An interview with Dr Jom’a

Monday, 3 November 2008

Gaza City
20 May, 2008

What is life like in Gaza at present?

The situation in the Gaza Strip is bad. People are finding it increasingly difficult to reach the clinic. The lack of fuel is affecting public transport and many of the patients on our surgical waiting lists are unable to make the journey. This morning, a patient living thirty kilometres out of the city was forced to cancel his appointment, couldn’t get to us without transport. An urgent case had to be postponed, it’s terrible.

In kitchens all over Gaza cooking gas is no longer available. We are switching to kerosene stoves, which haven’t been used for fifty years. Now kerosene is becoming scarce. Petrol and diesel is nowhere to be found. The supply of rice is drying up. Rice has doubled in price recently.

How are people getting around this?

It’s difficult. People are eating bread rather than rice. Where people used to have three meals per day, we are now having to make do with two.

Anything and everything is used and adapted. Life is improvised to a certain extent.

Is life on the streets dangerous?

Inside the city we are mostly safe but around the border area there is fighting and regular Israeli incursions. These areas are very dangerous.

What are the main differences in life since the Hamas take-over?

Before the Hamas take-over there were clashes within the city. Factions of Fatah and Hamas were fighting on the streets – affecting the lives or all civilians.

Now the security situation has improved and things are better. Because there is only one militant group in control, life is quieter within Gaza. We rarely see any factional infighting and, similarly, there are less family feuds. On the Israeli front, however, things are worse. Gaza – including all its citizens - is now considered a “hostile area”.

No commodities are allowed to pass through the border. Fertilizer for agriculture is not allowed in.

Two days ago Israeli security forces attacked the area east of Rafah. A large poultry farm was hit. Because of this, one third of the Gaza supply of poultry is missing - 40,000 hens and chickens destroyed. Gaza used to be self-sufficient but, with a third of the regular supply missing, there is now a severe shortage of chickens and eggs.

Likewise, potatoes and other agricultural goods. Farms everywhere have been destroyed.

Crucially, Gaza’s isolation has meant a shortage in medical supplies. Medicines are allowed in but it is a lengthy procedure and shortages are therefore common. St John is very fortunate that we can co-operate with the British Consulate who transport vital supplies to Gaza on our behalf. Every two or three weeks we receive such deliveries. But we also experience shortages all the time. We have to try to manage, try to get around the difficulties.

What about other hospitals that perhaps do not have the same connections. How are they managing?

Many of the other hospitals have forged links with the Red Cross, but things are getting very bad and we are struggling.

Has the Gaza Cclinic has been very successful in arranging referrals for its patients?

Yes, last year we were able to refer more than 50 patients per month and this year we are doing better still, but we need to do more. Many cases are denied. Up to half of those for whom we request referrals are refused permits. There was a patient today with a retinal detachment. A 65-year old woman, Mrs Badrya El Qedwa. She doesn’t have a Gaza ID, and is not allowed to go to Jerusalem for treatment. Officially, she is registered as a Jordanian visitor, although she’s originally from Gaza. The crossing to Jordan is closed and she can’t return there either. Her background means she is not permitted to exit the Strip. Her condition is very bad, and she will lose her vision.

Last week, during the Israeli anniversary celebrations, the Gaza border was almost completely sealed. Only those classified by the security forces as “immediate emergency” cases are allowed to pass through. It is very difficult.

Worst of all is the lack of medical equipment. It is becoming harder and harder for Gaza hospitals to get maintenance performed and to repair equipment. All over the Gaza Strip X-Ray machines, for instance, are falling into disrepair – with no imminent solution in sight. Our own Ultrasound machine is out of order. We sent the failing probe off for maintenance almost one year ago, one year, but still we have not received the needed spare parts. This prevents us from doing certain vital diagnostics. Instead we have to refer patients to Jerusalem. This is a slow process. And many referrals are rejected.

I’ll give you a scenario to illustrate: recently, we saw a patient, a young girl just 14 months old. She had cancer in the eye and desperately needed to be referred to Jerusalem. We had to wait over two months. For four, five times we tried, until finally – along with her mother – she was allowed across the border. She now needs very costly medications. Things are extremely difficult and made so much worse by the movement restrictions.

What do you need?

Long-term our biggest need is to re-locate St John’s clinic into a bigger area. During the last three years the number of patients we see and treat has almost doubled. Our activity is constantly increasing. The need is growing – and the clinic is now very cramped. It is very important that, as soon as things stabilise, we try to move into something bigger. We need more equipment to keep up with the increasing activity, to better help our patients, to become more self-sufficient and less reliant of referrals. Short-term, we need a new Anaesthesia machine, a new Vital Signs Monitor and the Ultrasound.

In times like these, is it still possible to have hopes for the future?

Things are getting worse. Gaza has been effectively closed for almost a year now. Every now and then hopes are raised that the situation will improve in month or one year. For the time being things will continue as they are.

What I would like and what is needed right now is more visitors to come to talk to us, to experience the troubles we are faced with. We need international visitors to see the picture on the ground. Only then can they understand the difficulties we are up against. The people of Gaza are expecting help to arrive. We are still hopeful in many ways and we think that the international community should feel a responsibility for life here.