Palestine Red Crescent ambulances operate around-the-clock despite curfews

Published: 28 June 2002 0:00 CET

Sébastien Carliez, in Ramallah

Dr. Wael Qa'dan has been on duty almost around-the-clock for the past few days. And tonight, he will again spend the night at the Palestine Red Crescent Society's (PRCS) main office in Ramallah, like nearly 50 of his colleagues. Dr. Qa'dan is director of the PRCS emergency medical services (EMS) for the West Bank. In the Ramallah ambulance station, he manages a team of 14 staff and 20 volunteers. "Under normal circumstances, only 9 staff and 6 volunteers would be mobilized at once. These days and for the past five months or so, they all have remained on call, permanently," he explains.

The city of Ramallah has been under complete, Israeli-imposed curfew for two days in a row now. PRCS ambulances are the only Palestinian vehicles allowed to move around town, although movements remain restricted in many areas. "Ambulances sometimes get stopped at military checkpoints for hours, requiring the ICRC to intervene," says Dr. Qa'dan.

"We must take care of all kinds of cases these days, from urgent ones, like delivering babies, to cold cases, or high fever, abdominal or chest pains," he says. "We do between 80 and 100 sorties a day, and in each one, we transport up to six patients at once." On a normal day, before the current cycle of violence began, PRCS ambulances handled only 15 to 20 cases, most of them people injured in car accidents.

Dr. Qa'dan is interrupted by colleagues who explain that ambulances are also used to pick up PRCS staff and volunteers who cannot come to work by themselves, and drop doctors off at their respective hospitals. Ibrahim Al-Ghouleh, a paramedic in his late twenties, was picked up yesterday from his house in Baytounya, a neighbourhood now completely sealed off. "Since then, I had lunch in the ambulance and slept for a few hours at the dispatch centre," he says with a wide smile, despite the fatigue. He is now on his way to two households in neighbouring Al-Bireh, to give an injection to an old man and take a 13-year-old girl who cut her hand with a kitchen knife to hospital. It is 22:00 hours.

"Going at night is particularly feared," admits Dr. Qa'dan. "Only urgent cases are dealt with, mainly transfers of patients to hospitals." Tonight, 15 people will be taken to Ramallah hospital, of which five pregnant women about to deliver. A week ago on the road to Salfit, north of the West Bank, a Red Crescent ambulance was fired at in the middle of the night. Luckily, none of the crew members were injured. Over the past 20 months, three PRCS emergency personnel were killed in the line of duty, and 180 injured.

Over the past three months, 71 PRCS workers were arrested while on duty and detained by the army, some for a few hours, others for weeks. A 28-year-old EMS staff, is one of them. He was in prison for 66 days. Sitting at the dispatch desk today, he does not feel like talking about his detention. "Not yet," notes one of his colleagues, explaining that the experience is still too vivid. To date, one PRCS staff is still in custody. He was arrested in Jenin on 4 April.

To cope with such a volatile working environment, the PRCS has started a psychological support programme for its crews, especially those who go out into the field. For the past year and a half, individual debriefing and group sessions have been organized by psychologists. "Social workers also visit the families of our staff and volunteers," Dr. Qa'dan adds.

"Our people are under tremendous pressure from their families, spouses and children in particular, to stop such an increasingly dangerous job, which I found very understandable," notes Dr. Hossam Sharkawi, the emergency services coordinator at the PRCS. However, fewer than ten have quit their job in the past 20 months. "Most are still willing to do it, sometimes without realizing the sacrifice they make," Sharkawi explains. "It is my duty not to give up now," confirms Ahmed, a paramedic who is a father of three, before adding: "I need to sustain my family, and job opportunities are fewer than ever these days."

Next morning. The telephone never stops ringing. "Ambulances, allo?", answers the operator at the dispatch, flooded by calls from Ramallah's inhabitants, eager to hear fresh news. "They want to know whether the curfew is lifted or not," says Dr. Qa'dan. But why are they calling the PRCS? "People know that we work 24 hours a day. Our ambulance teams go out and see what's going on, and we liaise with the ICRC; we are a reliable source of information."

Later in the afternoon, the curfew is lifted from 14:00 hours to 18:00 hours. Ramallah's families go out for some quick shopping. They are able to move by themselves again and access what remains of the city's health and social services. It's temporary relief for PRCS emergency teams. Only for four hours.

In 2002, the ICRC called for almost 6 million Swiss francs to support emergency services in the West Bank and Gaza – their largest programme of assistance to the PRCS. It covers the running costs of 220 specialists and the fleet of 100 ambulances, as well as equipment, including 22 first-aid mobile units, as well as training and psychological support for the staff. The programme is partly supported by the German and Norwegian Red Cross.

On 6 May 2002, the International Federation appealed for 1.8 million Swiss francs, to replace stocks of medicines and medical supplies for the PRCS primary health care and home-based care programmes and to support the rehabilitation of medical institutions and social services. The total assistance provided through the International Federation to the PRCS in 2001 was almost 1.8 million Swiss francs.