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Civilians in the firing line


On top of a year and a half of restrictions came three weeks of intense fighting. For the people of Gaza, who bore the brunt of a conflict in which there are no winners, the road to normality and dignity is still a long one.


The story made the headlines across the Arab world. For three days, 14-year-old Amira Al-Gerem’s name was on the list of presumed dead in the district of Tel Al-Hawa, in central Gaza City, after tank fire reduced her family’s home to rubble, killing her father and two brothers instantly. Amira was found injured on 17 January, the day before the ceasefire between Israel and Hamas came into effect, ending their armed confrontation. The young girl had taken refuge in a neighbouring apartment, abandoned by its occupants who, like so many others, had been forced to flee the intensity of the fighting.

Although she miraculously survived, Amira has not escaped the war unscathed. She was rapidly operated on, and her bodily injuries will heal. Her mother keeps vigil by her bedside. She will be given a roof over her head, even if only temporarily. But will she ever wipe from her memory the moment when she had to climb over the lifeless bodies of her father and brothers to get out of her house — or what was left of it?

Here in January 2009, Amira personifies in many respects the Gaza Strip, ravaged by three weeks of unprecedented, unremitting violence. In this conflict, there are no victors and only one loser: the civilian population.

In the absence of independent information, it is difficult to tell the war’s precise toll. According to figures that the Gazan Health Ministry published at the end of January, more than 1,380 people have been killed and 5,640 wounded. One thing is sure, however: a particularly high proportion of the victims were women and children.

The figure, sad and unacceptable though it is, is not entirely surprising. The population of Gaza is almost oneand a half million. Most of them are crammed into densely populated urban areas. Conducting military operations in such a context can only put civilians at enormous risk.

Traces of the conflict

Shijaya is one of the poorest districts in Gaza City. Here, evidence of the conflict is everywhere. Barely a few days after the end of hostilities and before the reopening of schools, children once again throng the streets, their playground of choice. Dozens run alongside PalestinianRed Crescent and ICRC teams out and about to deliver urgently needed relief goods to families whose apartments were damaged in the fighting: plastic sheeting to replace windows and doors shattered by explosions, blankets, and buckets and other basic items required for washing and cooking.

It is not enough, however, to assuage the anger of Leila Al-Helou, one of the 80,000 recipients of the emergency assistance distributed in the days following the ceasefire. The mother of six picks her way carefully up the stairs of the building in which she lived, with seven other families, until just a few days ago. “The building was hit several times,” she says, surrounded by rubble and the debris of furniture.“Thank God, my husband, my children and I had already left the place.”

The building’s top two stories had collapsed with the violence of the shock. One of the remaining walls has a hole 1.5 metres in diameter, through which you can see the villages of southern Israel some 2 kilometres away. “We have been living here for 20 years. Now, we have nowhere to go, we have lost everything,” says Al-Helou.

Like an earthquake

Throughout the Gaza Strip, several thousand houses and apartments have been completely or partially destroyed in the conflict. At the beginning of February, the ICRC and the Palestinian Red Crescent counted more than 3,300 damaged houses in the areas where the fighting was fiercest. Some districts look as if they have been struck by an earthquake. But just about every person in the territory has suffered the consequences in one way or another.

When the conflict was at its height, two-thirds of Gazans were completely without power and one-third without drinking water. Three weeks after it ended, tens of thousands of people still had no running water, being obliged to buy it from private vendors at double the normal price. Certain districts in Gaza, as well as places in the north of the Gaza Strip such as Jabaliya, Beit Hanoun and Beit Lahiya, will have to wait even longer to be reconnected to public water and power networks.

Gaza City’s sewage treatment facility, situated in an agricultural zone, was bombed during the second week of the war. “Three million litres of waste water instantly flooded the surrounding localities and fields, wiping out crops and endangering the health of tens of thousands of people,” recalls Marek Komarzinski, an ICRC engineer. It took three weeks after the fighting was over to get the station back in working order.

Swamped by a sudden influx of wounded people, often in a serious condition, the health services worked round the clock for three weeks, until almost at breaking point, relying on generators to keep the equipment going when fuel supplies threatened to run out at any moment. According to the World Health Organization, eight hospitals and at least 26 primary healthcare centres, including the Al-Quds Red Crescent hospital, were directly or indirectly damaged in the fighting.

Consequences of closures
The blow to Gaza and its population was all the more severe coming as it did after one and a half years of deprivation. “The situation was already critical before the January conflict,” explains Antoine Grand, head of the ICRC office in Gaza. “The closures imposed by Israel since summer 2007 have had disastrous effects on hospitals, on sanitation systems, and on water and electricity supply.” The lack of cooperation between the Palestinian Authority, run from Ramallah in the West Bank, and the Hamas administration in Gaza has not facilitated access for the aid necessary to improve basic public services.

The restrictions have had other adverse consequences for the population: almost 50 per cent unemployment, rampant inflation, rising poverty, a drop in agricultural production, the deterioration in the diets of an increasing number of people, threatening their long-term health, etc. All of the humanitarian organizations working in Gaza have been striving to counter these effects, making representations to the Israeli authorities, since they control almost all routes in and out of the territory.

“To get Gaza back on its feet and repair its infrastructure, there must be a nonstop and unrestricted supply of building materials and spare parts,” warns Antoine Grand. “Workers are available. They just need something to work with. But if we go back to the pre-war situation, with one closure after another, reconstruction will simply not be possible.”

Sébastien Carliez (ICRC Geneva) with Iyad Nasr (ICRC Gaza).


An ICRC team assesses the destruction of houses in the Shijaya neighbourhood of Gaza City, 24 January 2009. ©TIVADAR DOMANICZKY / ICRC / VII


A Palestinian boy is carried to hospital in Gaza. ©REUTERS / ISMAEL ZAYDAH, COURTESY


Thousands of people have been left homeless by the fighting. ©TIVADAR DOMANICZKY / ICRC / VII


A mother watches as her son plays in front of their destroyed house. ©TIVADAR DOMANICZKY / ICRC / VII


Despite chronic insecurity, more than 400 PRCS staff reported to work during the fighting. ©TIVADAR DOMANICZKY / ICRC / VII


A woman recovers at Gaza City’s Shifa hospital. ©TIVADAR DOMANICZKY / ICRC / VII


Plastic sheeting was distributed to cover blown-out windows in Gaza. ©TIVADAR DOMANICZKY / ICRC / VII


Nothing much remains of some parts of Jabaliya in the northern Gaza Strip. ©REUTERS / SUHAIB SALEM, COURTESY


An elderly couple at a PRCS distribution site. ©TIVADAR DOMANICZKY / ICRC / VII


The influx of wounded ran so high in Shifa hospital, surgeons had to operate round the clock. ©TIVADAR DOMANICZKY / ICRC / VII

Palestinians run as they carry a wounded man after an Israeli air strike in Gaza, 2 January 2009. ©REUTERS / ISMAIL ZAYDAH, COURTESY
“There was a lack of respect for medical teams”

Dr Khaled Jouda is head of the Palestine Red Crescent Society (PRCS) in the Gaza Strip. He explains how delicate the work of his teams was during the crisis in January.

What was PRCS’s role during the events?
We tried as much as we could to continue providing all types of medical services at all times to the population throughout the Strip. Our ambulance teams took the wounded mainly to the Al-Quds hospital in Gaza City. During the three-week conflict, we managed to transport around 2,400 injured people and moved 1,100 civilians trapped in dangerous areas to safety. Our teams also evacuated 750 bodies. Most of the time, the movement of our ambulances was carried out with the coordination of the ICRC and sometimes even escorted by ICRC teams.

What were the biggest challenges faced by your teams?
The evacuation and transportation of wounded and sick people were made extremely difficult, due in particular to the unpredictable nature of the fighting. The movement of our emergency medical teams was very much limited even when they were operating close to their bases or to our warehouses. I have to say that there was often a lack of respect for medical teams and for the Red Crescent emblem. The toughest challenge we faced, though, was when the PRCS compound was hit by shelling twice on the same day, setting a warehouse, some offices and our cultural centre on fire. After the second incident, the fire brigades were denied access to our buildings for three hours. That could have had disastrous consequences for the lives of 350 people, many of whom were wounded and sick being treated at the Al-Quds hospital, as well as families who had taken refuge in our compound.

We decided to evacuate the hospital amid continuous fighting in the neighbourhood. Patients in the intensive care unit were taken out lying on their beds. Newborn babies were moved in their incubators. The patients who could walk had to carry their intravenous drips by themselves. It was a horrifying scene and I still find it difficult to describe.

The conflict also took its toll on our staff. One volunteer was killed and six medical workers were injured. But despite all these difficulties and the personal challenges that the conflict posed on our teams and their families, about half of our 800 regular staff members reported to work during these three weeks. Another 30 people volunteered to join our teams.

What were your needs and priorities in the immediate aftermath of the crisis?
Our first priority is to rehabilitate the damage to our facilities, in particular parts of the hospital and the warehouse. Then, we need new ambulances and spare parts to repair those that were damaged during the conflict. For the sake of the population of Gaza, cooperation and coordination with partner National Societies are crucial to mobilize the support we need so that we can resume normal activities


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