Medical Initiative For the Benefit of

The Children of Palestine

Ear Surgery for Palestinian Children

By Dr. Ibrahim K. Ladaa

Message from Nablus, August 26, 2003

Dear Colleagues,

I have now been at the Rafidia Hospital in Nablus for five weeks and have carried out two ear operations daily. Up to now I have performed 32 ear operations.

The pathology of the middle ear exceeds all imagination. In almost all operations it’s a case of a cholesteatoma , in English ‘caries’ or ‘bone corrosion’; in Arabic ‘pearl growth.’  Even the old Arabs described this ailment, without a microscope, and indeed both terms are correct. This tumor eats its way into the bones, destroying them from childhood, but no metastasis develops so we are talking of a semi-malignant tumor. Especially under a microscope and with its light reflection it looks like a pearl.  There are various sizes and also different localizations and dilations accompanied by destructive effects and symptoms such as vertigo, tinnitus, a running of the ears, hard of hearing almost to the point of deafness and  intracranial complications, as has been the case three times up to now.

A twenty-year-old man has been suffering for years from a running of the ears and everything connected with it.  The intracranial complications were shown to me by the internal specialist. The audiogram showed an almost total deafness, the CT revealed a sclerotic mastoid and an intracranial perforation in the inflammatory process. The patient seemed to be very tired and sluggish and suffered from headaches and vomiting. I operated on him the same day.

I would like to take this opportunity to thanking the Storz firm because without their modern, new instruments these extensive operations would not have been possible or possible only under difficult conditions; I would have needed much longer than three hours for an operation. The infected very large tumor filled up the whole mastoid and the middle ear, destroyed the mastoid walls and wandered under the dura mater. All that was cleaned.

The operating theatres of the Rafidia Hospital are on the second storey. I had only just finished the operation when I heard a loud noise coming from below. When I asked what the cause of the noise was, an older colleague explained to me that “Mid-day prayers will shortly be taking place; at four o’clock this morning three corpses were brought in.”  The Israelis took the fourth corpse with them. We stood at the window of the operating theatre and were able to look from above at all that was happening on the street below.  Hundreds of young men were waiting in front of the entrance to the hospital and holding black-red-green flags.  When the martyrs, draped in green, their faces uncovered, were carried out, a huge cry echoed through the crowd and patriotic songs and slogans rang out because these four young men had died fighting Israeli soldiers. At four o’clock in the morning the Israeli army had surrounded the refugee camp where the men came from and attacked the houses in which they lived with rockets before destroying them with bulldozers.

The four young men were aged between 20 and 25. Two days later two young men from this same refugee camp blew themselves up in Israel, killing many other people as well, a deplorable development.  It is said that violence only causes violence, and occupation is the main cause of it all, a ‘circulus vitiosus’ (vicious circle).  Who can put an end to this circle of violence?

The 20-year-old patient was already up on the second day after his operation and, laughing, he came towards me in the corridor during the morning visit. You could see the joy in his eyes -   and that was the greatest joy for me - and yet another day of operations had begun.

Kind regards,