Fieldset
Gunshot wounds and water supply: Gaza Diary

Zdeněk Müller is a construction engineer working for MSF as a logistician. His seventh assignment with MSF took him to the Gaza Strip. He shares his diary with us…

Zdeněk Müller at work in Gaza

I’m sitting in the cellar of our house with my colleagues, waiting for the outside situation to calm down a little.

Yesterday evening we were informed that Israel had killed two members of Hamas after shots were fired towards Israeli soldiers at the fence that separates Israel from Gaza. We expected an escalation, and at 9 am the first rockets from the Gaza Strip were fired towards Israel.

Ultimately, hundreds of rockets were fired.

Rocket fire

During the day, you can hardly see the rockets in the sky – they just leave a thin white trace behind them, similar to a jet plane. When they get hit by the Israeli air defence system, the rockets explode and become small white clouds.

A few seconds later there is a deafening bang and all the windows in the building start to shake.

During these escalations, Israel bombs heavily across the Gaza Strip – causing many of the loud bangs we can hear. We monitor the situation on several channels and keep in touch with our colleagues.

Both sides of the conflict have our GPS location, and a huge MSF logo is painted on the roofs of the base and the hospitals where MSF conducts activities, to avoid being hit.

Still, it’s been a hard night.

Later…

The following day, rocket fire and airstrikes continue.

MSF suspends all its activities and plans the evacuation of part of the team. But it is impossible to leave the Gaza Strip at that moment, and by the next day the situation has calmed down so we can slowly get back to our regular work. 

On our way to the hospital this morning, me and José, the nurse team leader, are very surprised that local people are already working again, shopkeepers opening their shops and people driving their donkey carts.

Just an ordinary day in Gaza.

But the mood in the hospital is very gloomy.

We are working in Al Awda hospital, and the house of one of their watchmen was hit during an airstrike.

The watchman died, along with his wife and one of his sons.

The hospital’s director has planned a funeral and other commemorative activities. I express my condolences to everyone.

Waterworks

I am working on mapping the water pipe system of this hospital, which needs to be repaired and improved.

I started with the desalination station located on the former roof of the hospital and I have continued, pipe by pipe, to know exactly where each of them leads and what they supply.

The problem is that sometimes the pipe is buried under a mound of sand or disappears somewhere in the floor or wall, so it has been quite difficult.

Demineralised water is usually used for special biomedical equipment (such as the autoclave, a machine to sterilise surgical tools) but at Al Awda hospital it is also used as drinking water.

Regular tap water is slightly salty in Gaza, which is why the consumption of demineralised water is high in the hospital.

But demineralised water is not ideal for the human body and is neither easy nor cheap to make, so we’re planning to modify the system hereso that only ordinary chlorinated water will be used for drinking and regular use.

I have made a huge effort to map the system of water pipes, and now we know exactly which parts have to be shut down or reconnected so that the right taps are provided with the right type of water.

The coming days will be filled with detailed planning to improve our sterilisation unit; a technical survey of the second and third floor of the hospital; and making a static review needed for reconstructing another MSF hospital in the city of Khan Younis.

Devastating injuries requiring repeated surgeries

These project planning and construction processes are closely connected to MSF’s work in Gaza, where we are treating huge numbers of people shot by the Israeli army during protests.

These protests have been taking place every Friday since March 2018, with people demanding that they be allowed to return to homes that are now in Israel, but which they were forced to leave in the past. They have also been protesting the blockade of Gaza.

The protests have been heavily suppressed by the Israeli side. More than 190 people have been shot and killed by the Israeli army since last March and more than 7,000 people have been injured.

The patients

The number of injured patients and the types of injuries are overwhelming for the local health system.

Many patients have seriously injured limbs due to the gunshot wounds, requiring repeated surgeries and long periods of rehabilitation.

Others suffer from complicated fractures, which are not life-threatening, but in local conditions there is a high risk of complications, in extreme cases leading to amputations.

What we’re doing

Our project has various aspects.

In the surgical unit, doctors repair damaged bones and tissues.

In the inpatient unit, the patients are usually isolated because of infectious bone disease (osteomyelitis) and we try to cure them with various kinds of antibiotics.

In the outpatient unit, we work with people using crutches or in a wheelchair and try to improve our patients´ lives through physiotherapy.

We would like to extend our activities in the area of reconstructive surgery, which demands extremely sterile conditions and other requirements. That’s why I’m here: to improve the quality of the operating theatres, sterilisation unit and other units by reconstructing one part of the hospital.

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