16 March 2018
Palestinian medical staff working in emergency departments are suffering from high levels of burnout, according to researchers at Al Quds University in Palestine.
The work of doctors and nurses in emergency departments anywhere in the world is characterised by high work pressure and stress. In the occupied Palestinian territory (oPt), such staff provide essential front-line care amid insufficient human resources, lack of medication and life-saving equipment, and, in Gaza, frequent electricity cuts. During periods of heightened violence – such as the violent crackdowns on Palestinian protests following US President Donald Trump’s recognition of Jerusalem as the capital of Israel – pressure on these services and staff increases significantly, as emergency departments are inundated with patients with traumatic injuries.
The recent survey by researchers Motasem Hamdan and Asma’a Abu Hamra found “burnout” – to be very high amongst emergency department workers in Palestinian hospitals. Among their sample of 444 staff in the West Bank and Gaza, 64% reported symptoms of high levels of emotional exhaustion (“feelings of being emotionally overextended and exhausted by one’s work”), as well as 38% high depersonalisation (“negative, cynical attitudes toward the recipients of one’s services”) and 35% highly reduced personal accomplishment (“feelings of competence and successful achievement in one’s work”).
Emotional exhaustion has been associated with high workload, job stress and lack of control over the work environment. It can negatively influence physical and mental health and well-being, leading to feelings of anxiety, depression and loss of self-esteem. The researchers attribute this phenomenon, at least in part, to the political context for these workers:
“In Palestine, the high levels of emotional exhaustion among ED workers can be explained by the excessive work pressure, which is due to the ongoing conflict in the occupied territories and the consequent large number of injuries and traumas, which require emergency care, as well as the ordinal patients seeking care in these departments. Consequently, workers experience considerable job stressors while dealing with life threatening situations and treating severe war injuries and time pressure. Adding to that, Palestinian hospitals work under difficult conditions and suffer from shortages of human resources, medicines and equipment.”
Ongoing conflict and frequent violence in Gaza and the West Bank have caused a large number of injuries and traumas in need of emergency care. During Israel’s 2014 military offensive on Gaza, more than 2,000 Palestinians, mostly civilians, were killed and 11,000 injured. Emergency department staff worked under severe pressure to support patients with serious and life threatening injuries.
Palestinian medical facilities and workers, including those in emergency departments, have also come directly under assault, both during military offensives in Gaza and frequent raids on West Bank healthcare centres by Israeli forces. For example, last July Israeli security forces raided Al Makassed Hospital in East Jerusalem, preventing staff from providing emergency medical care to critically injured patients. Israeli security forces also used violence against the staff, including pushing, kicking and beating.
Palestinian hospitals also suffer from shortages of human resources, medicines and equipment. This is most apparent in Gaza, where a decade of Israeli blockade and closure has contributed to the de-development of the health system. In recent months, Gaza’s healthcare crisis has seen 40% of medicines out of stock and hospital services temporarily shut down due to lack of fuel for generators.
High burnout levels are also associated with job satisfaction and turnover, and this study documents an increase in staff expressing anan intention to leave their jobs. Thus burnout threatens the sustainable provision of Palestinian healthcare. The researchers concluded their study by emphasising the need for prevention and management strategies to address occupational burnout.
Ultimately, the health and wellbeing of emergency department workers in Palestinian hospitals cannot be guaranteed under prolonged occupation, blockade and humanitarian decline. Political action to address these issues is vital. To find out more about how MAP campaigns for such action in the UK and internationally and get involved click the link below.
