Mohamed Hashem: This is Dr. Victoria Rose. She’s a British plastic surgeon based here in London who’s volunteered in Gaza to provide critical medical care to Palestinians amid Israel’s war on the besieged enclave, a war that various rights groups have labeled a genocide. Today we’ll be speaking with Dr. Rose to delve into the realities of Gaza’s health system amid Israeli attacks on its health sector and medical personnel. And we’ll be asking what it really means to be a doctor and healthcare worker in Gaza today. Dr. Victoria Rose, thank you for taking the time to come on Real Talk.

Dr. Victoria Rose: Thanks for having me.

Mohamed Hashem: No, I truly appreciate it and thank you for spending this evening with me. I know how busy you are. Dr. Rose, you know, where do we even start? You’ve been to Gaza twice in 2024, in March and then later in August. What’s been going through your head since then?

Dr. Victoria Rose: Um, mainly when I’m going to go back again.

Mohamed Hashem: Wow. See, I didn’t expect that to be your answer.

Dr. Victoria Rose: It’s quite difficult because a lot of the… we went before the war started so I’ve always had people in Gaza that I knew and colleagues in Gaza that I knew. And when we went back in March of 2024, so many people were surprised to see me and made an effort to come and see me when they knew that I was at the European Gaza hospital. And it cements your relationship with people. And then obviously you’re working in a very difficult set of circumstances so you gel very closely with your colleagues, with your theater nursing staff, all of the junior doctors that assisted me and the medical students. And then when you leave you have developed these friendships that continue on WhatsApp or email and people are constantly in touch with you. And then going back in August – September, because we were at Nasser for a month. A lot of people again came to Nasser because they knew I was there. But then I obviously gelled with a whole new tea m. So I have lots of people contacting me every day, um, asking me what I’m doing and when I’m going back, who do I know that’s coming, where they are, what hospital they’re working at, where all the other people that we’ve worked with are, who’s alive, who’s been injured. So you get these updates every morning. You wake up, there’ll be something on my phone from somebody in Gaza. And a lot of the time it’s questions about when are you coming back, do you know anyone that’s coming back, things that people desperately need for you to bring for them. And not the things that you would think that people would be asking you for. I’m being asked to bring shoes for people’s children and jumpers for, you know, five and six year olds because it’s getting cold now. I’ve been asked to bring pens and paper and pencils and kids toys. That sort of stuff is what people ask me for now. Whereas when we went in the March, the things that people wanted were phones, computers, electric cables, that kind of stuff. It’s all changed now and I think the basics are really, really scarce and very important to them.

Mohamed Hashem: Let’s actually set the scene on what’s happening on the ground in Gaza and what it, you know, what it looks like from your perspective. One statistic that’s been often cited was, you know, the UN saying that Gaza has 17 out of 36 functioning hospitals. But you’ve pointed out that that’s actually not the case. You pointed out that it’s really only four functioning hospitals. I mean, can you clarify this misconception?

Dr. Victoria Rose: It’s not that there’s only four functioning hospitals. It’s that there’s only four hospitals in that 36 number that they quote that have ever had the capability to deal with major trauma. And that was Al-Shifa, Nasser, then the European Gaza hospital, and Al-Aqsa. Indonesian, you can do certain surgeries there, but when we were looking at setting up the lower limb reconstruction program in sort of 2014, we looked at lots of hospitals that would be capable of taking lower limb trauma and doing complex reconstruction. The first place we settled was Al-Shifa, and we managed to run a really good program from there. But because Al-Shifa is the main hospital, was the main hospital in Gaza, has a lot of other responsibilities, so very quickly we started to look for other centers so that we could be more of a sort of a cold service that just purely did limb recon. We went to the European Gaza. It was possible to do some stuff there, but we settled on Nasser as the place that would be ideal for us to operate. The other hospitals are, I mean, some of the 36 that are included are physiotherapy centers. And there’s a couple of eye hospitals in there as well that just do ophthalmic work. So those are, and those are included in the 36.

Mohamed Hashem: Those are two eye hospitals are included in the 36?

Dr. Victoria Rose: So you can’t expect those centers to be able to deal with this kind of workload. Some do have some operating facilities so have been able to transform. Kamal Adwan has already stepped up but it’s not a big center that has capability to image and operate and the things that are needed in the middle of a war.

Mohamed Hashem: And you mentioned that you’ve been to Gaza before. I believe it was 2019?

Dr. Victoria Rose: 2019 and 2020.

Mohamed Hashem: And 2020 as well. So what was Gaza’s health system like even before the war?

Dr. Victoria Rose: It was, you know, it could have been better, but it was functional. And there were lots of efforts being made to improve the situation and lots of NGOs, particularly people like Medical Aid for Palestine had, you know, put a lot of time and effort into improving services, particularly for victims of the ongoing sort of skirmishes with Israel. So there were lots going on, and there had been a lot of investment, um, by foreign medical teams and by the Ministry of Health to get things up and running. So it had a lot of potential. There’s two medical schools in Gaza. Training has always continued. Lots of Palestinians do look to other parts of the world to complete their surgical training if they’re allowed a permit to leave. Qatar takes Palestinian trainees. Egypt takes Palestinian trainees. So lots was going on.

Mohamed Hashem: One of the young doctors that you met, he was taken by Qatar, I believe.

Dr. Victoria Rose: Yeah, he was in Qatar for I think five years, five or six years. So as I said, because there’s no specific training program in plastics in Gaza, he’d done the plastic surgery training program in Qatar at Hamad, and he’d taken his Arab board exam in plastic surgery. So he really was trailblazing that he would be the first Gazan plastic surgeon that was fully accredited in plastic surgery.

Mohamed Hashem: What was it like being inside those hospitals recently now that you’ve been, you know, the past year? I mean, we’ve seen, even there’s footage that you’ve provided, to different outlets where it shows you and then there’s tents inside the hospitals.

Dr. Victoria Rose: So that was in March at the European Gaza. All the internally displaced people were camped out inside and outside the grounds. So the gardens, the European Gaza is quite a beautiful hospital. It’s got sort of Levantine arches and beautiful architecture, but it was built with lots of sort of quads and gardens amongst the main buildings and they were all covered in tents. They had built, I think it was three meidan, so temporary wards during COVID and people had sort of camped outside those and all the way around the grounds that led to them. And then within the hospital, people were putting up tents in stairwells and in corridors. And some of the footage shows people coming out from behind blankets and carpets that they’ve hung up along the walls and there’ll be a family living behind a blanket or a sheet as you walk down the corridor. And it makes it quite difficult to get around and see patients because obviously every time you leave the operating room to go and see a patient on the ward, you’re inundated by local displaced people who are trying to find out whether you could see one of their relatives, are you the right doctor, could you see some maybe non-war injury problem.

Mohamed Hashem: They’re seeking medical care as well.

Dr. Victoria Rose: So they’re all seeking medical care. So the whole sort of situation is quite difficult to navigate because the mass of people. But by the time we went back in August, the IDF had declared that no internally displaced people could stay in the hospitals. And one of the rationales behind that was that if you needed to evacuate a hospital because conflict was getting close, it was very difficult to evacuate patients and all of the internally displaced people. So when I went to Nasser in August, there was nobody living in the hospital and the place was quite, um, derelict almost. But it made it a lot easier to see the structural damage to the hospital because you could see the buildings had been destroyed and you would walk through a corridor and it would end in rubble and you would walk into the CT scanner and the roof had fallen in, um, you could really see the damage that had happened.

Mohamed Hashem: I mean, both hospitals that you worked in, the European and Nasser, they were both evacuated.

Dr. Victoria Rose: Yes.

Mohamed Hashem: And how did that strike you?

Dr. Victoria Rose: I think Nasser’s evacuation was probably harsher because we were at the European shortly after it had happened and I had a friend, Ahmed Al-Moghrabi, who is another plastic surgeon who came to the European Gaza to see me when he knew that I was there. And he told me the story of being evacuated. And he was rounded up with his team and held outside the hospital and he had his scrub nurse next to him who was shot in front of him. And you could, you could tell just by talking to him how traumatized he’d been by that whole evacuation and siege that had happened, and the way in which they’d left and taken as much equipment as they could. And so that was much more real. The evacuation of the European was different in that they were given an evacuation order, and everybody seemed to leave before the army approached. So there were less stories of, you know, people being rounded up, questioned, abducted, shot. That sort of thing wasn’t as obvious to us as it was with the Nasser siege.

Mohamed Hashem: I want to ask you about Northern Gaza right now. That area had three key hospitals. It was Beit Hanoun, the Indonesian and Kamal Adwan, um, all of which have been taken out, uh, most recently Kamal Adwan has been burned by Israeli forces. But what does this mean for medical care in the area?

Dr. Victoria Rose: It means that there’s not much possibility to deliver it. Even if we can get the aid workers in, there’s no base structure for them to deliver any realistic care from. At Kamal Adwan, as I said, is quite a small hospital. I think it only has two operating theaters. One of my colleagues, and um, an American friend of mine, Sam Attar had spent quite a lot of time at Kamal Adwan in the March when we were at the European. And we met up at the end of our time and had a long conversation with him. And even in the March of 2024, it was very difficult to deliver any sort of meaningful care and they were operating in conditions that were far worse than the south. So with those hospitals now partially destroyed and no local team, you’re depending purely on aid workers and foreign doctors. And then you’re depending on what they can bring with them. So in March, we managed to take, you know, 25 suitcases full of equipment with us into the European Gaza hospital. So we knew that whatever happened, we would be self-sufficient and we had enough drapes, gloves, equipment for us to do the operations we needed to do. We also had a basic understanding of the hospital and context there that had told us what kit was available and people had been leaving kit behind when they’d been. But Kamal Adwan now, there will be nothing there. So anybody that goes in is going to have to take all their own hardware as well as their own disposables and that’s going to be impossible with the way in which aid vehicles are being controlled into and out of Gaza.

Mohamed Hashem: And what do you make of the, um, I guess the arrest of Dr. Hussam Abu Safiya who’s been detained by Israeli forces? I mean, we’ve seen the picture of him. I’m sure you’ve seen it as well when he was walking towards the Israeli tanks, um, and he was the director of the Kamal Adwan hospital.

Dr. Victoria Rose: I mean, it’s terrible the way in which the local medics have been abducted and held hostage. I mean, he is another in a long line of Gazan doctors that we know has been taken and will be held in a prison in Israel.

Mohamed Hashem: Did you know them or work with at all?

Dr. Victoria Rose: I didn’t. I didn’t know him personally, but I do, you know, I do know people that have been taken. I knew Adnan al-Bursh who was unfortunately killed. He was one of our orthopedic colleagues that came to London and worked at King’s College Hospital in London with us as a trainee.

Mohamed Hashem: And so you’ve known him here and there?

Dr. Victoria Rose: I’ve known him here and there. So that was very difficult for our charity to sort of stomach really, because we know what sort of man he is, and it seems very unlikely that he would pose any realistic threat to Israel. He’s a very, he was a very gentle man. Um, we know Mohammed Obeid who’s another orthopedic surgeon who was taken and we haven’t heard any information about him. He’s being held in one of the camps in Israel. So there’s, you know, lots of people. My anesthetist when I was at Nasser in August had been taken from Al-Shifa and held in a camp in Israel for 36 days, and told me stories of being, um, cuffed with his hands behind his back and a bag over his head, um, that he lost 10 kilos in weight, that he was beaten and then suddenly released with no explanation. So you hear these stories firsthand. So you have a kind of image of what is happening to the doctors. So it’s very, very upsetting to see the pictures of what happened at Kamal Adwan.

Mohamed Hashem: And there was also Iyad Rantisi who also was reportedly killed in custody. But now that you say that you’ve known Adnan al-Bursh, um, what was your reaction when you first found out that he was killed?

Dr. Victoria Rose: We couldn’t really believe it actually. Um, as I said, he’s really, he’s a gentle giant and we were very surprised that he had been a target. But I think when you looked at the situation, he obviously had stayed working. He hadn’t left. He had put up some Instagram images of himself sort of staying behind, refusing to evacuate. But I mean, that was more out of a sense of duty rather than any sort of sense of defiance. I think we were really, really concerned when we knew that he had been sort of taken. Um, we have heard stories about his death from other people and that he was beaten to death. It’s been very upsetting. He was, you know, one of the champs that we trained. So it’s been really, he’s one of three Palestinian orthopedic surgeons that came to work with us at King’s. It’s been really upsetting for the whole team.

Mohamed Hashem: And when it comes to, you know, the idea of international solidarity between medical colleagues across countries, um, organizations and what not. Where do you think international solidarity with medics in Gaza is right now? I mean, we haven’t seen the British Medical Association say anything about the Hussam Abu Safiya case, for example. But I’d like to get your thoughts on it, Dr. Rose.

Dr. Victoria Rose: I think there is a lot of support for Gaza full stop. A lot more than the country is publicizing. I can honestly say that every time I’ve come back, I’ve never ever had anyone say anything negative to me. I get positive comments about the work that I’m doing. People are very much in support of what ideals our charity is doing. Lots of people tell me regularly that they cannot believe that the British government has not done more to help a ceasefire come to fruition. Even Jewish friends that I have want a ceasefire and want this to end. And I really feel that as a population, our voice isn’t being heard at all, that the people that are speaking for us are not saying, you know, are not reiterating what we’re saying. And I think that’s very much the same for the medical profession in the UK. I don’t know many people, as I said, that feel that what I’ve done is in any way wrong. In fact, most people I know would, if they could, go and help themselves. But the restrictions are so difficult and there’s, you know, specific specialties are needed.

Mohamed Hashem: Going back to Hussam Abu Safiya’s case. You know, like I said, he was a director of Kamal Adwan. He was quite outspoken about what’s happening on the ground in Northern Gaza. Um, he played a crucial role in procuring medical aid to the hospital. My question here is, do you think that with his arrest and the arrest of others as well, that the Israeli forces are sending a message to any medic that’s being outspoken about the situation on the ground?

Dr. Victoria Rose: I think they are definitely targeting medics. I think they are definitely targeting medics. They seem to be arresting a lot of the medical population. And I know from the trips that we did in March and in August – September, that lots of key figures in the hospital had been intimidated and encouraged to leave Gaza, particularly at the beginning of the war. These are stories that we heard firsthand from some of the sort of management level, particularly of the European Gaza hospital.

Mohamed Hashem: And if someone were to ask, well, you know, what is your evidence in making a statement like that, what would you say?

Dr. Victoria Rose: It’s firsthand from people that I met. So from my colleagues, as I said, my anesthetist told me that he had been abducted from Al-Shifa and held in a camp in Israel. One of the medical directors at the European Gaza Hospital told me that he had been threatened and encouraged to leave at the beginning of the war.

Mohamed Hashem: And do you think what’s happening at Kamal Adwan is an effort to push people to the south?
Dr. Victoria Rose: Yes, definitely. And that’s based on information that I’ve had from colleagues in Gaza, who are from the north, and are now unable to get back there because of that Netzarim Corridor that’s been set up, and that is specifically blocking Gazan citizens from returning to the north. So by destroying all of the medical facilities in the north, it does make it very difficult for people to continue living there. They’ve cut aid to the north. I think recently UNRWA said that of 52 aid trucks going into the north, 48 were denied in some form or another. So you can imagine the situation that the people are in up there.

Mohamed Hashem: Dr. Rose, I’m going to read you a quote that you gave at a recent panel. I think it was the ICGP (The Irish College of General Practitioners) panel. Just want to get your thoughts. Um, you said, “I’m sick of hearing about Hamas terrorists and Israel’s right to defend itself. The bottom line is this is a human rights issue and children are being murdered. It’s got to stop.”

Dr. Victoria Rose: Yes. I still hold my belief in that. I think you have to, you have to start from 50% of the Palestinians in Gaza are under the age of 16. Yeah. So if you’re waging a war on terrorists, you surely, you’ve got to target them specifically and that hasn’t been happening. It’s been a blanket bombing of a population and I don’t believe that this now is about Israel’s security or getting rid of Hamas. This is purely the destruction of a population and that is a human rights issue.

Mohamed Hashem: And when you hear statements like this is a war on children, would you tend to agree with it?

Dr. Victoria Rose: It can’t be viewed as anything else because 50% of the population are children. So it is a war on children. Whether or not it is intended to be a war on children is irrelevant. It is a war on children.

Mohamed Hashem: Let’s actually speak to that. In your August trip, the last trip you took to Gaza, you mentioned that you saw an increase in children under five.
Dr. Victoria Rose: Yeah.

Mohamed Hashem: Um, why do you think that was? Why was there an increase?

Dr. Victoria Rose: I think it was an increase in children between the ages of five and 14 was what I saw, far more than I’d seen when we were there in March. A lot of it, I think, is as we said, just the numbers of children that are around. But one of the big NGOs had a theory that anyone under five is normally sheltered by their parents. So if a blast goes off, they’re picked up by their mother, their father or one of their older siblings and they’re protected. And anyone over 14 is normally pretty agile on their feet and aware of the situation around them. Bomb goes off, they run. And I think that tranche of children that are just a bit too old to pick up and not quite old enough to have their wits about them are not in a situation that they can get themselves out of. And so they are falling and they’re definitely was an increase in that population when we were there in August.

Mohamed Hashem: And what kind of wounds were you seeing?

Dr. Victoria Rose: They’re mainly blast injuries. So mainly, as we were saying, when a bomb goes off, whatever is around, masonry, bits of car, it gets whipped up in that sort of explosion and then it’s projected as a high-volume missile. It will hit a civilian at quite a high velocity, and it will penetrate the skin, break the bone underneath or it penetrates the skin, injures the abdominal contents, the chest contents, or into the brain. So that’s the sort of bulk of the injuries that we were dealing with. Then you have burn injuries, some from the heat of the blasts, but a lot from children running away. You’ve got to remember that there are no enclosed living quarters now. People are in tents. A lot of cooking over open flames, pots of oil, pots of boiling water. So lots of injuries from running away, running into hot oil, hot water, running into cars, donkey carts, that kind of thing. You see a lot of those injuries as people are trying to escape. And then you see specific gunshot injuries. So some of the drones have firepower capability. So those are the quadcopters that have guns on them. They are targeting civilians. We saw a number of children that had been hit by a quadcopter. And sniper injuries are still happening. Sniper injuries, you can still, you can hear gunfire, um, most of the time, uh, so, and you see people come in with gunshot wounds.

Mohamed Hashem: To the head?

Dr. Victoria Rose: To every part of the body. The last one I saw was a 26-year-old man who had most of his shoulder blown off, back of his shoulder blown off.

Mohamed Hashem: That was a gunshot?

Dr. Victoria Rose: That was a sniper injury. Yeah.

Mohamed Hashem: The reason why I bring it up is Dr. Mark Perlmutter who is an American doctor who worked in, um, Gaza said that there’s not a doctor that’s worked in Gaza that can’t testify that they didn’t see kids shot in the head.

Dr. Victoria Rose: Yeah. I think that’s true. I’m going to say in the face. Mine was in the face, but I mean, head, it all counts. Yes. I would say that’s a fair statement.

Mohamed Hashem: You know, what’s it like dealing with children in these circumstances?

Dr. Victoria Rose: It’s really difficult. It’s really, really difficult because number one, I’m not a trained pediatrician or pediatric surgeon. So for me it’s a whole host of pain. And then on top of that, it’s a very difficult problem to manage because you’re managing the child but you’re also managing the parents who are normally quite hysterical at the time. I think you look at them and you know that a lot of the injuries could be prevented if we had a ceasefire. So there’s a whole host of emotions when you’re managing children.

Mohamed Hashem: And you know that there’s this stereotype, let’s say, of doctors that work on autopilot, but I don’t know if that’s even possible in a place like Gaza. I mean, are you able to kind of just detach yourself from everything that’s happening around you?

Dr. Victoria Rose: I think I did detach myself in that it was such a constant stream of things to do, of people to treat. But there was no end of moments when I stood there and was angry at what I was seeing. And you’d find a patient that hadn’t been seen for a few days, and their wound was now infected and there were maggots in it. And you would, it would annoy you that you were in this situation where there weren’t enough doctors or enough operating rooms or enough equipment to stop things like this happening. But most of the time you just had to get on with it, and keep going because there was so much to do and you needed to make a difference. And when you’re there for a finite period of time, even when we were there for a month, my mentality, it was very much, I’ve got to keep going and do as much as I can because I’ve only got a month. And I knew from when I first went and I only had two and a half weeks that time goes very quickly, and you can’t waste any time getting emotionally caught up in things, because if you do, you won’t be able to get through the volume that you need to get through. And there’s no point in going if you can’t help, if you can’t get through a volume of cases.

Mohamed Hashem: Do the children speak to you? Do you speak to them?

Dr. Victoria Rose: Yeah, yeah, they do. They speak to you a lot. Most of the children speak really good English because they learn it at school. So a lot of the kids speak better English than the adults.

Mohamed Hashem: It’s, um, yeah. Is there a specific conversation that stuck with you?

Dr. Victoria Rose: There’s lots. There’s lots of sort of children that I treated. Uh, there was a young boy who had had an injury to his face in an explosion. He’d, his nose had been, um, blown off, the tip of his nose. And, um, and a huge laceration through his cheek and inside of his cheek had gone. And he had sustained the injury, I think, about a month before I got to Nasser. And, um, I remember going to him to talk to him about what we were going to do and explain to him that I would take some skin from his forehead and I would put it on his nose. And obviously he couldn’t really speak very well because of the injury that he had. But he was questioning me as to how can I use his head to make a nose? And it’s such an obvious question for someone to ask when you say this is what you were going to do. And I remember thinking it’s surreal to be having a conversation with a, you know, with a 12-year-old boy that totally understands what you’re doing in the middle of a war zone. How can you do this? But yeah, so there were lots. There were lots of children that remain with me.

Mohamed Hashem: Yeah. Dr. Rose, have you been in any other war zones other than Gaza?

Dr. Victoria Rose: No, no. It’s not really, um, something that I ever imagined doing. It’s purely by chance that I’m in Gaza. I often say that I’m only there through, I was shamed into going in 2019 because, because Graham and Sarah who run IDEALS are orthopedic surgeons with me at King’s and they’ve been going for many years. And they would hold, they would go every other month, I think, after the March of Great Return. We had so many people to operate on that they were going every other month. They were sending a mission. And on the month that they weren’t going, they would hold a remote sort of, um, Zoom, although it probably wasn’t Zoom at that time, it was a platform we were using. And they would talk to the orthopedic surgeons in Gaza and discuss the cases. And I remember one morning getting in really early and they were having the consultation in my office because it had a TV in it. And I listened to them talk about a patient that I knew they needed a plastic surgeon that does what I do. And I couldn’t see how they could possibly do the operation they were discussing without either myself or one of my two colleagues. And that’s when I said to Graham, look, I’ll come. And then once I’d been the first time, I went back. And then in 2020, I met Ahmed El Mokhallalati and he asked to come back to London to do some training. And then he came and he trained with us for two years. And, you know, we just got on really well. I met his family, his wife, his daughters. You know, he came to my house. My family know him. And you just suddenly develop a bond with someone. And so when he went back to Gaza, obviously we stayed in touch. We had planned to do lots of cases together. I was going to go back in May. And then I think it was Operation Protective Edge stopped our mission in that May 2023. And then October, the pictures of the cases changed. And that was, you know, when I sort of started looking at what he was dealing with. I remember him sending me an image at the end of October of a child that he wasn’t sure whether he should amputate the leg of this child or not. And he sent me the pictures and said, you know, would you amputate the leg? And I remember standing in my kitchen thinking, you know, he’s just at the start of his career and he really shouldn’t be dealing with these problems on his own with no other plastic surgeon to help him out. …

Mohamed Hashem: And this is, he’s Face Timing you?

Dr. Victoria Rose: He used to WhatsApp to send images. And so little messages and images. And that’s when I sort of said to my family, I said to Philip, my other half, I know this sounds really mad but I have to go and help him. And I think at that time…

Mohamed Hashem: What does Philip say at that moment?

Dr. Victoria Rose: Oh my God, are you mad? What are you talking about? Don’t be stupid. And then luckily Graham is even more stupid and had already had the charity registered as an emergency medical team. And so it was, it was rather than, you know, me going, it was, okay, I’m going back with IDEALS. And I think Philip was, I mean, obviously mainly concern for my safety, which is understandable. And I always say now, I don’t know how I would have been if the boot was on the other foot because I think it’s much harder for him being here when I’m in Gaza than it is for me. Not that I don’t think of him. I think of him every day. But I’m busy. I’m doing stuff. I’m making a difference. I know what the hospital looks like. I know what the lay of the land is. I know that it’s dangerous but I also know it’s probably not as dangerous as your wild imagination is thinking it’s dangerous. I know a lot of people in Gaza, safe places and ways out. And not that I’m not going to get hit. I mean, it’s obviously a possibility. But once you’ve been and you’ve seen it and how it’s all working, there is this false sense that you could get in and out without a problem. And luckily most of the UK medical teams have managed to do that. And until that changes, I, my risk analysis is probably still wildly different from his unfortunately. But yeah, I know that I put him through hell every time I go. In fact, we’re in the throes at the moment of, he normally stops speaking to me a few weeks before the trip’s due to go and he’s just…

Mohamed Hashem: This is the stage right now? This is the point we’re in right now?

Dr. Victoria Rose: He’s just about to start. We haven’t had confirmation that we’re going in February. So he’s teetering on winding up to it. But yeah, I’ve got a pretty awful end of January coming.

Mohamed Hashem: Can you talk to me about the Palestinian team that you’ve been working with, the Palestinian medical team?

Dr. Victoria Rose: They’re amazing. They are without a shadow of a doubt, some of the nurses that I’ve worked with in the two hospitals are so much, you know, just so much better than the staff that we have in the UK. And I suppose it’s unfair. I’m sure if we were in a similar situation in the UK, my UK team would step up.

Mohamed Hashem: But why do you feel inclined to say that?

Dr. Victoria Rose: I just, to come to work in the face of such adversity every day, to put your life at risk, to remove yourself from your family and put them at risk without somebody protecting them, um, it’s incredible. And they are all on a rolling shift that’s never going to end. You know, they’re just working all the time. It’s incredible. I cannot believe them, you know, the way in which they work. But more than that, they’re really experienced now in what they do. They know war injuries. They know what to do. You know, they tell me, I would do something, they’d say, no, that, you can’t do that. We haven’t got this bit of kit. So this is what we’re using. And they would make you something or give you some substitute that would work exactly as well. And it just, just the resourcefulness, the determination. And they laugh and joke with you and, you know, tell you all about, you know, their families and what their children are up to and where they lived before the war and, you know, what it would be like after the war. And I’ve got to come back and, you know, go to their house for dinner. And I just, they’re just an amazing, amazing group of people.

Mohamed Hashem: Can you talk to me about the situation on the ground right now with everything that’s going on? I think Ghassan Abu-Sittah called it the triad of death, um, and this is the hypothermia, the malnutrition and obviously the injuries from the bombing. What does this mean for the people? What does this mean for the patients?

Dr. Victoria Rose: The problem that we have now is that the conditions are deteriorating. So there’s been less aid getting in. So malnutrition is getting worse. I think if you look at the UN data, the OCHA (United Nations Office for the Coordination of Humanitarian Affairs) reports that come out, I can’t remember what they quoted, but it’s something like 60% of children would be admitted for treatment of their malnutrition if they were anywhere else in the world. So that gives you an idea of just how bad this malnutrition is. This isn’t, you know, people not getting their five a day. This is in need of medical intervention. And then you have these closed, crowded living conditions which breed diseases. And we’ve already seen a huge outbreak of chickenpox in one of the camp areas. I think 500 cases the UN had documented. So you can imagine what other illnesses are, diarrheal illnesses, things that spread quickly. I don’t think I saw a child that didn’t have lice or scabies. That was just standard. And you, you know, you just accept that because of the way they’re living. But now the conditions are worse. So you think of Gaza as a Middle East country where it’s 30 degrees all the time. But it’s dropping to 7 at night and that’s really cold, particularly if you weigh, you know, 15 kilos. That’s really cold. And there’s no aid getting in. So you’ve got no winter clothing. As I said, my friends are not asking me for mobile phones and laptops anymore. They’re asking for jumpers for three-year-olds and shoes for five-year-olds. So you can see how the tables are turning now. And it’s just disastrous. If you don’t die of a blast injury, you are going to die from exposure or malnutrition or infection.

Mohamed Hashem: I heard a quote, um, by Dr. Tanya Haj-Hassan who also worked in Gaza, volunteered there. She said she worked in the ICU and she said usually when patients die, she would take a moment to basically honor their life, but in Gaza she said that there was absolutely no time for that because of the sheer amount of injured and wounded coming in. But was that your experience too or did you draw similar parallels?

Dr. Victoria Rose: Yeah. I think we had a few cases where we put a patient on the operating table and we knew probably from the start that they wouldn’t make it to the end of the operation. And that’s very difficult to deal with because there’s a massive low from the fact that you’ve failed. But then it’s also quite upsetting to get them onto a body bag and ship them out and get the next one in. It feels like you’re not paying the respect that you need. But at the same time, you have a volume of cases to get through and people need your help. So it just breeds this situation where you can’t stop and think about what’s happening. Otherwise it impacts on the next person.

Mohamed Hashem: And is there a sense of being on autopilot like I mentioned earlier?

Dr. Victoria Rose: I think so. I think most of us are. You know that you have to keep going and seeing as many people as you can. It’s that scatter gun effect. The more you see, the more likely you are to have positive outcomes. So you have to keep seeing the patients, keep operating and keep going.

Mohamed Hashem: And when you look at the official death toll, it’s over 45,000 killed, um, obviously that doesn’t incorporate those who are missing or under the rubble, um, but for you, someone who’s been there and when you look at that number, do you feel like, oh, you know, it’s definitely more than that given what I have seen?

Dr. Victoria Rose: I don’t think I’ve met anyone that hasn’t told me that one of their immediate family has been killed. So it’s definitely believable that it’s at least that number. The figure that’s more shocking is the, you know, over, well over 100,000 injured. Yes. And that’s difficult to swallow because I’m not seeing all of those patients and I don’t know who is, because I’m working in probably the two of only three hospitals that could cope with multiply injured patients. So, you know, what’s happening to all of those people that don’t get to Nasser or don’t get to the European or don’t get to Kamal Adwan or Al-Aqsa? What is happening to those injured people? And are they going to survive that injury? Are they then going to become another addition to the 40 plus thousand? I think that’s more worrying.

Mohamed Hashem: Are these the kind of questions that would keep you up a bit at night?

Dr. Victoria Rose: I think they’re the sort of questions that make you want to go back and keep working.

Mohamed Hashem: Makes you want to go back.

Dr. Victoria Rose: Yeah.

Mohamed Hashem: We talked a bit about the targeting of medical workers, um, the deliberate targeting of medical workers earlier in the interview. But I want to ask you about Lebanon. You know, Israel has been accused of targeting first responders in Lebanon, um, killing over 200 during its bombing campaign. Now, do you see similarities between Lebanon and Gaza specifically in this regard?

Dr. Victoria Rose: I think you can draw similarities in the areas that have been destroyed. For me, I think the deliberate targeting, there were so many stories that don’t make it out into the press. My colleagues operated on an ambulance driver in January at the European Gaza hospital. And I met him in the March and he came back in just for us to check the wound on his leg and the metalwork that had been put in. And his story was that a blast had gone off when he was in the ambulance. They’d gone to treat the survivors. And then when they got there, his ambulance was bombed, specifically bombed, one vehicle. And you just think, how does that happen? How do you hit a target and then go back and hit it again? Why’d you destroy a building and then go back and destroy the road outside it? It doesn’t make sense unless you’re specifically targeting people who are trying to provide medical assistance.

Mohamed Hashem: So Francesca Albanese, who’s the UN Special Rapporteur on Occupied Palestine, has called for medical professionals to cut ties with Israel. What’s your take on that?

Dr. Victoria Rose: Uh, it’s, I suppose it’s difficult to not understand where she’s coming from. And there has been a lot of, sort of, I suppose backlash at the government from the Israeli medical teams who, you know, have refused to continue treating some of the, prisoners in the camps because they feel that it’s inhumane what’s been happening to them. Quite a few of those doctors have now spoken out to different sort of media outlets. Um, you know, B’Tselem’s got quite a few stories of doctors that have come to them and said, you know, this is, uh, it’s not right what’s been happening to the detainees. We don’t support it. So, you know, I can totally see that that’s a justifiable statement when you look at what’s going on in Israel alone. But certainly, you know, what’s going on in Gaza would definitely justify that statement.

Mohamed Hashem: We’re coming to the end of our conversation here, but you know, you mentioned quite a few times about your decision to go back. I just want to get it right now. You know, what’s going on through your head about your return to Gaza for a third time?

Dr. Victoria Rose: I need to go back because I’ve got so much stuff I’ve got to take for people. I’ve got a list of things that I’ve got to put in my suitcase. So I have to go back just to deliver all the stuff that I’ve been asked to take now.
Mohamed Hashem: And how would you describe the failure of the international community in bringing an end to the war on Gaza, which has been widely labeled a genocide? And I’m also including the failure of the UK government in bringing an end to the war on Gaza.

Dr. Victoria Rose: I am not certain what the underlying current is that stops us from bringing an end to the war. There are forces at play that I clearly don’t understand. What I cannot understand is why we cannot improve the human rights for the people that are stuck in this war. I cannot understand why we cannot pressure Israel to make access to Gaza better so that we can get the aid that we have, and there is so much aid and so many people willing to provide aid, why we can’t get that in, why we can’t get medical personnel in, why we are being stopped from returning power supplies, water supplies, all of those things that are basic human rights. Okay, we can’t stop the war, but we must be able to put pressure on Israel to allow these things to happen.

Mohamed Hashem: And after everything that you’ve seen, and this will be my last question, um, do you feel like there’s any justice that can be served?

Dr. Victoria Rose: I think you can’t underestimate the sway of the population’s opinion. I keep thinking – I was born in the very early ’70s, so I grew up when apartheid was active and that didn’t end overnight. And that was gradual, gradual, gradual sort of sanctions and desist. And very slowly, one by one, people came around. And I think we cannot stop putting pressure on our governments because they clearly are not speaking for the populations. And we need to look at governments that are coming out. So we need to look at places like Ireland and Spain that have been vocal. And I think that one by one, we can all fall in line with them and eventually we’ll reach a critical mass and something will happen. So whatever, you can’t just say it’s not happening, why is it not happening? We have to press on. We have to press on with this message. It’s the only way that it’s going to end.

Mohamed Hashem: And on that note, Dr. Victoria Rose, I can’t thank you enough for taking the time. I truly appreciate it. Thank you for coming on Real Talk.

Dr. Victoria Rose: Thanks very much.