By Claudia Blume

Few other surgeons working for Doctor Without Borders/Médecins Sans Frontières (MSF) around the world have as much experience treating war-wounded as Dr. Edgar Escalante from Vancouver.

A native of El Salvador, he spent 13 years as head of the orthopaedic department of a hospital in the capital San Salvador during the country’s bloody civil war. After he retired, he moved to Canada because he wanted to live in a calm and peaceful place. But he soon got bored and applied to work with MSF, an organization he first got to know following an earthquake in El Salvador in the 1980s. “I have always wanted to work for a humanitarian organization, but I have been busy raising 7 children,” he laughs. “After I retired, my wife encouraged me to follow my dreams.”

Dr. Escalante has since spent 20 months working as a surgeon in war zones with MSF, first in Yemen, then in Kunduz hospital in Afghanistan. Three months after he left Kunduz, and already on his next assignment in Jordan, he received the news that the hospital had been destroyed in an airstrike on October 3, 2015. “I was devastated, it was very tough,” he recalls. ” I cried for several days. It was one of the worst moments during my time with MSF.”

There have been plenty of difficult moments in Jordan too, where he spent 14 months working in Ramtha hospital, an MSF emergency surgical project close to the border with Syria. During most of the time he spent there, the hospital was full of war-wounded who had come across the border from Syria. He and his team initially saw mostly victims of barrel bombings, and later patients with gun shots. Most of them were women and children.

One of the patients Dr. Edgar Escalante remembers most vividly is a 19-year old pregnant woman who had been severely wounded in a bomb blast in Syria. “We had to amputate both her legs,” he recalls. “Almost as soon as the operation was over she went into labour, and we had to transfer her to a government hospital to deliver the baby.” The next time he saw her, in a nearby refugee camp where he regularly went to see his former patients, the young mother was walking towards him on artificial limbs, smiling and holding the baby in her arms.

As the hospital’s surgical activity manager he had to make many difficult life and death decisions. Two of his patients with severe brain, chest-and abdomen injuries, as well as multiple fractures, were considered to be hopeless cases by his colleagues, who urged Dr. Escalante to take them off life support. But he insisted to fight for their lives, against all odds. “I am a person who does not easily give up,” he says. “I have a sixth sense.” Both of the patients are now fully conscious and able to walk, and hugged him whenever he saw them at the refugee camp where they now live.

At the end of June, things suddenly changed at Ramtha hospital. Following a deadly car bomb attack June 21, Jordan sealed its borders with Syria. More than 75.000 Syrians, most of them women and children, have since been stranded in a desert area called the “Berm” at the border, without access to humanitarian aid. War-wounded are no longer able to cross the border into Jordan to seek treatment.

“There are no new cases coming in to Ramtha hospital,” says Dr. Escalante.” We usually had about 45 patients, but in September there were only ten, all of them existing cases.”

He says that the newly-opened operating theatre is now unused, and that the medical staff is concerned that they are no longer able to provide assistance to the many Syrians who are in desperate need of medical care.

The surgeon recently returned Canada, and will travel for some well-deserved holiday. But he is already planning his next return to the field with MSF. “It’s still pending,” he says, “but I’m just waiting for MSF to come to me with my next assignment.” After decades of treating patients affected by trauma, Dr. Escalante will continue to work wherever he is needed most.

Claudia Blume is a press officer for Doctors without Borders.