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Courage under fire
by Roland Huguenin


Why would anyone want to become an ambulance driver in a potentially violent situation? Why would young people risk their lives to save a wounded person? As violence sweeps the Palestinian territories, the story of Khaldun and Boaz exemplifies the spirit of total commitment to a humanitarian ideal.
Many people in Jerusalem will remember Friday, 29 September 2000 as a dramatic setback to the Middle East peace process embarked on seven years ago. But young ambulance drivers Khaldun and Boaz will probably come to think of it as the day when their belief in the fundamental principles of humanity and neutrality were tested under fire.

On that day, violent clashes in old Jerusalem claimed the lives of six Palestinian youths and left another 150 injured. It took 45 minutes for the ambulances to gain access to the site because the gates were blocked by the security forces. In this highly volatile atmosphere, ambulances and medical teams started to treat the wounded and to organize their transfer to hospitals.

Khaldun, head of the Palestine Red Crescent Society (PRCS) emergency medical services, was active on the spot along with many volunteers evacuating and assisting the wounded. At around 2p.m., he noticed that angry Palestinian youths were about to throw stones at an ambulance of the Magen David Adom (Red Shield of David - MDA) at the intersection leading to the Mount of Olives. His instinctive reaction was to rush to protect his Israeli counterparts sitting in the back of the vehicle. To do so, he had to throw himself physically in front of them, at risk of being hit by the stones himself.

Tragic toll

A particularly worrying feature of the violence was the extent to which the humanitarian emblems were ignored or even targeted on both sides. The list of casualties among ambulance staff and the number of ambulances damaged or destroyed is testament to this. Between 29 September and 19 November 2000, 217 Palestinians were killed and 8,784 wounded. Eleven PRCS mobile first-aid posts were deployed in the West Bank and Gaza. Among the dead was PRCS ambulance driver, Mr. Bassam Balbeisi, father of 12 children, who was shot in the Gaza Strip while trying to perform a medical evacuation. A further 64 emergency medical technicians were injured and 42 PRCS ambulances damaged by bullets.

On the Israeli side, during the same period, 15 people died and several hundred were wounded. Eleven regional MDA stations were involved in evacuating the wounded. As with the PRCS, the MDA encountered difficulties in carrying out its humanitarian tasks. In the thick of the fighting, 36 MDA ambulances were burned, vandalized or stoned; 5 ambulance staff sustained injuries.

  Boaz, a member of the MDA, who was behind the steering wheel of the ambulance, was slightly hurt on the hand. "There was nothing I could do," he says. "Suddenly my ambulance was surrounded by an angry crowd wielding stones." The young volunteers eventually got away safely, although they had to abandon the ambulance, which was later torched by the crowd. The incident severely tested Boaz's humanitarianidealism: "I thought the ambulance was untouchable, a sort of sacred symbol that all people would respect."

The burnt-out shell of the ambulance still full of stones was a stark reminder that this was not the case, as were the many other casualties amongst the dozens of ambulance staff and ambulances of the PRCS and the MDA (see box), both of which were targeted by bullets or stones in the ensuing weeks of clashes. Khaldun and Boaz come from "opposite sides of the fence", but they had both been attending special training courses for ambulance drivers organized jointly by the MDA and the PRCS. They had got to know each other and found that they shared the same ideals and dedication. They both know that, whatever the circumstances, there is nothing to gain by destroying an ambulance. For the person who fires the bullet or throws the stone may one day find that his or her own life depends on one.


On the spot

During the violent clashes between Palestinian protesters and Israeli security forces in Jerusalem, the West Bank and Gaza in September and October 2000, PRCS volunteers had to deal with a record number of injuries. Were it not for the new methods of disaster preparedness and emergency response developed by the PRCS in collaboration with the ICRC and the Federation following the first intifada (uprising), local hospitals would have been completely overwhelmed.

It was Martin Hahn, a paramedic with the ICRC, who in 1996 suggested introducing the PRCS's emergency medical services to a system used in his home country, Germany. The system involves mobile first-aid posts, which are packed into two large aluminium containers and transported in a regular ambulance. The larger container holds such basic equipment as a tent, stretchers, mattresses, blankets, a collapsible water container, a foldable table, loudspeakers, an emergency light system, an electrical generator, reflecting vests, and splints to fix broken limbs. The smaller container has a selection of basic first-aid materials, including medicines, disposable syringes and needles, minor surgery kits, examination kits, bandages and gauze, and infusion sets, able to meet the needs of a regular flow of patients for six hours before having to be replenished.

The first-aid posts are designed to be set up under cover, if available, or in a tent, at a safe distance but within easy reach of the emergency area where the injuries are most likely to occur. Their purpose is to enable injuries to be treated on the spot, thus avoiding prolonged transportation by road and, most importantly, to prevent hospital emergency wards from becoming swamped with casualties all arriving at the same time. Trained volunteers are able to assess the severity of the injuries, apply the appropriate first aid and provide immediate relief to the wounded.

From 1996, a PRCS programme for the training of volunteers and first-aiders in life-saving techniques has been supported by the ICRC; hundreds of young volunteers have completed the course. Clearly, the number of fatalities would have been even higher, were it not for the efficient and dedicated action of these young volunteers.

Roland Huguenin
Roland Huguenin is head of the ICRC's regional promotion office in Cairo.

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