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P 151637Z JAN 09
FM AMCONSUL JERUSALEM
TO RUEHC/SECSTATE WASHDC PRIORITY 3862
INFO RUEHXK/ARAB ISRAELI COLLECTIVE PRIORITY
RUEHGV/USMISSION GENEVA PRIORITY 0166
RHEHNSC/NSC WASHDC PRIORITY

C O N F I D E N T I A L SECTION 01 OF 02 JERUSALEM 000144 
 
SIPDIS 
 
E.O. 12958: DECL: 01/15/2019 
TAGS: PHUM SOCI EAID ICRC KWBG KPAL PREF PTER GZ IS
SUBJECT: ICRC SURGEON DESCRIBES CONTROLLED CHAOS AT MAIN 
GAZA HOSPITAL 
 
Classified By: Consul General Jake Walles for reasons 1.4 (b) and (d). 
 
¶1.  (C) Summary.  ICRC surgeon Harald de Veen told donors and 
international medical NGO representatives January 14 that 
Gaza City's main government hospital, al-Shifa, has been 
functioning as well as can be expected and coping with 
massive numbers of injured.  He said clinical staff are 
capable and following protocols.  He urged donors and 
international medical NGOs not to send foreign doctors into 
Gaza, arguing that even experts sent on an ad hoc basis will 
be disruptive.  ICRC medical sector coordinator Eileen Daly 
said Rafah crossing and central storage facilities in Gaza 
are overwhelmed with in-kind goods waiting to be inventoried; 
in-kind medical supplies should be sent only based on 
Ministry of Health (MOH) requests, he said.  De Veen said 
field hospitals will not be useful unless secondary hospitals 
are no longer available to receive patients discharged from 
al-Shifa.  End summary. 
 
Al-Shifa: Chaotic, but Managing 
------------------------------- 
 
¶2.  (C) ICRC surgeon Harald De Veen said al-Shifa receives 
primarily blast injuries with multiple traumas, including 
penetrating head and abdomen injuries, as well as cases 
requiring traumatic amputations.  He said the atmosphere is 
chaotic, but the hospital well managed.  Surgeons are working 
in three shifts of fifteen doctors.  There are six operating 
rooms, some with two tables in use at a time.  De Veen said 
he had seen as many as ten simultaneous operations, sometimes 
with multiple surgical teams working on the same patient. 
Al-Shifa normally has twelve ICU beds, but an additional 
twelve beds are now in the ICU. 
 
¶3.  (C) De Veen said obstetrics is in a separate building, 
and some beds there have been allocated for trauma victims. 
Access is remarkably quick, he said, compared to other 
conflict zones he has worked in. "Dead or alive, patients are 
there within minutes," he said.  "These are serious injuries 
-- I want to stress that -- it's gruesome.  You hear a bang, 
and minutes later cars are screaming in with bodies, body 
parts..."  Attempts to stand up a triage station lasted only 
a day and a half, according to De Veen, leaving patients, 
family, and media direct access to the emergency room and 
creating chaos. 
 
¶4.  (C) De Veen acknowledged that many of the patient 
transfers from al-Shifa are necessary because of space 
constraints, not medical reasons, and secondary and tertiary 
surgeries will be needed post-conflict to correct care 
provided during the hostilities.  He said clinical standards 
are generally met, with notable exceptions in orthopedics, 
especially in amputations.  (Note: An NGO hospital director 
separately complained to Poloff January 6 of poor orthopedic 
work coming to his hospital from al-Shifa.  End note.) 
 
International Personnel Not Needed 
---------------------------------- 
 
¶5.  (C) De Veen was blunt in urging medical NGOs not to send 
foreign medical doctors to Gaza.  He said al-Shifa physicians 
are experienced in mass casualties. ICRC medical coordinator 
Eileen Daly said Rafah and Gaza's central storage facilities 
are overwhelmed with in-kind goods that must be inventoried. 
She asked donors to send in-kind medical goods only in 
response to specific Ministry of Health (MOH) requests. 
 
¶6.  (C) Asked about alleged IDF use of white phosphorus, de 
Veen said he saw no evidence of injuries from white 
phosphorus at al-Shifa and noted that ICRC previously 
distributed protocols for reporting suspicious 
weapons-related injuries. ICRC has not so far received 
reports through that channel.  He told Poloff privately that 
he saw no pressure for clinicians to give Hamas militants 
preferential or expedited care. 
 
Comment 
------- 
 
¶7.  (C) Al-Shifa is the largest, most sophisticated hospital 
in Gaza City. De Veen was clear during the briefing that his 
experience was limited to al-Shifa, and the situation in 
smaller Gaza City hospitals, or in southern areas like Khan 
Yunis and Rafah, is likely worse.  Gaza-based ConGen contacts 
reported IDF activity as close as 500 meters from al-Shifa 
January 15 and that a nearby Palestinian Red Crescent Society 
(PRCS) hospital caught fire from shelling.  There are 
persistent rumors that Hamas is hiding in bunkers below 
al-Shifa, and that the IDF may target the hospital or cut off 
access to it. If al-Shifa hospital is seriously damaged or 
 
JERUSALEM 00000144  002 OF 002 
 
 
made inaccessible, the capacity to treat traumatic injuries 
in Gaza will be seriously undermined.  End comment. 
WALLES