11 January 2016
With six major outbreaks of violence in 10 years, and over 10,000 injuries in the 2014 attacks on Gaza alone, medics in Gaza are sadly well-versed in dealing with major trauma injuries. However, the blockade and closure of Gaza and restrictions on the movement of medical professionals in and out of the territory mean that they are often unable to access training, whether locally, elsewhere in Palestine or abroad. This limits their ability to keep up to date with the latest developments in the practice of emergency medicine.
That is why Medical Aid for Palestinians are helping to train local medical teams in Gaza responding to traumatic injury cases. Last month, paediatric trauma and intensive care nursing specialist Darren Darby and Emergency Medicine consultant Dr Simon Calvert visited Shifa Hospital as part of MAP’s largest-ever, joint medical mission to Gaza, in partnership with our sister charity IDEALS. We caught up with Simon and Darren in Gaza to discuss the difficulties of providing effective emergency medical care in this context and their impressions of the local Palestinian teams with whom they worked:
Darren: “This is my second time to Gaza, my first time was in October 2015.”
Simon: “This is my fourth visit. I came for the first time in September 2014 just a month after the conflict. You can see that some rebuilding work has been done, but I appreciate that there are lots of difficulties including the lack of electricity and other issues that are affecting the operations of the hospitals like the lack of medication. I have seen construction in the hospital and other work that has progressed with each visit, like the new wing that was built in Shifa Hospital.”
Simon: “The basic idea is to build on other training courses that provide knowledge and skills to medical professionals. Our goal is to improve how effectively doctors work together. You have all these experts in their own field: orthopedics, pediatrics or intensive care specialist. What we try to do is improve how all these experts come together in the treatment of a patient – not only in situations of mass casualty but also for complicated individual trauma cases, when teamwork is indispensable.”
Darren: “The idea is that a team can be more successful than just a group of individual experts. We try to re-emphasize that nurses, radiologists, even the blood bank are part of the team and it is not just one doctor directing everything.
Simon: “Every department is like a link in a chain. They are all connected, and each aspect is vital in a patient’s care.”
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| The Shifa Hospital Emergency Department, during the 2014 attacks on Gaza |
Simon: “One of the issues is that doctors from Gaza have so little opportunity to learn from others on best practice for example about how to treat patients if it is a complicated case. Their only option is to take information from the internet . For me as a doctor, it is very helpful that I can access conferences to learn from my peers from all over the world to share best practice. What we do is create an opportunity for the doctors to talk through some cases and share our best practices from the UK.”
Darren: “The fact that people are not being paid their salaries makes it hard for them to stay motivated. In the UK as a doctor, you may love your work but you also do it secure in the knowledge know that you are going to get paid. The doctors and nurses in Gaza come to work without reward, and I find it truly amazing that doctors work so hard here just because they want to help their community. It is not just about the money. I think morale is also hard to maintain because of the restrictions on movement, travelling or even restriction on living abroad.”
Simon: “Their resilience is amazing, the doctors just keep going and they do it with a smile.”
Darren: “In the UK, we have trauma care from the moment the injury happens to the moment the patient goes back home. It is not just what happens in the ER and emergency room that makes the difference. You have to look at the whole path of the patient, and this doesn’t take that much of an investment. We found that we need to build a team together here in Gaza, so that when the patient arrives the whole team is ready. For example, if a patient arrives in Intensive Care, that team has to coordinate with the operation theatres so they can be ready to receive the patient. The biggest need is to have a system and a good, dedicated team.”
Simon: “This is what we call the chain of survival which includes: good access to a hospital, good care at the scene of accident, good care in the emergency room and in surgery, and afterwards good follow up with physiotherapy and psychological assistance. If one of these parts is failing, you don’t get the same end result. It is easy to focus on the emergency room and the surgery, which is the big single event, but actually every step is just as important. For lots of reasons, it is challenging in Gaza to connect all those dots.”
You can read more about our latest medical mission to Gaza, and watch interviews with the British and Palestinian medics undertaking limb reconstruction surgery at al Shifa Hospital, by clicking here.
If you would like to support MAP’s work in Gaza, you can make a donation by following this link.
Featured image: Darren, Simon and the trainees