Manchester's disaster doctor looks back
'I can feel it now in my stomach, that constant threat of something might happen'
By Rachel Pugh
For the whole of the Christmas holidays in 1988, Dr Tony Redmond lay on the sofa locked in a silent mental battle with himself, unable to share in the games of his three young children around him — his days overwhelmed with images of suffocating piles of dead bodies and his fevered dreams haunted by memories of the smoking carcass of the Boeing 747, in a crater in Lockerbie filled with yet more bodies.
In one short month the life of the young A&E consultant at Wythenshawe Hospital had been upended. He had begun it by leading a pioneering South Manchester-based pre-hospital medical team to bring emergency medical aid to earthquake-ravaged Armenia — the first such UK team to respond to a disaster overseas.
Less than 24 hours after his homecoming he’d been called to take the same team to the quiet Scottish village of Lockerbie, where the bombed 747 had gouged a path through the main street, scattering hundreds of bodies over the surrounding fields. The two experiences had completely overwhelmed him.
“I realised I had to make a choice,“ recalls Tony, starkly. “Resolve never to do anything like this again — bury it, put it behind me and spare myself and my family. Or make it my life’s work and do it properly. For better or worse I chose the latter.”
Thirty three years on, he has attended almost every international disaster since — including the Iran earthquake of 2003, China’s in 2008, the Philippines hurricane of 2013, the Haiti earthquake in 2010, as well as more than 30 hazardous trips to Sarajevo during the Balkan Civil War working for the World Health Organization (WHO). He also coordinated the UK’s response to the Ebola virus and supervised the establishment of Manchester’s Nightingale Hospital when Covid struck.
But the achievement that matters most to him is that the UK now has UK-Med — a Government-supported multi-disciplinary register of NHS medics, nurses and other health professionals, ready to be deployed to practice humanitarian medical aid at the drop of a hat anywhere in the world. It’s the culmination of his battle to have disaster medicine recognised as an entity in itself.
Sitting in the immaculately tended garden wrapping around the Bramhall home Tony has shared with his wife Caroline for more than 40 years, this gentle, wiry man, with smiling eyes and an accent betraying his Failsworth upbringing, speaks about being shot at, months sleeping on floors, dying children and living in constant fear for his own life and those of his team. Much of it is recounted in his new book Frontline: Saving Lives in War, Disaster and Disease, to be published next month.
The start of it all for Tony was SMART — a team he set up at Withington and Wythenshawe hospitals with colleagues whose specialisms ranged from plastic surgery and emergency medicine to anaesthetics and burns. The unit focused on offering specialist care to people before they reached hospital, thereby increasing their chances of survival.
And it wasn’t the first time Manchester had made a major innovation in emergency medicine. Tony is fascinated by how the seeds of the discipline were first sown here: the groundbreaking nineteenth century surgeon Robert Jones set up the first comprehensive accident service in the world when he put field hospitals at intervals along the Manchester Ship Canal during its construction and staffed each one with doctors who were trained in fracture management. “Manchester is good at innovation and recognising things and taking them on quickly,” says Tony.
When the Armenian earthquake struck in December 1988, SMART was asked by a Manchester journalist why they were not going, and within days a chain of events led to the assembly and departure of a trauma team. What they met was destruction beyond their imaginations: Soviet government interference, the theft of most of their equipment on their outward journey and a rumour mill fanning civil unrest, which limited their ability to give care. They returned frustrated by their modest success, but more convinced than ever of the need for organised disaster medicine. Out of it was born UK-Med.
As the years went on, Tony got used to practicing medicine in scary and unpredictable environments. He describes a moment in a refugee camp in Iran when SMART went to help Kurdish people fleeing Saddam Hussein and the first Iran War. They had been told by their Iranian minders that the situation was unsafe and they should return to Tehran. But the anger and hostility that met them was from desperate people who knew that the tent in their midst contained medicines.
Flourishing his Swiss Army knife, Tony cut through the cords binding the tent flap closed and shouted “This clinic is open!” The mood changed in a second as cheers and celebration broke out, and the medics had a window to assess the situation. A queue of women had been waiting for three days carrying babies dying from meningitis, and most of them would not last the night.
They swiftly created a tent system and an “intensive care unit” allowed them to pick the sickest infants and link them to intravenous antibiotics. Miraculously the next day, the babies were alive. “I have never forgotten those children and how far a tiny drop of medicine can spread in a pool of need,” Tony says.
The most stressful place was Sarajevo. “It was horrible,” he says. “I can feel it now in my stomach, that constant threat of something might happen.” He remembers one wounded Serb patient holding a hand grenade in her hand which she threatened to detonate if she was not transferred to a hospital in Pristina.
In the end he made around 30 perilous trips to the besieged city of Sarajevo, often under gunfire. He and his colleagues lived in flats abandoned by the owners who had fled the country, eating tinned food and sleeping on the floor in sleeping bags. By day they practised medicine in fear of a sniper’s bullet. One evening they risked sniper fire to accept a supper invitation from a local couple desperate for a semblance of normality, and were shot at as they stepped out on a balcony.
Although he has never been shot, Tony’s work has exacted a heavy physical toll. Over his years in the Balkans he developed heavy metal poisoning, which nearly ended his career. In Haiti he was seriously ill with malaria and in the Philippines he broke his back when thrown off a high-speed Royal Navy boat when transferring between islands.
There’s also the mental toll. He admits to breaking down in furious tears driving home through Manchester from his first visit to Sarajevo on Bonfire Night when fireworks triggered a state of physical “full alert” in him. He cannot bear the sight of blood and violence on the TV, because he can’t do anything about it.
He’s missed many birthdays, wedding anniversaries and chunks of his children’s growing up. And all while returning to NHS posts in between disasters — practising emergency medicine at Stockport, North Staffordshire, Salford and Keele.
I ask him how he handled it all, and he says he’s never had counselling. “I’m cautious about saying what you need to do to handle your own mental and emotional reactions, because everyone does it differently,” he says. “I am just the way I am and I just carry on.”
Perhaps there are clues in his upbringing. He was brought up in a very poor Catholic family in Failsworth, the fifth of six children. His father had rejected the priesthood and became a painter and decorator. His mother battled to keep the family together. Tony’s experience of doing home visits with his midwife aunt, Frances, when he was only a small boy, combined with losing his beloved Aunty Mary to tuberculosis affected him deeply, persuading him that “people in their darkest hour and their greatest need, particularly the very poor, should be offered help.”
He passed the 11 plus, gained a place at Manchester Medical School and soon found himself climbing the ladder in Accident and Emergency medicine, becoming only the second consultant in the discipline in the UK at Salford Royal (then Hope Hospital).
At 69 he is now “cruising into retirement”, but only reluctantly. “If you are going out to an emergency you cannot become a burden,” he says. He is still chair of the board of UK-Med, Emeritus Professor of International Emergency Medicine at Manchester University and works with the WHO to set standards for emergency teams.
Was all the sacrifice worth it? Tony hesitates to answer: “All I have ever wanted to do was to help people to support the most needy and to give the best medical care wherever it is needed,” he says. “I think it was.”
Frontline: Saving Lives in War, Disaster and Disease, by Dr Tony Redmond, is out in hardback on September 16th from HarperNorth. £16.99, also available as an audiobook (£12.99) and ebook (£8.99). Pre-order it here.