At this time of the year in the UK the nights are ‘drawing in’ and there is the white sparkle of frost in the mornings. The season of Advent has started and Christmas soon to be celebrated.

Yet in Bethlehem, at the heart of the Christmas story, the celebrations are cancelled this year. Across this beautiful land people are in fear, sorrow, and pain. We sing the beautiful hymn O Little Town of Bethlehem whose words seem so apt right now: ‘Yet in thy dark streets shineth the everlasting light; the hopes and fears of all the years are met in thee tonight.’

Very movingly Rev Munther Isaac shows us the nativity in the Lutharan Church in Bethlehem. A baby in a manger but in the ruins of a bombed building, separated from his parents. The shepherds and wise men cannot approach. God is under the rubble and it is from this place of real suffereing and anguish that we cry out for hope at this Advent time.

Our focus in Cairdeas is in Gaza, where we have been working with partners for 10 years, and on the unfolding horrors of the humanitarian crisis.  We should have been there celebrating the graduation of the very first Professional Diploma in Pain and Palliative Care at the Turkish Palestine Friendship Hospital as well as our annual course for undergraduates within the Islamic University medical school. Instead we hear from our colleagues and friends increasingly awful and at times desperate message which can’t begin to contain the horror and loss. You, perhaps, have been finding it difficult to watch.

Listen with me to our palliative care colleagues and hear their words as I share some of the realities on the ground. I have also worked with our International Faculty to write a Statement of Solidarity and you can see the detail below.  This is a personal statement from colleagues and not organisational.

Now the cancer hospital is closed with a small number of children being evacuated but for the majority there are no treatment options. Analgesia is almost absent for chronic illness but also for burns and crush injuries. Disease outbreaks, starvation and unclean water are causing outbreaks of disease and reveal the unfolding public health disaster.  Public hospitals remain in southern Gaza; European Gaza Hospital and Nasser paediatric Hospital; both vulnerable to the resumption in bombing.

The courage of our healthcare colleagues is humbling. Many have moved five or six times to try to stay safe and many have lost their homes. All have lost family members, and all are trying to balance caring for their family while continuing to offer support for patients.  

Our colleague, Dr Hamman Alloh, a nephrologist, spoke in an interview of why he is staying with his patients - ‘What would happen to my patients? We are not animals that do not deserve healthcare. Did I train for 14 years in medical school and speciality training to abandon my patients now?’ This was Dr Hammam’s last interview before he was killed in his home by a missile strike. His head of internal medicine at Al Shifa Hospital, Gaza’s hub for healthcare, Dr Rafaat Lubbad, an inspirational colleague who was an advocate for palliative care, was killed shortly after along with his family.  
We are losing the healthcare wisdom of the past, the leaders of the present and the promise of the future.

Dr Khamis Elessi, the lead for palliative care in Gaza and our dear Cairdeas partner, published a letter in the Lancet in the first week of this crisis, warning of the grave consequences we are now seeing - ‘If the massacre continues on its current path, we will be dangerously close to witnessing a large-scale genocide of civilians and patients. I am a doctor in Gaza, and I want to survive for my family and for my patients.’

Our palliative care colleagues continue to send messages from Gaza when they can: 

‘'We are physically ok, but mentally and emotionally so far from being alive. We die hundreds of times every day. Each and every one of us has lost at least a relative, a friend, a colleague or more. God help us all.' Doctor.

‘The situation here in Gaza is worse and more difficult than what is reaching you. The occupation demolished homes, streets, schools, hospitals, churches, and healthcare centres.  They cut off electricity, water, and all the necessities of life. My hope is to die with all my children and not leave them and them not leave me. I cannot live without them, and I do not want to die and leave them here in this unjust world.’ Cancer nurse.

‘Unfortunately, we are on our way to collapsing from the horror of the scenes we see, despite our strength; but it is beginning to fade and the world is watching as if we were in a movie theatre showing a horror movie and the viewers are silent.’ Paediatric doctor. 

‘We need you and your colleagues to reach our scene of massacre to all the world. We trust you. Please be our voice outside. Gaza, the beautiful city which you knew and loved, it has become city of ghosts. All its buildings, streets, schools, trees completely destroyed. We are without any life support, and supplies. Many people are still under the collapsed building ask for help, many health workers are killed while they offer their duties.  ‘The world became blind and deaf to our suffering. We don't ask more than life with peace and dignity like all people over the world and to be considered human beings.’ Pharmacist.

You can see the request from our group of Gaza clinicians by clicking on the link HERE. 

As I write this I am reminded once again of that great Advent hymn ‘O Come O Come Emmanuel.’ Sung in some form for 1200 years with a Latin form in the 12th century and this version written in 1851. It has inspired many down through the ages with its message of hope, its message of the presence of God in our times of trouble and in our times of joy, of peace and justice for all.

I will be singing these words more fervently than usual and wishing each of you joy and peace at this in this season and hope for 2024.

O come thou Dayspring from on high, and cheer us by your drawing nigh. Disperse the gloomy shadows of the night and deaths dark shadows put to flight. Rejoice, rejoice Emanual shall come to thee.'

“O come, O King of nations, bind in one the hearts of all mankind. Bid all our sad divisions cease and be yourself our King of Peace.” (O Come O Come Emmanuel)