Crises of a Rafah nurse
Muhammad Lafi tells of experiences helping suicide bombing victims in Jerusalem, the wounded in Gaza; he dreams of getting away for a while
Lafi, 38, is first senior emergency room nurse in the European Gaza Hospital in Rafah, a 230-bed facility built in 2000 to meet the needs of the 300,000 residents of the southern Gaza Strip.
Lafi rarely has difficulties getting to work, as he lives in the city of Rafah. But more than half of his colleagues live to the south.
On such days, Lafi and the other medical personnel may have to work, understaffed, for two or even three consecutive shifts, treating approximately 130 emergencies every day.
“Of course this affects the quality of the care we give our patients. We are very committed to providing the highest professional care, but we are only human,” Lafi says.
On other days, he faces a shortage of medications and supplies, such as small gauges for children, neck stabilizers or even something as basic as a syringe.
Such supplies are regularly held up at the Israeli checkpoints, or are in short supply because the Palestinian ministries are unable to supply them.
'Mutual respect for each other'
Lafi graduated from the Qualified School of Nursing in Gaza in 1987. For five years, he worked in the intensive care units and emergency room at Sha’arei Tzedek hospital in Jerusalem, but had to leave when his permit was revoked after the outbreak of the Intifada in 2000.
“I believe I am a good nurse and I was treated as a professional. The staff was warm and friendly," he says. "We talked about our professional work and about our lives. And sometimes, we even talked about politics. We didn’t agree on much, but it didn’t affect our respect for each other or our work.”
Lafi recalls when the police brought a well-known Israeli right-wing extremist into the emergency room.
“He was in jail and was brought in handcuffs. He saw my nametag and started screaming that he wasn’t going to let an Arab treat him. I told him that I was the nurse in charge and that I would care for him to the best of my professional ability - and that’s the way it was," he says. "My colleagues and supervisors supported me. He wasn’t too happy. Then they took him back to jail.”
The comparison between the large, university-affiliated Shaarei Tzedek Hospital and the European Gaza Hospital is inevitable, and the differences are great.
While Shaarei Tzedek has more money, staff and support, the European Gaza Hospital does provide medical-surgical, pediatric, obstetric-gynecological and neo-natal services, and recently opened an IVF (fertility) unit, of which Lafi is particularly proud.
Yet, Lafi notes, since southern Gaza is a very poor region, the hospital treats numerous cases of intestinal diseases caused by organic phosphors and other malnutrition-related illnesses.
Many traffic accident, war victims
The hospital also treats a comparatively large number of road-accident injuries.
Lafi explains that since the main road through the southern Gaza strip has been closed by the IDF, the only alternative route between Rafah and Khan Yunis is a small road with too much traffic. Since villages span both sides of the road, children crossing the road to school or to play are often hit by passing vehicles.
“And of course, we treat a lot of gun shot injuries from the Israeli army,” he adds quietly. “And in Sha’arei Tzedek I used to see many geriatric cases. We don’t treat as many geriatric cases here. In the Gaza Strip, people die at a younger age.”
Is he bitter? He shakes his head and says he is not. “The differences only push me to do something to develop services for my own people. They motivate me to do more.”
Always a professional
Lafi’s commitment and his professionalism are evident in nearly everything he says, but the conflict intrudes into his work even as he tries to avoid it. At Sha’arei Tzedek, he treated some of the victims of suicide attacks; now, he often treats patients shot by soldiers or brought in by armed guards.
He sighs. “I do my job as a nurse and I do not judge the way people defend themselves or try to determine who is an innocent victim. But it is emotionally difficult and confusing.”
Despite it all, Lafi says he is “very satisfied" with whathe is doing.
"I am developing professionally, I am helping to develop services and I like to help my people,” he says.
But since the hospital lacks facilities and the conditions are often inadequate, too much of the learning is merely theoretical.
“The students are smart, and they have good potential, but they just don’t have enough hands-on experience,” he observes.
Lafi says he finds his work varied and fulfilling. He says he knows he is progressing professionally and feels that he is making a real contribution to the advancement of medical services in the Gaza Strip.
But he acknowledges that many of his colleagues are not satisfied. “The salaries are low and the working conditions are not suitable,” he explains. “I understand people who feel they just can’t go on working like this.”
He reconsiders and says, “Maybe I’m just too busy to be frustrated.”
Between his clinical, administrative and teaching responsibilities, he rarely sees his wife and five children.
Lafi was recently awarded a Fulbright scholarship to study public health at Tulane University in New Orleans.
“It will be good to get away for a while," he says.
But but he says he knows he will come back to work in the Gaza Strip. "We don’t get much support for our work here. Our days are filled with all sorts of frustrations. But if someone says thank you, that’s usually enough to keep us going.”
Article reprinted with permission from 'Bridges,' an Israeli-Palestinian public health magazine sponsored by World Health Organization. Bridges is written, edited and produced by Palestinian and Israeli academics and health professionals. Contact 'Bridges' at bridges@who-health.org
