The psychological impact for our patients is likely to be lifelong. We have managed to reconstruct everyone’s limbs, but we know from experience that our patients will require more treatment in the weeks, months and years to come, and it is difficult to predict what will happen in the future. We had patients in our hospital from teenagers to sixtysomethings, more than half of whom needed limb reconstructions or limb salvage operations. We are primarily trauma and reconstructive surgeons managing life-changing injuries using techniques developed over time through wars and the battlefield. By 7.15am, I was at UHSM and we very quickly established the number of casualties, the nature of the injuries and made a plan for our response.