The Palestine Entries: What it means to heal when there’s nothing to heal with

// Entry #30

The current healthcare system in the Gaza Strip is notorious for its limitations in resources and space, a direct consequence of a siege that prohibits most medicines and equipment from reaching hospitals and health clinics throughout the territory. It isn’t entirely evident at first, but tour any public healthcare facility — most private ones, too — and the fragility of Gaza’s healthcare infrastructure becomes impossible to ignore. Al-Shifa Hospital, Gaza’s largest, provides the clearest understanding of what it means to heal when there’s nothing to heal with.

Al-Shifa’s burn unit is the medical complex’s newest wing, funded in full by international donors. It is by all accounts the hospital’s cleanest and most well-stocked department, featuring its own set of IV lines and a designated ICU room for the most severe cases. Seasoned physicians treat patients in rooms containing standard hospital beds, wash basins, and medicine cabinets. After treatment, patients are moved to adjacent rooms arranged with two beds, empty drawers, and a television.

At face value, nothing seems wrong with the unit’s current set-up. But the emptying medicine cabinets tell a different story.

Burn units have become increasingly necessary in Gaza with the advent of household power generators and more specifically since Israel’s invasion in 2008-2009 which involved the use of flesh-burning white phosphorus. Exploding power generators are a weekly occurrence in Gaza and the hundreds of Palestinians burned by phosphorus bombs still require intensive treatment. Traveling outside of the Gaza Strip for treatment in Israeli, Jordanian, or Egyptian hospitals is difficult, expensive, and mired with so many bureaucratic inconsistencies that the process of receiving foreign treatment can oftentimes be detrimental to one’s health. This makes Gaza’s burn units all the more important and its medicines all the more necessary.

But this new burn unit doesn’t even have enough gauze to bandage sensitive areas, antibiotics to prevent infections, or creams for pain relief. A physician opens the door to the department’s medicine cabinet and reveals a total of 26 different medicine bottles, some empty, some holding needles, and the rest containing enough pills to treat no more than five patients. The doctor’s task is not to treat burn victims; it’s to treat burn victims with as little medicine as possible.

As the physician elaborates on the condition of the hospital’s newest department, the power goes out. Within seconds, an emergency backup generator kicks in and powers the facility but not before all of the unit’s heart monitors and computers reset. Luckily, there are only two resting patients at this time.

The burn unit also boasts a children’s play area reserved for children undergoing treatment. Pink walls surround an empty room; it’s a sight not worthy of a photograph. The hospital does not have enough funding to purchase toys.

Al-Shifa’s emergency room is not any better. Seven beds separated by frilled curtains fit in a tightly cramped room. There is absolutely no sense of privacy but that is not anyone’s main concern. Here, patients are stabilized before being transferred to specialty departments but this regularly proves to be a difficult task for even the most experienced of doctors.

There is only one available antidote that is used for every poison and infection brought through Al-Shifa’s emergency department. Aspirin supplies are tremendously limited and the three heart monitors (remember, there are seven beds in this wing) malfunction multiple times a day. The on-call physician for the evening recounts numerous incidents of monitor misreadings and the measures he’s had to take to avoid further complications.

Of course, the doctors make do with what they have. Medicine in this part of the world moves away from the usual reliance on technology and becomes a truly human affair, even though this does not always turn out for the best. Foreign donations help a great deal but Gaza’s hospitals are still limited in effectiveness. The physicians exist and so does the medical expertise but the medicines do not and this is the greatest difficulty.

Sami Kishawi

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