Mark Clarfield on a hospital under rocket fire

Mark Clarfield My hospital, the main institution serving southern Israel, has come under rocket fire since the very first day of the war. As a result, there have been far reaching changes in its functioning. Extra staff: doctors, nurses and orderlies have been added to the emergency room on every shift. All leave has been cancelled.

The surgical service has been most affected. More than half of elective operations have been cancelled in order to keep hospital beds and ORs available to look after any and all casualties – both civilian and military. The activity of our helicopter pad which is right in the middle of the hospital campus allows us to know when there are “incoming wounded.” A team of doctors and nurses is always waiting on the ground for the moment that the helicopter touches down. Unfortunately, this scene is one which I have witnessed for years, since this assault by Hamas on southern Israel did not begin with the advent of our recent response. It has been going on for years. However, the rate of landings has increased dramatically. A bit like “M*A*S*H” but without the laughs. Mark Clarfield looking at map

There have been other effects on the hospital’s functioning. For example, we are a 1100 bed teaching institution located on a large campus. There are a couple of six storey towers and a number of outlying smaller buildings. These include my own Department of Geriatrics which was located in a one storey building. On the second day of the war we got a call from the Home Front Command which had decided to close us down. Our department is in a one storey building and would not be able to withstand a direct hit.

Within six hours we were to discharge as many of our 25 patients as possible – either home or to surrounding nursing homes. Those patients too sick to be moved were transferred en bloc together with our staff into a more secure building on the third floor of one of the towers. We function with half of our patients and just under half of the staff. Those not working on our “mini-ward” have been sent to the ER or other wards.

During this exodus there were three alarms in the Beer-sheva area. It is hard to describe the fear and anxiety of these frail patients and their families as we tried desperately in the 45 seconds (sometimes) given to us by the alarm to move patients into the relative safety of the halls. We did a pretty good job and fortunately for us the rockets struck elsewhere.

While I am still allowed to use my office, it is not only weird to sit here alone, it is also sometimes quite frightening. For example, just yesterday the alarm went off and I ran into the hall, crouching in the “safe” area which would have done me no good in the case of a direct hit. Several seconds later I heard and felt a tremendous crash as a Grad rocket landed just 100 metres from the hospital.

I was lucky this time.

Dr A Mark Clarfield, a long-time contributor to Medical Post, is a doctor at the Soroka Hospital, Beer-sheva, which serves the south of Israel.

  • Mark Struthers

    “A bit like “M*A*S*H” but without the laughs.”

    But then, do we laugh at the enormity of suffering suffered by this health facility in Beer-sheva … or cry at the piffling suffering inflicted on Gaza by Israel’s defence forces … or vice versa?

  • Mark Struthers

    If the ER at Soroka Hospital is a bit like “M*A*S*H” but without the laughter, then what must it be like in the casualty unit at the Shifa hospital in Gaza City?

  • James Woodcock

    In public health all preventable deaths are our concern. But we must focus on where the need is greatest. I hope the BMJ can find more space to focus on the humanitarian catastrophe that Israel is inflicting on the Palestinian people in Gaza. There not only do we have the far greater direct deaths caused by the intensive bombardment and invasion but a huge refugee crisis amongst an population imprisoned in a narrow strip on land. This is compounded by the deprivation due to the ongoing blockade imposed on a population displaced and deprived population. It is a shame Dr Clarfield does not draw attention to the suffering his country is inflicting. All of us in public health should demand Israel desists and allows the borders to be opened.

  • raphi pollack

    The tragedy as I see it, is that this escalation could have been avoided. If the Israeli government would have dealt with the problem in its incipient stages, we never would have reached the current escalation. As soon as the Hamas started to fire rockets into southern Israel, the Israeli government should have done what any sovereign government would do…namely silence the fire. But they chose to wait 8 full years before responding to the rocket fire. Perhaps if firmer measures would have been taken earlier,this escalation would have been avoidable.
    Avoiding small problems does not always make them disappear.

  • Richard Bartley

    If it is bad in an Israeli hospital, one cannot imagine the hell of a Gazan hospital.

    Hamas targeting of Israel is totally unacceptable, but allowing the concentration camp conditions of the Gaza Strip to worsen over many years has created a breeding ground for radicalised Palestinians. Israel, America, Britain and the wealthy Arab nations should hang their heads in shame.

    Killing 1000 Palestinians is not the answer. It is an abomination.

  • Another concerned medic

    Here are real tragic stories we are interested to hear as reported by palestian and israeli medics.

  • Caroline Richmond

    Dr Clarfield must be suffering badly, with all non-urgent admissions cancelled. If he finds waiting doing nothing stressful, he could offer himself to the injured people of Gaza, and take much-needed drugs and dressings with him.

    There is a UK-based charity called Medical Aid for Palestinians, and they need donations urgently, so please dig into your pockets. They also need Israel to permit import of adequate quantities of food and medical supplies to Gaza.

  • Y. Gazit

    Mr. Struthers heart’s bleeds for ‘Palestinian’s’ suffering, in such extent that he becomes blind whenever Israelis suffering is concerned. I have no idea what motivates this person to view this conflict through a distorted mind. The ‘poor’ Palestinian have been shelling southern Israel for the last 7 years, it’s just about they begin to pay for their crimes. I can assure Mr. Struthers that his country where ever it is, would have wiped out Gaza from the map if it had been bombarded for seven years. Only God knows what makes him think that he has the right to preach us how to defend ourselves?
    As for Mr. Bartley, I can only assume that this fellow prefers to see 1000 people killed at the other side of the border. I wonder if he cared about 1000 Palestinians if his own children live were on the stake. What a hypocrisy.

  • Caroline Richmond

    Yes, Dr Pollack, Hamas are firing rockets at Israel.
    Why should it be OK for Israel to have weapons, but not OK for Palestinians?

    It is senseless to discuss who started the conflict, but instructive to remember that Israel has for a long time restricted or blocked the import of food and medical supplies into Gaza. Hamas, reasonably anough, want the blockade lifted before they will agree to a ceasefire.

    Also, since the present conflict began, Israel has prevented western journalists from entering Gaza, thus preventing the type of eye-witness reporting which we get from Israel.

  • Adam

    Y. Gazit posses a series of false premises to justify his apparent indifference to Palestinian suffering:
    “7 years of rockets” ignoring 60 years of oppression and theft
    Israel “wiped out” or the reality of Palestinians themselves and their properties and possessions literally being eradicated.

    “defend ourselves”! – this is pure chutzpah

    “I can only assume that this fellow prefers to see 1000 people killed at the other side of the border.”

    Well me personally no I would not, and like the fellow in question I assume he would also wish for no deaths on either side of the ‘border’, but I can see how such an event if it were actually possible would be a fairer more equal situation, and may give pause to the Israeli hawks who keep up this insane ‘defense’.

    And of course people will respond passionately about Palestinian deaths, as there are so many, and that is the point, by comparison Israeli deaths do not count – because in the great scheme of things and moving away from personal losses and no doubt personal griefs the suffering in Israel is not even slightly comparable to the slaughter and dispossession, grief and anguish in Gaza.

    Israel’s propaganda machine must be very desperate to be using these weak and transparent arguments to justify what is a collective punishment against a captive population in revenge for voting for a government that Israel and the USA don’t like.

    If Israel wants peace it will need to talk peace, unfortunately it does not, and uses a legitimate resistance by Hamas and others to justify its continued terrorizing of Palestinians and further threatens and even attacks its neighbors, the only state in the Middle East with Nukes which it refuses to have inspected by the UN.

    Israel is a terrorist state and the sooner its population realises this the sooner there can be peace in the Middle East.