Archive for April, 2014

UK Paramedic in Gaza: What I’ve been up to so far

April 19, 2014

Originally posted at Paramedics in Gaza

I’ve been in Gaza for nearly six weeks now, and I’ve largely found my feet. I plan my days around when there will be electricity, know when I’m being overcharged in a taxi and can drink 3 cups of sugary tea without getting the shakes. Countless meetings are finally paying off, and possibilities for work beyond observing are beginning to appear. This week I taught a First Aid session in the remote Bedouin community in the north, which I hope to repeat. Next week I’m teaching a basic trauma First Aid course for the Palestine Trauma Centre who sponsored us to come to Gaza. I’m particularly looking forward to it as the folks at the PTC have been so welcoming and do amazing work.

Beyond that, I’m working with the Ministry of Health to develop a training around ambulance pre-alerts to the Emergency Department, and making a presentation on the use of communications equipment in the UK ambulance service for their managers. They’re looking to develop in this area, despite the blockade on GPS and most communications equipment. The time I’ve spent here and conversations I’ve had increasingly point to equipment and economic limitations as the biggest issue for the health service here, rather than any lack of knowledge or ambition. Even when the present situation makes maintaining any service at all very difficult, there is an awareness of service improvement and a desire to plan for the future. I certainly don’t envy the managers here their jobs – it makes the UK’s National Health Service (NHS) look relaxed and over-resourced. Which is saying something.

I’m also meeting with the Red Crescent ambulance service to plan some work with them. (more…)

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Israeli forces injure 5 medics after ‘targeting’ Gaza ambulance

April 12, 2014

Published yesterday (updated) 12/04/2014 10:05

 

(MaanImages/file)
GAZA CITY (Ma’an) — Five Palestinian medics suffered from excessive tear gas inhalation after Israeli forces fired a tear gas canister at their ambulance in the northern Gaza Strip, a medical official said.Spokesman for the Gaza Strip ministry of health Ashraf al-Qidra said that Israeli forces had “targeted” three military ambulances near the Eastern Cemetery east of Jabaliya.

The five medics were treated on the scene, he added.

The circumstances of the reported attack were not immediately clear.

An Israeli military spokeswoman had no information regarding the incident.

“We leave without expecting to return”: meeting the firefighters of Gaza

April 10, 2014

trucks

Originally posted at Paramedics in Gaza

Yesterday I visited the Civil Defence Directorate, which provides the fire and rescue service in Gaza, as well as some emergency ambulances and marine rescue. These guys have a reputation as being fearless, as well as being the most vulnerable to attack during times of war. In the 2008-9 war, 13 Civil Defence workers were killed in the line of duty, with 31 injured. This includes medics killed in their ambulances by snipers and firefighters injured by secondary drone attacks while rescuing victims of the initial strikes. These risks are additional to jobs which are considered dangerous even in peaceful countries like the UK and USA.

I found out plenty about the Civil Defence’s ambulance service, including interviewing staff and looking around muralthe ambulances and equipment stores, but I’m going to save that for a later post and just write about the firefighters. In the UK, the ambulance service and fire service are separate so please forgive any ignorance about the equipment and vehicles I saw. I knew they were fire engines because they were big and red, and I knew it was a fire station because there were some weights in the corner and a ping pong table. Beyond that, it was all new to find out. (more…)

How we spent your donations! Thank you!

April 9, 2014

Originally posted at Paramedics in Gaza

Before we travelled to Gaza we decided to ask friends and colleagues for donations so we could take some medical kit with us. We were hoping for a few hundred pounds, so we were really surprised and excited to raise about £2000! Thank you so much to everyone that donated, including friends of friends who don’t know us but read our call out. It was amazing to be able to revise our planned donations to include more kit, better quality equipment and more expensive models that are designed to be reused (which we know they will be).

Here is everything we bought!

Complete kit

Everything we bought

We decided to take four complete first response kits to donate to the ambulance services here. As paramedics we had a fairly informed idea of what would make a decent kit, and we tried to tailor it to the needs and skill levels of crews here. We left out paramedic specific equipment and added extra trauma supplies. We also put in extra shears, stethoscopes, torches and pentorches for the crews. (more…)

Al Shifa Emergency Department – largest in Gaza (part 2)

April 9, 2014

See Paramedics in Gaza for original post

In part one  I gave a brief introduction to the Emergency Department (ED) at Al-Shifa hospital, Gaza’s largest healthcare facility. I spent a few hours there last week meeting staff and seeing for myself the current situation in the ED and Intensive Care Unit. In this post I’d like to focus on the shortages affecting health care provision in the ED and ICU, which are the same shortages affecting every part of the health service here.

Image

Shortages here come in a few different forms. Firstly, many drugs are scarce or completely unavailable. Secondly, many disposables (single use bits of medical equipment, such as suction tubing or syringes) are expired or unavailable. Thirdly, parts and servicing for medical equipment are often unavailable. This includes ambulances themselves, as we heard from the Ministry of Health.

The reasons for these shortages is a little complicated. The largest factor is the Israeli blockade of Gaza, which includes control of goods crossing into the country at the Kerem Shalom and Erez Crossings. This means that all imports of medical equipment must be approved and coordinated by Israel, making shipments vulnerable to delays, refusal or seizure. In the past these controls were circumvented by the smuggling of medications and equipment through tunnels under the Egypt-Gaza border. In the past the Ministry of Health, for example, have received 30% of their medicines through the tunnels. In 2013, the vast majority of these tunnels were destroyed by Egypt, cutting off a vital lifeline for Gaza and the health service in particular. As a result, shortages have been exacerbated with little hope for improvement. (more…)

Al Shifa Emergency Department – largest in Gaza (part 1)

April 2, 2014

See Paramedics in Gaza for original post

Last Thursday I visited Al-Shifa hospital, the largest medical complex in Gaza, to get a look at the Emergency Department (ED). I was hoping to get a better grasp on the structure of the ED, to meet some of the staff and to see for myself the situation they’re working in. I saw and learned so much that I’m going to split this into a couple of posts to make it manageable. In this post I’ll describe my visit, the structure of the hospital and touch on the role of the hospital in the recent history of Israeli military assaults on Gaza. Then in another post I’ll look at the day-to-day challenges of working in this environment with particular reference to equipment and drug shortages.

"What could have been a modern university-like hospital is, however, reduced to a completely worn-out, almost makeshift, field hospital after years of siege, as well as a lack of maintenance and upgrading." - Norwegian doctors Mads Gilbert and Erik Fosse, 2009

 

First off I met Dr Nser Al Tater, a cardiologist and the general director of the hospital who welcomed me and gave me a bit of an overview of the situation. We talked most about the impact of the electricity crisis on the hospital – I’d read details recently but to hear stories along with the statistics was eye-opening. The hospital is currently reliant on generators for 16 hours/day, requiring a huge amount of expensive and increasingly unavailable fuel. The generators aren’t designed to be used so much and have previously cut out completely – Dr Al Tater told me about a cardiac surgery where the electricity cut out ten times over the course of the operation. All life support had to be continued manually while each blackout lasted. In between, surgery resumed. Similarly, a recent powercut in the neonatal ICU resulted in staff manually ventilating 12 babies until the power returned to their ventilators. (more…)