July 9, 2014: Reading back through this blog will give you a glimpse into the healthcare system in Gaza, particularly the emergency services. During my three months as a UK paramedic visiting Gaza, I felt like I got a decent understanding of the situation that my Palestinian counterparts work in. I saw the mismatched selection of donated ambulances and equipment they work with, the empty shelves in ambulances where basic medical supplies should be stocked and saw bombed out ambulances, now hoisted onto the roof of the Red Crescent ambulance station in Gaza City as a reminder of the systematic targeting of rescue workers during previous Israeli offensives.
The healthcare situation that I left behind in Gaza three weeks ago was desperate, and stretched to the limit. In the absence of drugs, equipment, reliable electricity or salaries, the day-to-day functioning of the hospitals, clinics, emergency services and firefighters appeared solely reliant on the commitment and resilience of its workers. Previous wars cast a shadow over every part of the health system that I visited. The horrific memories of Cast Lead seemed to echo around the Emergency Department at Al Shifa hospital, its main entrance sickeningly familiar from graphic videos of mutilated bodies being dragged inside from cars in 2008/9. In breaks from resuscitation training with Red Crescent EMTs, I drank sweet tea while they told me war stories. The time shrapnel came through the ambulance windscreen. The time they managed to fit 12 patients in the back of one ambulance. The time they put a dead body in the passenger seat because the back was full of the injured. Phones came out to show me videos and photos; the EMT next to me carrying a child with her legs blown off. A shaky camera phone video of an ambulance worker, hit by tank fire, dying in the back of his own ambulance with a non-rebreathe mask stifling his last breaths.
The shadow of previous wars went hand in hand with the threat of future violence. Hospitals and ambulances were scraping by when things were quiet, stoically accepting that there aren’t always gloves when you need them, and sometimes you have to wash and reuse equipment that was designed to be single use. Introduce an open-ended mass casualty incident to that scenario and the result is hell. And the healthcare workers knew what that would look like because they’d been there before.
Now ‘Operation Protective Edge’ is underway, and once again the health workers of Gaza are in hell. At the time of writing, 53 Palestinians are dead and 465 have been injured in Israeli attacks. In a photo from Al Shifa, a doctor treats a patient lying on a desk. I sift through news reports with Google Translate, trying to follow up Facebook rumours that an ambulance crew was targeted in Nuiserat yesterday. I think of the Civil Defence workers I met a couple of months ago, and their courage in the face of danger. They told me, ‘we leave without expecting to return’ and I wonder how many of them won’t, this time. I think of the ambulance crews who insisted on waiting for calls parked in the street during previous wars in order to respond more quickly, despite the increased danger. Friends in Jabalia, Nuiserat, Rafah take pictures and videos of air strikes and the plumes of smoke that linger afterwards, then post them to Facebook. Outside the Emergency Department at Al Shifa hospital, the injured are rushed inside from waiting cars. Once again, Gaza is in hell.
Edit: a friend in Jabalia camp in northern Gaza reports that land behind the Red Crescent ambulance station there has been targetted by an Israeli air strike in the last few minutes, injuring three. No official news source yet, will update when further information appears.
Edit 2: Just read this report which mentions a nurse injured on duty, when the European Hospital in Khan Younis was attacked