What’s being done to try to get those in Gaza medical and humanitarian aid

Since the Hamas attack on Oct. 7, Israel’s retaliatory air and ground military response has left Gaza in ruins. Less than a third of the hospitals there are intact and operating at even a diminished capacity. As Beaverton, Oregon, Dr. Ahmed Ebeid put it after he returned from a volunteer trip to the region, people are dying from war wounds even if they make it to a clinic or hospital due to a lack of capacity, medicine and basic medical supplies like gauze and surgical gloves. We talk with Ebeid, who returned in April from his second volunteer trip to Gaza this year, along with Arnaud Queim, the Middle East regional director for Portland-based Mercy Corps.

This transcript was created by a computer and edited by a volunteer.

Dave Miller: From the Gert Boyle Studio at OPB, this is Think Out Loud. I’m Dave Miller. Since the Hamas attacks on October 7th, Israel’s response has left much of Gaza in ruins. According to the World Bank, over a million people are without homes and 75% of the total population is displaced. According to the U.N., less than a third of Gaza’s hospitals are still intact and those that are crippled by a lack of fuel and supplies. Dr. Ahmed Ebeid is an anesthesiologist from Beaverton. He has been on humanitarian medical trips to Gaza eight times since 2008 including two, since the full-scale Israeli war began. Arnaud Queim is the Middle East regional director for Portland-based Mercy Corps. He joins us in the studio now. They both join us for updates. It’s great to have both of you on the show.

Arnaud Queim: Thank you, Dave.

Ahmed Ebeid: Thank you, Dave.

Miller: Arnaud first, we last talked in November just a month into this current war. At that time, you described what was happening as a staggering humanitarian crisis on a scale you had maybe not seen before, or at least not for a very long time. How do you describe it now?

Queim: That’s the problem of describing this kind of crisis because they get even worse. What was very hard to describe in the first place has just become much worse. At that time, I think we spoke about the challenges which we spend months trying to find solutions for. We had reached a point in April where we were able to send trucks on a regular basis inside which was far from being enough, but already we had some form of a robust approach to doing that. And since the beginning of May, most of that was interrupted because of the Rafah offensive.

Miller: So what does that mean, practically speaking, in terms of your ability to operate in Gaza, to just even, say, bring supplies in?

Queim: So as I said, bringing things in right now is almost impossible. We can maybe at a very, very low level bring one truck maybe once a week through a new system. But for all intent and purpose, that’s not really scalable. We had some goods in when the offenses started, so we were able to retrieve some and remove them away from Rafah because Rafah was the logistical hub where all the warehouses were. Unfortunately, some are still there. We hope to regain access to that, to take them to shelter, hygiene, food kits. And so we were able to take some and we will redistribute them in the coming weeks. The other way of operating there for us has been by sending cash, which is a pretty robust system. We have a call center in Ramallah and we call people in, we send people from our team inside Gaza to cross check the information we have, and then after we monitor the redemption of the transfer we make, which at this moment is pretty high ‒ it’s like almost 80% ‒ and people are able to buy things on the market.

Miller: But are there things you can even buy with that cash?

Queim: Yeah, so that’s been something that is, of course, a condition for this cash transfer. The markets have worked on and off since the beginning, and of course, it’s far from being fully functional. Usually, you use cash because it’s the most efficient way of distributing goods. But in this case, it ended up being something that was very much about addressing the highest level of vulnerability in the communities for people who could not queue in very long lines and things like that to receive this cash, help them find other ways to procure them. And in spite of the challenge, we have to send humanitarian goods in, it looks like there are new trucks coming in these days with commercial goods, including this morning. I was reading a report from one of our colleagues who said she had the first banana she could eat in eight months. So it looks like some goods are sometimes coming in, and it’s very useful to have cash for that.

Miller: Does the fact that some goods are coming in show you that there is an entry point that that you hadn’t been aware of that’s working, that could mean some kind of opening for more humanitarian aid.

Queim: So we know where the entry point is. It’s Kerem Shalom, which is the Israeli crossing point at the very south of the strip which we use for human aid. But at the moment, this is extremely difficult for us to use. The lack of access is not a logistical one, it’s a political one. So if the commercial goods are privatized over aid, it’s also a regrettable decision because yes, it’s good to have things on the market. But if you, at this stage of the crisis with the level of vulnerability we have on the ground, we want to be able to target the people who need it the most first.

Miller: Ahmed Ebeid, I mentioned that you have taken eight humanitarian medical trips to provide medical care in Gaza going back to 2008, but two of them have been this year. The most recent one you returned in April. That was the second trip this year. Can you give us a sense for the medical work that you do and the conditions that you work under when you’re providing that care?

Ebeid: Thank you for the question, David. So there has been a blockade on entry of medical supplies to Gaza since 2006. So it’s been almost 20 years now that there is difficulty in getting certain healthcare, technology and provisions into Gaza. So some things are very small, like maintenance pieces for MRIs or endoscopies or medical scopes that would have to wait six to nine months to get in. So a small maintenance item could cause a hospital not to be able to use that particular piece of equipment for an extended period of time, and thus adding to the burden on the medical system. Because even though there were around 60 hospitals in Gaza, they were serving 2.4 million people. So there was still an overcrowding of the medical system and hardship on patients to reach and get the appropriate medical care.

So, our trips prior to this war were a lot of them trying to get some of the technology in and then training the doctors inside on using it. I’m an anesthesiologist, but I also practice chronic pain management, and we would try to train the doctors on the ground on some of the technology that we use here in the United States and then bring as much of it in. When the war happened, my role changed because when we got there, the hospitals were overwhelmed with the amount of injuries. The hospitals that were taken out of commission put more burden on the hospitals that were still functioning. So out of almost 140-150 operating rooms that were available prior to October, they were down to about 25 when we were there. And now, since May and since the escalation of attacks on the medical infrastructure including hospitals, there’s only about 10 to 12 functioning operating rooms in the entire Gaza Strip. So when you think about the magnitude, you have thousands of patients with war injuries that require immediate surgical attention, but only 12 operating rooms to deal with that. Add to that that medical supplies are not coming in.

So when we went in January and then in March and April, we took in with us the supplies that we could use while we were there for two weeks each time. So we took enough supplies that would keep us functioning for the two weeks that we were there. But we hear firsthand stories about how, when these hospitals come under siege from the Israeli military, all the supplies are blocked out and they have to do surgeries without anesthesia. The amount of injuries that come in causes a significant amount of deaths just because they don’t have supplies. They don’t have simple things. They don’t have tubing to transfuse blood, even though they can get blood because there are donors, but they don’t have the tubes for it. They don’t have labs to figure out who needs the blood and who doesn’t. They don’t have CAT scans and MRIs because they were all destroyed to quickly troubleshoot who is going to do what in the operating room. And this has significantly increased the death toll from the military attacks because now you have a medical infrastructure that is not capable of dealing with the injured patients.

Miller: There is so much more demand in general for medical care than there is supply right now in every way. Has it been up to you to be one of the decision makers in terms of saying you’re going to get this operation, you’re going to get this care and you are not?

Queim: I was lucky enough not to be in that situation because my role is in the operating room, so we treat whoever comes our way, but the emergency room doctors and the surgeons in the emergency room have to make that decision minute by minute. They get 10, 12, 14 casualties at the same time. And they say, who do we think will actually survive the operation? And the rest, unfortunately, are left to die without surgery. The problem is that even though they do their best, so you treat what you can in the operating room and then you take them out of the operating room to the surgical ward or to the intensive care unit, these are extremely undersupplied as well. You don’t have wound care supplies. You don’t have adequate IV antibiotics. You don’t have the means to sustain these patients and then you have death that way, too. So it feels like you can’t escape death. So if you’re not dying directly from the injury, you’re dying because you can’t access the operating room. And if you can access the operating room, then you’re dying because there’s not supplies to take care of you afterwards. So at some point, it felt like there’s no way to escape death.

Miller: What has it been like for you to come home after one of these trips, to leave a place that is in such dire straits and to come back to the U.S. where for so many people here, life is going on as normal?

Ebeid: I get asked that all the time, David. And it’s actually very hard. I have a story about that. When I came back in April. I was actually doing a talk in Bend. So, I’m driving me and my wife and we stopped for lunch, and then my wife starts planning the day. She says we’re having lunch now, we’re going to reach Bend at about six o’clock, the talk is going to go from six o’clock to eight thirty, then it will be time for dinner. And my reaction was we’re going to have two meals today? And she and my daughter started telling me that yes, we can have two meals today because we have these privileges that we can enjoy, and we understand that other people don’t have this privilege, but we don’t have to suffer because other people are suffering. It’s just the way life is and things of that sort. But it really does affect you deeply, especially going to Gaza so many times I’ve built friendships over time. I’ve had physicians that call me and consult about patients and things of that sort. And then to see these people and the amount of suffering they go through and then to come back here and be able to enjoy a meal at a restaurant, just thinking about what I just saw, is very hard. It does take a big toll on you. But thank you for giving us this avenue to educate people. [We are] trying to educate people as much as we can about the situation in Gaza and get more public support to put pressure on our government to do something about it.

Miller: Arnaud Queim, how much are your Gazan workers ‒ and when we’ve talked to Mercy Corps staff from all around the world, we’ve heard over and over that it’s in-country workers who do the majority of Mercy Corps humanitarian work all across the world ‒ how many of them are still able to do this work in a country where many people have had to flee repeatedly and they go to a place where they are told they’ll be safe, and then they have to flee again? Can they still help their fellow countrypeople?

Queim: But it’s a very important question. We started this crisis with 60+ staff in Gaza, about a bit less than half left Gaza since then. So we are down to 35 staff. We don’t expect this to go much lower because those who left had families that they wanted to take out and protect basically. But yes, the first question is how do you maintain the health and the capacity of your team so that they can deliver aid for the population around them.

Miller: Do you have an answer to that question?

Queim: I mean, that’s the first thing we do when we have a crisis of that nature, we work like every responsible organization to ensure that they are. We rented places. After the offensive in Rafah, we had to relocate them to a different part of the Strip. We try to support access to food, water, and we know that it’s even very complicated. But there is also an element of mental health. And they know that they are not only useful in terms of delivering aid, but also every day, we collect testimonials from them to have a good sense of what is the actual situation on a day-to-day basis and also to use that to help the world understand what is going on there.

Miller: Ahmed Ebeid, do you have plans to go back for another medical humanitarian trip?

Ebeid: I would love to go back. The problem is that the point of access through the Egyptian border in Rafah is being permanently closed and the only access is through Israel proper, and they have not been allowing any medical teams internationally to go in. But as soon as the opportunity arises, I would be among the first there if I can.

Miller: Ahmed Ebeid and Arnaud Queim, thanks very much.

Edeid: Thank you.

Queim: Thank you.

Miller: Ahmed Ebeid is an anesthesiologist from Beaverton who has done two medical volunteer trips to Gaza since October. Arnaud Queim is the Middle East regional director for Portland-based Mercy Corps.

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