Washington Physicians for Social Responsibility, (the state chapter of national Physicians for Social Responsibility, which is the U.S. member of the International Physicians for the Prevention of Nuclear War-IPPNW) has sent delegates to visit Israel and Palestine many times since 1993. Our friendship with the late Dr. Eyad El Sarraj, founder of the Gaza Community Mental Health Programme, led us to begin sending medical service delegations to Gaza in 2009, following Cast Lead. This month, we completed our eighth medical service time in Gaza. Nine medical professionals spent eight days working in Gaza City and Khan Younis – teaching, operating and consulting.

We also had the opportunity to travel to many parts of the Gaza Strip and to talk with colleagues and citizens about their experiences of the summer war. The remarkable devastation in many areas was beyond our expectation. Entire villages have been destroyed, thousands of people are homeless. As winter approaches, the reality of crowding in the shelter of schools, with relatives, in temporary caravans or in tents creates the potential for a medical disaster. With the tunnels in Rafah closed and movement of goods through Kerem Shalom (the only transfer site from Israel) limited, reconstruction of homes is forecast to be very slow. Prices are high and food is difficult to afford. Schools are double and triple shifting – many children cannot afford the transportation to and from school and families are struggling to provide security for their children. The price of fuel for cars and for cooking continues to rise – well above the ability of most people to afford.

No "post" to post-traumatic stress disorder

In the hospitals (one rehabilitation hospital was totally destroyed), equipment needs repair and medicines are often scarce. The siege of Gaza (ongoing since 2007) combined with recurring war has resulted in medical personnel stressed and overworked. Nearly every person we met experienced the death of a close personal loved one in Operation Protective Edge. There is no “post” to “posttraumatic stress disorder” in Gaza – traumatic stress is continuous and recurring and the more appropriate description of this nearly universal experience is “continuous traumatic stress injury”. Those providing mental health counselling are not immune to the sorrows of loss. Twenty-eight family members of the Director of our host organization, the Gaza Community Mental Health Programme (GCMHP), died in one bombing this summer. The mother, three brothers, one sister-in-law and one niece of a professional staff member of GCMHP were killed in another bombing. Grief is present throughout the length and breadth of Gaza.

What remains of the El Wafa Hospital. Photo by Bob Haynes

Economic and environmental disaster

The siege has resulted in an economic disaster – with little or no access to exporting products and with extremely limited access to fishing in safe water (Israel limits fishing to a shallow three nautical mile zone), the rate of unemployment is at least 40 per cent – bringing with it all of the complex problems that accompany wide-spread unemployment. The environmental disaster that exists will not be fast or easy to remedy. Electricity is available on a limited basis, potable water is extremely limited, raw or partially untreated sewage runs into the Mediterranean, sewage treatment facilities have been damaged or destroyed. The presence of unexploded ordinance from the summer war threatens lives every day. We are haunted by the image of children climbing on the piles of rubble that were their homes, looking for artifacts of their lives. Possible contamination by toxins from the explosive materials that destroyed those homes may affect the future health of Gaza.

Leaving with sadness, concern, inspiration and hope for the people

We came away filled with sadness for the people, filled with concern for the economic and physical well-being of the people and inspired by the generosity, courage and faith of the people of Gaza. Again and again, they asked that the world recognize the collective punishment they are experiencing and that they be treated with justice and equality as human beings.