Human Catastrophe at Gaza's Hospitals

The latest Israeli war in Gaza has claimed more than 330 lives, including scores of children, and left thousands wounded, forcing overworked and under-supplied medical personnel to scramble in a desperate struggle to save lives.

One of those doctors, Norwegian physician Mads Gilbert, was in Gaza during Israel's last major assault, Operation Cast Lead in 2008-09, and is now tending to the flood of wounded pouring into Shifa Hospital as a result of Israel's Operation Protective Edge. Dr. Gilbert was interviewed by Dennis J Bernstein for Pacifica's "Flashpoints" program.

MG: I am now in Shifa Hospital in central Gaza City. Shifa Hospital is the trauma center for the 1.7 million Palestinians living in the Gaza Strip. It's a very important hospital, but its function is almost crippled by the longstanding, seven-year Israeli siege of Gaza, which has caused extensive deficiencies on all types of equipment needed for running a hospital; disposable instruments, sutures, and the more basic things like water and electricity.

So, it's really a miracle that the staffing at Shifa managed to improvise all that you need to improvise in order to sustain a caseload, like we had [Thursday], of around 100 cases coming into Shifa, many of them severely injured. And before I go to the injuries, let me just underline one thing. Health is not only a question of a health-care system, it is in as much a question of the basic commodities in life -- water, food, human security, education, work and so on. And all these basic pre-conditions for public health are lacking in Gaza as a result of the occupation and the siege of Gaza.

As for the injuries, we have had a steady current of injured, dying, dead during this close to two weeks of Israeli onslaught. The most striking impression and documented feature is that 80-90 percent of the injured and killed are civilians. This is according to U.N. and the Palestinian Minister of Health. Fifty percent, pretty much exactly 50 percent of the injured are women and children. About one-quarter to one-third of the killed are children.

This is really a large-scale attack on the Palestinian civilian society. And bear in mind, that to a man in Gaza there absolutely is nowhere to hide -- there is nowhere to hide. There is no shelter, there is no early warning system, no sirens, no civil defense. On top of that you can't see, you can't really get away from this mess. You can't take your family and escape to a neighboring state or up in the mountains or away. Because you are incarcerated. It is like a prison being bombed. Completely.

DB: Now let me ask you, in terms, you said that most of the wounded and killed are civilians. Could you say a little bit more about it, just to keep a human face on this, who you've seen, who's coming in, and what do the wounds look like? Are they consistent with advanced weaponry? What can you tell us about that?

MG: Well, you know, war is a dirty thing. And we just received up to 30 [victims] from families that were bombed now around 8:30 [on Friday] just as we're having these talks, women, children, elders coming in with shrapnel injuries from the heavy Israeli artillery that has been shot ... since last night. These artillery grenades produce deadly shrapnel that travels at a very high speed and, if you are unlucky, they will penetrate one of your cavities, the abdomen, the chest or the brain, and cause life threatening bleedings. And this is a time-critical event if you want to survive. The doctors and the surgeons must detect the bleeding, and immediately do surgery to stop the bleeding. This is one type of injuries.

The other type of injuries we are seeing are the traumatic amputations. We have seen now, like in 2006, 2009 and 2012, extreme amputations: legs ripped off at the level of the hip, arms ripped off under the armpit and bodies cut in two, with no signs of shrapnel injuries. Now we don't really know what kind of explosives these are, but it has been discussed among people who are knowledgeable about weapons, that this might be the result of explosives called the DIME [Dense Inert Metal Explosive] weapon, a metal explosive.

But I underline, we don't have any proof of this. And it doesn't really matter what type of weapon you are injured or killed by. If you are killed or injured, the end point is the same. So if I should talk about any illegal weapon used by the Israeli forces, it is the weapons that are illegal according to the international regulations and laws of war regulated in the Geneva Conventions.

And there are three illegal weapons that Israel is using. Number one is the collective punishment defined by the siege that has lasted for seven years and that is really making the whole population suffer really large difficulties. The second illegal weapon is the indiscriminate shelling of civilian areas, not protecting the civilians at all, which is against the Geneva Conventions, Article 33. And the third illegal weapon is the disproportionate use of force. The fighting parties are obliged to use proportional force. Israel is using an overwhelmingly disproportional use of force which is reflected in the fact that now close to 300 Palestinians have been killed or massacred, and one Israeli is killed [at the time of the interview on Friday]. That is 1 to 300 which tells you everything about the disproportion.

So really this is a very uneven, if you can even call it a war. It is an occupant who is viciously bombing a large civilian population. They have nowhere to fly and are basically defenseless.

DB: Now we know about all the embargoes. We talked a little about this before. Do the hospitals, where you are in Shifa [Hospital] in Gaza, do the hospitals have the supplies that they need? Are people getting what they need? Is it able to come in?

MG: Absolutely not. As a result, as I said, of the siege, the hospital system has been sort of slowly crippled along with the civilian society. And when the Egyptian president closed the tunnels which was really the life-line into Gaza, the fuel crisis went up 400 percent and it basically sort of crushed all the public budgets. So for example, doctors in this municipality can no longer afford fuels for the generators which is producing electricity in order to run the waste water pumps and the cleaning machinery for sewage. So currently 65,000 cubic meters of raw sewage is running into the Mediterranean area.

And in every aspect of civilian life, and a normal life, they are effects of the siege. So the hospitals are only one sector where this lack of supplies has really reduced the capacity. And let me illustrate this by saying that on the 17th of June, the leadership in Shifa Hospital decided to cancel all elective surgeries, meaning planned surgery and only doing emergencies. This was a few weeks before the attacks started.

And on the 3rd of July, two days before the attack started, they decided to only do life-saving emergency surgery. That means, basically, that 1.7 million Palestinian people are without the health care that you need for your daily life. Like for cancer, for orthopedic, for anything that you are being treated for.