Mosul, Iraq’s second city, is slowly rebuilding its healthcare infrastructure after years of war and destruction. Dr Henryk Pich, a consultant anaesthetist and intensive carephysician at the University of Dresden,
Germany, visited the region soon after the fighting had ended, supported by the independent aid organisation CADUS. Moved by the makeshift treatment centres he witnessed in the hospital ruins, he promised the skeleton team of local doctors at the paediatric hospital that he would return, bringing with him much needed equipment and training resources.
Dr Henryk Pich spent time travelling in the Middle East as a young man. Not surprisingly, he feels a personal connection to the region and, after seeing the devastation caused by years of war to cities such as Mosul, wanted to offer whatever help he could. He contacted CADUS, an independent German aid organisation building mobile clinics for areas with significant need and, once the fighting had ended, joined a highly skilled, inter-disciplinary team of paramedics, nurses, doctors, technicians and project managers working in Mosul.
His first trip centred on a refugee camp outside of Mosul providing primary healthcare to the hundreds of thousands of refugees displaced from their homes, from where the team visited the specialist women and children’s teaching hospital in Mosul, the Al Khansaa Hospital. The experience formed a lasting impact on Dr Pich: “The Al Khansaa used to be one of the biggest hospitals in Northern Iraq – with 300 beds for women and children’s services and a high quality reputation in the wider region – yet 85 % of the hospital and its resources had been destroyed or stolen. The staff are very well trained, but there is a lack of equipment. There is a lot of improvisation and many things have to run at a rudimentary level. I naturally expressed my concern and desire to help as much as I could and pledged to return.”
Dr Pich is passionate about ultrasound, particularly in the specialties of regional anaesthesia and emergency medicine, and uses his skills to educate others whenever possible. He explained: “Point-of-care ultrasound is a vital resource for intensivists and emergency physicians around the world. It enables a quick and accurate diagnosis, guides life-saving interventions, and operates as the ‘eyes and hands’ of modernday doctors. The reliability, durability and portability of some ultrasound systems make them ideally suited to use in wartorn destinations, and it made sense to me to return with an appropriate ultrasound machine and training resources.”
The potential impact of a new point-of-care ultrasound system in the Mosul hospital could be far-reaching, and so Dr Pich approached FUJIFILM Sonosite for support for his return mission and a Sonosite M-Turbo system was donated. Dr Pich explained: “I know this machine well and was very happy to take it to Mosul. It is small, light and easy to carry in one hand. It has excellent probes of various types that are resilient and reliable, and the whole system is intuitive to use and easy to teach to others. In a critical care setting, time is of the essence and this ultrasound machine boots up within a few seconds and is ready for use straightaway.”
With the ultrasound system arranged, Dr Pich had clear objectives for his next visit – to hand over the machine and, alongside an Arabic translator, deliver a training course in regional anaesthesia and emergency ultrasound. “In Germany I carry out a lot of FAST (focused assessment with sonography for trauma) scans, and planned to teach this technique to my Iraqi colleagues, as well as lung scans and guidance for nerve blocks.”
Dr Pich was eager to see how life had changed for the people of Mosul since his visit the previous year: “There is some life on the streets again, security has greatly improved and, although there is still a lack of basic materials in the hospital, staff continue to work there with enthusiasm and dedication. It was a pleasure to hand over the M-Turbo and deliver the training course to surgeons and radiologists. I talked about regional anaesthesia, guiding needle insertion, and how to interpret views of structures and identify nerves; I had a practice pad and needles with me, so they could each experience a simulated exercise.
Then one radiologist on the course was very keen to use it to guide her in taking biopsies of breast tissue, which was an application of the device that I hadn’t foreseen. As soon as the course was over, the Iraqi attendees took the M-Turbo to the emergency room to assess a woman with a hernia in the abdominal wall – it was very satisfying to see it being used immediately and effectively to raise the level of care they could provide.”
Dr Pich continues to be involved with CADUS and is now working with them to plan ongoing support for Al Khansaa in the future: “It is very important for us to keep the connection with our colleagues in Mosul, not only to encourage more donations but also to transfer knowledge and skills. I am very grateful to Sonosite for its generosity and think the M-Turbo was just the right piece of equipment they needed. I felt a large sense of responsibility transporting this valuable machine to a war-stricken country, for people who really needed it, but I am very pleased with what we were able to accomplish. The most satisfying aspect of this experience is knowing that I fulfilled my promise to the dedicated staff at Al Khansaa, to bring resources and education that could help them deliver, and raise, the quality of care the women and children in Mosul so desperately need."