Israel looks to floating hospitals to ease Gaza health crisis

Shifa Hospital credit: Reuters Doaa Rouqa
Shifa Hospital credit: Reuters Doaa Rouqa

With Gaza's hospitals like Shifa acting as terrorist strongholds and needing to be evacuated, "Globes" examines solutions to the crisis.

Israeli military pressure on Gaza's Shifa, Nasser and Indonesian hospitals is seeing thousands of patients being evacuated and Israel would like to see them hospitalized in temporary facilities. According to data from the Hamas controlled Ministry of Health, which may not be the most reliable figures, there are 30,000 casualties in the Gaza Strip.

In Israel the Ministry of Foreign Affairs and Prime Minister's Office are encouraging the deployment of field hospitals in the south of the Gaza Strip. The call has been responded to by the UAE, which has announced that it will set up a 150-bed field hospital. In addition the Red Cross and an unnamed country will also set up field hospitals in the region west of Khan Younis. Egypt has established a field hospital in the Rafiah region and has announced that it will set up another hospital for the wounded in El Arish. But many other countries have not expressed much enthusiasm for similar aid.

Another significant move being promoted in Israel is the establishment of hospitals off the coast of Gaza. The Israeli Foreign Ministry contacted a number of Western countries, such as Germany, France and Italy, to ask them to send floating hospitals to Gaza. The plan is for large hospital ships that will provide rapid humanitarian aid to the residents of the Gaza Strip, which could take in many wounded from the hospitals in Gaza, which are Hamas terrorist bases. In Israel, the floating hospitals are seen as an immediate solution to the evacuation of the wounded from the hospitals in Gaza.

Three different medical aid ships are currently making sailing to Israel from France and Italy. But they will only be able to admit on board no more than a few hundred patients at a time. Until they reach the region, countries such as Cyprus and France are trying to work with Israel and Egypt to open a sea corridor that will allow the evacuation of the wounded Palestinians. The Israelis want to monitor the equipment that enters the area and make sure that it does not end up in the wrong hands, while the Egyptians want to transfer as much medical activity as possible to the sea to prevent the establishment of field hospitals in their territory, which would most likely become refugee camps. The delay in talks over all this is also holding back the arrival of the floating hospital ships already on the way and the departure of other aid ships. Some countries already have floating hospitals that could be used offshore from Gaza, while others would need to invest in converting ships to hospitals.

Which ships are already sailing to Israel?

The Italians announced that they will send ships to the region. The Italian ship Vulcano set sail last weekend to the Eastern Mediterranean.

The Vulcano is designed to serve as a logistics supply ship, providing fuel and food for the Italian fleet of warships, but can be converted into a floating hospital during wartime. This is the most modern supply ship in the Italian navy, and one of the most sophisticated in all of Europe. It was intended to serve a central role in the deployment of NATO forces in the Eastern Mediterranean and the Red Sea, and recently the French even ordered a ship of the same model. The Vulcano cost $400 million to build and weighs about 27,000 tons and can carry 170 crew members. In the coming years at least five more ships of this model are expected to enter service in the Italian and French navies.

However, the number of patients it can treat is extremely limited. It allows the hospitalization of dozens of patients only, and on board no more than 30 medical staff.

France has also announced that it is dispatching two similar ships to the region, the helicopter carrier Tonnerre, which is already sailing for the eastern Mediterranean and the Dixmude, which is preparing to depart. Both are Mistral-class ships with small 900 square meter hospitals on board with 29 rooms and 69 hospital beds, designed for intensive care. Each of the ships has room for 50 more hospital beds in helicopter hangars.

These Italian and French ships combined will have close to 300 temporary beds, a very small number in terms of the estimated number of Palestinian casualties in Gaza.

What concerns the foreign armies?

Hospital ships are military ships and on their decks are sailors from foreign armies. NATO countries are concerned that rockets might be fired at the ships or that Hamas and Islamic Jihad terrorists might smuggle their way on board, drawing them into the war. So crew are not eager to anchor near the Gaza shore and become a target of terrorist vessels or rockets.

Former naval officer Lt. Col. (res.) Dr. Eyal Pinko from the Department of Political Science and the Begin-Sadat Center for Strategic Studies at Bar-Ilan University explains, "Deploying marine hospitals less endangers forces than deploying hospitals on land. It is also faster and more immediate but very challenging for preventing terrorist individuals from coming on board. Anchoring off Gaza or Egypt is problematic and carries a danger from Hamas and ISIS. On the other hand anchoring off Israel requires coordination on bringing Palestinian patients into its territorial waters.

"Therefore, the most reasonable scenario for the foreign forces is to anchor 20 miles from the coast, outside of territorial waters, although the distance also creates hardships in bringing patients from the shore." Another possibility being proposed is to anchor off El Arish in Egypt, 75 kilometers from Gaza, even further for the casualties.

In order to minimize the risks regarding terrorist organizations, hospital staff are expected to narrow down the criteria for hospitalized patients who can board the ships. For example, allowing only children of a certain age and below accompanied by their parents to board, and this only after a strict security check carried out with the support of Egypt, only after crossing the border at Rafah, then flying the patients on helicopters to floating clinics. However, this would provide only limited humanitarian aid for a very small number of patients, and is not a solution that would ease the plight of the thousands of evacuees from Shifa and other hospitals.

What types of treatments can be performed on the hospital ships?

Prof. Nachman Ash, a senior faculty member at Ariel University and former Chief Medical Officer and Director General of the Ministry of Health, explains that the medical teams on the ships will prefer to treat urgent cases, such as the injured who need hospital beds, rather than those where they will have to stay on board for further treatment. It will be difficult to leave those with head injuries or serious injuries on the ship, who require hospitalization for a long time with further rehabilitation, and the long way to and from it will not be easy for them either."

Therefore, Prof. Ash says, any ship that arrives in the area will oblige the crew to coordinate with Egypt or other countries on the possibility of continued hospitalization in local hospitals. "It is important not only to understand how the patients are admitted onto the ship, but also where they are directed afterwards," he says. Such a move, it should be noted, will further reduce the number of patients who can board the floating hospitals.

Is the US expected to send similar help to the region?

Despite the extensive US naval involvement in the region, which includes deployment of two aircraft carriers, more than 10 destroyers and cruisers and a large cruise missile submarine, the two largest US hospital ships, Comfort and Mercy, have no plans to sail to the Middle East. These are the largest and most sophisticated hospital ships in the world. Each of these ships carries a thousand hospital beds, 12 operating rooms and intensive care units, radiology equipment, laboratories, pharmacies, CT scanners, oxygen facilities and even a dental clinic. According to "The Washington Post", the Mercy is making its way to a mission in the Pacific Ocean while the Comfort is docked in its home port in Alabama for refurbishment.

However, Ford, the US Navy's newest aircraft carrier currently stationed off the coast of Lebanon, has a hospital wing on board with 41 inpatient beds, a laboratory, an operating room, a three-room intensive care unit, staffed by 11 medical officers and 30 other personnel.

Does Israel have a floating hospital ship?

Israel has never seen the need for medical ships, and made do with field hospitals deployed relatively close to combat zones. However, the warships of the Saar 5 and Saar 6 models can carry several dozen patients on board each, and the Israel Navy assigns teams to them from fleet headquarters.

In 2010, for example, after the earthquake in Haiti, Israel helped evacuate the wounded to the US ship Comfort. Brigadier General (res.) Prof. Trif Bader, director of Clal Health Services Kaplan Medical Center and Herzfeld Geriatric Hospital, who led the expedition, says that the IDF usually relies on points that are close to the disaster area, but regarding ships: "There is a balance between proximity to the area and the war itself, and between the safety required for the medical staff."

Published by Globes, Israel business news - en.globes.co.il - on November 14, 2023.

© Copyright of Globes Publisher Itonut (1983) Ltd., 2023.

Shifa Hospital credit: Reuters Doaa Rouqa
Shifa Hospital credit: Reuters Doaa Rouqa
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