HONG KONG — For six intense weeks beginning in March, Dr. Ben Wu, a veteran anesthetist and medical officer with the Hong Kong Red Cross, navigated the perilous reality of a field hospital in Gaza, offering critical medical care amid relentless conflict. Dr. Wu, who holds dual specialties in emergency medicine and anesthesiology, recounted an environment defined by constant shelling, acute resource scarcity, and the harrowing scenes of severely injured civilians, particularly women and children. His deployment underscores the extreme challenges faced by international aid workers in active war zones and highlights the difficult ethical decisions essential medicine demands under fire.
Dr. Wu’s journey into humanitarian aid began in 2006, leading him to crisis zones including Ethiopia, Sri Lanka, and South Sudan. However, the mission to Gaza this spring presented unparalleled danger.
“I prefer places that are most urgent and least visited,” Dr. Wu stated, describing his motivation.
The initial days of his mission coincided with a brief ceasefire, offering a deceptive calm. This fragile peace quickly shattered, replaced by the continuous roar of explosions. The influx of patients—many with severe blast injuries and amputations—was immediate and overwhelming.
Operation Under Siege
The medical team quickly adapted to the extreme security threat. The operating theater was fortified, with sandbags stacked three deep on three sides of the surgical tent, and a repurposed shipping container served as a designated safe room against potential armed assaults. Dr. Wu described the surgical environment as a grim race against time, often working while listening to nearby gunfire.
“Walking out might be more risky,” he noted, explaining the necessity of maintaining focus during complex procedures despite the surrounding chaos.
One deeply scarring memory involved a teenage girl whose face was lacerated by flying shrapnel, causing her to lose several fingers. Dr. Wu lamented that such severe trauma should never be inflicted upon a child.
The Impossible Choice of Scarcity
The sheer volume of casualties quickly exhausted the already meager medical supplies. Dr. Wu faced agonizing triage decisions, particularly concerning blood transfusions.
“We sometimes only had ten units of blood available,” he explained. “A critically bleeding patient might need all ten units to survive. But that same amount could save five less severely injured people. Who do you choose to save?”
He acknowledged the brutal calculus of limited resources, where saving every patient is often impossible. In cases where the severity of injuries and the collapse of the local health system rendered survival unlikely, the team shifted its focus to palliative care, ensuring patients could pass away with dignity and respect, often administering high doses of morphine after appropriate farewells with family.
Finding Moments of Humanity
The relentless pressure demanded extreme mental resilience. Dr. Wu and his colleagues were confined to the short stretch of road between their accommodation and the hospital—a zone he described as a large “prison” constantly monitored by drones. Yet, he emphasized the importance of finding small pockets of solace.
“Powerful psychological strength and a sense of humor are key,” he said. He described the startling beauty of Gazan sunrises and sunsets, and the fleeting warmth of seeing patients share their scarce food with stray cats.
When back in Hong Kong, Dr. Wu remains committed to urgent local crises. He immediately utilized his field experience to assist victims displaced by a recent five-alarm fire in Tai Po, helping set up a temporary clinic to provide essential prescriptions for chronic patients who could not access their medications.
Championing Humanitarian Anesthesiology
Dr. Wu’s commitment led him to pursue anesthesiology later in his career, despite already holding emergency specialist credentials. He recognized that complex battlefield injuries required advanced surgical support.
“The greater the capability, the more you can achieve,” he asserted, highlighting that anesthetists play a vital, often-unseen role in determining outcomes during major trauma surgery. He champions the use of regional anesthesia, which requires fewer resources and is safer when faced with intermittent power outages common in deprived areas.
Dr. Wu hopes his experience will inspire more young doctors, especially those in less visible specialties like anesthesiology, to join humanitarian efforts. He cautions that true aid work demands not just technical skill but a deep understanding of the local culture and the geopolitical context fueling the conflict.
“Rescue is a cumulative process of experience,” Dr. Wu concluded, affirming his intent to continue deploying wherever the need is most dire. “If no one else is going to treat them, then I will go.”
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