In Gaza, the reality exceeds anything I've experienced in humanitarian emergencies"

You were deployed to Gaza on an emergency mission with Humanity & Inclusion (HI). What was your role?

I'm a physiotherapist, and I've been working in the humanitarian field for eight years, mainly with HI, in emergency contexts: Iraq, Syria, Yemen, Ukraine... In Gaza, I was deployed as a rehabilitation specialist in emergency context. My main mission was to provide technical support to our teams.

How did the mission go?

I was due to enter Gaza around March 20, but the end of the ceasefire on the 18th delayed things. In the end, I was able to stay for three weeks, from April 24 to May 20. We were based in Khan Younès, then had to be evacuated to Zawaida for security reasons. Daily life was punctuated by the incessant noise of drones, bombardments and shaking windows... It was by far the most intense and frightening environment I've ever experienced.

Did these conditions have a direct impact on your work?

Yes, very much so. Every move required security clearance in the morning, with very restricted hours. At the beginning, we couldn't move before 9 or 9:30 am, and we had to be back by 2 pm. This reduced our working hours enormously. And our Palestinian colleagues, who depend entirely on the organisation's vehicles - since there is no public transport - often had to make long journeys to get to the office. Some of our offices were even temporarily evacuated because the strikes were too close.

What types of pathologies have you encountered on the ground?

The needs are enormous. I've mainly seen complex cases: recent amputations, complex fractures, head injuries, spinal cord injuries... There are also many complications linked to a complete breakdown in the chain of care. For example, patients who keep their external fixator on far too long because of a lack of surgical follow-up. I met a teenage arm amputee for whom no prosthetic solution currently exists.

You mentioned a lack of equipment. To what extent does this hinder the help you can provide?

We're facing a dramatic shortage. We have barely twenty wheelchairs and pairs of crutches left. And we have more than 1,800 people identified as needing technical aids, including less than 800 in wheelchairs. Access to the north of the strip is virtually impossible, so even if we had stock, we wouldn't necessarily be able to distribute it. And there are no other players to take up the slack: everyone's in the same situation.

In such a context, how do you define your intervention objectives?

They are very pragmatic. We focus on educating patients and their caregivers: how to avoid bedsores, stiffness and infections. The idea is to ensure a minimum of autonomy, especially if the person is going to be displaced or inaccessible afterwards. It's not rehabilitation as we know it in a stable setting, but it's the most useful thing we can do with the resources we have.

What struck you most during this mission?

The intensity of the conflict, of course. And the teams. They are incredibly committed, despite being personally affected by the war. But also the feeling of helplessness: seeing patients in great suffering and knowing that, despite all our efforts, we won't be able to give them what they deserve. That's really hard. We're faced with a terrible emergency that's getting worse and worse, and in which we have very little room for manoeuvre. In spite of everything, our teams continue. Because every action, no matter how small, counts.

In such an extreme context, one imagines that rehabilitation cannot be a priority for people who are already struggling to feed themselves or have access to drinking water...

Yes, completely. It's a factor that weighs heavily. We have red lines that we can't cross in terms of hygiene, to avoid causing complications. But these rules are very difficult to respect when you consider the conditions in which our patients live: extreme promiscuity, lack of water, virtually no equipment for washing... We sometimes supply hygiene kits to the wounded to limit the risk of infection, but our stocks are now depleted.

As for nutrition, it's catastrophic. The lack of protein slows healing, increases the risk of infection and makes any rehabilitation work much less effective. There's no meat, no eggs, no milk. The vegetables we can still find come only from Gaza. And the few products imported via humanitarian aid are rare and often out-of-date. It's a constant battle.

Are there any patients who have marked you in particular?

Yes, quite a few. There was a young patient with a fractured humerus and nerve damage in his arm. He had also suffered a head injury, with severe after-effects: loss of hearing, sight... He was very withdrawn. We took care of him after his injury. We were able to help him a little on a functional level, but for his sensory problems, there was simply no specialised service available. It's very frustrating.

And then there's the brighter story of a little boy with an arm amputation who managed to take up the violin again. He adapted and found a way to hold his bow with his remaining arm. He even started taking music lessons again, thanks to a local NGO. Now that's overwhelming. It's an immense victory, in a context where every step forward is an achievement.

How was the contact with the local population? Tiredness, resignation, hope?

With our colleagues, we felt a tremendous weariness. They're not hopeless, but they're very affected psychologically. Since the end of the ceasefire, they've been under constant stress. They come to work leaving their children behind, in an ultra-precarious context, and yet remain incredibly committed.

I've had less direct contact with the beneficiaries because of security constraints. But what I have noticed is a deep appreciation of HI. In some areas, our mobile approach is the only way to access a rehabilitation service. There are no more outpatient facilities, only a few hospitals with very strict admission criteria. Chronic cases are often overlooked.

This was your first mission to Gaza. What do you take away from it?

I'm overwhelmed. What I don't understand is how we let this happen. The situation has been getting worse for over a year and a half, and yet nothing seems to be stopping this war. What strikes me most is the incredible resilience of the people, but also the feeling of abandonment that we sometimes feel.

Our Palestinian colleagues have lived through the unspeakable: forced displacement, immense family losses, repeated traumas. And yet, they carry on. They think of others, of those who still need help. This is both a source of strength and immense pain.

And today, can HI still intervene effectively?

We're doing everything we can, but we're at the limit. Our stocks of technical aids are virtually empty, access to areas is increasingly restricted, and the risks for both teams and beneficiaries are becoming difficult to manage. If we completely lose the ability to operate, there will be no more center-based and mobile services, and services will remain only in the few hospitals able to operate. In other words, almost nothing.

And the consequences will be serious. Some people will develop irreversible disabilities, with serious, even life-threatening, medical complications. Without rehabilitation, some amputees will never be able to be fitted with a prosthesis. Others will suffer from infected bedsores, major functional losses... And in a context where basic needs - food, shelter, water - are not even covered, this will make them even more vulnerable. It's a never-ending spiral.