The interior of the heavily damaged European Hospital in Khan Younis after an Israeli army attack in May. Getty Images
The interior of the heavily damaged European Hospital in Khan Younis after an Israeli army attack in May. Getty Images
The interior of the heavily damaged European Hospital in Khan Younis after an Israeli army attack in May. Getty Images
The interior of the heavily damaged European Hospital in Khan Younis after an Israeli army attack in May. Getty Images

Gaza's hospitals 'gasping for breath' with doctors killed and patients lying on floors


Nagham Mohanna
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Israel's latest offensive in Gaza has added to the burden on the remaining hospitals, where the deaths of doctors and the shortages of equipment and beds are pushing the situation once more to the brink.

That was the warning from the head of the World Health Organisation this week, who said Israel's attack on Gaza city and orders for people to leave are pushing them into an “ever-shrinking area unfit for human dignity”.

“Hospitals, already overwhelmed, are on the brink of collapse as escalating violence blocks access and prevents WHO from delivering life-saving supplies,” Tedros Adhanom Ghebreyesus said.

Israel’s intensifying ground offensive has left medical staff scrambling to treat hundreds of wounded people every day. Mohammed Abu Salmiya, the director general of Al Shifa Hospital, said Gaza city's largest medical facility no longer had the capacity to handle severe cases.

“With every advance by [Israel] into the heart of Gaza city, the number of victims increases, and the health system is gasping for breath,” Dr Abu Salmiya told The National.

On Saturday, he was working in the hospital's emergency department when two victims killed in a strike were delivered to the ward: his brother and his sister-in-law.

"I was shocked and devastated to see the bodies of my brother and his wife," Dr Abu Salmiya said.

"Anything is possible now, as you receive your dearest ones as martyrs or wounded. The occupation's crimes continue, and the number of martyrs keeps rising."

The civil defence agency reported that at least 20 people had been killed in strikes on the city on Saturday.

Dr Abu Salmiya said the situation at the hospital was “catastrophic”.

“We are dealing with more than 100 injuries every day, and for most of them we are unable to provide medical services due to a lack of capacity and resources,” he said.

Israeli troops have this week stepped up their campaign to capture Gaza city. AFP
Israeli troops have this week stepped up their campaign to capture Gaza city. AFP

Some of his staff have been killed, others injured or arrested. Many fled south to protect their families as the Israeli military pushes deeper into Gaza city. Those who remain face relentless bombardment, including daily strikes near the hospital that make it nearly impossible to work safely.

Fuel shortages, he added, threaten to shut down the central oxygen station and halt ambulance operations. “If that happens,” he warned, “we will face a grave health and humanitarian catastrophe.”

Munir Al Bursh, director general of Gaza’s Health Ministry, echoed that warning. He said the main hospitals still functioning – Al Shifa, Al Ahli, and a handful of clinics – are operating beyond breaking point.

“There is no space left, not even for a single patient,” Dr Al Bursh told The National. “Dozens of patients and wounded are lying on the floors.”

With hospital capacity limited to fewer than 500 beds, doctors are inundated daily by hundreds of new injuries from round-the-clock air strikes and shelling. Many cases go untreated due to a lack of staff, equipment, or basic medical supplies, blocked by Israel’s closure of crossings into Gaza.

Israel is intensifying its attacks on the areas around the remaining hospitals, Dr Al Bursh said, disrupting the health system even more.

Gaza city residents have been ordered to head south as the Israeli army destroys buildings. AFP
Gaza city residents have been ordered to head south as the Israeli army destroys buildings. AFP

For families, the crisis is personal and devastating. Mohammed Abu Shanab, 47, was displaced from Gaza’s Shujaiya neighbourhood to Al Rimal. His 21-year-old son, Yahya, was gravely wounded in a bombing near the Al Samer area in mid-September.

“He stayed in the emergency reception area for about an hour before doctors could examine him, because of the overwhelming number of injured,” Mr Abu Shanab said. When surgeons finally took Yahya in, after a 10-hour wait, they operated under dire conditions, with electricity cutting off repeatedly.

Mr Abu Shanab had hoped to move his son south for follow-up care, but there was no transport. “I’m forced to stay here and watch my son suffer in front of me due to the lack of painkillers, antibiotics, and bandages,” he said.

After only two days, Yahya was discharged, far earlier than doctors recommended, because there were no beds left. “He needed at least a week,” his father said. “But there was no space for him, no place for the wounded.”

The health system has collapsed under the weight of war. Doctors are exhausted and undersupplied. Patients are crammed on to floors or sent home too soon. Ambulances and oxygen stations may soon stop working.

“Conditions are extremely difficult for people,” Mr Abu Shanab said. “There are no medical services because of the occupation, its bombardment, and its closure of the crossings.”

The WHO has warned that unless immediate steps are taken to ensure the safe delivery of fuel, medical supplies and humanitarian access, Gaza’s hospitals will not only fail the wounded of today, they will cease to exist for the survivors of tomorrow.

With reporting from AFP.

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Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.

Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.

Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.

Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.

“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.

Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.

From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.

Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.

BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.

Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.

Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.

“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.

Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.

“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.

“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”

The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”

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