Seriously injured patients are left in limbo as the charity’s relief efforts are thwarted

There have been no medical evacuations from northern Gaza for more than a month, so seriously injured people are stuck in damaged hospitals where they cannot receive adequate treatment, a leading medical charity has warned.

Ambulances urgently need access to take the most vulnerable patients to specialist care, said Patrick Münz, head of mission in Gaza for German medical charity Cadus.

There are no intensive care units operating in northern Gaza, so the Palestinians most seriously injured in Israeli airstrikes and fighting on the ground have been killed.

But dozens of patients in Gaza City’s two functioning hospitals have been stabilized after amputations or with severe burns, and could survive if they received treatment in Rafah or outside Gaza.

Cadus works with the World Health Organization to get ambulances north for evacuations, and travels with UN aid convoys bringing food or medical supplies.

“The people we will transport at least initially are patients in intensive care, but they are stable,” Münz said, adding that no transports have taken place for more than a month. “They should have been evacuated yesterday.”

The Palestinian Red Crescent (PRCS) has halted evacuations after medical convoy personnel were repeatedly attacked, harassed and detained by Israeli forces.

The dangers for paramedics were highlighted in late January when two people were killed trying to reach six-year-old Hind Rajab, who was trapped in her family car in Gaza City and surrounded by the bodies of dead relatives after it came under fire .

The PRCS accused Israel of deliberately targeting the ambulance after the army approved the rescue mission. Israel said its forces were not in the area at the time.

Even for international aid workers, traveling to Gaza City is dangerous and logistically challenging. Unrwa halted food convoys in February after one came under fire from Israeli ships, but the need to get patients out is urgent.

“Of course we also get scared, I think that’s healthy… to understand the risk we’re putting ourselves in,” Münz said. “But I am ready, it is very important that we can start this now.”

Cadus has not been allowed to bring its own ambulances to Gaza, although the UN and the German Foreign Ministry are lobbying the Israeli government. For now, it is using PRCS vehicles – “this also increases the risk because PRCS ambulances are already targeted,” says Münz – and is trying to buy VW Crafters for conversion.

The roads have been damaged by months of fighting, so the team must be prepared for breakdowns, including extra spare tires. A large part of the route runs through a ‘red zone’ where there is still active fighting.

There will likely be injured people along the roads, and they won’t always have the time or resources to stop when their mission is to pick up patients from a hospital.

“There’s a real chance that there will be mass casualties along the way… seriously injured people lying on the street because they got hit by a sniper or whatever,” he said. “So it will also be mentally difficult for the team.”

He hopes the first evacuations will take place this week. The WHO is providing the names of patients referred to the Israeli military, which is expected to take two to four days before they are approved. The Israeli army then gives a time and route for the evacuation.

On Monday, a Cadus team on a pilot mission reached al-Shifa hospital, one of two still functioning at a limited capacity and serving an estimated 300,000 people trapped in northern Gaza.

Aid workers have described a “siege within a siege” in northern Gaza, with widespread hunger and “famine”. More than a hundred people were killed when Israeli forces fired near a desperate crowd surrounding an aid convoy in late February.

Cadus, which has also operated in emergencies in Ukraine, Iraq, Syria, Bosnia and the Mediterranean, began its mission in Gaza in early February and opened a trauma stabilization point in Khan Younis district.

Patients from there are sent to Rafah where there are better equipped field hospitals and some may be transferred to Egypt.

The logistics of operating in Gaza, even in the south, are extremely challenging. Each team of eight must bring all their own food, water and medical supplies, and staff who volunteer there are warned that they cannot immediately change their minds. Once in Gaza, it takes at least eight days before you receive permission from the Israeli authorities to cross the border again.

The team sees an average of 25 to 45 patients per day. About a third of the people treated so far are children, including a girl whose leg was broken by an aid package air-dropped into the area, Münz said.

Münz described a situation he had never experienced in other conflict zones, where patients injured in the ‘red zone’ had to find their own way to the hospital, in relatives’ cars or on donkey carts, or even on foot, because it is too dangerous. to send ambulances to pick them up. Many die along the way.

“People need to come to our trauma stabilization points themselves,” he said. “This means that there are so many patients who are seriously injured and don’t even reach our (medics).

“Of course, we have also seen civilians killed or targeted in Ukraine,” he said. “But what we see here, what goes into our trauma stabilization point, the deaths upon arrival, sometimes when they just take an entire family, the mother, the father and the children. Sometimes it’s really hard to understand why it has to be done this way.”