ICRC SURGEON DESCRIBES CONTROLLED CHAOS AT MAIN

C O N F I D E N T I A L SECTION 01 OF 02 JERUSALEM 000144 SIPDIS E.O. 12958: DECL: 01/15/2019 TAGS: PHUM SOCI EAID ICRC KWBG KPAL PREF PTER GZ IS SUBJECT: ICRC SURGEON DESCRIBES CONTROLLED CHAOS AT MAIN GAZA HOSPITAL Classified By: Consul General Jake Walles for reasons 1.4 (b) and (d). ¶1. (C) Summary. ICRC surgeon Harald de Veen told donors and international medical NGO representatives January 14 that Gaza City's main government hospital, al-Shifa, has been functioning as well as can be expected and coping with massive numbers of injured. He said clinical staff are capable and following protocols. He urged donors and international medical NGOs not to send foreign doctors into Gaza, arguing that even experts sent on an ad hoc basis will be disruptive. ICRC medical sector coordinator Eileen Daly said Rafah crossing and central storage facilities in Gaza are overwhelmed with in-kind goods waiting to be inventoried; in-kind medical supplies should be sent only based on Ministry of Health (MOH) requests, he said. De Veen said field hospitals will not be useful unless secondary hospitals are no longer available to receive patients discharged from al-Shifa. End summary. Al-Shifa: Chaotic, but Managing -------------- ¶2. (C) ICRC surgeon Harald De Veen said al-Shifa receives primarily blast injuries with multiple traumas, including penetrating head and abdomen injuries, as well as cases requiring traumatic amputations. He said the atmosphere is chaotic, but the hospital well managed. Surgeons are working in three shifts of fifteen doctors. There are six operating rooms, some with two tables in use at a time. De Veen said he had seen as many as ten simultaneous operations, sometimes with multiple surgical teams working on the same patient. Al-Shifa normally has twelve ICU beds, but an additional twelve beds are now in the ICU. ¶3. (C) De Veen said obstetrics is in a separate building, and some beds there have been allocated for trauma victims. Access is remarkably quick, he said, compared to other conflict zones he has worked in. "Dead or alive, patients are there within minutes," he said. "These are serious injuries -- I want to stress that -- it's gruesome. You hear a bang, and minutes later cars are screaming in with bodies, body parts..." Attempts to stand up a triage station lasted only a day and a half, according to De Veen, leaving patients, family, and media direct access to the emergency room and creating chaos. ¶4. (C) De Veen acknowledged that many of the patient transfers from al-Shifa are necessary because of space constraints, not medical reasons, and secondary and tertiary surgeries will be needed post-conflict to correct care provided during the hostilities. He said clinical standards are generally met, with notable exceptions in orthopedics, especially in amputations. (Note: An NGO hospital director separately complained to Poloff January 6 of poor orthopedic work coming to his hospital from al-Shifa. End note.) International Personnel Not Needed -------------- ¶5. (C) De Veen was blunt in urging medical NGOs not to send foreign medical doctors to Gaza. He said al-Shifa physicians are experienced in mass casualties. ICRC medical coordinator Eileen Daly said Rafah and Gaza's central storage facilities are overwhelmed with in-kind goods that must be inventoried. She asked donors to send in-kind medical goods only in response to specific Ministry of Health (MOH) requests. ¶6. (C) Asked about alleged IDF use of white phosphorus, de Veen said he saw no evidence of injuries from white phosphorus at al-Shifa and noted that ICRC previously distributed protocols for reporting suspicious weapons-related injuries. ICRC has not so far received reports through that channel. He told Poloff privately that he saw no pressure for clinicians to give Hamas militants preferential or expedited care. Comment -------------- ¶7. (C) Al-Shifa is the largest, most sophisticated hospital in Gaza City. De Veen was clear during the briefing that his experience was limited to al-Shifa, and the situation in smaller Gaza City hospitals, or in southern areas like Khan Yunis and Rafah, is likely worse. Gaza-based ConGen contacts reported IDF activity as close as 500 meters from al-Shifa January 15 and that a nearby Palestinian Red Crescent Society (PRCS) hospital caught fire from shelling. There are persistent rumors that Hamas is hiding in bunkers below al-Shifa, and that the IDF may target the hospital or cut off access to it. If al-Shifa hospital is seriously damaged or JERUSALEM 00000144 002 OF 002 made inaccessible, the capacity to treat traumatic injuries in Gaza will be seriously undermined. End comment. WALLES