2 days ago
'They aim to kill': Surgeons in West Bank say Palestinian patients are coming in with more complex injuries
Surgeons are witnessing an increase in the severity of attacks on Palestinians in the occupied West Bank, creating a greater life-saving challenge for medics who believe victims have been deliberately maimed.
They told The National their patients' typical wounds have escalated from light injuries to people being severely wounded or killed by the Israeli security forces or illegal settlers.
'They're aiming to cause more casualties, not just to scare people away like before,' Dr Mariam Aweidah said. 'We're not seeing more numbers, but we are witnessing a lot more advanced and more difficult cases.'
The latest UN figures show that 10,712 Palestinians in the West Bank have been injured, including almost 3,000 by live ammunition, since September 2023. The violence committed by ultranationalist Jewish settlers has also reached an average of four attacks every day.
Head shots
Before the October 7 attacks the security forces would break up disturbances by shooting at people's limbs, but after the Hamas killings medical staff have witnessed a massive increase in major trauma.
Another doctor, who did not want to be named, said while previously the security forces were shooting at Palestinian youths 'to move them away from their area of operations, so they aimed at the legs just to push them away,' causing light wounds.
'But now we're seeing them aim to shoot as many people as possible and the injuries are more complex, more advanced, and it's usually aimed to kill.'
Occasional air strikes on towns have also caused life-threatening blast injuries as well as deaths.
The potential for saving life is also greatly challenged by the huge increase in Israeli checkpoints, with their vast queues meaning that a 35 kilometre journey from Jericho hospital to Ramallah now takes three and sometimes four hours.
Surgeons gather
To save more lives, surgeons of all specialties in the West Bank are being taught the fundamentals of trauma surgery, to provide emergency surgical care in conflict and catastrophe.
The David Nott Foundation (DNF), a charity training frontline doctors in conflict zones, organised a course to train 60 Palestinian surgeons across a variety of medical disciplines.
If an orthopaedic specialist has to deal with a severe head injury, they will now have an understanding of the steps required to keep them alive.
The course, with the help of the World Health Organisation, managed to get the surgeons trained across five days last month, the main driver being keeping patients alive to get them to specialist medical centres in time.
'In the hospitals, you could have just one surgeon on duty and when a case comes in regardless of whether they're a vascular or an orthopaedic surgeon, they may have to deal with that specific trauma,' said Hetty Cane, who organised the programme for DNF. 'And this is a real problem in West Bank because the checkpoints often mean that you can't transport ambulances through them.'
The doctors, some with 20 years surgery experience, were taught a variety of skills from ballistics, damage control, vascular surgery, head and maxillofacial trauma, plastic surgery and paediatrics.
'It's essentially an all-round course, supporting skilled surgeons to deal with every field of trauma surgery' Ms Cane added.
Hospital isolation
Those new skills will be vital for Dr Aweidah, for at times she has been the only surgeon on duty at her hospital.
'If I'm on call in Jericho, I am the only surgeon in the region, so I can't move, so I just have to stay in the hospital to stabilise the casualties before they can be moved between cities,' she said, speaking from the Palestine Medical Complex in Ramallah.
'As surgeons we are doing so much more than we used to. I'm a general surgeon, so brain surgery is not something I would like to do, but if I am alone in a hospital and the city is closed and I can't get the patient into another hospital safely, I would have to operate.'
The key point, she states, is to 'save lives as much as you can in the hospital you're working in'.
At times, with major chest injuries, general surgeons have had to 'just open up the chest and operate in the ER' but they had 'very good success stories based on the training with the David Nott Foundation,' she added.
Ceasefire worries
More worryingly for West Bank medical staff is that during the Gaza ceasefire from January to March there was a substantial increase in West Bank violence. There fears that after any peace deal with Hamas the situation could again become more intense if Israel attempted to annex large chunks of the West Bank – especially after Israeli cabinet minister Bezalel Smotrich stated this week he wanted to sever the territory in two.
'That will make the surgery training even more important,' said Dr Aweidah, who has been a doctor for 12 years. 'We are preparing for the worst, and that's why most of the training that we're having is just to build more expertise to deal with mass casualties and very bad advanced injuries.'
She reflects that the future 'is not very bright' and that 'all the signs indicate that it's going towards a worse situation'.
