A Life-Saving Surgery Under Difficult Conditions
For much of the past year, Chinese neurosurgeon Zhang Shijun's most vital instrument was not the advanced craniotomy system he was accustomed to using in brain surgery, but simple, handheld skull drills. During his one-year medical aid mission in the Northeast African nation of Eritrea, which ran from July 2025 to July 2026, Zhang, 47, learned that when stripped of the high-tech trappings of a modern operating room, a doctor's most valuable assets are solid technical skills and an unwavering resolve under pressure, as reported by China Daily.
"Back in my home hospital, we're used to having a high-powered electronic drill spinning within seconds just by releasing the foot pedal," he said. "In Eritrea, we could only rely on manual equipment most of the time, putting our wrist and shoulder strength into turning the drill over and over again."
"Moving from a well-equipped surgical room to an environment with scarce resources was a tough lesson for many of us medical aid workers. But we've all learned to overcome these challenges and live up to the trust our local patients have placed in us," he said during an interview ahead of China's ninth Doctors' Day, celebrated annually on Aug 19.
Zhang is the deputy director of the neurosurgery department at Yellow River Sanmenxia Hospital in Henan province. He also served as deputy head of the 18th Chinese medical aid team to Eritrea, which comprises 18 medical experts. They all come from Henan and specialize in a broad range of fields including radiology, surgery, traditional Chinese medicine and anesthesiology.
In Eritrea, the Chinese team was based at the Orotta National Referral Hospital in the capital city of Asmara and several other local medical institutions. Throughout the mission, the team received more than 35,600 patient visits, performed or guided over 4,100 surgeries, delivered TCM therapies to nearly 20,000 patients, conducted 9,000 CT and ultrasound examinations, and trained about 180 local medical workers.
As one of just two neurosurgeons on the team, Zhang was among the only surgeons in the country capable of handling complex neurosurgical cases, a fact that became starkly evident in his most memorable case.
A Race Against Time
A man in his 20s was transferred from a remote area to the hospital three days after falling into a coma due to a spontaneous intracerebral hemorrhage. An emergency head CT showed a hematoma in the patient's brain, and the team decided to perform emergency surgery to clear the clot. By the time the patient arrived, he had one pupil blown, no limb movement, and his brain was herniating.
The surgery took place under conditions that would be unimaginable in a modern operating room. There was no scrub nurse, no surgical microscope, and only one hand drill with a dull bit. Zhang drilled four holes in the patient's skull. The bipolar coagulator malfunctioned during the surgery, and the team had to swap out three different bipolar units before the device started working.
Despite these obstacles, the surgery was completed after about three hours. "When the patient gradually woke up... it hit me that... one slip in surgery..." Zhang recalled, his voice trailing off, as reported by China Daily. The patient gradually woke up and his limbs started moving again.
"It was the most touching moment," Zhang said, reflecting on the profound trust the patient had placed in him—a trust he described as "handing me his life."
Adapting and Innovating
Zhang's work in Eritrea was not limited to emergency procedures. He performed about six surgeries a week on average, and occasionally four surgeries a day on their busiest days. The team also brought innovative solutions to address local health challenges. After learning of a high prevalence of chronic subdural hematoma in Eritrea, they brought a type of cranial perforator and special drainage tubes from China. With this domestic device, the procedure took only 10 minutes, compared with about an hour before, dramatically improving efficiency and outcomes.
The team's efforts were recognized by local medical leadership. Tewelde Yohannes, medical director of Orotta hospital, praised Chinese doctors for their role in filling gaps in certain areas of expertise. In an interview with Eri-TV, he said Chinese doctors play an important role in filling these gaps, underscoring the value of the medical aid mission.