Mar 8, 2024 | Featured Articles

Providing medical and humanitarian care in a war zone is challenging at the best of times, but aid workers on the ground in Gaza have been faced with unprecedented conditions. An emergency aid co-ordinator and a rapid deployment staff member talk to Christine Maguire about the increasingly dire situation, mostly for the war-wounded women and children.

With over 31,000 Palestinians killed and almost 73,000 wounded since 7 October 2023, and most of the population displaced to the south, where hunger and disease spread and the threat of an Israeli offensive looms, the situation in Gaza is increasingly dire.

Thousands of people in Gaza City have lost relatives in the Israeli airstrikes. (Copyright: MSF)

Gaza’s health infrastructure has been decimated after almost five months of attacks that have seen overcrowded hospitals – none of which are fully functioning – bombed, raided and left without electricity and basic supplies.

Marie-Aure Perreaut Revial, an emergency co-ordinator with Medecins Sans Frontieres (Doctors Without Borders) (MSF) who was returning to Gaza, spoke toEmergency Services Ireland about working at Al Aqsa Hospital in Deir-al-Belah in central Gaza.

“It was overcrowded, apocalyptic emergency departments……with patients lying everywhere, directly on the floor, or in the best case scenario on cardboard boxes, because there were no beds. And when we say patients, we’re talking critically injured patients,” she said

Patients waiting to be assessed at Al Aqsa Hospital in Middle Area, Gaza. (Copyright: MSF)

“Sometimes they will be [the doctors and nurses’] own relatives or colleagues. But then you have another patient who is also critically injured next to them. So, it’s a lot of very difficult, if not impossible, equations they must deal with. At the end of the day, you would have many healthcare workers saying, ‘Did I make the right decision? Did I go to the right patients?’” she said.

At the European Gaza Hospital (EGH) in Khan Younis, as nearby explosions rattle windows, International Committee of the Red Cross (ICRC) medical teams perform “war surgery”, where the mission is “doing the most for the most” for victims of mass casualties, and a lack of supplies means improvisation is essential.

“You have an airstrike somewhere, and then you have a whole residential building collapsing, and at least 20 people coming in,” Kunlawat Note Chittarat, a member of the ICRC’s rapid deployment staff in Gaza told Emergency Services Ireland’. “When you don’t have water, how do you make sure you’re stitching up something that won’t be infected again in the next few hours?”

Wounds are being kept open, covered with gauze, to prevent infection, and doctors’ aprons replace sterile bed sheets when they run out. In operating theatres, ventilation and even the saline dripping into IV bags are done manually.

At Al Aqsa, “We had very, very high infection rates, and sometimes we would see people who had one wound that was so so badly infected – and I’m talking worms coming out of the wounds – that then they needed an amputation,” Revial said.

Tents outside the European Gaza Hospital (©ICRC)

Displaced Palestinians have flocked to hospitals for shelter, even though “there is no safe space left”. Chittarat estimates “20,000 are living in and around the EGH compound” with tents lining the corridors, and even the staircases.

Many of the doctors working there are also displaced. They “risk their lives to come here to work,” Chittarat said. “Going back home, they don’t know if their home will still be there, or if their families will still be there waiting.”

Revial tells the story of a nurse who learned that her sister in northern Gaza had been killed from a TikTok video and returned to work after one day. “She said, ‘I have nothing else I can do. I cannot reach her, we cannot get her body back. I don’t know about the rest of the family… So I need to work to forget…..’”


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