Working in Palestine since 1989, Médecins Sans Frontières (MSF) teams now offer post-operative care (dressings, physiotherapy and re-education) to almost 5,000 people suffering burns or trauma injuries in three MSF clinics. The wounds and accounts of our patients offer a window into daily life in Gaza.
- Deteriorating living conditions increase risk of domestic accidents such as burns
- Food insecurity is widespread
- More wounded presenting to our clinics as demonstrations increase
First off, Gaza means confinement. A strip of land 42 kilometres long and 12.5 kilometres at its widest, it takes just an hour and a half to drive from north to south.
Gaza is hemmed in by the sea to the west, a "security barrier"—a chain-link fence topped with barbed wire—to the east, while in the north a wall several metres high has been erected to prevent people from crossing the border. And yet another wall, this one underground, is under construction. This is home to close to two million people.
Many of Gaza’s inhabitants have never been able to leave, particularly since a blockade was imposed by Israel after Hamas won the Palestinian legislative elections in 2007. “I’ve only ever left Gaza once. It was for an operation in Egypt when I was 8. I don’t remember a thing!” says 22-year old Hassan, who was shot on the border in December.
"Many of Gaza’s inhabitants have never been able to leave, particularly since a blockade was imposed by Israel after Hamas won the Palestinian legislative elections in 2007"
Today still, the Israelis deliver exit permits extremely sparingly and, between 2016 and 2017, the number fell by 50 per cent. According to OCHA, the United Nations Office for the Coordination of Humanitarian Affairs, an average of only 240 people a day were authorised to cross the border in one direction or another during the six first months of 2017 — for business or educational purposes, medical reasons, or because they are members of international organisations. For everyone else, the journey is quite simply impossible.
Médecins Sans Frontières introduced a program of reconstructive surgery in 2010 to address the lack of care that has resulted from these restrictions on travel. Surgeons and anaesthetists come from other countries to assist our Palestinian nursing team with performing complex surgery not available in Gaza.
The problems with electricity are an illustration of the everyday hardship faced by people in Gaza. For several months last spring, the Gazans were rationed to just two to three hours of electricity every 24 hours, and these were often during the hours of darkness. The situation has improved somewhat, but people still have to keep their homes going with four to six hours of electricity a day at most.
“During the hours when we have electricity, we try to do everything at once. So we rush, and that increases the risk to our children”
“During the hours when we have electricity, we try to do everything at once. So we rush, and that increases the risk to our children”, explains Ussaid’s grandmother. Fourteen-month old Ussaid was admitted with burns to his hands. A total of 35 per cent of patients in MSF’s clinics are under the age of five and 60 per cent under the age of 15.
Deteriorating living conditions
For years now, living conditions in Gaza have slowly deteriorated. Although almost all the buildings that were flattened during the 2014 offensive have been rebuilt—principally due to international aid—half of the population are food insecure. People have to get by as best they can and family solidarity has become one of the cornerstones of their ability to adapt and resist.
“When I don’t have enough money for food, I ask around. Sometimes my stepmother lends me 15 shekels. I feel so ashamed. But she says we’re family, that I’m like her son and we have to support each other,” says Abdel Raheem, a 30-year old patient admitted to an MSF clinic in Gaza.
Obtaining clean water is a major problem for Gaza’s inhabitants. Over 95 per cent of the underground water table is unfit for human consumption and tap water is too salty. Private water companies are able to deliver but this is only a small part of the solution.
The system of disposal and treatment of wastewater is also far from effective. Wastewater is piped into the sea, so people can no longer bathe in it. The sea, that could be a source of revenue for Gaza’s inhabitants, has it own artificially imposed limits—pollution and fishing restrictions enforced by the Israelis.
Frequent domestic accidents
Even so, life goes on in Gaza. Some people still cook and prepare tea on stoves or on fires on the ground. Many patients suffering with severe burns are referred to MSF clinics due to domestic accidents related to such practices. Two-thirds are caused by a boiling liquid.
Which is what happened to 15-month old Shahed three months ago. The entire contents of a teapot heating up on a fire fell on her during a family meeting. “ It’s heart-breaking to see our daughter like that. We haven’t made tea since”, says her mother. Burns caused by exploding electric generators some people use to compensate for the lack of electricity from the public grid are also common, as are burns caused by direct contact with fire.
"MSF has seen a sharp increase in the number of wounded patients admitted to its clinics in Gaza - from 19 in November, to 162 in December and almost 200 in January"
After fighting opposing supporters of Hamas and Fatah in 2007, three offensives launched by Israel in 2008-2009, 2012 and 2014, and 10 years of blockade, people are struggling to find their bearings and the young find it hard to believe in a future in the Gaza Strip.
The blockade has impeded the economy and unemployment is extremely high.
Since December 2017, many young people have taken part in demonstrations organised by various authorities in Gaza to protest the US President’s recognition of Jerusalem as capital of Israel. And MSF has seen a sharp increase in the number of wounded patients admitted to its clinics in Gaza - from 19 in November, to 162 in December and almost 200 in January. Most injuries are due to bullet wounds to the lower limbs.
It’s pointless talking to them of any reconciliation between Hamas and the Palestinian Authority, political leaders or the international community. “They’re all looking after their own interests”, asserts Hassan. To the question, “Do you see hope for Gaza?” his only answer, like many other Gazans, is ‘Inshallah’.