Almost a week ago, my editor Mehr Husain and I had the honour to interview Professor Nick Maynard who has been lately in the news for his valuable services to help and support the vulnerable Gazans amidst the ongoing Israel – Palestine conflict.
Professor Maynard is associated with Medical Aid for Palestinians, which is a UK based charity and which aims to meet the humanitarian needs of the Palestinian people. He is a leading consultant and an upper GI surgeon based in Oxford. He has been the Director for cancer services for Oxford University and is the President of AUGIS (Association of upper GI surgeons of Great Britain and Ireland).
At the same time, he has been travelling to the West Bank and Gaza for more than a decade to teach medical students and junior doctors. He has recently returned from Gaza, where he led an emergency team at the Al Aqsa hospital. He graciously shared his insights and experiences of dealing with one of the worst possible humanitarian catastrophe.
Momina: Professor Maynard, I believe you have been visiting Gaza to teach surgery since 2010 but this time you went amidst a serious humanitarian crisis. Can you tell us about your experience?
Professor Maynard: I have been travelling to Gaza since 2010. For many years I have been teaching medical students and junior doctors and recently have been going out to Gaza to carry out cancer surgery. I was in Gaza in May this year teaching cancer surgery and also had planned to visit Gaza for a week of cancer surgery in October but then October the 7th happened and that was cancelled but I was very keen to go to Gaza to help with the massive need for humanitarian aid.
Mehr Husain: Why it is that you go to Gaza? Were medical facilities pre-October in a bad state? Is it an act of charity?
Professor Maynard: It’s a very good question and people often ask. Its very easy to answer as I love Gaza. The reason I went there was very fortuitous. Someone invited me and I fell in love with the place and particularly the people. Gazans are very beautiful people and I have made many friends out there. They have always needed medical help from abroad. They have very fine doctors and nurses, but their resources are limited, and their training is lacking as they don’t get a chance to go abroad and learn. Very few health professionals have been allowed into Gaza for over 15 years, so they have little opportunity to learn from people abroad. The need is great there and I tried to fulfill that need.
Momina: Professor Maynard, you must have entered Gaza via Rafah border. What’s the situation there, as much aid is not allowed in and across Gaza?
Professor Maynard: When we got to Rafah, we had a long trip from Cairo across northern Sinai. As we reached on the Egyptian side of Rafah, we passed hundreds upon hundreds of trucks waiting to go in. A lot of trucks were turned away and one of the trucks was a truck full of diapers. When we went to one of the shelters in Gaza, we were told that there were not enough diapers and its odd that these trucks were turned away. Many other trucks were also queuing, and it seemed quite clear that there was a huge delay in any aid getting into Gaza. In quiet times there are approximately 500 lorries going in there and now it is well under that.
Mehr: There is a popular narrative that if the aid goes in Hamas might take it? Is that the belief preventing aid from going in?
Professor Maynard: Once the aid gets inside Gaza, the distribution is very poor because of the military action going on there. After 1st of January, only 14% of the aid intended for Northern Gaza went into Northern Gaza. I cannot comment whether aid is being taken by Hamas or not.
Momina: What were your feelings as a doctor while working in a collapsed health care system, where you were unable to provide even the basic health care facilities?
Professor Maynard: I am used to working in Gaza where supplies are always limited but my past experience was nothing as compared to what we saw. We admitted very young children with severe injuries and burns and we had no pain killers to give them. We had enough anaesthetic to put patients to sleep in order to operate them but the equipment in the theatres was lacking. One day for instance we had no running water, so we used alcohol gel to sterilize our hands. The amount of needles and switchers was limited, and we had to adapt significantly.
Momina: What was the significance of the telecommunication blackout and how did it impact doctors and health care professionals?
Professor Maynard: It definitely made telecommunication within the hospital extremely difficult as it was hard to contact anyone in the hospital and you had to go and find the staff personally. Once there was an aerial bombardment in a particular camp and the ambulances had no idea where they had to go, so they had to wait until patients arrived in cars and donkey carts. When the casualties arrived at the hospital, they informed the ambulances where the bombardment had taken place. As there was no communication between hospitals it was difficult to coordinate activities to serve patients.
Momina: You once mentioned in one of your interviews about a certain child who would come up to you looking for food as he was abandoned because his parents had died during the war. Is there any international agency or a local institution looking after these children?
Professor Maynard: UNICEF and other organizations are aware of this situation but during active warfare it is difficult for them to help these children. There is an acronym WCNSF (wounded child no surviving family) being developed for these children in Gaza and currently there are many children residing in Al Aqsa hospital who are without families.
Mehr: What hope is there now for the medical industry in Gaza? We are looking at a region that is completely annihilated and there are children who might want to pursue medicine. Is there any scope for them?
Professor Maynard: I believe there is always hope. The longer the military action goes on, the more the health care system is being destroyed. So, we don’t know what will be left to rebuild. There is a lot of thought going on already whether how to rebuild Gaza. I am attending a meeting in Jordan in two weeks’ time, and we are going to be discussing this and there will be large number of people willing to go there to help rebuild health care structures in Gaza. With medical schools destroyed, we need to study whether or how to continue to train doctors. Providing worldwide online teaching to medical students and doctors is also under consideration. Truly an enormous amount of work is required to resurrect the health care services. I am hoping beyond hope that something is left to build on.
Momina: Working in challenging situations with mass casualties can be really stressful. What coping strategies do you apply for yourself and would also suggest for volunteering doctors?
Professor Maynard: I go with a UK based charity called medical aid for Palestine which partners with IRC (International rescue committee). They provide ample psychological counselling, but nothing could prepare us for what we experienced in Gaza. All of us who volunteered were close and spoke a lot with each other and secondly, I have a hugely supportive wife and family.
Mehr: We have been seeing so many videos of people calling out for help and feeling not heard. The level of isolation is hard to imagine. Were you ever asked if the world was listening?
Professor Maynard: I have been asked many times. They have felt abandoned by the rest of the world for many years. Gaza has been blockaded for 16 years now. With a few exceptions they do not believe they have had support from the outside world. After October 7th, I have been questioned many times whether, why they have been abandoned and why they have been treated like animals. So simply being there means a lot to them.
Momina: During a war like situation, you expect to come across young men, but this war was different as most of the casualties were women and children. What sort of injuries did you witness?
Professor Maynard: Most of the casualties were women and children and the injuries that I was operating were severe blast injuries. The most common injuries included shrapnel causing internal damage, terrible burns in children, traumatic amputations and even head injuries with a major portion of brain exposed.
Momina: Did you observe any Middle Eastern influence with regards to developing make shift hospitals?
Professor Maynard: I have heard about a Qatari field hospital and a Jordanian hospital being built. The UK based charity group, medical aid for Palestinians is also considering setting up a field hospital for Gazans. Although there is huge potential for the setup of a possible field hospital but at the moment no place is safe in Gaza until a ceasefire is announced.
Mehr: When are you planning to go back to Gaza?
Professor Maynard: I am hoping to go back in March and entirely depends on the security situation there.