Yemen: The Trauma that could never mend

Since war broke out in Yemen in March of 2015, Taiz has been the front line between two warring sides. The constant airstrikes and battles in Taiz destroyed numerous homes, separated families, took away innocent lives and displaced even more civilians. Our project is situated near the Taiz’s front line. As a result, we received and treated many patients  from Taiz wounded by airstrikes.
September 29th was a usual day in the ER. A crying child with pneumonia, beeping noises from the monitor of a middle-aged man with uncontrolled hypertension, cries of pain from several men injured in road traffic accidents. But then I received a phone call from our partner MSF hospital in Taiz: the airstrikes in Taiz had been particularly heavy that day, and we needed to prepare ourselves to receive more wounded. 
Amongst the arrivals was a 65-year-old woman who was wounded by an airstrike while walking in a market. Her right lower leg was ripped apart. Fragments of bone were entangled with torn muscles and tendons, covered by gauze soaked in blood. The distal ankle and foot were barely attached by flesh and skin. She lost a lot of blood on the way and her blood pressure was critically low. We controlled the bleeding, then stabilized her with intravenous fluids, blood transfusion and antibiotics. It was clear that her leg needed amputation. As I tried to look for her close relative for the surgical consent, I found out that her husband died during the same air strike. My heart sank.
Another 50-year-old housewife arrived shortly afterwards. She had multiple injuries after being thrown away by the blast from an airstrike. Her right arm was severely fractured with bone and muscles exposed. Her left ribs and left scapula bone were fractured from the impact of the collision. Multiple big wounds scattered across her frail body. Perhaps she was more fortunate--her husband and young daughter were with her. I asked the daughter to step outside as I examined the wounds and discussed the details of surgery. She was too young and innocent; no children should ever see a mother suffer this way, I thought.
These bloody injuries were horrible to witness, but for me, the most striking and saddening image is the expression on these patients’ faces. The blank eyes that stare into the open space. The brief verbal responses that lack emotion. The absence of crying or agitation. They are in excruciating pain but they do not scream, perhaps moaning only when the pain becomes unbearable. It was as though they are still stunned by what happened and did not know how to react emotionally. As a medical doctor, I may be able to treat the physical injuries or save their lives, but I can never mend the psychological trauma. 
ER doctor Jimmy Leung from Hong Kong worked in the hospital supported by MSF in Ibb governorate, Yemen from August to November 2016 for his first mission with MSF.