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Children in the Gaza Strip
Photo: ANAS BABA / AFP
It was last Sunday when the health system in the Gaza Strip moved a little closer to the abyss: Two of the region's most important medics were killed in an air strike.
The neurologist Moin Al-Alul and the specialist in internal medicine Ayman Abu al-Ouf.
Both were specialist doctors rarely found in the Gaza Strip.
For the doctor Fahd Haddad it was the most difficult day so far.
He works in the emergency room at Shifa Hospital, which is the largest in Palestine with around 750 beds.
“Doctor Ayman was my teacher, the teacher of my generation, and those before us.
He was an incredibly talented doctor, an outstanding specialist in his field, a public figure, ”says Haddad.
His voice becomes fragile.
"I don't really want to talk about it."
He must concentrate on rescuing the injured.
It's the third major bombing for him since he started working in the hospital.
200 dead, almost a third of them children
By the middle of this week, the Ministry of Health in Gaza had listed over 1,600 injured and over 220 dead, of which around 30 percent were children.
Haddad's colleague, the surgeon Adnan al-Burj, also works day and night.
The injured are brought in with intricate wounds from explosions.
He says: "Everything is missing." There are drugs to treat open wounds, painkillers and drugs for chronic diseases.
He has no capacity for cancer patients and patients with less acute illnesses.
"For this, patients have to be treated outside of the office."
The connection breaks off.
Bombs hit nearby.
When he got back on the line, al-Burj said wearily: “There are air strikes everywhere.
At this time, in the evening, the party begins. "
The only corona test laboratory was hit
His clinic has reached its limits - and it is only one of many.
There is an agreement with private clinics in the Gaza Strip for emergency situations like now, so that patients can be transferred as soon as their condition is stable.
Sometimes, says al-Burj, doctors also use emergency stretchers or birthing beds when the normal ICU beds are running out.
But health care is already on the brink of collapse.
The only corona test laboratory in Gaza was also hit.
The leading doctor was injured in the head, says al-Burj.
He is now also in Shifa Hospital, his condition is critical.
Working under extreme pressure, sometimes under constant fire: "Some of us have already had to receive dead relatives," says the doctor.
A colleague saw his dead son in the clinic after an attack.
He once treated a young boy who was the only one who survived an air raid.
The rest of his family were killed in the attack.
"We experience collective punishment"
During the last offensive in 2014, the human rights organization Al Mezan Center for Human Rights researched attacks on the health system in Gaza. The report that was due to be submitted to the UN states that 17 hospitals and 56 health centers were destroyed in the conflict at the time. 45 ambulances were affected; 511 of the 2,217 Palestinians killed at the time had no access to medical care because ambulances could not get through to them.
Issam Younis, 57, the director of Al Mezan, was involved in the report and will be in touch from Gaza City on Wednesday morning.
The telephone connection keeps breaking off.
Younis left his apartment for fear of bombs, he says.
"Quite a few roads that lead to hospitals have huge craters from the bombs." The biggest problem, however, is that no more diesel is getting to Gaza.
The hospitals have generators, but they too would be hit by a massive blackout.
"We are experiencing collective punishment."
"The air strikes hit a lot of civilians and medical infrastructure," says Nathalie Thurle, medical coordinator of the aid organization Doctors Without Borders (MSF), whose clinic near the Shifa Hospital was also badly damaged.
Israel has closed the border crossings
Thurle answers from the West Bank, but she is in constant contact with her colleagues in Gaza City. In the MSF clinic that was hit, doctors treated over a thousand children in the past year, she says. Fortunately, the house was not completely destroyed, so it is hoped to resume operations in the near future. But the street in front of it, which also leads to the Shifa Hospital, had been bombed. "Patients can barely move," she says. "Too dangerous."
Thurle himself is also stuck.
She is currently unable to go to Gaza to support her colleagues because the border crossings are closed.
This leads to another emergency: “We are not getting any medical supplies to Gaza.
The most important materials that are urgently needed for the care of the wounded are becoming scarce. «Including blood bags for transfusions.
Doctors Without Borders wants to donate its own material, but it cannot be brought to Gaza at the moment.
"The border has to be opened," says Nathalie Thurle.
Time was pressing, the situation was getting worse every day.
Many children have nightmares
Around 58,000 people have currently been evicted from their homes, says the doctor.
They are accommodated in empty schools - but that increases the risk of a new wave of Covid 19, under which the hospitals would then probably collapse for good.
Because the Gaza Strip with its two million inhabitants has only received around 120,000 vaccine doses so far and only half of them have already been given.
Shifa Hospital emergency doctor Fahd Haddad says Gaza has just experienced the second wave of Covid.
But now there is no time to think about a longer-term fight against the pandemic: "At the moment we often only have a few seconds to save a life."
Not only the care of the visible wounds is a problem.
"We are all survivors of trauma," says Yasser Abu Jamei, director of the Gaza Community Mental Health Program, the largest non-governmental organization in Gaza that deals with the psychological consequences of the conflict.
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Yasser Abu Jamei, Director of the Gaza Community Mental Health Program
Photo: private
Children, who still have no words for what they experienced, clung to their parents, wet themselves, or seemed stubborn or absent, says Jamei.
He tells of children who are plagued by nightmares and who have difficulty concentrating.
Some are so severely traumatized that they develop psychosis.
"Don't show the children what fear you are"
Jamei, who himself lost a large part of his family in the 2014 Gaza War, and 80 colleagues looked after around 3,100 people last year.
Psychiatrists, psychologists, social workers, and nurses often offer a combination of behavioral therapy and medication for adults.
Help children in art therapy.
"When they are on the mend, something negative often happens again, which throws them back," says the psychologist.
Triggers that lead to retraumatisation are omnipresent.
"Without a change in the political conditions, we cannot overcome trauma."
What is his advice to parents during the current offensive?
“You must stay with your children and make them understand that you can comfort them.
Hug them, allow them to express their feelings. "
The second step is to find a safe place - as good as possible in the case of ongoing air strikes.
“Let the children find the safest place in your apartments.
If bombs fall, take them to this place.
Don't look out the windows, don't keep following the news. "
And: "Don't show the children what fear you are," he explains to the parents.
That is difficult, but fathers and mothers have to work on it in order to protect their children.