Rebel Libyan soldier’s NHS amputation

By Neil Bowdler Health reporter, BBC News

Mahran Agil, 30, used to work in a perfume shop. In his spare time, he loved buying, breeding and selling pigeons.

Then the uprising against Colonel Muammar Gaddafi began and he was catapulted into a bloody civil war.

“Gaddafi was killing the people of my country. I had to fight for them,” he says, sitting in a wheelchair in a large light rehabilitation room at Charing Cross Hospital in west London.

Soon he was fighting alongside friends and strangers in the battle for Tripoli, armed with a double-barrelled hunting rifle.

On 20 August, the day the capital fell to rebel forces, he was shot three times in his legs. One bullet exploded in his lower right leg, shattering the bones.

“In the first five minutes I felt nothing. After that I fell down,” he says.

He was taken to to a field hospital where he was given nothing but a cast and some painkillers.

Then at a military hospital, steel work was fitted to his lower leg before he was moved to Tunisia and then to Britain, after the UK government agreed to provide up to 50 places at specialist hospitals for Libyans needing surgery, prosthetic limbs and rehabilitation.

The request came from the new Libyan government, which is also footing the bill.

But by the time he arrived in Britain, the surgeons thought it was too late to save his lower leg.

“He’d had a severe injury to the bones to the leg but he’d also lost a lot of soft tissues all the way down to and including his ankle joint,” says plastic surgeon Professor Jagdeep Nanchahal of Imperial College Healthcare Trust.

“It was also clear he had deep infection because you could smell the bacteria.”

An amputation was recommended.

“He was disappointed,” says Professor Nanchahal. “He had come to us expecting reconstruction and had gone though multiple surgeries in other countries with that view, so it took him a little while to get his head around that.”

‘V’ sign

On 20 October, the day Colonel Gaddafi was captured and killed, Mahran’s lower right leg was amputated.

An X-ray showing the broken bones in Mahran Agil's leg before amputation

All infected tissue was removed and the bones were amputated at a point where they could provide a good lever for a new prosthetic leg and allow ample room for the prosthesis.

Muscle and tissue was then wrapped over the stump to provide ample padding.

“Once he made the decision that he was going to have an amputation it’s all gone swimmingly well,” says Professor Nanchahal.

“In just over a week he was in a gym doing upper body work, he was on a prosthesis within a couple of weeks and now he’s about four weeks after the procedure and he’s actually walking pretty well.

“Mahran’s been extraordinary because as other Libyans have come to this centre he’s engaged with them and cheered them up.

“A lot of them are pretty unhappy. They’re in a foreign country, they don’t understand the language. These are fit young people who suddenly feel that their lives have been taken away from them.”

Mahran himself appears a little uncomfortable with the attention. But he is keen to stress he has no regrets.

“When I left home and I went to fight I was expecting even to die, so all options were there,” he says. “This is a fate and destiny I received from God, so I’ve accepted this.”

The interview over, he raises his hand to make a “V” sign, then asks to be filmed with the nursing and medical staff who are helping him through his recovery.

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