The killing fields

Contact Wounds: a war surgeon's education

Jonathan Kaplan <em>Picador, 278pp, £17.99</em>

ISBN 0

In the past 18 months or so, a new kind of autobiography has become fashionable, perhaps reflecting the public's growing awareness of humani-tarian crises, which seem to happen one upon another. This is the memoir of battles waged by forensic pathologists, human-rights lawyers, refugee experts and those employed by organisations such as Medecins sans Frontieres and Oxfam, the so-called missionaries of the modern world. Jonathan Kaplan, who wrote a successful first book about his work as an air-ambulance doctor and war surgeon, The Dressing Station, has now written a sequel, Contact Wounds.

Kaplan is a 21st-century Renaissance man. He is not only a doctor and a surgeon, but an orthopaedic consultant, an academic, an adviser on medical matters for television companies and a documentary film-maker. He can also write. Contact Wounds has the same brisk, unsentimental tone as his first book, while being more far-reaching, more autobiographical and more reflective about the nature of warfare and medicine.

Descended from Jewish east European traders and scholars who fled the pog-roms in the 19th century, Kaplan grew up in South Africa, where his father was an orthopaedic surgeon and his mother a pathologist. When he was 16, he spent four months on a kibbutz in Israel, where his father had on various occasions served as a volunteer surgeon. During his stay, he was taken to the Sinai Desert and saw the detritus of the Six Day War: the broken trucks, the burnt-out tanks, the discarded machine-gun belts and the boots scattered in the sand, abandoned there by Arab prisoners who had been told to discard their shoes, to prevent them from escaping.

Although Kaplan fell foul of aggressive young Israeli nationalists, he returned to South Africa both exhilarated and appalled by the vision of war and its destructiveness. It was the moment at which the Anti-Apartheid Movement was gathering pace, and he was soon witnessing police and army crackdowns and seeing their casualties. It was inevitable that he would decide to become a doctor.

At first, it was a question of acquiring a training in the skills that he would need if he was to follow his interest in war. Spending his leaves and internships in postings to remote places, he saw famine, poverty and wounds caused by weapons, with all the resulting medical implications. Not wanting to serve with the South African Defence Force, he opted to study surgery in London, and even though he specialised in orthopaedics, his travels had equipped him for operations of all kinds. His training finished, it seemed only logical to combine hospital consultancy with spells as a volunteer surgeon in the war zones of Eritrea, Kurdistan, Burma, Mozambique and Angola, and then to turn his hand to documentaries investigating humanitarian crises in such places. The deaths of friends in accidents, and in reprisals for the dangerous pur-suits in which some of them engaged, only strengthened his need for personal action.

As a doctor, Kaplan has a particular take on war, neither the passing glance of the journalist nor the day-to-day administrative preoccupations of the aid worker, but a sickening vision of what long-running conflict does to those caught in the crossfire. Contact Wounds, with its descriptions of purulent abscesses, reeking sepsis, frothing pus and saw wire singing through bone, is not for the faint-hearted. But Kap-lan is a skilful and impassioned reporter with a need to make others understand the horrors of his work.

As there is virtually no area of modern doctoring in which Kaplan has not had a hand, it is not surprising to find him making impatient swipes at inefficient health services, management business plans and the "very, very worried well" - private patients terrified by intimations of mortality. The least successful chapter of Contact Wounds is, in fact, his account of serving in Iraq, where he covers ground made familiar by others who are as angry as he is about the war waged by the United States and its allies. By contrast, his descriptions of work in the field, his evocation of clinics in refugee camps, among the starving and the destitute, and the efforts of heroic medical staff to provide care under atrocious conditions, stay long in the mind.

Like others who have written well on humanitarian matters, Kaplan is engagingly candid about the addictive and heady nature of war work, the way its simplicity and sense of purpose provide definition and reality not easily found in ordinary life. "We search for completeness," he writes, "in the land of the maimed."

Caroline Moorehead's most recent book is Human Cargo: a journey among refugees (Vintage)

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