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11 min read

Eye witness: life and death in Gaza’s European Hospital

Returning plastic surgeon Tim Goodacre reports on the struggles, the despair and the dignity of the people and the medics of Gaza during their long nightmare.

Graham is the Director of the Centre for Cultural Witness and a former Bishop of Kensington.

Medical staff stand beside a bed in which a man lies with an amputated leg.
Medics confer about a patient in Gaza's European Hospital.
Tim Goodacre

Tim Goodacre is a vastly experienced plastic surgeon who recently spent two weeks in a hospital in Khan Younis treating the extensive injuries of the people of Gaza. I caught up with him to ask about his experience there.  

Graham: Let me start by asking what was it like getting into Gaza? What was the process and how difficult was it to actually get in in the first place? 

Tim: We went in as an emergency medical team under the under the auspices of the World Health Organisation, which is coordinated with UN OCHR. It was easy obviously to get to Cairo. Then we joined a convoy, a group of cars convening in the small hours of the morning in Cairo and then being escorted across the Sinai desert. We got to the border in time for dusk. What was staggering at that stage was seeing the number of lorries lined up, waiting on the Egyptian side to get in. They were two deep on one side, one deep on the other with a thin passageway through which we could drive through for mile after mile after mile of these lorries. 

Was this humanitarian aid sent from other nations? 

Absolutely. It was aid labelled from different countries or agencies. Crossing Rafah the next morning was all pretty haphazard and chaotic, but we met our driver on the other side. We then had to travel to Khan Yunis on the coast road because it was the safest part of the south Gaza strip. We went through a route called the Philadelphia Road, which is a gap between the two borders. As we drove along, we immediately were jumped on by some young lads who had put razor wire across the road. We picked up two of them who hung onto the car each side, with our window s firmly shut. As we sped along, they were our ‘protectors’, taking a pitiful sum to ensure that we would not be stopped at further razor wire and our vehicle plundered. It was our first experience of the lawlessness that's inherent at the moment in Gaza. 

All along that side of the road there were people putting up new tents after a recent further mass displacement, as far as the eye could see. It made a huge impact on me - the devastating plight of the people who were there. It looked like those pictures of Glastonbury or Woodstock, where as far as you could see, the rolling fields or sand dunes or whatever were totally covered in makeshift dwellings. It was pretty cold and windy. And subsequently, while we were there, it rained an awful lot and your heart just went out to these people.  

So these were people living in tents and temporary shelters? 

 Well, not really. They're barely tents. They're just finding flimsy bits of wood, putting them up and nailing them together. And these are not just the very poorest of the poor. This is everybody. Many of them were people from very well-to-do houses whose families have been displaced. I've worked in many parts of the world where there's poverty, but I’ve never seen so many people displaced.  

One of the things that's remarkable however is the relative cleanliness, the desire to maintain dignity in the most appalling circumstances. But a young lad who’s now a young doctor (who I have worked with for a decade now) came to see me and he was the most dejected person I've ever met. He said to me ‘they've taken away my dignity’. The abject pain in his face was something that I won't forget.  

You’ve been to Gaza many times before. What was different about this time? And you've seen it in the aftermath of previous wars and conflicts. What was what was particularly different this time? 

 It's utterly different – it’s the displaced population with nowhere to go and seeking shelter. When I first went in 2014 after Operation Protective Edge, I was taken to a huge neighbourhood of northeast Gaza, which had been flattened and at the time the impact on me was extraordinary. When I’ve visited subsequently over the last decade, they will show you this bombed out building and that flattened area, but I've never seen such vast numbers of displaced people. On the second day we moved into the European Gaza Hospital (EGH), which is where we were going to stay for the two weeks we were there. Inching slowly along amidst endless hordes of people walking around, seeing the dejection, despair, the hopelessness with nowhere to go - this for me is what defines this whole episode and makes it very different from others. This is in no way a diminution of other conflicts and human tragedies, but when there was bombing in Baghdad or in Kiev and Ukraine, people might go into underground shelters - there are places they can perhaps go to escape. Even in massacres such as in Darfur or Congo, there are places to run to. There is nothing like that in Gaza. 

Was there a pattern to the kind of medical emergencies and wounds that you were having to deal with? 

 The vast majority of injuries were the impact of high explosives, so we naturally saw quite a lot of burns, although the majority of severe burns alone were being managed by the Red Cross team also at EGH. Some of them were people who had been crushed and pulled out of buildings which had collapsed. But that was that was the minority. The majority of our cases were direct results of bomb blasts. Every time you hear a bomb, somebody is being killed, yet many others are caught on the fringe of that. Shrapnel travels at astronomical speeds and hits people in in a completely random way. These injuries are devastating. There were scores of people coming in with limbs missing. Seeing somebody with a leg off at the thigh, a leg off below the knee, an arm ripped off was all too common. It was hard to take in - you have to become somewhat immune to the backstory behind each dreadful injury, and concentrate on the carnage in front of you, to be able to deal with the constant onslaught of cases. 

How were the medics coping with it? You were there for two weeks. They are there for months, presumably on end? 

 I think it's incredibly important that we don't focus on the visiting medics. I usually peeled off at about 9pm or so in the evening - I had to go to bed and had to have a rest, but there were people trying to work through the night. What I want to focus on is the local people, particularly a young colleague, Ahmed, who was 36 years-old. He was statesmanlike in his ability to pull things together. His family are actually mostly in Dublin as they've got Irish passports. I cannot tell you how much admiration I have for that young Gazan man who shared his room with me.  

He has been managing to create a team who work alongside him, since many of the staff who had worked at the hospital before (some of whom we had trained over several years in limb reconstruction) were not there. That is because they might not be alive, or having to support their displaced families, or simply are afraid to travel in daily to the hospital, or whatever. It is a huge demand on individual doctors to leave a family group (who invariably try to stay together, so that if they are bombed, they all die together and do not have to be a sole survivor.) to then work away from such possible loss of all their family members. It's an incredible sacrifice to be working in medical care when your family are all huddled together in a place where they may all lose their life, and that gets to them in the end.  

The orthopaedic side is almost on its knees. Most of the system in the hospital is utterly on its knees. There were early years medical students who had been taught quickly how to manage wounds and to skin graft. They haven't got any pay, but some people have given a little money to my colleague’s account to try and give them some support. There were IT students and all sorts of others pulling together. How people can work in in such adversity and make things happen is quite a testament to the to the strength of humanity.  

It all begins to play on your mind, and you start thinking is there another one coming? And you get no warning when the attacks are unleashed. 

What was it like living under the bombardment, which was presumably pretty constant during your time there? 

There may have been the odd period of four or five hours when there was no sound of close bombardment at all, although during that time there was probably small arms fire going on somewhere. But otherwise, it was relentless. One became somewhat used to the bombs in the distance, but when they're close by… Every time one of these bombs goes off, there are people dying. And that really that played on your mind. So huge numbers were seeking shelter anywhere in the vicinity of the hospital. If you can imagine a hospital corridor where every route is full of makeshift shelters, and you just go up around a stairwell and on the corner of each stair, there will be a family which will be hanging drapes up, trying to find some sort of privacy and dignity among the utter destitution.  

I found it very difficult to sleep during those times. The hospital is in a quadrant, a square. On one corner there was a supermarket which latterly was hit by an F16 delivered weapon. You could hear the sound of the rocket go off alongside the scream of the low flying fighter jet, and the whole building shook. There's also the incessant sound of drones. It all begins to play on your mind, and you start thinking is there another one coming? And you get no warning when the attacks are unleashed.  

It made me realise what soldiers undergo when they get what used to be called shell shock. There, even if you're not injured yourself, this constant shocking damage gets to you. I knew we had the knowledge that after a short time, we would be getting out - but it made me realise how tough Ahmed and others working there have to be. It will be having a devastating impact on the population, and for a nation.  

I imagine the psychological effects of that are going to last for a long time in the lives of these people. You don't get over that quickly. If you live with that level of tension, thinking any moment now, I could die, that must stay with you and the marks of that stay for a long time. 

I'm sure that's true. I'm not an expert in PTSD and things like that. Ahmed is a Muslim and said to me more than once that when you believe in an afterlife, you believe that your time will come at some point, and you accept that. We don't know when it is or where it is, but it will come. I have frequently wondered whether any of the fighter jet pilots have ever experienced themselves what it’s like to be underneath the impact of one of their weapons? Having felt somewhat what it is like to be on the other side of such an onslaught, I do wonder whether very many of those involved in ordering conflict really have any kind of understanding of what devastation feels like, when there is nowhere to run? I fear for what this conflict does to the humanity of both sides. 

I genuinely don't feel brave, I don't. I'm not the kind of person who sees lights in the sky, but I know it was God’s calling to go there. It was simply the right thing, 

Did you see any sign of hope or anything that gave you a sense of the way out of this? 

 The sense of hope is within the people who are there. There are many people who say they still really don't want to leave. They feel this passionately. It's their land. They do want to see a new Gaza. I tried to be somebody who lifted spirits. Communities can be rebuilt and there may be a new future which will come from the dust. I've been in touch with people in my University Medical school in Oxford to see whether we can do something about getting these young people's education continued.  

You can imagine there wasn’t a lot of laughter in the whole environment, but on the few occasions when I did gather together with my colleague’s small group of young students and volunteers, usually late into the night, we would eat whatever food goodies they had to hand, and their sense of fun would burst out. Together there was a very strong sense of community amongst them. 

How did your Christian faith inform the way you interacted with the situation? How did your Christian faith help you process what you were seeing and experiencing there? 

 I must say it was a deeply spiritual time for me. It was absolutely powerful to me to know that God cares and loves each and every one of these people. I longed to organise a football game with the kids. I was told that they had tried to do that, and it had become too dangerous. So there seemed to be no organisation around looking after the well-being of the children, their education, or the deeper impact on them of this war. People were jammed into the hospital, obviously because it was seen as a safe space, and it was humbling to think that us (as foreign workers) being there made them feel somewhat safer. It humbled me immensely.  

I felt nothing but a sense of privilege in being a witness to all this. I was reading the Psalms regularly in daily prayer. There's also something about that land being the place where God himself suffered in Christ and went through his own agony, and that the Holy Family escaped through Gaza to Egypt.  

I genuinely don't feel brave, I don't. I'm not the kind of person who sees lights in the sky, but I know it was God’s calling to go there. It was simply the right thing, a privilege and an honour to have such access which comes with having my particular background of skills and past history with Gaza. God is over all these matters, and we are compelled to respond. 

 

Tim Goodacre is a Reconstructive Plastic Surgeon based in Oxford, with extensive experience of working in diverse environments outside the UK. He is immediate past Vice President of the Royal College of Surgeons of England. 

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6 min read

Letter from Istanbul: how many neighbours is it possible to love?

It’s easy to feel overwhelmed by the sheer mass of humanity in Turkey

Becky is a a writer living in Istanbul.

An Istanbul street curves and the sun illuminates one side
An Istanbul street.
Drew McKechnie on Unsplash.

 

Living in the megalopolis that is Istanbul in Türkiye, as the country is now calls itself*, is both wonderful and utterly overstimulating. As the sun dawns earlier in the summer months, I often ponder on what woke me up as I sip my morning coffee. Was it the Call to Prayer from our neighbourhood mosque; the caterwauling cats; fighting crows; howling dogs or squawking seagulls?

Istanbul (formerly known as Constantinople) is where East meets West, and home to up to 20 million people. It's the only city in the world to straddle both Asia and Europe, separated by the narrow Bosphorus sea, which you can cross by ferry in 20 minutes. 

Known in the Bible as 'Asia Minor,' Türkiye boasts a wealth of Christian history and numerous religious sites, including the breathtakingly preserved ancient city of Ephesus.

Once the largest Christian cathedral in the world, the Hagia Sophia in Istanbul’s historic quarter Sultanahmet attracts millions of tourists to its grand Byzantine architecture every year, as both a mosque and a museum. 

Istanbul's gastronomy is among the best in the world. The food, paired with the melting pot of history, faith, and culture, also makes for the warmest sense of hospitality in the world to visitors and newcomers that you could ever imagine. It is a stark contrast to what I was used to in the UK. 

Turkish hospitality is about way more than tulip-shaped glasses of tea and aubergine köfte kebabs; in Turkish culture, a guest is honoured, making them feel as if they belong. From the drawn out etiquette of home visits to literal fights breaking out when it's time to pay the bill, in Türkiye, a guest is seen as a 'gift from God.'

Speaking of hospitality, Türkiye's official population is indeed an estimate due to the constant stream of refugees that pour into the country and settle in Istanbul, hoping to build new, better lives for themselves.

It is a hugely built-up city, with each skyscraper competing for height and a Bosphorus sea view; here and there, you can spy small little houses called gecekondus (which means 'put up at night'). These are the (illegal) homes of newcomers. 

Türkiye is, on the whole, proud of its migration history (and its 2016 agreement with the UN). Of course, it's a country in a prime position to grant refuge to displaced people in neighbouring nations and as a transit country for people trying to emigrate west, and is home to the world's largest refugee population (3.2 million Syrians and up to 222,000 other nationalities). The latest refugees to seek sanctuary in the four thousand year old city are more Iranians. I enjoy friendships with Turkish, Persian, and Syrian friends in my faith community. 

Of course, attitudes vary regarding the many 'neighbours' who make their home in Istanbul. There are complaints that 'enough is enough.' There is a 'Türkiye first' rhetoric that permeates the Caffe Nero I sometimes work in.  (Eye-rolling and body language speak louder than words when the barista is short with a burka-wearing, stroller-pushing mum speaking Arabic. 

And I do get it. 'Istanbul is overcrowded' is a massive understatement. You can't even begin to compare it to the UK immigration rhetoric. 

Behind most discrimination is fear, and secular locals worry that so many refugees in Türkiye could lead to a different religious landscape one day.

I, too, am a guest here in Türkiye, and I am grateful I've been able to make it my home. I'm reminded that every person is worthy of love and respect no matter where they are from. 

Of course world events significantly impact attitudes towards refugees in Istanbul. Sadly, it's a fact that events around the world can shape people's discourse regarding certain people groups. I find it hard to switch off from what's going on around the world, and since Israel bombed Iran last two weeks ago, I've been glued to the news. 

My hairdresser is an Iranian girl who has a residence permit due to her husband's job in hospitality. I asked her how she was doing. She said she's scared for her mum and sister, who are in a city that's being bombed, and she wants to bring them to Türkiye. She said the scariest thing about it all is that all flights are grounded right now, and the internet is inconsistent; they feel utterly helpless. All I can do is hug her and tell her all life is precious to God, and that I am praying for peace.

A week later, I woke up to the news that the USA had struck Iran, with the intention of destroying three of its nuclear facilities. The world waits and watches with bated breath to see what will happen next.

I don’t have the answers for overcrowding or immigration policies, but when I reflect on 'who is my neighbour' I know it is whoever I find standing in front me.

 

Many in Istanbul do ask 'who is my neighbour? It is a question that has been asked for millenia, most famously by Jesus.

Jesus replied with a powerful story that would have pushed the buttons of all those gathered around on issues of race, religion, and hospitality, which became one of his most famous parables. In 'The Good Samaritan,' a traveller and a Jew are brutally attacked and robbed when he's walking from Jerusalem to Jericho. Beaten, bloody, and left for dead on the side of the road, a priest passes by, but instead of helping, he ignores the man and continues his journey.

Next, a Levite who also worked in the Jewish temple comes along the road, crosses to the other side, and walks away.

Finally, a man from Samaria (sworn enemies of the Jews) passes along the road, sees the injured man, and stops. He stops, tends to his wounds, puts the man on his donkey, and takes him to an inn to recover, covering all the expenses from his pocket.

You can imagine the sound of a pin dropping when Jesus asks which of these three was a neighbor to the man attacked by robbers: 'The expert in the law replied, 'The one who had mercy on him.' Jesus told him, ‘Go and do likewise.’

The message is simple- our 'neighbours' are all the people we come across. It's those different from us and even those with whom our ethnicity and national history demand we make enemies. 

As a white woman with a British passport, I am privileged. I can return to the UK when I choose. People don’t wince if they hear me speak English in Caffe Nero. As a resident in Istanbul, I navigate the attitudes and ever-shifting narratives towards immigration in Türkiye by prayer. 

I want to hold space for my Turkish friends who feel scared and frustrated.

I want to be a voice of peace to my friend who sends me a video of missiles heading for Iran over the border from Hatay, Türkiye. 

Living in Türkiye as a woman of faith has changed me, and I can't help but think that if we all adopted the Turkish philosophy of hospitality, which views all guests as gifts from God, deserving to feel like they belong, the world could be a different place.

I don’t have the answers for overcrowding or immigration policies, but when I reflect on 'who is my neighbour' I know it is whoever I find standing in front me, no matter where they come from. I ask for the strength to 'love my neighbor as myself' no matter the country on their ID card (or despite their lack of one). And when I feel overwhelmed by the sheer number of precious human lives arriving in Türkiye every day, I remember that each of them is also a neighbour - and my job is to care for the one in front of me.


* Türkiye is the new spelling of the country’s name. Find out more