The sun was setting when Dr Farhat Mantoo took her seat. She was calm, like the sea a stone's throw away from the makeshift venue she was addressing. But her words reminded us of a turbulent one, mighty assertive and far-reaching. After the moderator introduced her organisation 'Médecins Sans Frontières' (MSF) to the soldout gathering, Mantoo was asked what makes the MSF team go to conflict zones across the world and to stages like those she was attending.
''We are here because we believe in the one thing that brings all of us together,” said Mantoo at the Kerala Literature Festival 2024, in Kozhikode. “We are here because of global humanity and the solidarity that we feel for human beings across the world. We don't know if our words make a difference, but we do know that our silence kills.”
For the unversed, the MSF - also known as Doctors Without Borders - is an international organisation that exists to ensure medical assistance to people affected by conflicts, epidemics, disasters and the like. Its contributions have been pivotal in sustaining medical care in Gaza following Israel's full scale invasion of the Strip and alleged reports of targeted attacks on medical facilities.
Later that evening, after her session at the KLF 2024, Mantoo spoke to THE WEEK exclusively about the situation in Gaza, where shells and rocket launchers are asked not to spare either doctors or ambulances. Mutual grief was keeping Gazans together as the MSF's constant calls for a ceasefire continue to fall on deaf ears, said the executive director of MSF South Asia. Excerpts:
Q/ Tell us about Gaza's ground reality.
A/ At the end of the day, the fact of the matter is that there is no place safe in Gaza. The city is witnessing indiscriminate bombing. Nobody is safe and nobody is spared. This includes medical workers, health facilities and ambulances. On top of it, there is a communication blackout. So, it has been very difficult to get the injured and wounded to the hospital.
From cars to donkey carts, the people of Gaza are using all possible means to bring the injured to the hospitals. At the same time, the hospitals are overflowing because these institutions are also being used as shelters by the local population who have nowhere else to go.
Supplies including water, fuel and electricity are extremely limited due to the siege. These are the trying conditions under which our teams are working on the ground. So, there is a lot of humanity. A lot of helping each other is happening because people are left with themselves. There's nobody else to help.
Q/ How are doctors working amid this constant bloodbath and threat to their own lives? Is there a support system in place for the medical professionals?
A/ Since 2019, the MSF has had a mental health programme for the medical professionals of Gaza called "Help for Helpers." It was mainly aimed at supporting frontline workers to manage their day-to-day stress and trauma. If the doctors get to express themselves and build resilienc,e they get closer to normalcy.
However, for the last three months, it has been all about survival. Imagine you have to go and look for water and bread for your family. There is no electricity. You leave your family in the evening and there is no guarantee you will see them again. Many of our staff have lost their family members and homes.
WATCH THE WEEK's EXCLUSIVE INTERVIEW WITH MSF'S DR FARHAT MANTOO HERE:
They are forced to make very difficult choices - whether to stay back and treat the suffering masses when supplies are running low, or focus on moving their families to safety. Doctors face a moral dilemma because they have sworn an oath to stand by their patients. This adds a further layer of mental pressure on doctors.
Surgeons on the ground have amputated patients without anaesthesia. This is what the medical teams are experiencing in Gaza and it is causing them moral distress.
Q/ What happens when MSF comes across injured fighters from either side?
A/ There is a no-gun policy across MSF facilities around the world. That means combatants should leave their weapons the moment they enter an MSF facility. It also goes back to our charter as an organisation that we do not discriminate based on caste, colour, creed, religion or any other denominator. Anyone coming into an MSF medical facility will be treated as a patient.
Q/ Do the medical teams in Gaza have a direct communication channel with Hamas and IDF?
A/ Our 52 years of existence means that we have developed expertise in working in conflict zones. Around the world, our teams talk to all parties involved in the conflict. We establish communication with the warring factions because we have to ask for safe access for our patients and frontline workers.
Likewise, in Gaza, we are in touch with all the parties of conflict. We ask them to respect our humanitarian space and international humanitarian law - do not make health workers a target, and do not attack hospitals. Thus we want an immediate and sustained ceasefire. Only then, it is ensured that we get supplies and our workers are unharmed.
Q/ Are your requests acknowledged in Gaza today?
A/ In the current context of Gaza, we are, unfortunately, experiencing a disregard for humanitarian space. We have lost four of our health workers. Medical professionals have become both witnesses and victims of the situation in Gaza.
On January 11, one of our staff members lost a five-year-old daughter. In December, when we were evacuating our medical staff from north to south, our convoy was attacked. All the vehicles were marked, declaring that they belonged to the MSF. Yet, we could not manage to pass through the checkpoint. We lost a staff member and a family member of another colleague in the incident.
We have seen multiple times that there is very little or no respect (for us). According to WHO statistics, more than 300 health workers and health facilities have been attacked and targeted.
Q/ Why is humanitarian aid reaching Gaza late?
A/ For the last 16 years, Gaza has been under siege. There are three checkpoints to reach Gaza. Currently, the Rafah border is the only entry that is kept open. However, this checkpoint was not built for supply movement. This is a major reason for the slow movement of supplies.
Then comes the war factor. Indiscriminate bombings have left roads and hospitals damaged. There is no fuel supply in Gaza either. So, we cannot use cars or LMVs to transport these supplies to locations they are meant for.
And the last bit of it is that, irrespective of whatever we say, before October 7 the number of trucks that would pass into Gaza used to be over 2,000. Now (January 2024), we only have a handful of trucks when the needs have become immense.
Q/ The deaths caused by blasts and fighting aside, how are doctors dealing with communicable diseases, pregnant women and terminally ill people in the Gaza Strip?
A/ This needs the immediate attention of the world. Everybody is talking about the bloodshed and trauma in Gaza due to the war. But what happens to Gaza's cancer patients or TB patients or those in need of dialysis? What happens when there is no safe drinking water and people are forced to drink saline water? Where do pregnant women go to deliver their babies? What happens to sanitary hygiene?
How will girls get sanitary napkins when they cannot even find water or bread? Women are approaching our clinics asking for family planning tablets just to delay periods because there is no water. They are being forced out of their homes and are living in these shelters sans sufficient showers.
We are not simply looking at regular illnesses but possibilities of airborne and water-borne infections that we fear would be more lethal than the conflict itself.
Q/ How can someone join MSF's cause?
A/ MSF is not just an organisation of doctors, nurses and paramedical staff. We also include financial and logistics professionals. We are always on the lookout for such profiles who can go and work with us in different locations.
Dr Farhat Mantoo in conversation with The Week during KLF 2024 | Vishnudas K.S.
To join us, visit the website msfsouthasia.org
The hands that do that treatment for us are thoroughly scrutinised. So, our recruitment process is quite extensive in many cases. It takes between three to five months.
