Medical solidarity with Gaza: in conversation with Mads Gilbert

Mads Gilbert treats a wounded patient at Gaza’s al-Shifa hospital during Israel’s assault on Gaza. (Mohamed Al-Zanon/MaanImages)

Ahead of the English publication of his book Eyes in Gaza (co-authored with Dr. Erik Fosse), Norwegian doctor Mads Gilbert spoke to The Electronic Intifada about what he witnessed during Operation Cast Lead, Israel’s three-week long assault on the Gaza Strip starting in December 2008, during which more than 1,400 Palestinians were killed and thousands more injured.

Gilbert was one of the few internationals admitted into Gaza during the bombardment. His work at Gaza City’s main al-Shifa Hospital was followed closely around the world, as he provided updates on the medical situation to international media while working with Palestinian colleagues to treat horrific injuries, primarily among civilians. 

Gilbert’s medical mission built on decades of direct medical support work in Palestine but also longstanding solidarity work in Norway with the Palestinian struggle for liberation.

In conversation, Gilbert focused specifically on the legacy of those living with the wounds of war in Gaza more than a year since Operation Cast Lead, while offering a unique perspective of a medical doctor working in tandem with the growing global Palestinian solidarity movement. 

Stefan Christoff: You were one of the few internationals allowed into Gaza during the Israeli bombardment last winter. Can you share with us your memories on the decision to travel from Norway to enter Gaza during the Israeli bombings just after Christmas 2008?

Mads Gilbert: Once the Israeli attack started on 27 December 2008, we set-up an emergency medical team to leave for Gaza, a long-standing tradition in the Norwegian solidarity movement. We started this in 1981 and since then we have been consistently present in Palestine including during both intifadas. For the last 15 years we have worked in Gaza on medical solidarity projects, undertaking teaching and medical training projects while doing direct medical work. 

As soon as possible, we departed from Norway, myself and doctor Erik Fosse, flying to Cairo with solid backing from the Norwegian government via a grant of $1 million for the mission and also support from the Ministry of Foreign Affairs, which negotiated our way into Gaza with Egyptian authorities. 

After arriving Cairo on 29 December, we traveled to al-Arish [the Eygptian border town] and tried to enter Gaza on 30 December but there were bombings at the border and finally on New Year’s Eve, we entered Gaza in the early morning. 

On arriving in Gaza we reported directly to the Palestinian Ministry of Health and they informed us that we would be working at al-Shifa hospital. At al-Shifa hospital Erik Fosse worked mainly in the emergency room and I worked mainly in the operating room.

We stayed there for 12 days and nights. After 12 days we were replaced by the second NORWAC (Norwegian Aid Committee) team, so NORWAC had a presence at al-Shifa throughout the three weeks of Israeli attacks.

SC: Why did you feel it was important to offer direct medical services in Gaza during the bombing? 

MG: We have experience working in Gaza for many years and have seen the usefulness of coming to the support of the Palestinians. Not that the Palestinians can’t manage themselves; al-Shifa is a good hospital with an amazing staff of 400 doctors and 600 nurses. Also, they are unfortunately world-leading experts in disaster medicine, but in such circumstances a supportive presence from outside can equal more than quantitative support measured by your hands. It is about giving strength and hope. Over the years it has become clear that this is a core quality of medical solidarity. 

SC: After the UN-commissioned Goldstone report was released there was some media coverage on the deaths in Gaza inflicted during the Israeli bombardment, but too often we hear statistics and not the human stories behind the numbers. You were on the ground at al-Shifa and developed relationships with the war wounded in Gaza. Could you convey the stories of those living with the wounds of war in Gaza and the long term health impacts stemming from the Israeli bombardment?

MG: Gaza was already in a very difficult position before the bombing started. I returned to Norway from Gaza in late October 2008, before the last war, from a teaching mission at al-Azhar University. During that trip I spent time at both al-Quds and al-Shifa hospitals, meeting with my colleagues, and at that time before the war everyone told me that they can’t take the siege much longer because they are lacking everything, all basic medical supplies. 

Both the healthcare system and the population of Gaza were forced down on their knees by the long-lasting Israeli siege. Compounding this was the bombing that killed 1,400 Palestinians and injured 5,400. In total, 13 Israelis were killed and three of those Israelis were civilians, while among the 1,400 Palestinians killed, 28 percent were children under 18 years old, and every second injured was a woman or a child. 

So the losses for families in Gaza are extensive, painful and long-lasting; you will never forget that your child was killed by a human hand. It is critical to outline that this was not a natural disaster, not a tsunami or an earthquake; this was a 100 percent made-man disaster, pre-planned and executed in the most meticulous way by Israeli commanders, under the leadership of the Israeli government. 

Everyone around the world can experience a sudden loss and sadness when someone in their family or a close friend dies unexpectedly, in a car accident for example. But when so many deaths in such a small population are made-man and totally preventable it only adds to the intense burden left behind. 

The psychosocial impact of all these losses to a society is very hard to measure, all the children in Gaza are traumatized by the siege and this last onslaught only added to that trauma burden. The majority of children in Gaza have witnessed a rocket attack or artillery fire directly on their own homes, prior to Operation Cast Lead. Palestinians in Gaza are a very traumatized and squeezed population due to the siege. Still, the Palestinians in Gaza manage to prevail.

SC: Can you speak about your most recent trip to Gaza after the bombardment?

MG: During my last visit to Gaza, last August, I traveled all over for a few weeks and met a large number of the families and patients that I participated in the treatment of during Operation Cast Lead. What was most striking is that the Palestinians in Gaza maintain their dignity, their culture, their humanity, against all odds. 

The people of Gaza always are warm and welcoming despite the siege, despite the fact that they haven’t been able to rebuild their homes due to lack of building materials allowed into Gaza. All the $5.4 billion dollars that has been pledged by the international community to rebuild Gaza is sitting in the banks, given that Israel will not allow any serious amount of building material to enter Gaza. 

SC: Can you outline the current situation in Gaza as the Israeli siege continues?

MG: Gaza is facing a quadruple burden; first the siege, then the attack, the human losses and the continued siege with no hope in sight for an extremely burdened population who have done nothing wrong except for being Palestinian. So there is no verdict or international judge that justifies the killing and the siege on Gaza. This is an innocent population that is being collectively punished by the State of Israel, contrary to international law. The Israeli attack was a war crime but this point has to be pronounced formally by the International Criminal Court. 

The long-term physical impacts of the war are clear today in Gaza. Many wounds that have been inflicted are painful to live with, first because war wounds are painful but also because the provisions for clinics and rehabilitation resources in Gaza are quite limited. 

In Gaza there is a very good artificial limb shop, the Gaza Municipality Artificial Limb Center, that was on the brink of being closed down in 2006. However it was kept open after a huge fundraising campaign in north Norway — as one of our many outlets of solidarity work we decided to direct funds to Gaza’s artificial limb shop and they make very good prostheses. 

Gaza’s major artificial limb shop has provided orthopedic support, technical support like limbs or wheelchairs, to more than 700 patients with direct support from north Norway as a specific example. 

SC: Many injured by the Israeli bombardment last winter lost arms or legs. Can you outline the reality of the Palestinian war-wounded, those living today with serious injuries?

MG: All over Palestine, in the West Bank, in Gaza and also in Lebanon there are people of all ages without arms, legs or even eyes, like those shot in the eyes with rubber bullets during the first intifada, all of them subjected to the weaponry of the Israeli army. 

So the entire process of rehabilitation for the war-wounded is a huge undertaking, a process generally left to Palestinian civil society in Gaza, which is already completely drained due to the long-lasting siege. 

Also take into account that according to the Goldstone report, Israel bombed multiple schools and many have not been rebuilt, so for the young children with war wounds and physiological trauma, it’s extremely important to get back to normal life, to go to school, to find a good teacher who can care of them, to find some sort of reality after the mayhem created by the bombardment. When schools aren’t rebuilt it means makeshift schools, triple shifts for teachers at the schools and double classes in each classroom, adding to the burden. 

Those with amputations will hopefully receive artificial limbs but even with an artificial limb they then need serious training and resources for the training are limited due to the siege. Also, when you are 14 years old, it takes a great deal of patience to learn to use an artificial limb. 

So the siege doesn’t only limit food and fuel but also the ability for Palestinian society to rehabilitate all the war-wounded. The ongoing collective punishment and military attacks during the siege results in huge physiological trauma for the children, so rehabilitation for all the children is really difficult. 

In order to heal, children need to have space to talk about their experiences, to make drawings, to be listened to by caring adults who have the capacity and surplus energy to listen to the children. All this healing process is lost in the everyday struggle to survive, to find basic sustenance. 

SC: Beyond the impacts from Operation Cast Lead what the critical points stemming from the ongoing siege? 

MG: Water supplies in Gaza are extremely scarce. Gaza has the lowest annual liter-per-capita usage in the world and 80 percent of the water available is below the minimum water quality standard as defined by the World Health Organization.

Gaza’s sewage systems are broken and bombed. All the sewage-cleaning machines are missing parts. Much of Gaza’s infrastructure has been targeted and is not being repaired due to the siege. 

Tromsoe, Norway, my hometown, is a twin city with Gaza City, so the conditions of life in the municipality of Gaza, for the 550,000 inhabitants, are known quite well to me and others in Norway. Palestinians in Gaza have nothing. There aren’t even cars and trucks to take care of the solid waste collection, so the mayor was forced to rent 300 to 400 donkey carts to organize garbage collection. 

Gaza is a prison for 1.5 million Palestinians. Fifty percent are under 15 years old and the average age in Gaza is 17 years, so it is largely a child population being exposed not only to a siege but also repeated military attacks from drones, airplanes and Apache helicopters. 

Every night the Palestinians in Gaza relive their worst nightmares when they hear drones; it never stops and you are never sure if it is a surveillance drone or if it will launch a rocket attack. Even the sound of Gaza is frightful, the sound of the Israeli drones in the sky. 

However, let’s not pity the Palestinians in Gaza; mercy and pity shouldn’t be the dominating feelings after learning about Gaza. What the Palestinians, as people in a dire situation, need is respect and solidarity. Palestinians in Gaza need to get back on their own feet and the way that we can support them is to try to change the policy of our own governments, so that the US and Israel are forced to lift the siege. 

It is a shameful situation for the world, that in 2010 we are witness to 1.5 million people being starved. There is solid scientific evidence that child mortality is not decreasing, stunting among children is increasing, malnutrition is increasing, all this from an Israeli-made hunger for the population in Gaza, with the full support of the US.

How can we accept this in 2010? 

If we can’t respect and stand up for the basic human rights or humanity of the Palestinians, what is the meaning of the humanistic foundations that western society claims to be standing on? What will the history books write about Gaza?

SC: Returning to Norway after your experiences in Gaza, the shops are open, people are on the streets, but Gaza is a totally different reality. How difficult is it for you to convey the realities in Gaza, given the extreme contrast between the situation in Norway or in North America and the situation in Gaza? 

MG: An important question. In a simple way we have tried to become a voice for the voiceless, for the people in Gaza and in occupied Palestine because although the Palestinians do have a strong voice and narrative they are often not listened to and don’t get access to the mainstream media. 

Palestinians are silenced and we are trying to break that silence, as brave people in Israel are also doing. It is really important to underscore that we should fight against the demonization of the Israeli people in the way that Israeli leaders are demonizing the Palestinian people, because at the end of the day if we can’t talk to our enemies we will end in disaster worldwide. Dialogue is central to finding a real solution. 

Palestine really touches on our basic human values and is in many ways the mother of all wars today. My main obligation is not my solidarity work in Gaza but my work to convey the reality in Gaza to people outside. 

There is a duty I have been given by those patients, those killed, those living with amputations, all those who shared their lives with me as a doctor, as a friend. It is my duty to convey their stories to as many people in Norway and anywhere else, so that more people in Norway and globally stand up and say that they refuse to accept the current situation in Gaza, regardless of political points of view but simply on a human level. 

SC: As a medical doctor, what are your thoughts on the global movement in solidarity with the Palestinian struggle for freedom today?

MG: In a sense it comes down to a simple question of solidarity, which means that we have to support not pity. We have to be critical and not frightened by threats or accusations of being anti-Semitic because critiquing the Israeli government certainly is not anti-Semitic. 

Now the Canadian government is pursuing an absurd line that attempts to claim that critiquing the Israeli government is anti-Semitic, which is totally outrageous. Should Israel be the only state on earth exempted from real political criticism? 

The global boycott, divestment and sanctions campaign is critically important and we have been pushing forward this campaign in Norway. The Norwegian State Pension Fund divested from Elbit Systems last September, a subsidiary of the company that provides the Israeli army with unmanned aerial vehicles [drones]. Also we are working towards institutional boycott within major universities in Norway and this is moving in a positive direction. 

It is key to step outside of the consumerist box of everyday life in the north, to stop always wanting more than we already have — a good way to do that is to travel, travel to the West Bank, to Gaza and see for yourself the situation. 

We are all living as history is being written — our actions write history. Pretending to be neutral equals complicity; that is the old wisdom of history. 

Everyone has the duty to be educated on the reality in Palestine and other injustices around the world, to speak out on these critical issues. Let us not take for granted that our political leaders are speaking the truth because more often than not politicians aren’t speaking the truth. 

Every voice counts, we must refuse to be silent because silence is the biggest enemy of justice. 

Stefan Christoff, a journalist and contributor to The Electronic Intifada, is also active with Tadamon! ( and is at