The St John Eye Hospital in the Gaza Strip has long enabled patients afflicted by debilitating and potentially blinding diseases to see their future but its own now seems alarmingly far from certain.
Amid the rubble of the flattened surrounding neighbourhood, the building stands abandoned, its exterior marked by collateral bomb damage, the equipment inside looted or beyond repair.
As Dr Ahmad Ma’ali, the chief executive of the St John of Jerusalem Eye Hospital Group, explains, one obstacle will dominate if and when a permanent ceasefire is finally agreed on – whether donors believe that rebuilding is worth the financial outlay.
“People feel strongly they want to help but they want to know who's going to manage Gaza,” Dr Ma’ali tells The National. ”Is their investment going to be for nothing? Will the war flare up again? Is this going to be knocked down, demolished the day after?”
When we meet, he is in London visiting the St John Eye Hospital’s fundraising office for talks with the trustees, predominantly about the launch of the largest emergency appeal in the 142-year history of the charitable healthcare provider.
The walls of the conference room are lined with enlarged colour photographs that chronicle many past success stories of the group’s work across the Israeli-occupied Palestinian Territories in Gaza, the West Bank and East Jerusalem.
This oasis of calm here in a quiet corner of Charterhouse Square that dates back to Tudor times is all a long way from the devastating situation in the Levant since the attack by Hamas on October 7 last year, laments Dr Ma’ali.
He estimates it will cost about $6 million (Dh22 million) to fully restore the hospital’s vital medical services in Gaza through an ambitious 12-month plan should the fighting end.
”Law and order, and the safety and security of the staff,” Dr Ma’ali says, listing the immediate priorities. ”I don't think many of our donors would be comfortable helping unless there is some sort of assurance that the hospital will be sustained.
“It's very important that we give our donors assurance. I think the politicians and both parties have to give the whole world assurances that Gaza is going to be viable for people to live in, and then investors will come. I have no doubt.”
Vision for the future
Dr Ma’ali is the first Palestinian CEO of the hospital group that can trace its origins to the Middle Ages when a hospice was established in around 1070 by monks in Jerusalem.
The modern order was founded in 1882 by Queen Victoria out of concerns that many returning pilgrims had contracted trachoma, a contagious infection of the eye that can lead to blindness and is spread largely by flies.
These days, the greater threats to vision are glaucoma and diabetic retinopathy, a complication of the disease caused by high blood sugar levels irreversibly damaging the retina. The group estimates that about a quarter of the patients it sees have diabetes and 15 per cent of the population as a whole.
“Diabetes doesn’t stop,” says Dr Ma’ali. “It keeps working at the back of the eye, keeps bleeding, especially if people don’t have their medication. And I suspect some in Gaza don’t have their medications because of the scarcity of supplies.
“Therefore, our intervention is very important, that we do it on time. Otherwise, if we leave this maybe six months, patients who can be treated now with an injection or a laser session will be beyond our ability to treat them. They will become permanently blind, and, whatever we do after that will be too late.”
Trapped in hell
The group’s flagship hospital is in East Jerusalem, and King Hussein of Jordan was instrumental in arranging materials to be sent from his country to help with construction of the "modern-Crusade'' style building.
But before the conflict started staff were also working out of the hospital in the Gaza Strip and another in Hebron on the West Bank as well as in clinics in the Muristan, Kufr Aqab and Anabta, and through mobile care.
More than once, Dr Ma’ali puts aside his professional responsibilities to speak of strong personal concerns for the dedicated team of medical professionals trapped in the hell that Gaza has become in the continuing response by Israel’s armed forces.
They have, he says, been deeply affected, with some losing family members and many their homes. Most – from specialist surgeons, doctors and paramedics to nurses and medical volunteers – are now residing in the southern part of the strip after being asked, or ordered, to move from the north at the beginning of the war.
Despite so many living as refugees, however, their work continues, and Dr Ma’ali is clearly proud that the hospital has been able to continue to pay salaries.
“Because of the 1.7 million displaced people in Gaza, we’ve decided that we should be caring for these patients. We are the main, if not the only, provider of eye care.’’
Tortuous route for medical supplies
With no access to operating theatres or more sophisticated equipment, advanced treatment that requires a sterile environment is not currently possible. Poor sanitation and lack of a clean water supply is another major problem. In addition, there has been a dramatic increase in diseases such as hepatitis B and C, and skin infections.
Still, the nearly 50 medical staff in Gaza have been able to treat 10,000 patients so far this year, a figure they hope to quadruple by the end of December.
As an international charitable organisation, the St John Eye Hospital is seen as independent of the Hamas government by Israel, which makes obtaining fresh medical supplies possible albeit still challenging.
“We have kept good communications with the Israeli border control authority, and therefore we have been granted permission to ship and transport medications to Gaza,” Dr Ma’ali explains.
“The problem is that under Israeli policy all supplies to Gaza must come through international corridors. We were required to transfer all the equipment from Jerusalem to Jordan, and then through the Jordanian Hashemite charity back through the West Bank and Jerusalem, into Gaza.
“It’s a long, long process. It took us about three months really to secure the shipment.”
Very little more can be done until there is a permanent ceasefire. In that event, the first priority will be the welfare of the St John Eye Hospital’s people in Gaza. “We need to give our staff a break to recover from all of this. This has come from nowhere. It is a nightmare. Many are bereaved and we need to give them time to recover.”
Marking milestones
Only then can the possibility of reconstruction begin. The damage to the hospital in Gaza will require a full survey to ascertain its extent, most of the medical equipment needs replacing, and there are staff vacancies after several left the territory, probably for good.
Meanwhile, however, there is cause for Dr Ma’ali to celebrate several milestones. “When we did not get a ceasefire, we decided to go and work under fire and provide services. For me, this was a mega achievement for the hospital, and for the team as well.
“And the fact is that we are also responding to the needs of the people in the West Bank and reaching out to more patients.”
That means a record 80,000 people were treated in the first five months of this year, a 30 per cent increase on 2023. If the group continues at the same rate, it should exceed 150,000 patients by the end of the year – again, another 15 to 20 per cent more than the year before.
“We live in a very small geographic area, but one that brings with it so many complexities and so many problems. But we have responded really, really well.
“So I feel very proud. I'm the first Palestinian homegrown chief executive officer of the hospital. I have been part of this hospital for the past 25 years plus. I am honoured to be leading this organisation, and honoured to be able to help the people, especially those who are in Gaza.”
Details about how to donate to the Saving Sight in Gaza Appeal can be found at www.stjohneyehospital.org
