A FORMER senior surgeon at the SWAH has made an impassioned appeal to the Western Trust to commit to restoring emergency general surgery (EGS) at the hospital, stating he has no doubt patients here will die if the service is lost.
Essam Gharreb was a consultant general surgeon at the Erne Hospital and the SWAH for 28 years, leaving only four years ago. He was also the director of surgery at the former Sperrin Lakeland Trust.
Speaking to the Herald, Mr Ghareeb, pictured right, said over those decades he saw countless cases where surgery was required urgently, from gunshot and stab wounds, to industrial and farming injuries.
“What we dealt with here, it was the same as the Royal Victoria, but on a smaller scale,” he said. “We dealt with everything that was urgent.”
Noting other hospitals could transfer patients to bigger hospitals because they were simply closer – stressing SWAH was a special case given its isolation – he said that was very often not an option here, with many patients in a condition where they could not wait two or three hours for surgical intervention.
“I can give a lot of examples,” he said. “We had patients we had to deal with now, we had to deal with it and stabilise them.
“Stabilising a patient doesn’t mean I stick in a drip and stick them in an ambulance and send them on. If there is bleeding I have to stop it.”
Mr Ghareeb also rejected claims patients had better outcomes if they travelled to larger hospitals for treatment in emergency cases.
Noting ‘golden hour’ may no longer be used as a term in medical circles, he said the principal still applied and the patients remained the same.
“When I get a guy who is hit by a little bit of a drill in his jaw, and he is pumping blood, or the guy who cut his arm in the factory pumping blood, and they put on a tourniquet, it is not effective,” he said.
“They can’t be left for three hours to go somewhere. I had to take those patients to theatre.”
He added, “In my contract, like everyone’s after me, I had to live within half an hour of the hospital, of the acute surgical unit. Why did they ask me to do that? Because I had to be there quickly for that patient. So how come now that is all rubbish?”
When asked if local patients’ lives were at risk without a local EGS service, Mr Ghareeb was definitive.
“From my experience from working in that hospital for 28 years, from all the cases I dealt with, definitely it will cause death and morbidity,” he said.
“This is not only me saying this, this was the view of the people who were discussing it when they were trying to decide whether the hospital should be in Omagh or Enniskillen.
“I was involved heavily in that, as the director of surgery. They said there were about 10,000 people who were going to be very far away from an acute hospital if we put it in Omagh.
“That’s the only reason it came to Fermanagh.”
He pointed out there were now over 83,000 patients who were now too far from emergency surgery.
Mr Ghareeb, who believes the current removal of the service could result in judicial reviewin future, also expressed deep concern about the knock on effect of removing the EGS service from the SWAH.
“They will say they still have A&E, and they still have doctors there.” he said.
“Wait until after they close the surgery for a year, and see if they have any consultant in A&E.
“No consultant will work in a hospital if its A&E really doesn’t have a surgeon.”
Mr Ghareeb added this also applied across other departments, such as paediatrics and obstetrics and gynaecology.
“There is no gynae and obs doctor who will ever do any gynae surgery and open an abdomen knowing he has no consultant surgeon who will help,” he said.
“There is no paediatrician that will stay in a hospital where he knows if he gets a little child diagnosed even with meningitis, who at the same time, gets a bit of belly pain which sometimes comes with it, that he doesn’t have a general surgeon to tell him it’s OK.”
Dr Ghareeb, as a member of the local community, is a supporter of the Save Our Acute Services campaign and it’s call to create a new health Trust to ensure services in the Fermanagh and Omagh area.
However, when asked what could be done in the short term, he said the answer was simple – both the Western Trust and the Department of Health must definitively state they are committed to the restoration of EGS at the SWAH.
“You have to return the acute surgery. There is no doubt about that,” he said.
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