For ambulance drivers, the situation is particularly fraught, as demands for their services have soared over the last two months due to an almost complete lack of alternative transport to hospitals. The city of Rafah, in the southern Gaza Strip, has a total of 15 ambulances serving a population of more than 175,000 people. At the local headquarters of the Palestine Red Crescent Society (PRCS), ambulance drivers say the fuel crisis is making their work difficult and miserable. Fawzi Abdul Hadi is head of the Rafah PRCS Ambulance Service, and says the fuel crisis is severely affecting the delivery of health services across southern Gaza. “We are managing to keep our ambulances on the roads, but we’ve been forced to limit our movements, and now we can respond only to urgent cases,” he says.
The Rafah PRCS ambulance drivers normally respond to 250-300 cases a month in and around Rafah, though their work is by nature unpredictable. But Fawzi Hadi says they are now receiving up to 350 calls a month. “We can’t respond to all the calls now, because overall demand has increased so much. As well as emergencies, we also regularly transfer patients between local hospitals — and now we can [conduct only] less than half of the transfers, even though we sometimes ask transfer patients to share the ambulances in order to save fuel.”
Samir Abdul Hamid Akil has been working as a full-time PRCS ambulance driver in Rafah for the last five years. “We have four ambulances which all run on diesel,” he says. “We never used to operate our ambulances on less than half a tank of diesel, but of course we can’t do that now, although we actually need more fuel, because now many people have no other way of getting to hospital except by ambulance.” The Rafah PRCS ambulance drivers say locals have regularly resorted to using donkeys and carts in order to access hospitals. “We know of many cases where people have to use donkeys or mules and carts,” says Hadi. “Under these current conditions, it is very difficult for Gazans to travel anywhere at all.”
Collective punishment of a civilian population is illegal under international human rights and humanitarian law, but Israel has been imposing a crippling siege on the Gaza Strip for almost two years. In addition to denying 1.5 million civilians their basic rights to freedom of movement, including freedom of movement in order to access appropriate medical facilities outside of the Gaza Strip, the Israeli siege of Gaza has devastated the Gazan economy and infrastructure, and continues to severely undermine the delivery of all essential services, including humanitarian aid and emergency medical services.
Asad Daoud is an ambulance driver at the Emirates Hospital in Rafah. The hospital, which has a large obstetrics unit, receives around 1,800 patients a month, but has only one ambulance. Ten days ago the ambulance completely ran out of fuel, and the ambulance service had to be temporarily suspended. “The situation is miserable,” says Daoud. “We used to be able to deliver a good standard of service to our patients. But these conditions are extremely difficult because we do not have sufficient fuel in Gaza. I regularly transfer patients to the European Hospital in Khan Younis, which is only seven kilometers from here. But today I don’t still have enough diesel in the ambulance to drive to the European Hospital and back here again.” He says the Emirates Hospital ambulance service is now operating “on a day-to-day basis.”
The hospital director, Dr Khamid Se’am, points out that the Emirates Hospital does not have an intensive care unit, and therefore needs to be able to transfer critically ill patients immediately. “Up to 20 babies a day are born here,” he says, “and if they need specialist care we have to transfer them to the European hospital urgently.”
The hospital nursing director, Saleh al-Hams, reiterates that patients, including pregnant women, are arriving at the hospital on donkeys and carts, but stresses that all aspects of health care in Gaza are being affected. “Patients now come to our hospital any way they can,” he says. “We are facing problems transferring patients, getting hold of emergency blood supplies, and sending our doctors out on emergency calls.
“The bottom line is that patients’ lives in Gaza are being put at risk.”
This report is part of the Palestinian Centre for Human Rights’ Narratives Under Siege series.