It's a humanitarian disaster", "utter chaos". For sixteen grueling days, Imane Maarifi, a 37-year-old nurse, and Raphaël Pitti, anesthetist-resuscitator, accompanied by five other French doctors in coordination with the association PalMed Europe, went to the Gaza Strip to help the staff of the European hospital, located a few kilometers from Khan Younes.
From the first days of the war, thousands of Gazans had joined this town in the south of the enclave to flee the fighting in the north. For several weeks, however, it has become the center of clashes between the Israeli army and Hamas, and bombings are daily there, leaving many displaced people to fend for themselves.
"The population lives in a kind of trap, and in extremely difficult conditions. People sleep on the sidewalks, under makeshift shelters. The streets are very dirty and it has rained recently so there is water stagnant everywhere", relates Raphaël Pitti on the set of France 24, in a rare testimony - the information coming from Gaza is sporadic due to the "information blockade" imposed by Israel.
Every day, dozens of people flock to the European hospital in the hope, for some, injured, of being treated, for others, of simply finding refuge. In total, according to the figures put forward by the two caregivers, 25,000 people currently live around the establishment and nearly 6,000 inside.
“It has become a place of life where the population lacks everything,” summarizes Imane Maarifi. “I once had to resuscitate a patient on the ground, in a corridor, and at the same time see children stealing gloves from my pocket to make balloons,” she says, moved.
“Heartbreaking choices”
In these overcrowded corridors, medical staff and volunteers are still trying, as best they can, to continue providing the necessary care to the sick and injured. The establishment is one of the last still able to operate in the region.
“In human terms, there were many of us. Many volunteers do the work of caregivers, nurses do the work of doctors, and doctors do the work of surgeons,” describes the nurse. "All of them even work on their days off. It allows them to pass the time, have a meal and be able to be with their colleagues. I haven't met one who wasn't grieving and being there, and helping them also allows them not to be alone in their pain."
Also read “How are they going to evacuate them?”: the challenges of the Gaza hospital crisis
Faced with the influx of patients, humanitarian workers deplore a severe lack of equipment. “There are no sheets, no sterile treatment fields or compresses. We had very few opioids,” she explains. “So we had to make choices, select which patients were going to have morphine for example. We had to save everything.” The humanitarian remembers having to choose who to relieve as a priority between a "child who had received a shrapnel from a shell" and another "whose leg was torn off" - "heartbreaking choices", she testifies, her voice strangled.
In addition to the injured, there are also many patients suffering from chronic pathologies, respiratory problems or illnesses linked to poor living conditions. “My last patient, a 48-hour-old baby, died of hypothermia in my arms,” continues Imane Maarifi. “And we can no longer do dialysis or chemotherapy. All the patients who needed treatment will die or die,” she insists, recounting the case of a 24-year-old diabetic patient. Seven months pregnant, she developed complications due to the shortage of insulin. She lost her baby and died the next day due to lack of follow-up.
“All of southern Gaza is overpopulated”
“We are heading towards a collapse of public health in Gaza,” denounces Lucile Marbeau, spokesperson for the International Committee of the Red Cross (ICRC), which works in partnership with the Egyptian Red Crescent – responsible for coordinating aid. international destined for Gaza which transits through Egypt — and its Palestinian counterpart, which operates ambulance and medical services in the enclave. "Those wounded by the war must be amputated in series, the chronically ill can no longer receive their treatment and the living conditions raise fears of a resurgence of diseases such as polio, cholera or chickenpox, which will not be able to be treated ."
Beyond Khan Younes and the surroundings of the European hospital, it is "the entire south of the Gaza Strip which is overpopulated today", she insists. “In Rafah, where displaced people continue to arrive, the population can barely find space to settle.”
As the war spreads in the enclave, more and more Palestinians try to reach Rafah, near the border with Egypt. The city, which had around 270,000 inhabitants at the start of the war, saw its population increase sixfold. Today it is home to more than 1.3 million Gazans and resembles, like Khan Younes, a gigantic open-air displaced persons camp, where people are crowded into tents and improvised shelters.
In addition to "deplorable hygienic conditions - wastewater treatment plants no longer operate, depriving the population of toilets, access to drinking water is very difficult and people do not eat their fill because the prices of some available foodstuffs have jumped,” continues Lucile Marbeau.
To cope, “it’s total resourcefulness”, assures Raphaël Pitti. "We are seeing lots of small service jobs appear: the shoemaker repairs shoes, some take care of sewing clothes, others manage to recharge phones or fill single-use lighters to have the money needed to buy a little water and food."
Humanitarian aid in trickles
On December 22, the UN Security Council adopted a resolution calling on "all stakeholders in the conflict" to facilitate "humanitarian aid in the Palestinian territory." But more than a month later, all the humanitarian NGOs have drawn up the same observation: "What is coming in is not at all sufficient in relation to the immense needs of the population. It is a drop in the ocean" , denounces Lucile Marbeau. In addition to food needs, the latter also deplores the lack of provision of specific equipment, to carry out, for example, plumbing work to improve access to drinking water.
The UN resolution also calls for "safe and unimpeded" delivery of aid as well as the "protection of humanitarian personnel and (...) their freedom of movement". But again, this does not seem to have had any effect. “Access to northern Gaza is still impossible because of the security conditions,” insists Lucile Marbeau, recalling that her team has not been able to go to this part of the enclave since the beginning of November. “It is today the most deprived area and we cannot help many vulnerable people.”
In this context, the prospect of an upcoming ground offensive in Rafah, announced by Israeli Prime Minister Benjamin Netanyahu, arouses great concern. “In such a densely populated area, such a military operation would have dramatic consequences for the civilian population,” warns the spokesperson for the Red Cross. Especially since Rafah is also the entry point for precious humanitarian aid from Egypt.
“Today, accomplishing our missions on the ground is impossible,” concludes Lucile Marbeau. “We must at all costs achieve better respect for humanitarian law on the part of the various actors in this conflict to spare civilians.”
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