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.