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Gaza: Which way is up? A day in the field

08 Sep 2016

I walk out and I see a donkey pulling a cart, carrying a man and I don’t know why. I watch people sweeping the streets. We drive to work in a van. The equipment is in the back. We load it, and unload it and take it to the third floor. There isn’t much. Just some clothes, shoes, stuff that’s been sterilised so we can use it for the operations. We bundle it into theatre. 

I do my checks – Machine, high pressure system, low pressure system, ventilator, ancillary equipment, disposables, consumables, airway and breathing emergency plan, circulation emergency plan. Prepare for the case. Age, weight, a dozen calculations on the piece of paper I have put on the wall, my ready reference in case my patient needs urgent treatment on the table. In truth, they hardly ever do. That’s what you do as an anaesthetist. “There isn’t a situation that you can get yourself in that I can’t get you out of,” would be something like how my day runs. 

"All the while the hands are moving, the eyes are darting, the mind is racing, and the pieces of this jigsaw have to fit together"

Buzz, buzz. Our surgeon has made light again of the delicate, careful, meticulously planned procedure she has just done. She’s talking about someone else’s family, someone, one of her colleague’s children going to study or something. All the while the hands are moving, the eyes are darting, the mind is racing, and the pieces of this jigsaw have to fit together. Today it might be someone’s hand. Tomorrow releasing a contracture where someone was burned on a hand, foot, or face. Or an elbow, or a leg. I’ve lost count.  Always fixing something. We’re halfway through our assignment. That’s our day. One at a time. Minute by minute. 

I wait for my turn to talk to a patient and look out. I see earth, dirt tracks and a road, and I know the road is the road running North-South, called Salah El Deen and it runs from Erez to Rafah, but it’s a road from somewhere to somewhere else. Just like I know there’s a beach to the west cos that’s where the sun sets and cos it’s where water meets the sand. But there are tents, and horses and the flags that are supposed to be red-and-yellow to me that say safe swimming are green or black or red.

Sometimes the most familiar thing to me is my work routine. And two weeks in, that’s what I do. It’s so familiar, it’s like being at home. So much because my technician is on my wavelength – a working from the days when the hospital was run in a tent, for five or six years, so we speak the same language. So much because the machines are like at home. So are the procedures. And the processes. And the trolleys. It almost runs like clockwork. 

"Sometimes the most familiar thing to me is my work routine."

But when that ends, and we drive back home, it’s like when the day starts all over again.  As we each are dropped off one by one – the nurses, hygienist, new trainee and last of all, myself and the other international staff and the equipment – we arrive at home past the sign that says Médecins Sans Frontières. Put my key in the lock of a heavy iron door. Turn the key. Click. Up one, two, three, four flights to my flat. There’s a Médecins Sans Frontières sticker on it for me. Water in the cooler. Traffic below. Another day operating in Gaza finished. 

 

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