Human Catastrophe at Gaza’s Hospitals

The latest Israeli war in Gaza has claimed more than 330 lives, including scores of children, and left thousands wounded, forcing overworked and under-supplied medical personnel to scramble in a desperate struggle to save lives.

One of those doctors, Norwegian physician Mads Gilbert, was in Gaza during Israel’s last major assault, Operation Cast Lead in 2008-09, and is now tending to the flood of wounded pouring into Shifa Hospital as a result of Israel’s Operation Protective Edge. Dr. Gilbert was interviewed by Dennis J Bernstein for Pacifica’s “Flashpoints” program.

DB: Give us an overview in terms of the medical situation. What can you tells us in terms of the extent of the wounds, what type is most prevalent, the number of dead and wounded at this hour.

MG: I am now in Shifa Hospital in central Gaza City. Shifa Hospital is the trauma center for the 1.7 million Palestinians living in the Gaza Strip. It’s a very important hospital, but its function is almost crippled by the longstanding, seven-year Israeli siege of Gaza, which has caused extensive deficiencies on all types of equipment needed for running a hospital; disposable instruments, sutures, and the more basic things like water and electricity.

So, it’s really a miracle that the staffing at Shifa managed to improvise all that you need to improvise in order to sustain a caseload, like we had [Thursday], of around 100 cases coming into Shifa, many of them severally injured. And before I go to the injuries, let me just underline one thing. Health is not only a question of a health-care system, it is in as much a question of the basic commodities in life – water, food, human security, education, work and so on. And all these basic pre-conditions for public health are lacking in Gaza as a result of the occupation and the siege of Gaza.

As for the injuries, we have had a steady current of injured, dying, dead during this close to two weeks of Israeli onslaught. The most striking impression and documented feature is that 80 – 90 percent of the injured and killed are civilians. This is according to U.N. and the Palestinian Minister of Health. Fifty percent, pretty much exactly 50 percent of the injured are women and children. About one-quarter to one-third of the killed are children.

This is really a large-scale attack on the Palestinian civilian society. And bear in mind, that to a man in Gaza there absolutely is nowhere to hide, there is nowhere to hide. There is no shelter, there is no early warning system, no sirens, no civil defense. On top of that you can’t see, you can’t really get away from this mess. You can’t take you family and escape to a neighboring state or up in the mountains or away. Because you are incarcerated. It is like a prison being bombed. Completely.

DB: Now let me ask you, in terms, you said that most of the wounded and killed are civilians. Could you say a little bit more about, just to keep a human face on this, who you’ve seen, who’s coming in, and what do the wounds look like? Are they consistent with advanced weaponry? What can you tell us about that?

MG: Well, you know, war is a dirty thing. And we just received up to thirty [victims] from families that were bombed now around 8:30 [on Friday] just as we’re having these talks, women, children, elders coming in with shrapnel injuries from the heavy Israeli artillery that has been shot … since last night. These artillery grenades produce deadly shrapnel that travels at a very high speed and, if you are unlucky, they will penetrate one of your cavities, the abdomen, the chest or the brain, and cause life threatening bleedings. And this is a time critical event if you want to survive. The doctors and the surgeons must detect the bleeding, and immediately do surgery to stop the bleeding. This is one type of injuries.

The other type of injuries we are seeing are the traumatic amputations. We have seen now, like in 2006, 2009 and 2012, extreme amputations: legs ripped off at the level of the hip, arms ripped off under the armpit and bodies cut in two, with no signs of shrapnel injuries. Now we don’t really know what kind of explosives these are, but it has been discussed among people who are knowledgeable about weapons, that this might be the result of explosives called the DIME [Dense Inert Metal Explosive] weapon, a metal explosive.

But I underline, we don’t have any proof of this. And it doesn’t really matter what type of weapon you are injured or killed by. If you are killed or injured, the end point is the same. So if I should talk about any illegal weapon used by the Israeli forces, it is the weapons that are illegal according to the international regulations and laws of war regulated in the Geneva Conventions.

And there are three illegal weapons that Israel is using. Number one, is the collective punishment defined by the siege that has lasted for seven years and that is really making the whole population suffer really large difficulties. The second illegal weapon is the indiscriminate shelling of civilian areas, not protecting the civilians at all, which is against the Geneva Conventions, Article 33. And the third illegal weapon is the disproportionate use of force. The fighting parties are obliged to use proportional force. Israel is using an overwhelmingly disproportional use of force which is reflected in the fact that now close to 300 Palestinians have been killed or massacred, and 1 Israeli is killed [at the time of the interview on Friday]. That is 1 to 300 which tells you everything about the disproportion.

So really this is a very uneven, if you can even call it a war. It is an occupant who is viciously bombing a large civilian population. They have nowhere to fly and are basically defenseless.

DB: Now we know about all the embargoes. We talked a little about this before. Do the hospitals, where you are in Shifa [Hospital] in Gaza, do the hospitals have the supplies that they need? Are people getting what they need? Is it able to come in?

MG: Absolutely not. As a result, as I said, of the siege, the hospital system has been sort of slowly crippled along with the civilian society. And when the Egyptian president closed the tunnels which was really the life-line into Gaza, the fuel crisis went up 400 percent and it basically sort of crushed all the public budgets. So for example, doctors in this municipality can no longer afford fuels for the generators which is producing electricity in order to run the waste water pumps and the cleaning machinery for sewage. So currently 65,000 cubic meters of raw sewage is running into the Mediterranean area.

And in every aspect of civilian life, and a normal life, they are effects of the siege. So the hospitals are only one sector where this lack of supplies has really reduced the capacity. And let me illustrate this by saying that on the 17th of June, the leadership in Shifa Hospital decided to cancel all elective surgeries, meaning planned surgery and only doing emergencies. This was a few weeks before the attacks started.

And on the 3rd of July, two days before the attack started, they decided to only do life-saving emergency surgery. That means, basically, that 1.7 million Palestinian people are without the health care that you need for your daily life. Like for cancer, for orthopedic, for anything that you are being treated for.

So, it’s running on sort of an emergency, very basic level, and on top this now comes this large influx of very severely wounded. We were running six operating rooms last night. We were operating continuously as these 100 plus, injured came pulling into the hospital.

I am amazed. I am deeply impressed by the quality and the morality of the Palestinian health workers. From the ambulance paramedics, to the nurses, to the doctors, to the cleaners. They stand tall. They haven’t been paid normal salaries since March and before that they had 50 percent salary for eight months, still they come to work. They are working for nothing. … They are exhausted, extremely exhausted, but they don’t leave their people. I am deeply impressed by their morality.

DB: And, Dr. Gilbert, when you were there in 2008 and 2009, there were multiple attacks on hospitals. There were many attacks on ambulances. We understand that a hospital in the north that deals with the elderly and the infirmed was under attack. What can you tell us about that?

MG: This was the Al-Wafa hospital which was the most important rehabilitation hospital in Gaza and the Gaza Strip. Al-Wafa is – or was – a rather well organized rehabilitation center. They have 18 patients now. They were actually ordered by the Israeli armed forces to evacuate the hospital because they were going to bomb it.

Now, don’t forget that hospitals are protected by the international laws and the Geneva Convention. You can’t bomb hospitals like that, but Israel can. Where was the ICRC [International Committee of the Red Cross]? Where was the U.N? Where were the white cars rolling up to protect this hospital?

There’s total lawlessness, here. Israeli impunity seems to allow them to do whatever they want. Kill children. Kill elders. Bomb hospitals. Stop the water. Stop the electricity. Stop the supply of drugs. What is this, medieval times? What is this? What kind of morality is this? What kind of treatment of decent people is this? You call somebody terrorist and you think that you’re exempted from the laws of moral and international regulations? It shouldn’t go on like this. This has to be stopped.

And I tell Mr. Obama, if you have a heart, come to Gaza. Spend a night with me in Shifa Hospital and I’m absolutely sure that he will change his mind. Mr. Obama, come here and tend to the children of Gaza, screaming, injured, so many shrapnels and burns. See what this is actually on the ground. This is not a war against some enemy called terrorist. This is an all-out war against a civilian population of Gaza who has deserved nothing to have this hell upon them from the Israeli war machine. This is state terrorism, at a very high level.

DB: And, finally, you bring up the children. We know there have been multiple deaths of children, I think it’s over 40 now. We saw the slaughter on the beach. We saw other families being wiped out. There are the kids who already dead, and what about the impact on the tens, and hundreds of thousands of young people in the Gaza Strip? How does this impact on the child’s health if you are not wounded?

MG: That’s an important question. Let me just give you the numbers updated as of 4 o’clock this afternoon [Friday]. So hard, 62 children have been killed by the Israelis in Gaza, 24 women — that is 86 women and children, those already killed. This is among the 270 to be killed, so far. Among the 2,196 injured Palestinians, 637 are children. So the Israelis have injured almost 650 children and killed 62.

Now for a moment, God forbid, turn it around and ask yourself, what would the world leaders have said if Palestinian fighters had killed 62 Israeli children and injured 637 Israeli children in less than two weeks? This is what really troubles the Palestinians. We are treated like second-class citizens, like animals.

The laws that apply to the world, do not apply to us. Israel can do what they like. Nobody reacts. They can kill us, they can bomb our houses, they can close our borders, they can do whatever they like, and nobody reacts. This has to stop. This is not a world war. This is so extremely provocative, for the people all over the world.

As for the psychological trauma, Palestinians are strong. They have a very strong coherence in their families. They are filled with what the Arabs and Palestinians call sumud which means steadfastness, they stand tall, they stick together, they don’t rock. They have an extreme resilience. They are not beggars. They are not creeping around, asking for mercy. They say “Give us peace. Give us equity and equality and we will be fine. We don’t need developmental assistance, we just need basic human rights, and peace, and we will manage fine.”

But, of course, it’s an enormous psychological burden. I see like myself. I mean, the Israelis bombing day and night, it’s extremely frightening. We’re in a hospital, but imagine now these coming in from their homes, sitting there having their Christmas dinner, basically, and Israeli grenades hits right in the sitting room, in the living room. And mother and father are sprayed with blood, and two sisters are killed, and everything around them … they’re phoning an ambulance, that are coming to them, they’re getting help in the hospital.

You know, these are scars on your mind for a lifetime. But they mend, they come away. The unfortunate thing is that, they are re-traumatized every third, fourth year by the Israeli war machine, by the Israeli government, who seems actually to have a plan with these repetitious attacks on Gaza, to break the backbone of the Palestinian resistance. That’s never going to happen. Palestinians are like others who are occupied. They will never yield to the occupant.

Norway was occupied for five years, by the Germans, a couple of tens of years by the Swedes, 400 years by the Danes. We get rid of them. We’re a small but we’re a proud and independent nation. People want to be free, like the people in the United States. Why should the Palestinians demand less than freedom and independence?

DB: Well, that’s the question we’re going to leave it at right now. Dr. Mads Gilbert outside the operating room where the bombs continue to fall. Are they continuing to fall, the bombs, the drones?

MG: Oh, yes, oh yes. Oh yes, sir. We heard the drones, which means the hummers, or the humming bees, all over our heads. We are having a large, yellow … the light grenades, hanging over our heads, to light up the ground for the Israeli forces when they want to shoot. And we hear this deafening detonations and explosions from the Israeli air-to-ground rockets and from the artillery shells. I don’t want anybody to experience this, my friend. This is so frightening. This is so painful. And to see this current of injured, and bleeding, and dying children and women. It is even more than I can take, many times.