Contact Wounds: A war surgeon's education, by Jonathan Kaplan

The good doctor's dilemma

Jonathan Kaplan is multi-talented. He is a doctor, specialising in frontline surgical work, but also an investigative reporter, documentary film-maker and very gifted writer. Contact Wounds is both prequel and sequel to his stunning debut memoir, The Dressing Station. Perhaps taking the hint from a reviewer's remark he is "at his best when writing about himself", this book focuses more on his own background, South African upbringing, early sexual experiences and education, but is otherwise the mixture as before - and none the worse for that.

For Kaplan is, by his own admission, a war junkie. He writes of being on the Kurdish frontline, "out there, all the other fears that beset me - doubt about my professional commitment, my career, finding a home - vanished in the immediacy of survival; in the midst of war I'd glimpsed a sort of shelter, an elusive peace".

This is mainly what attracts him to the world's trouble spots, in this volume adding Angola and Iraq to Kurdistan, Mozambique, northern Burma and Eritrea. But it is not the whole story. There is also pride in his surgical skills and a generous idealism in his readiness to save innocent victims of the atrocities of war, or mend their shattered bodies.

In a "prodrome" (a "premonitory symptom of a disease", according to my dictionary), Kaplan describes learning to be a war surgeon as "an education in uncertainty and rootlessness, so that our work and our journeying become an attempt to define our place in the world". Rootlessness is the key word. His Jewish forebears were traders and scholars in eastern Europe and his grandparents, who would meet and marry in South Africa, had escaped from Cossack pogroms as children at the end of the 19th century. His parents were both doctors; his father had served as an army surgeon at El Alamein and, after the British withdrawal from Palestine in 1948, went as a volunteer to the new state of Israel, where he met the young woman doctor from South Africa who became his wife.

Their son Jonathan went to Israel too, aged 14, to stay on a kibbutz. Already obsessed by war, and trying to connect what he had read and heard about the Second World War with 1960s South African reality (but Sharpeville "didn't have the same ring as Normandy or Dunkirk"), he found that everything in Israel in 1968 spoke to him of war.

His difficulty, in Israel as in South Africa, was to see where he fitted in. He was no keener on bashing Israeli Arabs than on denying blacks and "Coloureds" rights in his and their own country. His father went back to Israel in 1998 to celebrate the 50th anniversary of the state he had helped to establish. Kaplan writes, "I envy him that connectedness... I have not returned."

His parents had left Durban for the US while Jonathan was a medical student in Cape Town. He would also leave the country - to avoid compulsory military service in the Angolan war - but for England rather than America. He did go to Angola a quarter of a century later, but not as part of an invading army.

After the fall of the Afrikaner government, South Africa was no longer involved there, though by the turn of the century the so-called "Third War" between the Marxist MPLA government and Jonas Savimbi's anti-communist UNITA forces was under way. Caught between the warring parties were the IDPs, "internally displaced persons": the flotsam of war, the ill and starving people driven from their homes, fleeing they knew not whom. Os enemigos might equally be rebels or government security forces.

Kaplan's first patient in the town of Kuito was typical: an eight-months pregnant, malnourished and feverish woman (malaria was endemic) who had had the bad luck to get in the way of an "enemy" bullet. It had gone through her neck and emerged on the left side of her face, which was covered with a rough dressing. She could not speak and the "visible part of her face was frozen in an expression of unremitting horror".

In Kuito Kaplan was working with the admirable relief organisation, Médecins sans Frontières. But he is as critical of some aid agencies as of governments that resort to war for inadequate reasons, or reasons that have little to do with their stated intentions, as in Iraq. Just by listing the "lovely names" of the "second-wave" humanitarian groups that flocked into Baghdad after the fall of Saddam Hussein - "Peace Wings International, Earth Network, Compassion for Innocent Victims in Conflict, Life for Relief and Development, Human Relief Foundation, Solidarity for Peacemaking and Sharing, Human Appeal International, Strategic World Impact, Global Care, Oasis of Love, Peace Volunteers and The Good People" - he throws doubt on their utility.

And when he adds that "one of the evangelical groups wore bright yellow T-shirts showing a figure astride the globe with a Bible raised in one hand and a crucifix in the other, insensitive attire in any Muslim country and exquisitely provocative in Iraq", we know we're in a madhouse where agencies and armies (good cop and bad cop) are each part of a Janus-faced oppressor. In such a context, the kidnapping of aid workers, however reprehensible, is not entirely surprising.

Kaplan describes the war in Iraq as a watershed. Until 2003, everyone saw doctoring in conflict zones as a good thing, and "aid workers were not generally sought out as targets by the people they came to help". Now that the distinction between humanitarian and military intervention has become blurred, he wonders if it is not time for him to renounce his idealistic dreams, hang up the "compact canvas pouch of surgical instruments" he has carried since his first war in Kurdistan, settle down and think about having a family.

Perhaps it is, but such a decision would not only deprive putative patients in conflict zones of an imaginative and skilful surgeon. It would deprive readers of further instalments of some of the most graphic war reporting to have appeared in recent years.

Tony Gould's latest book is 'Don't Fence Me In' (Bloomsbury). Jonathan Kaplan appears at Jewish Book Week in London on Saturday 4 March: www.jewishbookweek.com