Dr Mads Gilbert speaks to Caabu about working in Gaza's al-Shifa Hospital during Israel's attack last summer 2014

Norwegian doctor and activist Mads Gilbert spoke at a Caabu / Britain-Palestine All-Party Parliamentary Group briefing in Parliament on 16 June 2015 about his extensive work with trauma patients in Gaza’s al-Shifa Hospital. It was Chaired by Richard Burden MP, and was organised with the important assistance of Medical Aid for Palestinians.

You can listen to a full audio recording of Dr Gilbert’s talk here.

As is stands, 58% of Gaza’s population is under 18 years old, with the average mean age there being 17.8.

15 June 2015 was the eighth anniversary of the siege in Gaza, which has had “very severe medical consequences”. Dr Gilbert said:

“Every third below 4 child is stunted, underweight or wasted, meaning having significant signs of protein malnutrition, as a result of the long lasting siege and the lack of food stuff. About 75% of the below 2 are anaemic, and that is also a nutritional anaemia, meaning that you have too little haemoglobin in the blood. So when you then have a situation where 3,500 children are injured, of course these children have a very diminished starting point to handle that trauma, because when you are traumatised if you have an amputation, if you have a fracture, you need your immune system, you need your protein reserve to build up new tissue and not at least you need your blood, you need to have enough blood because many of these trauma patients will be needing.”

Gilbert focused on the paediatric population in Gaza, and the experiences from the patient flow in Shifa hospital. About Shifa Hospital, Gilbert said:

 “Shifa could have been a university level hospital, it is a nice hospital, it has all specialities, it has 6 operating rooms, it has about 220 trained surgeons, it provides all types of surgery to the population, neurosurgery, heart surgery and so on, but it is stained by this long lasting siege that makes the situation very awkward and difficult. First of all, the first thing you notice when you come during an attack is that the electricity is gone so the hospital is run on generators, two quite old generators which need spare parts which they don’t have because of the siege, which needs fuel which is very hard to get because of the siege, so the lights are going in and out,  electricity is cut off quite often, the ventilators in the ICU will stop, operating lamps in the operating room will turn back and we will be operating in the light from mobile phone screens until the light comes on again and they are not allowed to have headlights so I bring my headlights and of course that’s very welcome.”

During last summer’s attack on Gaza by Israel, Dr Gilbert recalled the night of the Shuja’iyya bombing, and the impact of the enormous casualties, and an eight year sieges had on the hospital and its staff:

“The night of the Shuja’iyya bombing on the 20 July 2014 we had between 400 and 500 casualties coming to Shifa Hospital which for my university hospital would be an enormous undertaking and this was about two weeks into the attacks and it lasted for 51 days and nights. It is a major problem in Gaza to provide enough sufficient and reliable treatment for the trauma victims, in particular the children. Many of the trauma patients are multi-trauma, very complicated cases and there should have been a chain of evacuation allowing the wounded to be evacuated through Rafah, through Erez to medical facilities who have more capacity than Shifa has. The second thing you notice as a result of the siege and background to that is that there is a lack of drugs, medical equipment, epidural needles, different types of local anaesthetics. So for many of the children being wounded less severely than those who had to be admitted, cuts and wounds that need stitching, more often than not would not have sufficient pain relief, simply because it was not available and there was not the capacity to take them to the operating room, like we would have done in my hospital and put them to sleep in general anaesthesia, so they were stitched up with maybe a little local anaesthetic if they were lucky. This is not because of a merciless attitude among my colleagues, the Palestinian doctors and nurses, but because, simply, there was such an overwhelming flow of patients that you had to cut short on certain facilities and treatment moralities. 

Also, the staff is a minimum factor because of the financial breakdown of the public economy in Gaza. When the attacks started in July, the staff in Shifa had not been paid their wages since Easter 2014 and before Easter they had been paid half their wages for half a year. So doctors, cleaners, nurses, paramedics were actually paying their way to get to work if they had to take a bus or a taxi and the family economies of the families is of course extremely difficult – 75% are dependent on foreign aid, according to UNRWA statistics. Despite this, there was never a lack of staff, but the staff were extremely exhausted, working long hours and the attack coincided with Ramadan so they were fasting from sunrise to sunset, and of course this with an enormous number of patients coming in, posed significant challenges to the staff, and many of them had their own family members, neighbours, friends coming in as patients, and sometimes also as severely wounded or even dead.” 

Dr Gilbert concluded his talk:

“I consider the doctors, the nurses, the paramedics, the volunteers, the young medical students, who risk their lives as we are speaking, as the true heroes of medicine and of humanity.”