“The worst thing was the ugly feeling of impotence. When you can’t save a life.”
I am an anaesthetic and recovery nurse at Epworth Private Hospital.
Born in Kuwait, I am a third generation Palestinian refugee. We came to Gaza when my father had an accident which left him a quadriplegic. So from early childhood, I became used to performing nursing tasks, looking after my dad. My dream then was to become a neurosurgeon and operate on my dad to heal him.
After school, I started seeking medical scholarships abroad, as there weren’t any medical schools in Gaza. But my father expressed a desire that I stay by his side, and I obeyed, letting my dream go. Instead, I went to an American Baptist missionary school in Gaza to study nursing.
Gaza was, and still is, under occupation. I did my nursing studies during the First Intifada, the first Palestinian uprising. From the start, I got a lot of exposure to war trauma: emergency care for wounded people, patients affected by gunshots, explosions and teargas.
I graduated and got my first job as a general nurse in St Joseph’s hospital in Jerusalem. I worked on all the wards – general surgery, neurosurgery, paediatric ENT surgery and general medical as well as intermediate cardiac care, so my experience and knowledge quickly grew.
For a Palestinian, travel is all but impossible, it’s extremely difficult to get the right permits and documents.
So I stayed at the hospital campus, rarely going back to visit my family. When my brother called me to let me know my father died, I was on the job, unable to leave immediately because I needed a permit to leave Jerusalem and enter Gaza from the Israelis. I contacted the International Red Cross and they managed to organize a safe passage for me to enter Gaza hoping to make it to my father’s burial.
Unfortunately, by the time I made it home, my father was already buried.
Burial is part of the grieving process in my culture, and being deprived of that, I found it extremely hard to accept and make peace with my father’s death.
Like many of my friends, I dreamt of going to the States and working there. After my father’s death, I organized the right documents and passage to the US, to sit the American license exam. I never made it past the airport gates. The immigration officer, despite my documents being in order, turned me away on mere suspicion of illegal immigration. I had to return to Gaza.
I was extremely disappointed, I had no job or money for about a year. Then I found out about a new hospital that was opening in the Jabaliya refugee camp. I applied, passed the interview and got a nursing job.
It was a hospital built by volunteers, using money donated by the Palestinian community.
There was no budget.
We had boxes full of medical tools and equipment, donated by surgeons and other hospitals. I helped to set up the Al Awda hospital from scratch, equipping theatres, getting everything in place for opening, setting up equipment and procedures, educating the younger nurses and support staff.
We were still a way away from being ready to open, despite pressure from the management to start working. There was still much to be done, but then one morning, there was a call for me to run to the emergency department.
There was a blue baby on the trolley.
The father of the child said the toddler had swallowed a marble. We rushed the baby to theatre, the surgeon did a quick tracheotomy, and then slipped his finger underneath the larynx to try and push the marble out. But he couldn’t quite get to it. I jumped in, as I had long fingers, and I still remember the sound as that marble hit the ceiling!
We treated the baby’s wound and eventually he came to and started crying.
Hearing that cry was the best music you could ever hear.
That was our hospital’s first patient. And even though we weren’t ready, we had to open as the word spread about us. The hospital was officially opened in April 1997, and our first official patient came in to delivery our first baby.
It was a bare-bones operation, relying on charity donations. Again, I worked across all departments from emergency to maternity. Jabaliya refugee camp is minutes from the border with Occupied Palestine (Israel now) where the Israeli army often attacks the area.There were a lot of clashes, Israeli attacks.
We witnessed so many atrocities –whole families wiped out, children and young men burnt alive by explosives.
The worst thing about that time was the ugly feeling of impotence. When you can’t save a life. I’ve seen so much. I remember a 12 year old boy, shot dead through the heart. His mum sent him to buy some salt, and he walked past some soldiers who decided to practice sniping on him. I watched his parents arrive at the hospital, screaming and crying. The mother blamed herself for sending him to buy the salt from a nearby shop.
In a way, as the most experienced nurse in Al Awda hospital , I was the core of the nursing unit. I trained a lot of the younger nurses, led by example.
So if ever I was overwhelmed by emotions, I’d go off into a room by myself to smoke and cry.
I couldn’t let the others see me do this.
Aside from clinical work, I also did a lot of work in the community. We’d go out and teach people how to deal with common illnesses, chronic diseases, do first aid. I’d travel to people’s homes and do workshops or give lectures.
I enjoyed nursing a lot. A good nurse makes a huge difference to people’s lives – a good nurse saves lives. I always put people’s lives first, even if it meant going around protocols sometimes, putting some noses out of joint. I guess I was quite stubborn, and still being young, a bit of a hothead.
I often questioned the status quo, made suggestions, tried to improve things.
Some of my actions got misinterpreted, some politics happened behind my back that I wasn’t happy with.
So after a few years, I decided to leave the Al Awda hospital and go and work for a paediatric public hospital in Gaza. About 50% of the population in Gaza is under the age of 15, so it was an extremely busy hospital.
My first 3 month rotation was in the Oncology and Haematology department. We had kids with all sorts of cancer, and hematologic anomalies including Thalassemia, a genetic blood disorder common in the Mediterranean region.
My next rotation was on the general ward. There we faced another struggle in the form of meningococcemia, which is a bacterial infection that affected children.
All you needed to treat a child was a ventilator and a syringe driver. But we did not have that equipment, and our survival rate was close to zero.
It was a time of extreme emotions for me. It made me happy to get to know beautiful kids, to help them and help some heal. On the flipside, it was heartbreaking to lose the kids who could not be saved, extremely painful to watch children die. I didn’t realize it at the time, but I I was struggling with depression, my emotions were all over the place.
When this hospital finally got its own ICU, I was invited to work there. Once it was setup, and the necessary equipment was installed, the survival rate for our meningococcemia patients went to 87%.
That was a major victory for us.
Then I was offered an opportunity to move to a new public paediatric hospital. I took the job, essentially doing similar work: nursing duties and training new and returning to work nurses.
However, after about a year, I started mending my relationships at the Al Awda hospital, and started doing some part time work there, while still working at the public hospital.
Eventually, the CEO of Al Awda asked me to return full time.
First, we talked through the issues that caused me to leave in the first place.
He’d been told that I undermined the doctors, that I thought too much of myself. I said “Well, why shouldn’t I? I have the skills and the knowledge, and I’ve saved many lives. If occasionally I step on peoples toes while I’m trying to save a life, I am not apologetic. I put lives first.”
But a lot of what he’d heard was twisted and misrepresented. For example, one of the stories involved an emergency case where a patient was delivered on the brink of death. His vitals were extremely low and he was not responding to the usual treatments.
Then his son showed me an ampoule.
It had 10mg of neostigmine, a drug that should’ve only been administered in a hospital setting in miniscule dosages of 0.02mg. The guy took the whole lot, we didn’t know how and why. Lucky, I knew that the antidote was atropine. But the doctor on duty was a fresh graduate, and didn’t know. As time was scarce, I didn’t have time to explain. I just took over and instructed for the atropine to be given.
Once the patient improved and stabilized, I explained everything to the doc, who actually had no problem with it and was happy to have a good result. But somehow the story got twisted out of context, by those who felt I overstepped my boundaries.
I went back to Al Awda full time, as a Head Nurse for another four years.
In 2004, we were visited by the Children First Foundation, a Melbourne-based charity.
They bring kids from around the world to Melbourne to receive world class surgery. By pure coincidence, I ended up being their guide, and was then tasked with bringing four children to Australia for surgery.
Travelling with the kids was a massive undertaking. Everything got done at short notice, which made things harder.
The borders where closed at the time, with seventeen thousand Palestinians stuck on either side of the border with Egypt for weeks.
Through connections I had in the Palestinian Security authorities, I was able to organize a passage across the border. It was like a secret military operation. There were hours of waiting, many delays and frustrations as we made our way through crazed crowds; just to cross an area of 70 meters that separated Gaza from the Israeli controlled side of the border (Rafah Crossing)..
The kids had faith in me though, which is what pushed me on to keep trying, keep making the calls, keep going. There was a close call where the kids nearly got shot when they made a run for a security gate. I begged the soldier not to shoot them, but to shoot me. Lucky he let us go.
The people waiting for us in Australia didn’t understand why it took us so long, why we couldn’t just hop on the plane and come directly over.
They didn’t realize what it means, being a Palestinian, what trouble you encounter at every step, everywhere in the world. Nothing is easy.
When I finally we walked into Melbourne airport, the kids started running towards the gates. I panicked, yelling at them to come back. I was terrified the border patrol would shoot them. And the immigration office there said to me, ‘Mate, let them be’.
I froze. That moment, I felt like a human again.
That was when I decided, should I ever I leave Gaza, I’ll come to Melbourne.
For me, that was an introduction to Australia. While the kids were being treated, I stayed in Melbourne for 2.5 months, and I loved it.
I met many people during this visit, who organized for me to do some lectures to educate people about Palestine. I did a lecture at the Melbourne University College of Law, another at RMIT.
I also did a few private lectures at people’s homes, who’d gather their friends for informal gatherings to listen to me. I talked about the humanitarian side of life, the impact on it by the politics and occupation. I told them about my country and the life of my people, what it’s like to live when a simple walk to school can prove lethal.
I didn’t choose to be a refugee.
I’d rather live in my home village, where I am a landlord. I would rather tend to my farm and livestock, look after my land, my family. That’s what most Palestinians want, to go back to the villages taken from them in 1948.
In 2007, I made the decision to move. I came by myself, going through the immigration system to get my residency and nursing license. It wasn’t easy, it was very expensive and complicated, a lot of waiting, paperwork and delays.
While I was going through this process, Gaza came under another attack.
The bombardment was so close to my home, I lost one of my cousins, and nearly lost my wife and child. I felt so helpless and frustrated. That added the pressure on me to get my registration.
But I am very grateful for the support and help I had in that time, from the people I met prior through Children First, and at my lectures. The TAFE in Heidelberg (ETEA) helped me immensely, allowing me to do the course on credit and pay after I started working.
Finally, I got my Australian nursing license and started working for Mercy Private Hospital as an anaesthetic and recovery nurse. I worked there for 3 years.
In these first years, I also helped to establish a charity here called Towards Hope Foundation, to continue with my community involvement and the need to help people
Unfortunately, after 3 years, I sustained a back injury at work, developing a lumbar disc in my back, and could no longer do the long hours required of me. I had to leave Mercy, and my charity, as WorkCover told me I was not allowed to do volunteer work.
For the next few years, while my back was healing, I did agency work with Belmore nursing agency. It was casual work with short hours, mostly during the twilights, or the occasional night shift.
Eventually my back got better: it’s still not 100%, but I can cope much better now.
Last year I went back to part time work at Epworth Cliveden, a small campus of the Epworth private hospital. I continued with my anaesthetic and recovery specialization.
Here we mainly do plastics – both cosmetic and reconstructive. We also do gynaecology, pain management such as neuro frequency implants for pain control, using lumbar blocks to control chronic pain, post-surgery care.
My job is to assist the anaesthetist, prepare the patient for theatre, monitor them while asleep.
In recovery, I look after the patient, help them wake up and orient themselves, look after their vitals, make sure they are stabilized and pain free. I help control their nausea or vomiting, if it happens, basically make them as comfortable as possible. Once they are awake and stable, I send them to the ward.
Work is different here to what I was used to in Gaza. There are some similarities, but there are bigger differences.
Nursing here is more specialized, you don’t really jump from department to department, like what I did at home.
In Gaza, I did everything: emergency, cardiac care, intensive care, paediatrics, trauma, medical emergencies, staff management and community education and volunteering. Here, I do my specific tasks, and that’s all.
I’m not too bothered by that. Now my wife is here, we have two children, so my main priority is to put the food on the table. Despite retraining, and getting her Master’s degree, my wife still can’t find work in the medical science industry here, so I am the only provider.
I’ve always been ambitious, and I was always driven to do the things I love, which is charity work, community volunteering and helping sick children. The impact of that type of work is incredible.
You give life to kids who don’t have a life. You give hope.
But my biggest struggle in Australia is how expensive it is. I wasn’t rich in Gaza, but here I find it much harder to keep up. It’s hard to get ahead, to keep up with the demands of life here. So for now, my ambitions and dreams are put on hold, as my priority is to look after my family, pull them through.
I am trying to make the best out of my life here.
In Gaza, our life stresses came from politics and the wars. Life was about physical survival. But here, it’s all about financial survival, and for me, it’s almost harder, perhaps because I am not used to it. But please don’t get me wrong. I love Australia, the country, the people. The lifestyle is easy. It’s the economic, financial part of it that’s not easy.
For now, I’m 100% focused on my current job. Physically, I’m half of what I’m used to be, the back pain is always with me; I need to save all my strength for the paid work, so that we can all keep going and look forward to the future.
كيف حالك يا رياض الك وحشة والله
الحمد لله. مين حضرتك؟
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