Gaza: Innovative physiotherapy techniques improve patient’s quality of life during war
From locally sourced crutches to homemade pressure garments, our teams in Gaza are adapting amid continued supply shortages to treat wounded patients.
The 15 months of war in Gaza and Israel’s accompanying blockade have left Doctors Without Borders/Médecins Sans Frontières (MSF) physiotherapy teams struggling to provide essential care to patients who are war-wounded. We have not had the proper equipment to support people healing from severe burns, amputations and other life-altering disabilities. As a result, MSF teams have had to adapt, creating new tools and innovative techniques to support patients in need of rehabilitation.
Abed al Hamid Qaradaya, a physiotherapy activity manager working with MSF at Nasser hospital in Khan Younis, Gaza, explains how our teams continue to provide rehabilitative care to patients with severe wounds despite the massive obstacles created by the Israeli blockade on Gaza.
By Abed al Hamid Qaradaya, MSF physiotherapy activity manager at Nasser hospital in Khan Younis
Throughout the war in Gaza, our teams have faced many challenges and been displaced from several places due to insecurity and Israeli offensives – from Gaza City to Khan Younis and Rafah. Since May 2024, we are back in Khan Younis, supporting Nasser hospital in southern Gaza. Because of this ongoing displacement, we currently work in a tent, no longer in an equipped physiotherapy centre. We have had to adapt to a new model of care that focuses on functionality. The aim is to improve the patient’s quality of life despite the challenging war environment.
In recent months, we have been providing rehabilitation services to more than 100 patients every day who are under follow-up here in the hospital. The injuries we see are difficult to treat as they are distinctive, such as double amputations, in addition to certain types of fractures that affect several parts of the body. In general, rehabilitation services are expensive and require a lot of space and tools like electric machines, gym equipment and wheelchairs. Due to the Israeli blockade and the lack of medical supplies entering Gaza, we have started to provide these services using local alternatives to these tools.
Since we weren’t able to receive these specific pieces of clothing in a sufficient quantity, we decided to hire a tailor and provided him with a sewing machine so we can support patients with “home-made” pressure garments.
For example, we faced a huge shortage of crutches. Our patients were unable to walk and we were in a dilemma. We didn’t know what to do. An idea that came to our mind was that we could design and build the crutches with the same standard sizes at any shop. So, we started to manufacture these from locally available materials like wood and metal. We drew a quick plan for designing the crutches with specific sizes and sent them to several local carpentry shops who still had wood. We tried several prototypes with our patients, modifying them until we came up with the final shape. It was a successful experiment. We designed more than 500 crutches during the war and distributed them to our patients. It helped them a lot. We shared our success with other healthcare providers, who also adopted the crutches for their patients.
One of the most touching stories we witnessed during the war was a young boy who lost his right leg and left arm. This boy had been sitting in a wheelchair for a long time and was unable to move. We didn’t have an appropriate wheelchair for him, so instead we decided to design a specific pair of crutches for him. We started to adjust it, and we tied the crutches to his hand using simple things like plastic, ropes or tape. We tied it to his hand and with this support he was able to walk again. It was as if he came back to life. I remember his tears. It was a historic day for him and his family. They were all crying that their boy was able to walk again.
Another critical shortage we faced was the compression garments we used extensively before the war for the rehabilitation of burn patients. If burned tissues are not treated with pressure, they begin to wrinkle and cause severe deformities in the joints. Since we weren’t able to receive these specific pieces of clothing in a sufficient quantity, we decided to hire a tailor and provided him with a sewing machine so we could support patients with “home-made” pressure garments. We have provided more than 400 pressure garments to burn patients since the war started.
When the ceasefire in Gaza was announced, I was overwhelmed with various feelings. I feel scared of the uncertainty of the future and what it will be like. Our experience during the war was unforgettable but I know, for sure some of our patients will still suffer for years. I never could have imagined how important my role as a health worker would be in this war. Every step we took made a difference. Much of the work we did was seen as a miracle for the patients. Despite the difficult injuries they have, I see patients getting better and improving with the little hope we give.
MSF teams in Gaza, Palestine, have been providing physiotherapy and rehabilitation since 2007, and occupational therapy since 2015, for patients who have suffered wounds from war and violence.
