From the Diary of a Doctor, a volunteer with Physicians for Human Rights-Israel: A Visit to the Gaza Strip (Feb. 2011)
February 2011, Physicians for Human Rights רופאים לזכויות אדם ע"ר-ישראל http://phr.org.il (Israel)
At the Erez Checkpoint, as I was standing in front of the concrete walls and the enormous iron doors that exemplify the severe blockade policy imposed on the people of Gaza for the last four years, I felt - as a neurologist, a member of PHR Israel - that I can break the walls of the blockade with my humble reflex hammer. At the northern entrance to Gaza City, I was swept by a feeling of triumph with our success in getting permission to enter the Strip and break the blockade two years after our last visit to Gaza. I felt as if time had stopped. The same grey houses, old black walls, most of them decorated with colorful inscriptions that stand out, praising and commemorating those who died in the war against the occupier. Colorful paintings were decorating fences and walls of houses along the streets.
In the neglected grey streets of Gaza there were many wagons drawn by donkeys and horses (called “Karro” by local people). Those are used as the main means of transportation, and replace cars due to the scarcity of gas due to the blockade. People were wandering in the streets without purpose, desperate, not in a hurry to get anywhere. The complete ban on the entry of basic construction materials caused a full halt to construction, development, and to the high level of unemployment in the Strip.
Our first stop was at the Ministry of Health. We were warmly welcomed by the Minister of Health together with all his staff and some senior doctors from hospitals around the Strip. The Minister spoke about the harsh conditions resulting from the blockade of Gaza and the unbearable health conditions. We were left with a strong feeling of uneasiness.
According to the Minister, the abominable blockade caused a severe lack of medications, even to the stock of basic medicines. Even the supply of Paracetamol syrup, for reducing fever in babies and children, was lacking for long periods of time. In addition, there is an almost complete lack of numerous medicines essential for treating severe and dangerous diseases such as various tumors or liver problems, as well as kidneys, heart and brain. At times, a new medicine would arrive, one that is expensive and effective for treating a severe disease, but since this medicine has to be combined with another medicine that is not available, the patient cannot be treated. Such cases cause a lot of frustration, suffering and pain, both for the patient and the treating staff. Moreover, there is a complete lack of various new and effective drugs for treating stubborn and grave diseases.
We were told that there is a lack of equipment and technology in hospitals across the Gaza Strip, and especially equipment for operating and ICU rooms. This equipment could have saved the lives of many people suffering from severe diseases or complex injuries resulting from air force attacks or the mortar shells fired by the Israeli military.
Furthermore, there is a lack of trained staff, particularly specialized doctors in various fields, such as neurology, neurosurgery, nephrology, oncology and other specialties because of the blockade policy and the restrictions on medical personnel to exit the Strip for training programs or internships in other countries.
During the first day, we visited hospitals in the southern and northern part of the Strip, including the European Hospital in Khan Yunes and Shifa Hospital in Gaza City. We saw buildings with partially destroyed walls and marks of shells that were fired during the attack on Gaza two years ago, and there is no way to repair them. A lack of furnishings and equipment was evident, and we heard many complaints from the medical teams about the dire shortage in medicine and medical equipment, and their inability to attend training programs. We felt deep frustration and helplessness.
One tragic case, which I will never forget, had to do with a man in his fifties who we were asked to examine in the European Hospital in Khan Yunes. He suffers from disc herniation of cervical spine which causes pressure on the spinal cord. The patient was lying in his bed, having difficulty raising his head or moving all four limbs. He told us in a hoarse voice, crying, that a few weeks ago, after immense effort he managed to cross the border to Egypt so he could get to a hospital in Alexandria for an operation – discectomy – which he was told was essential to save his spinal cord. But immediately after the operation and upon his return to the Gaza Strip, he was quickly hospitalized in Khan Yunes Hospital suffering from severe neck pain, and he developed difficulty swallowing and disruption of speech, combined with weakness of four limbs. To our astonishment, in the spinal X-ray we saw two large metal objects that were inserted between the neck vertebras in an unprofessional manner. Their frontal parts were sticking out of the spaces between the vertebras and were pressing on the respiratory and upper digestive tracts, putting his life at risk. His examination showed a severe spastic weakness in all four limbs, and mostly in the right limbs in addition to the difficulty in speaking and swallowing.
The patient’s severe condition requires an urgent operation for the removal of the two objects and a re-execution of the original operation in a professional manner in order to prevent full paralysis in all four limbs and permanent confinement to bed for the rest of his life. A team of hospital doctors reported that there is a lack of suitable equipment such as a special microscope needed for such an operation, and there is also a lack of specialized physicians able to perform this operation.
Helplessness, anger and frustration pervaded the room and we were all distressed, and great despair was seen on the patient’s eyes, as well as his relatives who were waiting for help and hoping to find a solution. After a long discussion it was decided to get the suitable equipment and to ask for a specialist surgeon from Physicians for Human Rights.
In the afternoon hours we examined a large number of patients who were streaming to the improvised clinic that was urgently erected for us, in a small medical center in the Al Burej refugee camp. I examined two patients suffering from an undiagnosed Parkinson’s disease and who therefore had not received adequate treatment and had become very handicapped individuals, dependent on others for all the basic tasks of daily life. Adequate treatment would have definitely improved their situations and slowed the progression of the disease.
Another patient suffered from a partial paralysis and progressive muscular dystrophy in his right hand, due to a neck injury that occurred during the war, which caused a lateral neck disc herniation that was not treated because of the conditions of the blockade.
More and more wretched patients could have been saved were it not for the severe and unbearable conditions that the harsh blockade over the Strip causes.
This is inconceivable and does not suit the conditions of the free world of the 21st century.
Dr. Rafik Masalha works in the Department of Neurology, Soroka University Medical Center, and is a Lecturer in the Faculty of Health Sciences, Ben-Gurion University of the Negev.
(Translation: Tamar Novik, Editing: Joan Hooper)
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