In conflict zones where emergency medical infrastructure has collapsed, the line between life, permanent disability, and death often comes down to a matter of minutes and the presence of specialized vascular surgeons.

Through a vital humanitarian partnership, UOSSM Canada and Qatar Charity have maintained specialized medical clinics across Gaza to treat complex trauma injuries. The Vascular Surgery and Diabetic Foot Clinic continues to perform emergency, life-saving surgical interventions for victims of active shelling and stray gunfire.

This case study details the emergency medical response and recovery of F.A.A., a 26-year-old displaced woman whose arm and life were saved through immediate vascular reconstruction.

The Human Context: Displaced in Halawa Camp

Forced from her home by ongoing violence, 26-year-old F.A.A. was living in a temporary tent in Halawa Camp, east of Jabalia.

While seeking shelter inside her family's tent, F.A.A. was struck by a stray bullet in her right arm. The gunshot wound caused catastrophic internal and external bleeding, severe arterial damage, and massive psychological trauma.

Accessing medical care was hindered by continuous active bombardment:

• Delayed Evacuation: Active shelling prevented ambulances from reaching Halawa Camp for over 90 minutes following the shooting.
• Infrastructure Breakdown: Local primary care facilities were overwhelmed and lacked the specialized vascular personnel and surgical equipment needed to manage major arterial trauma.
• Risk of Fatal Hemorrhage: Uncontrolled bleeding from a major artery carries a high mortality rate within hours if not surgically repaired.

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Clinical Diagnosis & Medical Challenges

Upon arrival at the specialized clinic, leading surgeon Dr. Iyad Abed and the medical team evaluated F.A.A. and confirmed four severe, interconnected diagnoses:

1. Transected Right Brachial Artery: Severe trauma to the main vessel supplying oxygenated blood to the right arm and hand.
2. Severe Hemorrhage: Uncontrolled arterial blood loss leading to severe blood pressure instability.
3. Right Elbow Joint Fracture: Structural bone fracture caused by kinetic bullet impact.
4. Acute Blood Loss Anemia: Dangerously low hemoglobin levels resulting from rapid blood loss.

The Medical Risk: Delayed intervention for a brachial artery injury frequently leads to irreversible ischemia (tissue death), requiring full limb amputation, or fatal hypovolemic shock.

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Surgical Intervention & Treatment Protocol

Operating under the UOSSM Canada and Qatar Charity project initiative, Dr. Iyad Abed immediately initiated emergency surgical procedures to control and restore blood flow.

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Key Surgical & Medical Interventions:

• Vascular Reconstruction: Surgical repair and microsurgical reconnection of the right brachial artery to restore active blood flow to the lower limb and hand.
• Fracture Stabilization: Application of an arm splint to fixate the fractured right elbow joint and prevent nerve or tissue re-injury.
• Hemodynamic Stabilization: Transfusion of two units of packed red blood cells (PRBCs) to treat acute anemia and stabilize systemic blood pressure.
• Targeted Pharmacotherapy: Rivaroxaban (anticoagulant) to prevent blood clots, alongside Ceftriaxone and Levofloxacin (antibiotics) to prevent deep-tissue and complex wound infections.

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Clinical Outcome & Recovery

Following vascular repair surgery, blood circulation to F.A.A.’s right arm was fully restored. Post-operative evaluations confirmed stable arterial pulses, controlled pain, and no immediate vascular complications or active bleeding.

F.A.A. remains in structured follow-up care through joint orthopedic and vascular clinics to monitor arterial patency, bone fixation, hemoglobin recovery, and targeted physiotherapy.

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Patient Voice: In Her Own Words

"I thought I would lose my arm and maybe my life because of the severe bleeding and the delay in reaching the hospital. Thanks to the doctors and the support provided through the UOSSM project, I received the surgery and treatment I urgently needed, and now I am recovering safely." — F.A.A., 26

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Adaptation in Crisis: From Indonesian Hospital to Al-Shifa Hospital

Due to the situation on the ground and extensive damage to facility infrastructure, the Indonesian Hospital was forced to completely shut down last year.

Refusing to abandon the patients and wounded civilians who depend on these life-saving services, UOSSM Canada swiftly adapted. Medical teams, specialized surgeons, and key equipment from the Indonesian Hospital were successfully redeployed to Al-Shifa Hospital.

It is through this relocated setup at Al-Shifa Hospital that specialized care, including the Vascular Surgery and Diabetic Foot Clinic, continues to function today. Doctors like Dr. Iyad Abed remain on the frontlines, ensuring that despite venue loss, total destruction, and active war, lifesaving surgeries for patients like F.A.A. never stop.