14 May 21
Eva HeikiiEva HeikiiSwedishNurseGaza

Different countries, different challenges: Treating COVID-19 in Sweden and Palestine

Eva is an ICU nurse currently on assignment in Gaza, one of the most densely populated places in the world. She shares her experience of the pandemic so far…


I remember the feeling I had in the beginning of the pandemic: I was overwhelmed.

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How we struggled with all the patients we received at the hospital’s intensive care unit (ICU) I worked in, in Sweden. We didn’t have time to prepare, they just came, one after the other.

We didn’t have enough respirators to provide oxygen to the most severe COVID-19 patients. We had to dig deep down in the long-forgotten stores, and we found ventilators that dated back to the 80s.

I panicked, didn’t know how they worked. I didn’t feel comfortable in the situation.

Lost control

Later, I was asked to move to a new hospital.

I remember thinking that I’ve done assignments with MSF, working in low resource environments, working with large numbers of patients – this shouldn’t be harder than that.

"They struggle – as we did back home – to find ways to deal with all the challenges linked to the pandemic"

But, during my first week of night shifts at the new hospital, I was responsible for the care of four people with severe COVID-19. Normally, I would treat one.

I soon concluded; this was harder. Not that situations can be compared like that, I just had the feeling that I lost control.

Strong teams and shared joy

We all worked too much – I did more than 50 hours of nightshifts in a week. And we were tired.

I didn’t want to go to work but it felt like somebody pushed me.

None of us had a choice; we were too few but the only ones that could take care of these severely ill patients.

So, we all went, one day after another. And we got used to it. We 

"We built strong teams and supported each other through tough situations as well as shared joy"

The second wave was easier – we knew the situation, we knew more about treatment and how to manage the patients. I felt more comfortable, and I could focus more on improving care.

The teams around the patients were mixed between experienced doctors and nurses and those who had never been in an ICU before.

But, despite the difference in experience, we built strong teams and supported each other through tough situations as well as shared joy.

An assignment

An email from MSF, asking if I could go and support the COVID-19 ICU in Gaza came right in time.

I had no reasons to say no, I had no reasons not to pack all this experience and go and support somewhere else.

So, I went, and I arrived just in time for the second wave here.

In Gaza, MSF is supporting the existing health care system with COVID-19 care.

That means we don’t treat patients ourselves but support the hospitals and the staff employed by Ministry of Health (MoH) with things like technical expertise and supplies.

Different struggles

In Gaza, the struggles are different from home.

In one of the hospitals I support, they do not have enough oxygen to treat severe COVID-19 patients. And, since there is an oxygen shortage here, they can’t step up the treatment to non-invasive ventilation for those who need it.

Sometimes they need to refer these patients to another facility, hoping there is room there.

"Life in Gaza isn’t easy, even without COVID-19"

I’ve seen many patients’ conditions deteriorating fast, and when the ambulance finally arrives, the patient’s blood-oxygen levels are too low and I wonder if they will survive the transfer.

An invisible threat

The second wave is spreading quite fast here and is stretching the healthcare system to its utmost. 

Gaza has the world’s second densest population; people live in cramped conditions and social distancing is a struggle.

Life in Gaza isn’t easy, even without COVID-19. A big part of the community struggles with unemployment and does not have enough food for their family.

A view over Gaza City, taken February 2019.

The virus is an invisible threat but the thought of your family not having enough food is a more concrete one.

Because of this, people need to go out every day in crowded places to earn some money and buy some food.


I meet staff in the wards here who are struggling with limited supplies and equipment to support all the patients that are arriving every day.

"We stand together in this fight, just with different resources"

They struggle – as we did back home – to find ways to deal with all the challenges linked to the pandemic.

They see patients die and they struggle as much as I did with the fact that they couldn’t save that life.

People here are in some ways familiar with suffering and death because of the occupation and multiple wars, but suffering and deaths continue to affect us, no matter what.

A patient stands outside al-Awda hospital in Jabilia, in the Gaza Strip. July 2019.

The staff are tired here, but they continue to do their jobs every day. They don’t have a choice either.

They don’t get any psychosocial support as we did back home. Still, they go to work every day. I admire them and I enjoy working beside them.

I am so happy MSF is here and that we can share knowledge and experiences to support our Gazan colleagues through this struggle.

We stand together in this fight, just with different resources.

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