Dr. Andy Ferguson:
I’m Andy Ferguson. I’m a GP and public health specialist and with that work I’ve been a regular traveler to both Gaza and the West Bank for the past 14 years. I have never experienced anything like I experienced in Gaza over Christmas and New Year and I hope that I never do ever again.
(man in the car) Final load up, fingers crossed. Everybody.

Dr. Andy Ferguson:
Access to Gaza is now really very difficult. I flew out to Cairo on Christmas Eve. We were part of a UN convoy going from Cairo to the Rafah Crossing on the border between Egypt and Gaza on Christmas Day. At that moment in time, the fighting was becoming more and more intense in the middle areas of Gaza and towards Khan Yunis. We were originally due to be deployed to a different hospital, but because of the security situation that was changed and we were diverted to the European.

When we finally made it to the hospital, our immediate impression was, wow, it was so completely different to whatever we’d seen before and in complete chaos reigns. There are about 22,000 people currently living in makeshift tents on the grounds of the hospital or actually on the floors in the hospital corridors themselves. You’ve also got some of the remaining staff living within the hospital, some of them with their families as well. The situation within the emergency department particularly, it was chaotic. There were hundreds and hundreds of patients, you know, in there at any moment. Many of them because the primary healthcare system has broken down, looking for the ongoing management of their diabetes, you know, high blood pressure, heart failure, kidney failure, cancer. And then on top of that then you get groups of 10, 20, 30 newly injured patients often with a number of dead bodies arriving within that chaos.

By far the greatest number of injuries are those affecting the limbs. Um, you can’t imagine really the horror of some of those injuries, people who’ve had traumatic amputations from the blast itself of arms, legs, the most horrible complex, uh, devastating, uh, fractures affecting their limbs as well.
Ahmed was one of the patients that we met quite early on. So he was in a shelter with the rest of his close family when it was shelled. Absolutely tragically, the rest of his family died in that attack.

Ahmed( in arabic): I spend the next 4 days at the school bleeding. There were no paramedics or anything. I had to drink salt water because there was nothing to eat or drink. After 4 days, my uncle came looking for us, and found out that i was alive.
He was resuscitated and then transferred through to the European hospital where our team found him. The shelling itself had caused a traumatic amputation of his left leg below the knee.

(another doctor): We’ve been trying to preserve as much length as possible but unfortunately because of the infection, we have been unable to control the infection. There’s a lot of, uh, antibiotic resistant bacteria in the hospital.

For Ahmed and people like Ahmed, it’s what comes next. Someone like Ahmed is going to need, uh, a prosthesis, you know, to help them walk, ongoing support, rehabilitation for the rest of their lives. But despite everything that had happened to him, he was so keen to tell his story because he saw that as being important. He saw hope for himself in the, uh, in the future both for him as a person and for Gaza itself, which really was very humbling and incredibly inspiring for us as a team to hear.

There is intense fighting going on around the European hospital at all times. So throughout the day, whatever you were doing was accompanied by bomb blasts, the sound of tank fire, machine gun fire in the surrounding streets. It’s been a really bad night. There’s been a constant sound of drones and jets overhead, shelling and machine gun fire in the background. Every time that you heard that, you wondered who was on the receiving end, uh, what buildings had been damaged, what families had been devastated by what you were hearing. And then waiting for the sound of sirens, sirens from the ambulances arriving in the emergency department and then patients being transferred to where we were working in theaters.

I’m struggling to find the words for how I feel and how the rest of the group feel. Horror, disbelief, terror, outrage. None of them seem enough. The natural tendency at the moment is to focus on the trauma, you know, the people being killed, injured, disabled by the ongoing conflict. But also the primary healthcare system has completely broken down within Gaza. The UN, you know, are now saying that only 14 out of 36 hospitals in the whole of Gaza are even partially functional. There are chronic shortages of essential equipment, drug supplies. Even whilst we were there, day by day, those supplies were running out. And on our last day in theater, our team themselves used the last dose of morphine and also the last dose of pethidine. So any of those strong opiate painkillers at that point in time had completely run out. There’s now a complete loss of any form of antenatal care, postnatal care for women. All those patients with diabetes, heart failure, heart disease, kidney failure, cancer can’t find access to any ongoing care. Even with the situation as horrifying as it is in Gaza, it’s possible for things to get even sadder. We met Nohan who is a 15-year-old girl. She actually fell escaping from a bomb blast towards the end of October, uh, and was taken to the Indonesian Hospital in the north of Gaza. And the doctors there thought that this rapidly enlarging swelling around her left knee was a traumatic injury. But it just got worse and worse and she got sicker and sicker and she was in incredible pain that wasn’t responding to any form of painkillers that she was given. And eventually after several weeks she was transferred through to the European Hospital. And tragically her x-rays and the CT scan were highly suggestive of sarcoma, which is a really nasty tumor of the bone. And CT scan of her chest then confirmed multiple secondaries, spread of that tumor in both of her lungs. We’re desperately trying to evacuate both the girl and her mom into Egypt and start what will probably be palliative chemotherapy. And actually I just heard a couple of days ago that her and her mom have got out, uh, and she’s currently in Qatar receiving treatment. So obviously we just hope for the best.
In Nohan’s context at least she’s been quite fortunate, but that’s not the case for many. The situation now is completely unprecedented. The level of devastation, the complete dismantling of the health system from the hospitals down to the primary health care centres to the vaccination program and public health initiatives, none of it is functioning. So if you ask me what the hospital system within Gaza needs right now, the only real answer is an immediate ceasefire. It’s an end to the killing. It’s an end to those people being injured. But it’s also to allow the necessary volume of aid to get into Gaza itself. Uh, and until we get to that situation, there’s going to be no beginnings to a recovery. In the past, you know, whenever there has been a major escalation in the conflict, we’ve talked about a recovery period of maybe 2 to 3 years. But we’re now talking about probably two to three decades and that may be a conservative estimate given the level of destruction which is there. I have never experienced anything like I experienced in Gaza over Christmas and New Year, um, and I hope that I never do ever again.