Posts Tagged ‘equipment’

“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…)

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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.

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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…)

International Medics visit Ministry of Health Ambulance Depot

March 24, 2014

See Paramedics in Gaza for original post

Yesterday we visited the Ministry of Health’s ambulance depot in Gaza City. The government’s ambulance service runs alongside that of the Red Crescent, the Civil Defence, Military Medical services and some some small NGOs. The day-to-day emergency calls are predominantly responded to by the Red Crescent, but the Ministry of Health vehicles have the capacity to assist at busy periods and especially during conflicts.

They also run many community first aid trainings, health professional refresher trainings and have recently participated in some Majax (major incident) drills with other services. During quieter periods the MoH ambulances mainly run patient transfers, including taking dialysis patients to appointments, transferring between hospitals and taking patients to the Rafah and Erez border crossings for treatment abroad. They have about 30 intensive care ambulances and 67 first response vehicles, with 23 EMT-Is/nurses and 142 first responder (EMT-B) drivers. At present they are short of some nurses who have been recalled to hospital Emergency Departments due to staff shortages.

We had a long talk (and coffee) with a few different managers, who were all formerly on the road and will still get back into uniform in times of crisis. Then we had a look round some of the ambulances in the depot, talked to some of the crews and tried to get our heads round the huge issues facing the ambulance service here. In many ways, the ambulance service is a microcosm of Gaza in general. The complex problems facing it as a service are also the problems facing the wider population. There’s the huge issue of the Israeli blockade, now compounded by the political situation in Egypt. Then there’s the border closures, which leaves intubated patients waiting at the Erez crossing into Israel for hours while the medical team keeping them alive watch the oxygen and equipment batteries run down.

There’s the resulting scarcity of resources that means that the MoH ambulance have no non-rebreather masks (something that we use routinely and offhandedly back home) among many, many other items.  There’s the crippled economy, a government that can’t pay its workers on time and the resulting poverty and 50% unemployment rate. Then there’s the dependence on international aid, the lack of training opportunities and inadequate infrastructure. And of course there is constant tension and violence, with occasional vast and devastating military aggression.  In short, these broader issues combine in the health service to make the provision of even a basic standard of care exceptionally difficult.

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