Caring for Children in Conflict: An Account from a Children’s Nurse in Gaza

People often ask me, “How on earth can you work with children in places like that? It must be heartbreaking to see innocent children affected by war.”

But the truth is there’s something very special about children – they’re resilient. It might be because they aren’t fully aware of what’s going on around them, but younger children especially have an amazing resilience.

They might have been forced to leave their home, or perhaps they’re sick or hurt. Although they don’t understand why these awful things are happening to them, they still smile and laugh and play: they still want to be children.

Kathleen Shields is a children’s nurse who normally works with the NHS. She recently returned from Gaza, where she cared for children and babies, some only a few weeks old. Here, Kathleen gives her touching account of the resilience and resourcefulness she witnessed at our field hospital in Al Mawasi.

When caring for young children, as I did a lot during my time in Gaza, there can be a lot of joy and laughter, which can almost uplift you. Children bring you joy in situations that can otherwise be extremely challenging and heartbreaking.

When you have a small child in front of you and you can distract them and play with them and make them smile and laugh, it helps you forget about what’s going on for a few minutes.

I remember one case quite vividly. A family brought their small child to our field hospital with a burn injury to his arm, the dressing for which needed to be changed. It can be quite a distressing process for an adult, let alone a child who’s scared and in pain.

A lot of the work we do in paediatrics is around addressing pain, addressing a child’s concerns when they’re worried or anxious. And often that can be done through distraction and playing, trying to take their mind away from their injury or source of discomfort and instead making them laugh and smile.

With this child in particular, we used some medical gloves to make balloons and drew faces on them together while we changed his dressing. Moments like that – ten minutes or so of playing with children – can mean so much, not just for the child but for the parents too. They were so appreciative not only of the medical care we were giving him, but also of the fact that for a short while, their son could play and laugh and be a child again.

Kathleen with a ten-week-old baby at the UK-Med field hospital in Al Mawasi, Gaza. © Sean Sutton/UK-Med

Lots of the parents I met were very thankful. One mother I met asked for my name so that she could look me in the eye and thank me personally. She spoke very little English, and I speak no Arabic, but she really wanted to say that to me directly. All I’d done was soothe and calm her newborn baby, who was in pain because of her clubbed foot.

The treatment for clubfoot is normally repeat hospital visits over many months in order to have casts fitted to the baby’s lower legs to help straighten them over time. Knowing the mother and her baby would keep coming back to our field hospital meant that it was important to have a positive relationship with the family.

Resourcefulness in a conflict zone

Compared to working in the NHS, where of course you’ve got a lot of medicines and equipment available, working in a field hospital can certainly be challenging at times.

You have to think outside the box. For example, you might not have your first choice of medication available, so you have to find alternatives. That was definitely the case when I first arrived, when we were still in the process of equipping the field hospital.

At the UK-Med field hospital, the team provides care for patients of all ages, from babies to the elderly. © Sean Sutton/UK-Med

The other thing is that in paediatrics, often children can have wheezy episodes like asthma. When I was working in the field hospital, we only had one ‘spacer’ – which is a piece of equipment a bit like a plastic tube that fits onto the mouthpiece of an inhaler. In resource-constrained settings, you can wash and reuse them, but ideally you want more than one. So, often people use empty plastic bottles as a substitute – you cut off one end for the mouthpiece, attach the inhaler at the other end, and use that in the same way as a spacer.

One afternoon the team collected many bottles, washing them thoroughly and cutting the ends to create makeshift spacers that could be used for children.

At the time of publishing, nearly 8,000 children have been killed in Gaza, according to Gaza’s Ministry of Health in figures that have been quoted by the UN.

© Sean Sutton/UK-Med

“There’s still so much to be done”: A bittersweet ending

For the local staff, that kind of resourcefulness was reflected in their commitment to their work. They were so resilient and completely undeterred by whatever challenges they came up against.

They were coming to the hospital each day, ready to work from the very early hours of the morning, even though they didn’t have a means of transport to get there. Many of them had been displaced, so they were living in tents without running water or electricity, yet they would walk or travel by donkey and cart to the hospital every day, without fail.

These were senior nurses too – their medical skills and expertise were phenomenal. I was in awe of them, really, and I felt incredibly lucky to be working with people who were so committed to helping and caring for others no matter what difficulties they had to overcome.

A primary health doctor at the UK-Med field hospital checks the health of a malnourished child. © Sean Sutton/UK-Med

I quickly became friends with a lot of the local health staff, and leaving them to return to the UK felt bittersweet. I left feeling as though there was so much else I needed to do. I still worry for their safety even now. I wonder if the conflict will drag on and how that might affect the local staff I worked alongside and the families and children I cared for. My work didn’t feel complete, in that sense, because there’s still so much that still needs to be done.

I’m sure, though, a lot will have changed already as the team continues to scale up their response. The field hospital I worked in is already better equipped now, and UK-Med is building another field hospital just north of Deir Al Balah.

I’m glad to see UK-Med expanding its work in Gaza because there is an enormous demand for that kind of lifesaving medical aid. There’s an overwhelming need for healthcare, for nutrition support, for shelter. Working in Gaza was like nothing I’ve ever witnessed before. It’s essential that funding needs to be directed to this context because the need is so great.

To support and expand our medical work, we have launched our Gaza Health Crisis Appeal. Please consider donating today.

UK Aid is helping to fund our response, but you can donate now so that we can help more people and scale up our work to meet the immense and growing health needs in Gaza.