Interview
Change
War & peace
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. 

Article
Change
Identity
1 min read

How to be (un)successful

Could busyness really be the counterfeit of significance?
A man sits cross legged in a park with a laptop on the grass in front of him. He looks to one side.
Malte Helmhold on Unsplash.

You probably want to be a success. 

That’s OK – it’s a very reasonable thing to desire.  

The questions ‘Am I successful?’ or ‘What is success?’ are deeply significant and to ask such questions is a normal part of the human experience. The yearning for a life of purpose, as elusive as it can seem, is felt acutely by the majority of those who have ever lived – certainly by more than might admit it. (Those feelings of inadequacy you experience may be more common than you think.) And now more than ever it is understandable that you may feel you are not particularly successful, or not successful enough. We are assaulted by a combination of capitalism and consumerism, social media and cancel culture, polarised ideologies and virtue signalling, topped off by the wounds of our parents passed down – all of which can amalgamate into producing some pretty angsty, pressure-driven people. 

It’s not just you; I’m pretty sure we all have a bit of a problem with success (the word itself is so subjective), and our idea of it can often be fuelled by wounds rather than vision, romanticised projections rather than reality. Because we are all somewhat flawed, any worldly contribution we try to make can get precariously entangled with a me-fixated narcissism on a fairly regular basis.  

Most of us know that being successful is not simply about money, looks, large numbers or power. That’s just a caricature to which very few reasonable people actually subscribe, right?  

Well, sure – at least on the surface. 

My social-media feeds are rammed full of early-to-mid-thirties enjoying a kind of spandex-clad transcendence. 

The thing is, despite seeing through it and being repelled by it in others (we see it’s all vanity, inch-deep), something in us longs for success on these terms. But much more interesting than skimming along the surface of ‘success’ is excavating deeper into some of the core motivating beliefs we humans have about ourselves, such as mistaken pride in thinking we each control our destiny, or paranoia that tells us there’s an inherent scarcity of everything in the world. These are the swell that carry along the undercurrent of comparison – where we see the lives of others and long for a different reality for ourselves. And comparison – so often eliciting either pride or despondency – rarely ends well.  

A cursory glance through the wisdom of online articles on the matter tells us millennials typically understand that material wealth isn’t the marker of success – there are enough old, sad, rich people to show that. Instead, success has now become synonymous with living a life that others want. Chase an experience. Go adventure. Wanderlust. #yolo. To succeed in life is to publicly consume as many unique experiences as you can during your short time on earth.  

I don’t know about you, but my social-media feeds are rammed full of early-to-mid-thirties enjoying a kind of spandex-clad transcendence. Success for today’s generation would seem to look a lot less like the overweight suit-clad city trader selling their soul to the system, making shedloads of cash to buy a slice of suburban real estate with a Porsche in the drive, and more like the lithe and mindful global citizen doing ‘life on my terms’. Think coastal living, yoga on a stand-up paddleboard in the morning, slaying the emails in your industrial co-working space, eating a superfood lunch, nailing a couple of zoom calls early evening before smashing some gua bao and margaritas with ‘your peeps’ at the latest pop-up restaurant before taking an Uber home. #squadgoals  

There’s no escaping the fact that technology has shrunk the world and as James Mumford notes, ‘global capitalism has brought so many different ways of life closer to us than ever before. We can see vividly a greater number of people who we want to be.’ This can bring up hidden feelings we thought we’d buried long ago.  

I often feel unfulfilled. Sometimes completely lost. For years I haven’t been able to admit that. Until fairly recently I would find myself looking at others and thinking: ‘Don’t they ever struggle with life’s big questions? Don’t they ever want to give up? Surely, I can’t be the only one sinking under the weight of comparison?’ Far from freeing me from my broken sense of self, the version of faith I was trying to live by was exacerbating the core wound I recognised in myself. That wound was a sense of feeling a failure, unsuccessful. And like an unwelcome parasite, it fed on comparison to others.  

Read any random couple of articles on ‘successful’ people talking about how ‘successful’ they are, and a lot of what’s conveyed is a profoundly angsty relationship with time: ‘You only have one shot at life’; ‘I don’t want to waste my time on earth’; ‘You can never get it back.’  

It’s as though we have an inherent recognition – and for some, dread – of the physical limits placed on us by virtue of being mortal and human. But what if unencumbered productivity, unceasing activity and unrelenting progress – however that is defined – are signs less of success than of self-centred insecurity? Could busyness really be the counterfeit of significance?  

It’s as if we have, left unchecked, an insatiable appetite for accomplishment. It’s not hard to see where this comes from. Paul Kingsnorth comments that: “Modern economies thrive by encouraging ever-increasing consumption of harmful junk, and our hyper-liberal culture encourages us to satiate any and all of our appetites in our pursuit of happiness. If that pursuit turns out to make us unhappy instead – well, that’s probably just because some limits remain un-busted.” He goes on to suggest that this is a fundamentally spiritual problem, because ‘a crisis of limits is a crisis of culture, and a crisis of culture is a crisis of spirit.’ 

So far so depressing? 

It needn’t be. 

Fullness of life – true success, if you like - is found in living to serve others above ourselves. 

Despite my continued struggle with all of the above, (neatly summarised by the inner critic’s voice asking me ‘what have you got to show for your life?’), I am beginning to learn that ‘life in its fullness’ (as Jesus once described what he came to offer) is found elsewhere. So, what does this look like and how do we successfully access this fullness of life? This quote can come across – and I’ve heard it used as such – like a marketing slogan, dangling a golden carrot in front of sad or vulnerable people to recruit them into church. Presumably that wasn’t what Jesus had in mind.  

Now there’s no denying the fact that Jesus was one of the most influential people who ever lived. Arguably THE most influential. Generally, even those who don’t follow him recognize that what he taught was pretty timeless. (Also evidenced by the 2.6 billion people today who are happy to be called Christian.) All of this suggests he had some fairly wise takes on how to live life well, and that his perspectives have stood the test of time. So, when he is recorded as teaching about how to discover what he described as ‘life in its fullness’, the chances are there is something valuable and insightful for those of us searching for success.  

The thing is, in this particular speech, Jesus conceptualized ‘life in its fullness’ as a shepherd who ‘lays down his life for the sheep’. Sure, he was talking about himself, but he was also talking more broadly about the human experience. Jesus’ point is that fullness of life – true success, if you like - is found in living to serve others above ourselves. This flies in the face of much conventional ‘self-help’ wisdom, but it would seem you cannot find true abundance any other way.  

We might well think: ‘Well hang on a minute, Jesus claimed to die for the sins of humanity – we can’t all do that!’ Absolutely right, and please don’t try. But in dying and raising to life again, Jesus foreshadowed the journey of surrender and rebirth that each person who chooses true success must go through. As C. S. Lewis said: ‘Nothing that you have not given away will be really yours. Nothing in you that has not died will ever be raised from the dead.’ This new life of serving others above ourselves – where we seek to align our desires, loves and motivations, our use of time and energy, words and actions with those of Jesus – comes to resemble the promise of life in its fullness. Discovering that would seem fairly successful wouldn’t it? 

 

How to be (UnSuccessful) is published by SPCK.