LAST UPDATE | 8 Feb

‘…AND THE PROPHET sings not of the end of the world, but of what has been done to some but not others, that the world is always ending over and over again in one place but not another and that the end of the world is always a local event, it comes to your country and visits your town and knocks on the door of your house and becomes to others some distant warning, a brief report on the news, an echo of events that has passed into folklore…’. From Prophet Song by Paul Lynch (2023).

A senior manager of one of our partner hospitals last week told me that Emergency Department (ED) attendances for those aged over 75 were 50% up on this time last year.

On 7 January, Trolley Watch, the website that tracks people waiting for care, counted 226 patients waiting for admission in the ED in hospitals in Dublin, Louth, Meath and Kildare.

While undoubtedly this is very traumatic and disturbing for the patients and their families, I’ve often wondered if the word ‘crisis’ is the correct one to use for a situation that has bedevilled the Irish health system for more than two decades. It’s a word that is also applied to the other perennial scourge of our time, housing.

Whatever word we use for the current and perennial strain on the Irish healthcare and housing systems, imagine another unexpected true crisis: an albeit provoked attack and invasion of Ireland by a military power that occurred more than 120 days ago.

It has crippled the population of the above four eastern seaboard counties, affecting about 2.1 million of the population. At least 26,000 people are dead, mostly women and children, and more than double that are wounded.

90% of the population is displaced and are being prevented from leaving the affected areas. Widespread starvation, communicable disease and psychological trauma has replaced the immediate devastation. 500 healthcare staff are dead or disabled.

At last count, 61% of the healthcare infrastructure is destroyed, leaving just nine of the 24 hospitals in the regions intact.

Imagine that of our large teaching hospitals, only Beaumont, St Vincent’s and the Coombe are open and only barely functioning, with shortages of power, water, heat and medicines.

What if 61% of the 2,000 or so GPs and their practices in the region are disabled, leaving only about 800 partially functioning, with the knock-on effect of the strain on surrounding counties trying to deal with the spillover of refugees?

Finally, imagine that the invasion is ongoing and with, in the best-case scenario, muted criticism from the major powers, and in the worst, active contribution to the horrors by these powers in terms of equipment and material.

According to The British Medical Journal published on 24 January, between 138 and 300 Palestinian – and to a lesser extent, Israeli healthcare staff – have been killed in Gaza since the horrific murderous attacks by Hamas on 7 October killed 1,200 Israeli citizens.

In addition, some 212 Palestinian healthcare staff have been arrested, although these figures may be underestimates. Furthermore, at least 167 aid workers have been killed in Gaza – the highest of any conflict in this century.

At least 536 incidents of “violence against or obstruction of access to healthcare” have been documented in Gaza. As of 24 January, only 14 (39%) out of 36 hospitals in Gaza remain open and most of the those are only partially functioning.

Trinity College School of Medicine has been training physicians and surgeons since 1711, and latterly also physiotherapists, occupational therapists, radiation therapists, dieticians, and scientists. These alumni join and contribute to the global healthcare community, with its characteristics of marrying scientific rigour with compassion and love for their patients.

Many of our current staff and students have family and friends directly affected by the conflict.

In Gaza, these professionals now face an impossible task: being asked to provide treatment under unimaginable conditions, some even paying for their professionalism with their lives.

The reality is that Gaza is being destroyed. The unconscionable toll of thousands of civilian deaths, and injuries, most of them women and children, has been accompanied by the complete destruction of the healthcare infrastructure.

As a School of Medicine, educating healthcare workers of the future, watching the devastation befalling these professionals, their patients and the infrastructure they work in, I am asking that we imagine another country going through this, maybe your own country, and make your voice be heard to end this conflict.

I will take this opportunity to ask you to show your support by providing help to
humanitarian organisations Doctors Without Borders and Unicef, who are on the ground providing what care they can.

Prof Colin Doherty is the Head of the Trinity College School of Medicine, The Ellen Mayston Bates Chair of Epileptology, and a Consultant Neurologist at St James’s Hospital in Dublin.