NZ medical volunteers cannot avoid Gaza's political cauldron

By DIANA MCCURDY

The roar of helicopters overhead was Nicola Gini's first clue that something major had happened. The New Zealand intensive care nurse walked out on the balcony and peered into the streets of Gaza. Below, the Shifa Hospital carpark was swarming with screaming people and tooting cars.

"They're dragging bodies out of the cars and you can clearly see their injuries. They've got massive chest injuries. Some were obviously dead."

Then the loudhailers at a nearby mosque began shrieking the news: Hamas leader Sheikh Ahmed Yassin had been killed in a missile attack just 2km away.

Crowds began gathering at the hospital. "All of a sudden you look outside and there are thousands and thousands," Gini says.

"They come to the hospital to collect the bodies - they have to bury them before sundown - and you look outside and you can't see a single bit of ground where there's not people. And the chanting - it's surreal."

Gini had been determined not to get caught up in the political and religious struggles. As time passed, however, it became increasingly difficult to remain emotionally distant.

Gini had arrived in Gaza with eight other Aucklanders just three days earlier on a paediatric cardiac surgical mission funded by the Palestine Children's Relief Fund. They took annual leave to help New Zealand paediatric cardiac surgeon Alan Kerr to operate on critically ill babies and children in Gaza and East Jerusalem.

When they arrived in Gaza, they had little idea of what to expect. Even Gini, who had already been on two surgical missions to Palestinian territories, was uncertain.

The former Arab territory has been in political limbo since it was occupied by Israel in 1967. It is home to 1.3 million Palestinians, of whom about half live in refugee camps after being displaced by wars. Israeli authorities strictly control access.

The Gaza Strip gained infamy in the 1980s as the birthplace of the Intifada and it remains a hotbed of anti-Israeli feeling.

To control the constant threat of Palestinian terrorism, Israel carried out two high-profile assassinations of Hamas leaders in Gaza: Yassin and, more recently, Abdel-Aziz al-Rantissi. Predictably, Palestinian militants have vowed bloody revenge.

This is a country that polarises people. As Gini quickly discovered, the conflict was difficult to ignore. Soon after Yassin was assassinated, the injured began swamping the hospital, she says. Paediatric cardiac operations were cancelled. "They ran out of room in the recovery room, so they started to bring the casualties into the intensive care unit. We were there when they brought Yassin's son through who was injured."

Concerned about his Western staff's safety, the surgical registrar bundled Gini and an American nurse up in scrubs and smuggled them out of the hospital.

It wasn't the first time members of the New Zealand team had witnessed the harsh reality of life in the Gaza Strip.

Before they even started work at Shifa hospital, they had to cross into Gaza through the Erez Crossing - the main entry/exit point between Gaza and Israel. Israel allows only diplomatic vehicles through. Everyone else must walk through the workers' passage, an 800m covered passageway.

Even ambulances are barred because Palestinians have used them to transport weapons.

Hauling their medical kit and personal luggage, it took the medical team about four hours to pass through the many checkpoints and turnstiles. They later realised their passage had been luxurious compared to that of the Palestinians crossing on work permits who are routinely strip-searched.

A week later three nurses were barred from transporting medical supplies through the crossing. Despite 7 1/2 hours of pleading, they were consistently - albeit politely - refused, on the grounds they did not have permission from the correct authorities.

For a medical team wanting to be as efficient as possible, the delays are frustrating, says intensive care nurse Warren Nairn.

"I went over there just wanting to be non-political, but it's pretty hard to not feel strongly about it once you've been there and met individuals and worked with nurses and doctors and you just realise they are ordinary people like us and it's damn hard for them."

In Shifa hospital, the team saw another impact of the political situation. Gaza has difficulty attracting well-trained doctors and surgeons to its poorly resourced hospital. Many medical staff need to work two jobs to survive.

As a result, it is estimated that Shifa hospital barely manages to operate on 100 of the 300 Palestinian children who need heart surgery each year.

When the New Zealanders arrived at Shifa, they discovered Kerr - who arrived in February - had already operated on some straightforward cases. Kerr is on a six-month mission in Palestine to increase the rate and quality of paediatric cardiac surgery. Many children's conditions, however, were too complicated for Kerr to take on alone.

"A lot of them were getting surgery after the age when they should be getting their surgery," says Gini. "So they were a lot sicker beforehand and they will be sicker afterwards as well."

In two weeks, the New Zealand team managed to operate on eight children at Shifa and another eight in Mukassed in East Jerusalem. Most were discharged two or three days after their operation (in New Zealand, they would spend at least 10 days in hospital). Remarkably, all are progressing well.

The successes of the trip were tinged with frustration for Nairn. He found it difficult to accept that Palestinian children were dying while facilities at Israeli hospitals nearby were under-used.

Sending Palestinian children to Israeli hospitals is prohibitively expensive. Some hospitals do charity cases but, otherwise, paediatric cardiac surgery costs more than three years' wages for the average Palestinian. For the PCRF, it is more cost-effective to fly foreign surgical teams to Gaza to do the work.

Back in New Zealand, the members of the team reunited at Nairn's house this week to discuss the mission. Their ongoing disquiet is almost palpable.

They talk animatedly about the identity-card checkpoints that Palestinians face while going about their daily business, and of the huge wall being built to separate them from the Israelis. They muse about the travel restrictions which prevent many young Palestinians from leaving the Gaza Strip.

One nurse tells the story of an 18-month-old from the West Bank who was given permission to travel to hospital with his father and grandmother. His mother was refused permission to travel with them because she had recently been in Jordan. While strangers in a distant hospital operated on her son's heart, she had to wait at home by the phone.

Yet the team also acknowledge that there is another side to all of this: the average Israeli who cannot get on the bus to work or school without fear of a terrorist attack. Perhaps, they say, if they had spent a week in West Jerusalem with Israelis, they would be telling the opposite side of the story.

But the disquiet remains. "I'm not politically motivated in any way," says theatre nurse Elizabeth Johnson, "but you go in thinking, 'Right, I'm going to do this for the children', which is what it's about. And that doesn't change.

"You are there for the children 100 per cent. I went in trying not to form a view one way or the other but you can't help it. It just smacks you in the face."