Last month, laproscopic and colorectal surgeon Dr Shafi Ahmed visited Gaza with Medical Aid for Palestinians (MAP) team, on a mission to assess training needs for medics working in the territory’s overburdened hospitals.
Famous for being the first surgeon in the UK to live-stream a surgical procedure via Google Glass, Dr Ahmed is a pioneer of technical innovation in medical training.
MAP interviewed him at the Royal London Hospital this week, and spoke about the possibilities for using technical innovations such as virtual and augmented reality technology to bypass the restrictions which the blockade and closure places on Gaza’s beleaguered medics:
Could you introduce yourself and your work?
My name is Shafi Ahmed, I’m a general laproscopic and colorectal surgeon working at Bart’s Health NHS Trust, for the last eight years as a consultant, and mainly treating cancer patients. My other interest is teaching and training. I’m an Associate Dean of the medical school here, and run the clinical placements at the Royal London Hospital for 1,600 medical students per year, and for 300 elective students from all over the world.
I am also the youngest member of the Council of the Royal College of Surgeons, where I run the international surgical programme. I’m very much involved in international work not just at the college, but also on a personal level. I help two projects in Bangladesh: A rural community health practice called Proshanti, and a new surgical training centre in Dhaka called RAHETID. I also help a new project called the Beani Bazaar Cancer Hospital, the first of its kind in Bangladesh.
Have you been to Palestine before?
I had been to the West Bank, about 14 months ago. I was invited by the Palestinian Medical Society to speak at their conference in Bethlehem. I visited Al Makassed Hospital in East Jerusalem, and the Palestinian Medical Complex in Ramallah.
What were your initial impressions from this trip to Gaza?
The Palestinians themselves have one of the highest literacy rates in the world, and I found the residents of Gaza to be really intelligent, philosophical people. They were very friendly and welcoming, as were the MAP team who greeted me.
The trip was very busy – packed with meetings, visits to operating theatres and outpatient clinics, meetings with Health Ministers, and trips to the university where medics are trained in Gaza. All of the medics I met were looking for ways to further their knowledge and skills, and to open up Gaza to the outside world.
What needs did you see for doctors and medical infrastructure in Gaza?
Consultants and senior doctors there want advanced surgical skill training, which they are unable to access because of the blockade and the restrictions it places on their movement out of Gaza to the rest of Palestine or beyond.
Without this access to training outside of Gaza, they need a self-sustainable training model. Consultants need support to become trainers themselves, in topics such as basic infection control, basic surgical skills, and laproscopic skills. Ultimately, projects need to focus on ensuring the entire medical workforce in Gaza can self-sustain by teaching each other rather than relying on outside to bring trainers in.
Can you tell us about the seminars you ran on the use of Augmented Reality and Virtual Reality in medical training?
I did two lectures – one to the Palestinian Medical Society, and one to a medical school. I focused on augmented reality as a tool to support surgical training, which hasn’t been used in Gaza before. I used it as an opportunity to show them what was available around the world and to use those products for the first time.
There was such enthusiasm and openness to new ideas among the students. We want to look to how we can use these technology for training medics. At the new medical school at the Turkish Hospital in Gaza, they want to integrate new ideas from outside Gaza, such as simulation training and using remote training via online platforms.
I have a huge interest in the use of technology in health education, and believe in Gaza it can be used to overcome the frustrations posed by the blockade. This technology can help medics in Gaza communicate with people and get teaching and training from around the world.
What conditions did you see in the hospital?
I was amazed at how the accident and emergency (A&E) department manages huge workloads on minimal resources. They have one stethoscope in the whole of A&E. In the resuscitation department they have one blood pressure machine and just one pulse oximeter which wasn’t working.
Getting equipment and resources into Gaza is a problem, and often medics visiting the territory bring them in their suitcases. It can also be hard to develop one’s skills as a medic if you can’t access equipment. With basic resources, managing the workload in a hospital becomes difficult, and to it is more difficult to devote time and resources to training.
Any final reflections from your trip?
I’m quite encouraged by the standard of care, the knowledgebase, the clinical expertise, and the commitment of medical staff to healthcare in Gaza. They have good motives and aims.
What is disappointing is that doctors of all descriptions have aspiration – everyone wants to improve their standards – but in Gaza the only way they can do that is by trying to visit other countries or bringing other people in to help them. That’s where the frustrations arise from. It is impossible for doctors to easily access continuous professional development – a basic requirement for all doctors – with the blockade in place.