The Indonesian Hospital in northern Gaza is among the health facilities that have come under Israeli fire since October 7. Despite shelling in the proximity of the hospital and a severe shortage of supplies, especially fuel, the hospital continues to provide care and shelter to people who need it. The Indonesian Hospital has found itself in the line of fire on multiple occasions since the beginning of the attacks, including on October 30 and November 3, when two other major hospitals, Al-Shifa and Al-Quds, were also targeted by the Israeli occupation forces. Currently, the operations of the hospitals have been reduced to the minimum, running on secondary generators, enough to keep intensive care units and ventilation going.
Built in the period between 2012 and 2015, the Indonesian Hospital was envisioned as “proof of the long-term friendship between the Indonesian people and the Palestinian people”, and it is now one of the bigger hospitals in the Gaza Strip with a capacity of 235 beds. The building process of the hospital was coordinated by the Medical Emergency Rescue Committee (MER-C), an Indonesian social and humanitarian organization, and financed through donations by the people of Indonesia.
While the hospital was handed over to the Palestinian Ministry of Health shortly after construction ended, MER-C continues to have a strong link to the facility. Their volunteers remain in Gaza as the Israeli attacks continue, but communication, like for most people, is severely impacted by the frequent blackouts. Despite this, the volunteers and health workers at Indonesian Hospital are determined to stay. The People’s Health Dispatch met with Arief Rachman, a medical doctor, radiologist and member of the presidium of MER-C, to learn more about the situation in which the hospital finds itself today.
People’s Health Dispatch (PHD): How did the idea of building the Indonesian Hospital form, and how did you manage to get it built?
Arief Rachman (AR): We first managed to enter Gaza two years after the siege of 2007 began. At that time, people were already living under the standard. I’m talking about every aspect of human life: health, economic, everything, literally everything. After our medical team succeed in entering the Gaza Strip, we are coordinated with the Ministry of Health to assess the health system there. The population of the Gaza Strip was around 1-1,5 million people then. In North Gaza, it was around 600,000 people, so you are supposed to provide care to 600,000 people. At the same time, Northern Gaza is one of the areas that are most frequently assaulted by the Israeli military because of the border. [In 2009] there was only one regional hospital there, Kamal Adwan, with around 75 beds. You can imagine the disproportionality between the need and the health system. After seeing that, we decided that instead of focusing our program on providing medical service by offering support in surgery, for example, we will shift our focus to building a hospital. Development started in 2012, and we were able to build the hospital in three years, and equip it with European-standard equipment. In 2016, we handed it over to the authority of the Minister of Health in Gaza, so it is now fully part of the Palestinian hospital health system.
PHD: How many people are on the ground, supporting the work of the Indonesian Hospital right now?
AR: Around 800, mostly local staff. Sometimes there will be doctors or other health workers who have roots in Palestine, but live elsewhere, so they come and work at one of the hospitals in Gaza for a shorter period of time. Their number can be quite high, but in times of crisis like this, there will be zero people coming from outside to Gaza.
PHD: Frequent communication blackouts have affected the possibility of receiving information from the hospital, especially since October 27, but were you able to hear from the staff and volunteers since? What are they saying?
AR: Yes, well, the uniqueness of this war is that it’s a one-sided war, with all the power that Israel has. I’m not only talking about the military power, but also of the control of other aspects of life like electricity, fuel, even fresh water. And in situations like these, Israeli occupation forces will start to cut [on these aspects]. This is making the situation in Gaza more miserable, and it is not affecting only civilians, but also the health system.
Since you don’t have electricity, you will rely on generators. For the generators, you need fuel. The fuel needs to come from outside, meaning from Egypt or from Israel. And when the Israeli start to cut everything off, usually Egypt will do the same. So now, in addition to facing the direct effect of the war, the high number of victims, the injured people, we are also facing a humanitarian crisis. There is no electricity, there is no fresh water, and there is no food supply. People are getting more and more anxious. Usually, when the water is there, people can still live in their houses, but in this war, they are not safe there: so they go outside and take shelter in the hospital complex.
This is one thing that’s different compared to the previous wars. Now, in the hospital complex, we have around 1000 refugees and internally displaced people taking shelter. They depend on the same sources as the hospital. They need water from the hospital, they need electricity from the hospital, and this makes the burden even bigger. According to the last communication we had with the director of the hospital, if this situation is not relieved, the hospital will completely shut down in the next days.
PHD: Some organizations have warned that the Indonesian Hospital was already forced to switch off its main generator and rely on backups. What does that mean?
AR: Yes, in every hospital you usually have a backup system. If we are talking about generators, then there’s the main generator, and there’s a secondary one. But the issue is not the machine; the issue is the fuel for the machine. It’s estimated that the daily need of the hospital, for full operations, is around 2,000 liters of fuel per day. The tank that is installed in the hospital has a capacity of 15,000 liters. The problem is, there’s no supplier of fuel who could handle the transportation at this point. [Even if the fuel was available] you cannot imagine the risk of using standard transportation for getting it there. You could try that, and then there might be a military attack on the transportation. It would be a catastrophe, especially if that attack happens inside the hospital compound.
PHD: And did you manage to get any supplies through the Rafah border since they let aid trucks drip in?
AR: Unfortunately, not.
PHD: MER-C still has volunteers on the ground in Gaza. Are you able to keep in contact with them?
AR: Since Monday [October 30], our communication has been limited to short messages. Three volunteers are inside the hospital compound, and they keep updating us about the situation, sometime through voice notes or video messages, but because of the limitations of communication, there can be a delay of six or even 12 hours for these messages to reach us in Jakarta.
PHD: Today [November 3] there was also new bombing reported in the proximity of the Indonesian Hospital. Do you have any news on that?
AR: That happens on a daily basis. There is no safe area in northern Gaza if we’re talking about bombardment.
PHD: And based on that, what do you expect to see in the next days?
AR: The [most acceptable] scenario would be to open the Rafah border so medical teams and humanitarian relief can go in. I’m not talking only about the logistics here, about the civilians’ needs, but also about the needs of the medical staff. At this time, they are overburdened and exhausted. They are already burned out. It has reached a crisis level where we need fresh people, from international organizations, to come into Gaza so health workers can rest. They have to rest, because they have not stopped since the beginning of October.
PHD: Will the MER-C volunteers be leaving when the situation allows?
AR: No, no, they are going to stay inside Gaza because we need them to take care of the humanitarian work. Our first priority is to send a medical team inside, and the medical team will also need support for conducting an [initial] evaluation. Based on that evaluation, we will see what’s needed for the program, what kind of supplies we need to find in Egypt or in Jordan and get them into Gaza. Keep in mind, the last time we were allowed to enter Gaza was before the COVID-19 pandemic. After that, we were not allowed to cross the Rafah border.
PHD: What’s the formal explanation you got for that?
AR: Nothing. They don’t tell us anything. Maybe it’s different for European or US organizations, but for us, to enter Gaza we need a lot of documentation. The first part of that is the visa. So, we will travel from Jakarta to Cairo, and from Cairo we travel to Rafah. The second part of the documentation that we need for a team to get from Cairo to Rafah is issued by internal security authorities, and that’s a diplomatic discussion, we cannot know what happens there. Sometimes we successfully get the documentation, sometimes we don’t.
Since the north of Sinai has been a military zone for the past 5 years, it is becoming more difficult to travel to that region. You find many military checkpoints every half-kilometer, maybe one kilometer, and to pass each checkpoint you need to wait around for hours or more. It is very exhausting to travel to Gaza from the Sinai area. If you’re talking about Rafah city itself, that’s not habitable, so you need to stay at Al Arish, a town near the crossing, and then travel to and from Rafah, maybe 30 minutes to one hour in each direction.
It gets very difficult when you have to come to the border every day to ask whether you are permitted to enter or not. You come in the morning and if you are rejected, you have to come back in the afternoon. And tomorrow, the same routine.
People’s Health Dispatch is a fortnightly bulletin published by the People’s Health Movement and Peoples Dispatch. For more articles and to subscribe to People’s Health Dispatch, click here.
