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Guerrillas in the mist: how I met a Colombian rebel leader

BMJ 2014; 349 doi: (Published 28 July 2014) Cite this as: BMJ 2014;349:g4816
  1. Jeph Mathias, climate change adviser, Emmanuel Hospital Association (EHA) India, c/o Landour Community Hospital, Landour, Mussoorie 248179, Uttarakhand, India
  1. jephmathias{at}

Jeph Mathias recounts an extraordinary case of tendon repair in the jungle

A hand fell on my shoulder just as I was pulling my hammock’s last knot tight. The rest of my Médecins Sans Frontières (MSF) team, laughing over dinner preparations, was less than 10 metres away. I turned. He was just a boy, 16 years old perhaps, from the hair shyly fuzzing his upper lip—but camos, an AK47 casually held, and a knife ostentatiously dangling from his belt told me he was a dangerous guerrilla. I was being kidnapped.

“Medico,” he said, “the boss wants to talk.”

“Of course,” I replied nonchalantly, over-riding a panicky scream. “Where is he?” He angled his chin into the congealing dusk: “There. Bring your medicines.”

By making me walk ahead his, now unseen, gun and knife swamped my consciousness. Three hundred metres felt like 300 light years, warping me into a guerrilla camp where AK-47 wielding boys ambled around, camo clad and laughing.

They brought a kid with a severed extensor tendon, macheted by the indigenous man who’d surprised him in his hut. He’d shot the man and continued raping his wife. Consciously ignoring my feelings and switching ethics off, I repaired the tendon, focusing on anatomy and surgical technique and even giving instructions to my armed assistants. I could …

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