We were in Damascus from April 28 to May 5, 2006 in collaboration with the Palestine Children’s Relief Fund (www.pcrf.net) and the Ministry of Health, Syria. We met Dr Ali Khiyami, Dr Bashar Mirali and their trainees in the Orthopaedic Department, Damascus Hospital for the pre-operative assessment. Nuha, from the PCRF, was with us in the clinic. Approximately 40 patients were assessed. These included infants with congenital deformities of the upper limbs, children with birth injuries of the brachial plexus, cerebral palsy, growth plate injury, a father and 2 sons with skew feet, congenital pseudoarthrosis of the tibia, Klippel-Feil syndrome and scoliosis. 4 patients with scoliosis were selected for surgery. They were a 16-year old boy with congenital scoliosis, a 13-year old girl with idiopathic scoliosis and a 16-year old girl with neuromuscular scoliosis. All had posterior instrumentation and fusion. The 4th patient was an 18-year old girl with congenital kyphoscoliosis who needed an anterior release, posterior instrumentation and fusion. In addition, we presented 5 lectures to the trainees. These were on clubfeet, anterior cruciate ligament reconstruction, neuromuscular scoliosis, acetabular and pelvic fractures, management of growth plate arrest and the Ilizarov technique in children. We also presented several cases for discussion in the spring meeting of the Syrian Spine Association in the Damascus Military Hospital.

In Syria, we visited historical sites around Damascus and Homs. The Castle of the Knights was first built in the 11th century by the Emir of Homs and subsequently expanded by the knights of St John from Jerusalem in the middle of the 12th century. It was recaptured by the Mamluks a century later. Khalid Bin Al Walid, a warrior and companion of Prophet Muhammad (p.b.u.h), was born in Makkah in 585 A.D. and died in Homs in 642 A.D. In Lebanon, we went to Bourj Al Shamali (www.bourjalshamali) a Palestinian refugee camp in Tyre. We met Mr. Abu Waseem at the National Institute of Social Care and Vocational Training (Beit Atfal Assomoud) and then visited Sahar Fares, 13-year old Palestinian girl, and her family at their home. Sahar’s education is sponsored by a Malaysian family.

Nuha, as usual, has done a great job in organizing our visit. We thank Dr Ali Khiyami and Dr Bashar Mirali for allowing us to examine and operate on their patients. We found the trainees very enthusiastic and knowledgeable. We understood the limitations of working in a different country and the need for experienced surgeons as volunteers. Overall, it was a successful mission and we have been invited to Damascus again. We encourage others to volunteer for future missions.

Damascus Hospital

Posterior instrumentation and fusion for the 16-year old boy with congenital scoliosis

Anterior release followed by posterior instrumentation and fusion in the 18-year old girl with congenital kyphoscoliosis

Preoperative and postoperative x-rays of the 16-year old boy with congenital scoliosis and
his clinical picture on the 5th post-operative day

The head of the orthopaedic department, Dr Ali Khiyami (standing) and the trainees during our lectures

Poster announcing our participation in the spring meeting of the Syrian Spine Association in Damascus Military Hospital