Dr Yiu-Kai Au’s first-hand experience of medical volunteering in Gaza

Upon his return from the conflict zone, Dr Yiu-Kai Au, a retired surgeon who previously worked at Kwong Wah Hospital, Hong Kong, shared his first-hand experience of medical volunteering with the International Committee of the Red Cross at the European Gaza Hospital in Rafah, southern Gaza Strip, Palestine, from December 2023 to January 2024.

“While this was already my 25^th humanitarian mission overseas and 8^th mission in a war zone, experience from this mission was the most profound,” said Au. “The scale and impact of the artillery were more severe than in previous conflicts, such as the 2014 Gaza war. Unlike in previous missions, which primarily involved injured militants, most victims in the current conflict were women, children and elderly individuals. Their plight was severe. I utilized my expertise and experience to the best of my ability to help the victims and bring them hope.”

Plight of civilians
Au and a team of 12 medical volunteers, including orthopaedic surgeons, anaesthesiologists, physiotherapists and ward nurses, delivered medical services such as skin grafting, wound and fracture care, and physiotherapy to 70–80 patients with severe burns, bone fractures and infection. These patients had initially received treatments from local frontline healthcare professionals.

“Many patients were sent to the European Gaza Hospital following attacks in late-night or early-morning hours. Other patients came from the northern regions, where medical facilities had been destroyed,” Au said.

One of the most severely injured civilians treated by Au was a 68-year-old woman with severe burns covering nearly 40 percent of the body. She had stayed at the European Gaza Hospital with her family, including two daughters, since November 2023. “While palliative care was initially considered, her condition stabilized over the following months. Just before I completed the mission [in January 2024], plans were made for skin grafting for this patient,” he shared.

Au also treated two brothers – a 13-year-old boy with extensive burns covering half of the body and his 5-year-old brother requiring amputation of the left leg – 10 days after their injury. The brothers had lost their parents during the conflict and were being looked after by their grandmother and uncles.

Another patient treated by Au was a 32-year-old woman who had become paralyzed on the lower half of the body due to a spinal injury. After 1 month without treatment, she developed bed sores. Her 4-year-old son was her company after her husband had passed away.

“The patients appreciated our help, possibly finding hope from us,” Au added. “Despite the ongoing conflict, every patient received support from family or friends. Human connection and mutual support help them navigate challenges together.”

Lack of medical supplies and hospitals
“Across Gaza, there was a lack of medicines and medical supplies, such as anaesthetics, dressing, and bone stents for external fixation. We carefully used every [item] we had,” said Au.

“We were uncertain about when the supplies would be delivered, while patients were being sent to our hospital every day,” Au continued. “Upon my arrival, I was informed that three trucks carrying medical supplies were expected to reach Rafah from Egypt. Unfortunately, the trucks never arrived.”

“Currently, there are only seven or eight functional hospitals in Gaza, which comprise <30 percent of the total. With ongoing attacks, even fewer hospitals are likely to continue functioning,” Au added.

Future of Gaza
“We do not know when the war will end. If necessary, I will visit Gaza again later this year,” said Au.

“As the conflict persists, acute care remains the top medical priority. In the aftermath of the conflict, next steps will involve [longer-term] rehabilitation and reconstruction,” he explained. [Curr Trauma Rep 2020;6:194-206; BMJ Glob Health 2020;5(Suppl 1):e001980; Health Policy Plan 2019;34:230-245] For example, individuals who underwent limb amputation during the conflict will need gait training and prosthesis in the recovery process. [Orthop Trauma 2018;32:234-240]

“For the patients, the road to recovery will be long and challenging … potentially lasting up to 10 years” Au said.