Operating in a war zone: DO volunteers outside Mosul, Iraq

Just after Christmas last year, general surgeon Timothy Burandt, DO, left his Michigan home to volunteer for the aid organization Samaritan’s Purse in northern Iraq, near Mosul. Dr. Burandt spent the month of January operating on patients at the organization’s newly constructed emergency field hospital and returned for another month in April.

Because the field hospital was hours closer to conflict areas than the nearest medical facility, many of his patients would likely have died if their care had been delayed.

Ultimately, Dr. Burandt operated on more than 100 patients during his two months in Iraq. This fall, he’ll receive the American College of Osteopathic Surgeons’ Humanitarian Award for his service. Following is an edited interview.

What surprised you about practicing outside Mosul?

The degree of injury in a war zone is like nothing I’d ever seen before. We saw so much penetrating trauma—land mines, IEDs, snipers, pieces of metal and plastic ripping through bodies. The lethality and the volume of it is unlike anything I’ve ever experienced.

We took care of civilians as well as Iraqi security forces and ISIS fighters. I learned that many ISIS fighters are not ISIS ideologues. In so many cases, people were coerced into fighting with ISIS. They were kidnapped or ISIS had threatened to kill their families if they didn’t join.

What was a typical day like at the field hospital?

In January, when the hospital was still being set up, it was all emergency surgery and acute injuries, such as those from IEDs and gunshots. There were often mass casualties from people who had been at a market that got mortared or had been shot by snipers. We would have to see all patients in minutes and decide who went first, second, third, and so on.

When I returned in April, we were starting to see more chronic injuries. People would come in who had been hurt for days or weeks but were unable to get medical care because it was unsafe for them to travel.

It was more common for us to have a schedule of surgeries for the day then, though ambulances would show up at any time. We were operating from 9 a.m. to 5 or 6 at night. Afterward, we would do rounds, see how people were progressing, and make decisions about when their next operation would be.

Tell us about a patient who stuck with you.

In January, I operated on a 30-year-old mother who had been holding her baby when an IED exploded outside her house. She had penetrating shrapnel in her chest, arms and abdomen. She lost her left arm and right leg. The baby had been instantly killed, but likely saved his mother’s life by preventing shrapnel from getting near her heart or most vital organs.

She was hanging on by a thread in the intensive care unit, but eventually recovered to the point that she could be discharged. In April, she came back to the hospital and I didn’t recognize her. She was a young, vibrant woman. We taught her then how to stand up using a crutch. We’re hoping that soon, she’ll be able to get a prosthesis and start walking again.

She lived through something horrendous, but is thriving. She left all of us with a sense of hope.

How did you cope with worries about your own safety?

Samaritan’s Purse did an excellent job keeping us safe. I received safety training beforehand—hours of online courses on land mines, IEDs, and so on. When I got there, I was briefed daily on security in and around the hospital. They taught us how to react if there was an attack on the hospital. They had bunkers we could retreat to. Ultimately, you rely on security experts to take care of safety, so you can focus on your patients.

How did you emotionally cope with all the trauma you saw?

The surgeons try to do as much as they can as a group. Together, we would decide who got surgery first, who got placed on the four ventilators we had at the hospital. This way, no one person bears the weight of making a life-or-death decision.

Will you be returning?

I may be going back this month.