From Gaza to Glasgow: Doctor on working with Medecins Sans Frontieres and returning to under-pressure A&E in Scotland

Glasgow-based accident-and-emergency doctor Erin Kilborn says there are “parallels” between working in Gaza and a Scottish medical system still reeling from the onslaught of Covid-19.

Dr Kilborn, 37, worked with humanitarian organisation Medecins Sans Frontieres (MSF) in Gaza from February to July last year.

Speaking ahead of the World Extreme Medicine conference in Edinburgh on Monday, she described waiting with dread for the virus to arrive and returning to Scotland to find A&E departments under their own kind of strain.

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Dr Kilborn in the old city of Gaza mosque.

She dreaded the arrival of Covid-19 to Gaza’s densely populated area with little access to healthcare, while news reports showed people in Europe running out of toilet paper.

“We were so far removed from all of that,” she said.

“All we could think of was that we needed to plan for the worst.”

Covid-19 had a major impact on Dr Kilborn’s work and made the experience in Gaza even more difficult, but it has not been the only tough challenge she has faced.

Dr Kilborn during a night shift at an NHS hospital in Glasgow.

She has also worked with MSF in Haiti and Syria, and found working at a sexual violence trauma centre in the Central African Republic particularly gruelling.

“I’ve certainly had some very harrowing moments,” she said.

But she added: “Bad stuff happens to people all over the world, that's not dependent on the geography. I've seen some harrowing things in the UK as well. And I've heard some awful stories here too.”

She continued: “Some of the things that we see and that we deal with are really, really tough.

“You definitely have to have a certain level of grit and resilience. And I think that that's relevant across the board in health care, at the moment, especially with the pandemic.”

Dr Kilborn found returning to Scotland after six months in Gaza presented its own challenges, as the running of A&E departments had changed during the pandemic, and they now also face higher demand and staffing shortages.

She worked at University Hospital Wishaw for a year and now works between hospitals in Paisley and Inverclyde.

Working abroad is a “different level of stress”, she said, as there are often more patients and injuries can be more severe. International doctors also do not have the same support networks to lean on.

But there are comparisons to working in A&E in Scotland, she said, especially in recent months.

Speaking of dealing with 30 patients during a recent night shift, she said: “I'm managing that in a scenario where it's just me and one junior doctor.

“It actually feels quite similar to some other cases [abroad] where, for example, we've had a mass casualty incident with patients with gunshot wounds, and you're having to work quickly to work out who's really sick, who can wait a little bit, who do we prioritise for the two slots that we have in the operating theatre, who do we need to stabilise first before they can have their surgery.

“It’s different, but it’s kind of the same, especially at the moment.

“Our hospitals are crowded here at the moment. Patients are waiting hours to get into a bed and that can also be the same in some of our places overseas.”

She added: “It's a different kind of stress and it's a different kind of intensity, but there's a lot of parallels.”

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