Face-to-face with death

By Shevlin Sebastian

Mangalore native, Shazeer Majeed, a war surgeon talks about his work in Yemen, Syria, South Sudan, Iraq and Jordan

On a sunny February morning, in the residential area of Shmeisani in Amman, Jordan, the Mangalore native Shazeer Majeed looks out of the third-floor window. He has been in Amman for the past one year as the medical director for the Reconstructive Surgery Project of Medecins San Frontieres (MSF).

The organisation brings in war-wounded patients who need reconstructive, maxillofacial, plastic and orthopaedic surgery from Palestine, Iraq, Yemen as well as Syrian refugees living in Jordan. “We want to return them to a near-normal life,” said Shazeer.

But as he stared out of the window, the image of Noor Abdullah (name changed) came to his mind. The 14-year-old lived in the town of Ad Dahi in Yemen. He had found a land mine near his house. He tried to open it because it fetched a good price with scrap-metal dealers, but it exploded.    

The major injury was to his right hand. Noor was rushed to the emergency room of a hospital run by MSF. “There were a lot of shrapnel wounds and his forearm had fractured,” said Shazeer, who is a war surgeon. “The main artery which supplies blood to the hand was damaged.” 

The boy was in shock. But at the same time, he was aware of his injury. He kept telling Shazeer, “Please do not amputate my hand.” 

At that moment Shazeer did not have the equipment or the instruments to do vascular surgery. The instruments were in another MSF project, at Hodeidah, 53 kms away. But within an hour, it was brought to the hospital. 

Shazeer did a graft repair. He took a vein from the leg and used it on the forearm. “We were able to re-connect the arteries and restore the blood supply, which fixed the fracture and saved his hand,” said Shazeer, who has done numerous stints in South Sudan, Iraq, Syria, Jordan and Yemen. Within a couple of weeks, Noor was able to move his fingers and arms. And in four months, he made a complete recovery. 

But not everybody experiences this recovery. Shazeer admits there are many times when the patient dies. “But I pick myself up,” he said. “Honestly, we are putting in 16 or 18-hour days and when we return to our apartments, we just want to sleep. There is no time to think about victory or defeat in the operation theatre. Sometimes, after a patient passes away, we immediately begin work on another patient to save his life.”

There have been times when Shazeer has worked for over 30 hours at a stretch. This was during a stint in Yemen. “There was fighting close by,” he said. “We just kept receiving patients, so we slept when the operation theatre would be cleaned before the next patient was brought in.” 

Shazeer says that he copes with the job by shutting out thoughts about it as soon as he leaves the MSF Mission. “Otherwise, it would be impossible for me to remain calm,” he said. 

Sometimes, the MSF sends its staff to another country for five days, so that they can recover from the stress and the tension. “So, if you are in Yemen, they will send you to Djibouti,” said Shazeer. 

As for the patients, most of them are ordinary men, women and children. The military has its hospital to treat their victims. 

Usually, the people suffer from wounds and injuries which take place when a bomb blast happens. There are also high-velocity bullet injuries. But not all injuries are caused by the war between the Saudis, who are allied with the government of Abdrabbuh Mansur Hadi and the Houthis. 

“Sometimes, bullet injuries happen when there are fights between family members or friends because Yemen has one of the highest ratios of gun ownership per population in the world,” said Shazeer. “Everyone carries a gun in Yemen.” 

Even minor injuries can become fatal. Sometimes, the bullet may hit the leg. But if the hospital is four hours away, the person will bleed to death. Sometimes, the gunshot may be to the chest but the hospital may be only 20 minutes away. “Then he will get proper treatment and survive,” said Shazeer. 

Most of the time there are no facilities, like in any hospital. “There is a shortage of blood, or sometimes, we don’t have the right equipment,” said Shazeer. “It is usually a low-resource setting. So, I have developed ways to overcome these limitations.” 

As to the precautions that are taken to safeguard the lives of the doctors, nurses and patients, the MSF shares their location with the warring parties. On the roof of the hospital, there is a large logo of MSF; this can be seen from the air, along with the Red Cross sign which depicts a hospital. However, despite these precautions, MSF hospitals have been targeted in Yemen and Afghanistan. 

On May 12, 2020, insurgents attacked the Dasht-e-Barchi maternity hospital in Kabul. Twenty-four mothers, children and babies were shot dead. “The organisation is always in touch with the local authorities and keeps them updated,” said Shazeer. “We tell them we are impartial and neutral and have only one aim: to provide medical care to the people who need it.” 

Shazeer feels sad about the impact of the six-year war on Yemen. The economy is in freefall. Many young Yemenis want to go abroad for studies. Now they are unable to do so because of severe financial constraints. The medical facilities have broken down. 

“There is a lot of hardship, and a high degree of malnutrition because of food shortages,” he said. “There are outbreaks of cholera. But the people are nice, humble and smart. They are eager to learn and are good at grasping a subject.” 

Expectedly, Yemen had a large number of Malayalis. Before the war began in 2014, his MSF colleagues in Yemen worked with a lot of Malayali nurses. Now all of them have left the country. Many of them took advantage of Operation Raahat, which was conducted by the Indian Armed Forces to evacuate Indian citizens and foreign nationals from Yemen in April, 2015. “I don’t think there are any Malayalis left in the country,” said Shazeer.

However, there are many Yemenis of Indian origin. Their great grandfathers had migrated to Aden from India during the British rule, which began in 1839.  

A desire to help

Shazeer joined MSF in September 2014, because he was interested in doing humanitarian work. His inspiration was his father, Abdul Majeed, a surgeon who always helped the downtrodden as well as his former mother-in-law Nimmi Sheriff. “Their work for the poor had a big impact on me,” he said.

As for his education, he did his undergraduate studies from Yenepoya Medical College in Mangalore. This was followed by a residency in general surgery at the Amrita Institute of Medical Sciences in Kochi. Then Shazeer did his ‘humanitarian surgery in an austere environment’ from the Catholic University of Leuven, Brussels in 2018. At present, he is pursuing his Master’s in Public Health from King’s College, London.

Meanwhile, all these years of working in war zones has changed Shazeer. “I appreciate life much more,” he said. “We complain when we don’t have electricity in our houses for 15 minutes but there are people who stay in 50 degrees centigrade, and do not have power for days together.”

It is also a blessing to walk around in a city like Mangalore. “You can get out of your house, and get back without any major incident happening to you,” he said. “That is no longer the case in Syria, Palestine and Yemen. You could be shot at or bombed. I appreciate everything about life.”

Whenever he finishes a stint with MSF, Shazeer returns to Mangalore where he does operations alongside his father Abdul who works in private hospitals.

Asked how he has viewed the incessant attacks by one group of men on another, and vice versa, Shazeer said, “Man has been killing each other since the beginning of time. There has never been a time when men have not killed other men. It is usually in the name of religion, country, caste, or tribe. Man will always find a reason to kill other human beings. But what is most disheartening is that those who suffer are not involved in the battle. They are the ordinary people who just want to get on with their daily lives, like having a job and looking after their family. They want a normal life.”

(Published in Onmanorama.com)