen Iraqi surgeons’ burn treatment skills. Two weeks after IMC asked for his assistance, he was on a plane to Suleimaniya, where the training course was held. “I didn’t have time to think about my safety,” he says.

The IMC Iraq team brought together 24 doctors for the course, from cities as far-flung as Ramadi, Baghdad, Kirkuk, and Erbil. Many of them traveled for hours to get to Suleimaniya. Coordinating the course was no easy feat. It necessitated the support of the governor of the province, the chief of security and the director of the regional airport, to facilitate safe passage for all participants.

The immersion course taught by Dr. Sherman was a high-level specialized training program, involving hands-on practice for participants. The program began with a series of lectures, and moved on to a consultation phase. Sherman and his students visited two clinics, where about 30 burn patients were waiting to be examined. With his students gathered around him, Sherman talked about possible therapies for each patient, with students occasionally proposing alternatives when a therapy required resources unavailable to them. Blood banks, for example, are depleted in Iraq, so procedures that would provoke excessive bleeding, such as cutting away a patient’s damaged skin, generally cannot be performed.

For the third and final component of the course, Sherman chose three patients whose cases would expose the surgeons to technical procedures that they had never before witnessed, and performed operations on them while his students watched, posed questions, and, in some cases, assisted.

	Photo: IMC
	Dr. Sherman and one of his students examine an X-ray to help determine the course of treatment.

In the most dramatic case, Sherman, assisted by an Iraqi surgeon, nurse and anesthesiologist, reconstructed the heel of a 20-year-old woman whose lower leg had been virtually destroyed by an explosive device. A young woman studying for her teaching certificate, she was scheduled to have her leg amputated. “Her leg was terribly infected,” says Sherman, “and the surgical technique required for reconstruction was beyond the medical experience of the doctors at the hospital.” Ultimately, Sherman, with one student assisting and 23 others looking on, was able to save the woman’s leg - at no cost to her or her family. Using a flap of chest-wall muscle, he reconstructed her heel, a complicated four-hour operation that had never been performed before in Iraq. “The procedure went off without a single problem, with everyone working in beautiful harmony,” says Dr. Sharaf Aziz, the anesthesiologist who assisted with the surgery.

Sherman was impressed by the dedication and skill of his students. “Despite working under incredibly adverse circumstances, these doctors are finding a way to do great things,” he says. “What they don’t have are the resources to apply all the latest developments in burn treatment. Our aim was to give them an opportunity to observe many of these techniques in action.”