March 30, 2015 part one, We Don’t Hate You, We Just Don’t Understand What You Are Thinking Of Us

Another sunny day in Gaza, another ride along the beckoning Mediterranean, another trip where the smell of raw sewerage permeates the car for miles.  We are heading to El Wafa Rehabilitation Hospital. El Wafa means kindness or truthfulness, and by the end of the morning I wonder if there may actually be an undescribed Palestinian affliction: too much goodness.

We meet with Dr. Basman Alashi, engineer, manager and now an extraordinary hospital director and Dr. Ayman Badr, rehabilitation doctor and medical director who received a BA in Rumania, a masters in Cairo, and who has finished his clinical exams for medical school but has been unable to finish his thesis as he has been trapped in Gaza without a permit. Moussa Abu Mostafa, a PhD student in occupational therapy, head of the rehabilitation team, joins us as well.

Dr. Basman, speaks with a formal sincerity and heartfelt openness; he begins by talking about the facility here, the hospital, lab, physiotherapy, occupational therapy, an elder section where folks with no family supports and the need for 24 hour medical care can live out their days at no charge. There is an outreach program to homes in Rafah and Khan Yunis, There are plans to open up other sites in other areas of Gaza. 90% of the wounded are “needy, poor, cannot afford a shekel for a taxi, so they stay at home, they have pride and they are not going to ask [for help], so we ask them if it is okay to ask what they need.”

But I want to know more about the war; El Wafa Hospital was repeatedly attacked and ultimately leveled.  For me this is unimaginable, I am trying to wrap my brain around bombing a rehabilitation hospital. We look at photos before and after: an extensive modern medical facility reduced to a massive pile of rubble. Dr. Basman explains that “in the days before the war, they felt something was going to happen, there was tension in the building, so they prepared an emergency plan for each patient. Do they need to stay with us or can we train their families, so a few chose to go home, seventeen cannot leave, and then the war started.”

The first day or two were okay. “Day three we were hit by artillery. [This is said calmly but this is a mind boggling concept, the Israelis are bombing a rehabilitation hospital, does this bother anyone out there in international justice land?]. “The hospital stood one kilometer from the border on vacant land.  We were hit in the middle of the night, no warning, just a direct hit to the hospital, to the fourth floor.  We had men on that floor but we moved them to the first floor for safety, so we had no injuries. We thought it was a mistake. Israelis know it is a hospital. It is clearly marked.”

“We just went through our daily activity as nothing happened, afternoon day three, another hit, larger than first four; at that time we went to Shifa Hospital for press release, talked in Arabic, English, French, Spanish, German, telling the world, this is unacceptable, we are connected under Geneva Convention, and so forth. Eight volunteers stayed with us as human shield. At night, I drove them to the hospital under fire; they gave me an ambulance, I gave them free access inside the hospital so they can report any activities showing to the world what kind of patients we treat, unconscious, cannot move, cannot feel, some of them sleeping for year or three, coma for ten days.”

“But we continued to use the media to express our concern that Israeli must not target the hospital. I asked Israelis if there is any evidence [of militant activity in the hospital]?  The army released classified pictures saying this is El Wafa Hospital and a red dot saying this is launching missile.  We looked at the “hospital”, this is not the hospital, this is three to five kilometers away from us. [FYI, according to international law, it is never okay to bomb a hospital].  We made another press release, showed evidence, showed how buildings are totally different so Israelis are misled.”

“But Israeli continued asking the hospital and the area to evacuate.  On 17th July, 9 pm we received a call, pretended to speak Arabic but Hebrew accent, asked us to evacuate the hospital.  We took it as a normal call because all of Shejaria received such a call. Five minutes later, a robo call to evacuate, five minutes later a call from Israeli army, you need to evacuate; we will start targeting the hospital in ten minutes.”

Five minutes later, bombing from artillery, the air, we lost power, no electricity, the 8,000 square meter hospital went dark. We cannot see our hands, we had patients that need oxygen, breath through a tube. At that time we decided to evacuate for the safety of patients and staff, ambulances were scarce.  So we moved them in regular cars, two to four per car, carrying them in bed sheets, just under fire and we are moving and ask everyone around the hospital to move these helpless patients that they do not even know what is going on.”

“We were able to move them safely.  The Red Cross, Gail, called saying I have special message from Israeli army, how much time do you need to evacuate the hospital? I asked the management and doctors, they said we are waiting for a special equipped ambulance to carry four patients, with oxygen. I called her and said I need two hours. She said, okay, I will convey the message to the army.  Fifteen minutes later she called back.  The bombing continuing at the hospital while she is talking to them, chaos and darkness.  We lose our sense of direction. What should we do if not trained to dodge bomb?  She called me back, I have another special message from highest authority from Israeli army.  They will not target the hospital.  But the demand was not fast enough to get to the lower command. I was emotionally upset, it is too late. She said I am just a messenger. I told her she should say do not target the hospital. Which side are you on? Israelis know exactly who we are.”

“On March 17, we moved to a maternity clinic, Sahaba Clinic in the middle of Gaza City, and moved from 8,000 square meters, to 800 square meters. We were not able to take any equipment and medicine, just running to save our lives and our patients’ lives.   With the help of God we evacuated safely.  The next day we need medicine, clothes, bumpers, sheets, etc. At that time I went to the hospital which was a war zone at 10 am to look.  The damage and fire was still on, severe damage to every floor. We could stay no more than 30 minutes, drones flying over us, bombs everywhere.  We felt safety is our main concern so we left. We were able to take some medications, enough for one to two days.  We left the area without anything else.”

“On March 18 we called the Red Cross to arrange escort to the hospital to protect us and not to be targeted.  Israelis target ambulances. The Red Cross refused because the Israelis refused to give them safety, so we stood without any equipment, without any medicine or machines that better the lives, a 30 year investment. We extend our hands to local and international organizations.  Many supported us, brought us beds, sheets, water, food, medicines, free, so we started from zero building up the hospital. We took care of patients as day care, also received new patients, wounded, surgery done [elsewhere] and they need rehabilitation.  We are the only comprehensive completed medical rehabilitation hospital in Gaza City.  There is few that does similar services, not as comprehensive as ours.  We receive patients from the Ministry of Health.”

“The war ended on August 23rd, the building we are in now belong to El Wafa Hospital but it is far away from the original.  We were planning to move the hospital to Gaza City and this building was planned for elderly home. This building was donated by a Palestinian doctor, el Alami, the land given by the government, so once the war ended we moved all our patients to here, at Zahar City. We shared with elderly care home, now half hospital, half elderly care center.”

“We start as a team rebuilding the hospital, equipment, medicine, 19 clinics from the hospital were destroyed. Here we are now 225 days later, we are back in business, not of choice. Gaza needs our services due to blockade, continue preventing Palestinians go outside to get medical help. This puts us in a harder position, despite we have no budget or resources, we must continue our services even if only with our hands and comfort them with our feelings and they continue to improve their life.  The world saw us through the eyes of cameras and many organizations support us…UNDP approved us to enhance, extend this building another floor so we can accommodate more patients.  WHO, UNRWA, UNDP, Interpal, Australian charity care, Malaysian came to our aid. I am not saying we are proud of what we are doing.  The specialties that we carry, none similar in Gaza.  People used to pay thousands of dollars in Egypt or Israel, but since El Wafa was here, they came to us for minimum charge.  El Wafa is specialty, unique in service, in equipment, no one is similar to its equipment.”

“Everything we will see is donated even the food, tubes, needles. Who supports the hospital is Palestinian people, no other continuous income, especially Muslims, part of being a Muslim is helping the poor.  10% of donations go to management, this is low.  The staff put in tremendous efforts, as a team and this is how we work, a tremendous effort to bring back the hospital.  20% of the staff lost their homes, many lived close to the hospital or Shejaria, close to the border.  Our staff during the war, they were at the hospital 48 to 72 hours a time, leaving their families. This is my duty, the others who are not direct services they stayed home. Once we came here, all came back.  We lost two staff at home. One was walking in the street, a man with three daughters, he stopped by the grocery store, bought figs.  He was targeted by a drone walking alone; Israeli did not distinguish from woman, man, child, resistance, young, or old.  [The other staff] her home was destroyed, she went to the UNRWA school [for shelter] and it was targeted. She was hit by shrapnel in her head, her brain was out, she was 21 years old, unmarried.”

“Our concern was how to serve patients, we all risked our life just to continue. We had one lady with cancer in her spinal cord, no sensation in lower part of body.  If a bomb hit her, she would not feel her body frying.  We cannot leave such patient, we cannot live with ourselves, feeling that we left a person who was breathing. As Muslims, serving patients is first, serving us is second.”

“Many patients cannot come this far in our new facility, outpatient services too far, no transport, so we have to go to them and it costs. Only in Rafah and Khan Yunis, the areas really devastated, some of them do not understand the extent of their injuries, very poor, they may not know how to treat them. Need to rehabilitate the soul itself, teach the wife and the family, show him the love. This is 50% of recovery.  We have one patient on chronic ventilators. Now he is child, 10 years old, he was injured with his family, missile in cervical spine, C2 quadriplegia.  He lost his father, brother, uncle, girl twin, and four cousins.  His mother was pregnant, they were farming, bombed from a drone.  Whenever Israelis see a group, sitting in the farm, they were just eating, drone targeted them.”

“[Another patient is] two years old, father was killed, mother was injured, he is in coma, not on a ventilator.  He has a deep brain injury, he is at home now.  He was moved to another house, their house was destroyed, we were following them; he has gastronomy tube.”

“The new building is U shaped, the right side is the hospital, the left side is the elderly, the middle is management, so all separate.  We still have a problem that our space is too small, so children and adults are mixed. We had 17,000 square meters before and a garden, this facility is 4,800 square meters.”  The old hospital was very high tech with a high level of care and included a gym, swimming pool, hyperbaric oxygen treatment, video conferencing.  “We lost a lot.  It is difficult that we lost all this but we are all optimists and we look at the positive side of any events, because we are rehabilitation, anything we face, we look at the positive side of it. The hospital destroyed completely on the 23rd, thanks God we are all safe. We sent a message: we don’t hate you, we just don’t understand what you are thinking of us.  We are just human beings like anything else, we live on planet earth; we all look alike.  The Israeli response was the hospital was a terror site, like all other bombings, they justify everything.”

We ask if there have been an independent investigations. “Officially no, but media did extended investigation, eight independent foreigners with full access to the hospital, they have not reported anything. There is no justification to target children, hospitals, [he lists all the buildings targeted]. The only thing is to terrorize people to leave. So then the young boys out of school and working, the girl married too young, it is circle of devastation.  If I don’t give the father a chance to work, that means a problem in the family, but Gaza still survive.  If Israeli came to the hospital for treatment, my glasses looking to him as a human being and to treat.”

“Some departments like urodynamics, diabetic food center, hyperbaric center, the only one in Gaza, are not up and running, patients are waiting.  The hyperbaric, limbs were saved, five year old wounds were healed; we cannot get another one. I cannot plan where I will be in two hours.”  He says that it is harder now to find donors.  The Islamic Bank in Saudi Arabia four months ago offered four million dollars if the Israelis will agree not to target the hospital and Gaza will remain stable, so no donation. Larger organizations and governments are not donating, but individuals still donate who “believe in cause of Palestine. There are also financial restrictions on wire transfer, so bank calls, we have a wire, we need a contract, where it is coming from, what it is for.  We need to show purpose, restrictions from banks outside of Gaza, it has to go to a certain group that is not labeled as a ‘terrorist.’ We see this as a challenge, we don’t have a choice, succeed or just die, we will continue.”

“Another part of the tragedy, of the siege: killing the victim is part of the crime but also forbidding the victim to say we are victims and are human beings.  This is a human feeling.” This is the other face of the crime.

The tour of the hospital starts with an ambulance that was targeted by a drone filled with nails, we see the entry holes in the back door and the exit holes in the front, (dear IDF soldiers, why would you send a drone attack to the back of an ambulance???); they have not been able to replace the fractured glass so the windows are covered with cardboard sheets.

330-1aAmbulance targeted by drone during Israeli attack, summer 2014

330-1b

The first floor has a large room for physical therapy equipment; the area is clean and orderly.  The nursing stations and patient rooms are improvised but functional; Dr. Basman knows every patient and his or her story.  He greets the conscious patients warmly, there is a lot of joking around, moments of tenderness, a profound sense of caring.  The windows are open, a fresh breeze blows through the rooms, there is no antiseptic smell, families cluster around beds.  The most tragic patients are in various chronic states of unconsciousness and physical constriction from a variety of causes, motor vehicle accidents, cardiac arrest during labor probably due to a difficult intubation and an urgent C section, brain tumor.  But the patient who will always stay with me is the little boy, Hamad al Reify, with the high level spinal cord injury and quadriplegia.

330-1c

When the electricity goes out, he has 30 minutes on his battery run ventilator. They have no cardiac and respiratory monitors so nurses sit near his bed monitoring him with their eyes and their hands. He has a tracheostomy, but is able to communicate and has an unbearably winning smile.  He jokes, he dreams, he was given some toys, but he sent them home for his sister.  The staff clearly love him.  Some IT type person has designed a mechanism that fits under his chin and allows him to change the channels on the TV.  Later we see him in a reclining type wheelchair, basking in the sun. If he is lucky, he will spend his life at El Wafa. The staff has not received a salary in the past six months.

Dr. Basman ends with a message to the world. “Gaza is fine.  What you see from the outside, it looks devastated.  But if you live among the Gazans, you won’t leave. I choose not to return to America [where he lived for a number of years]. We are human.  I am born here.  You don’t have a choice where you will be born, but I have a choice for whom I am.”

Too much goodness.