Voice from the Field: Providing Intensive Care in Gaza



Sarah Woznick is a Doctors Without Borders/Médecins Sans Frontières (MSF) nurse who specializes in intensive care. She arrived in Gaza six months ago from Denver, Colorado. Operation Protective Edge began one day before what should have been the last day of her assignment. Sarah decided to stay to support the MSF team during a particularly difficult time. Here, she describes her experience.

I was quite excited to go to Gaza as my first mission with MSF. Not only because my specialty was indeed relevant to the project, but also as an opportunity to witness the reality of this context. And when I arrived, what I found first is a really warm group of people, very welcoming. Gaza is impressively paradoxical: there is at the same time a lack of access to a number of elementary things, and availability of others that you would not expect, such as luxury hotels on the beach side.

In the intensive care unit of Nasser hospital where I was working, I realized that they lack very basic items such as gloves, a disposable item that back home I would never dream of having to ration or do without. It was eye-opening for me. The Palestinian head nurse I was working with kept saying, “Don’t forget that we’re in Gaza, we face shortages all the time,” although Gaza is far from being an under-developed region!

Because of the blockade, none of the staff whom we are working with are able to get out of Gaza to upgrade their knowledge or benefit from trainings, so we are trying to bring this to them here. Our colleagues in Nasser work under very challenging conditions. A lot of them have not been paid their salaries for months, or [have received] only portions from time to time. But they don’t abandon. They know that if they stop coming to work, they could be replaced immediately. A fraction of a salary is better than no job at all. And most of them are really dedicated to the care of their patients, whatever it takes.

I remember once there was a strong argument between some of the staff inside the intensive care unit. They came to me and said, “You know, we are under a lot of stress here.” Actually, I came to realize that I was myself living under stress when we were invited to the farm of one of the doctors. I took a deep breath and realized I had not felt relaxed for quite a while . . . Gaza is a very urban and densely populated area, and you don’t realize the impact of living in such closed conditions unless you are away from it for some time. But most of the people here don’t have that option.

I was scheduled to leave Gaza the day after the military Operation Protective Edge started. The first day there were lots of air strikes in our area. It’s a strange feeling when you realize that bombs are falling not far from you. You know that you are safe because MSF is not a target, but your body doesn’t know that and releases lots of adrenaline. Your heart is beating faster, it puts you on high alert. Now I’m a little bit more accustomed, but it does still make me jump occasionally. I don’t think thunderstorms will feel quite the same for me now! Mostly, all of us think about our Palestinian colleagues—we worry about them. The MSF compound is a safe place, but their homes might not be.

Since the conflict started, I took on the role of helping to manage the post-operatory clinic and to prepare the emergency stocks in the pharmacy for donations to hospitals. We were able to have the clinic running nearly every day, bringing a basic team of one physiotherapist, one nurse, and one admission officer who all live nearby the clinic. We organize their transport with an MSF car picking them up from their homes and taking them back there, so that they don’t have to walk.

My role is more of supervising the activities, but on days when the clinic has been closed because of the bombings being too intense, some patients would still come to our office, so I would change their dressings myself. The difficult dressings are the ones for the small children, because you know they don’t understand, and they look at you wondering what you’re going to do to them.

About 40 percent of the new cases we had since the war started are children of five years or younger. I remember a five-year-old girl who had been burnt all down her back by hot water—which we see often—but this was no domestic accident. She got the burn when running away from a shelling into hot water. I remember her parents consoling her as she was crying, the scared look she had on her face . . . I wonder how she is now, because, unfortunately, the family has not been back to the clinic for follow up.

I remember another girl of 10 or 11 years old. She had a domestic accident with hot tea that spilled on her arm. She came to the clinic by herself. Nicolas, the MSF field coordinator, asked her, “Aren’t you afraid walking alone in the street?” and she replied “You know we’re all going to die one day.” I thought to myself that this girl is much older than she should be at this stage of her life.

One of our Palestinian colleagues told me that his kids are hiding under the table as soon as they hear a blast. Another one said, “My children all grab on to me as if I could protect them, but actually, I can’t.” It must be incredibly difficult as a parent to feel that you can’t protect your kids.

Back home I will definitely share my experience of Gaza, especially because in my country, the USA, not everybody understands the complexity of this conflict—most people are not very informed about it. It will be very hard for me to leave, and the people here will be in my thoughts every day. Even after the current crisis is over, I’ll think about the friends that I’ve met who are living in a place where they are trapped in so many ways. I wish for so many things for them: freedoms and choices they could have if they were not surrounded by walls.

MSF nurse Sarah Woznick [left] with colleagues in the Nasser hospital ICU