While the war in Gaza may feel a lifetime away from Cumbria, there are people living here who have faced the conflict to help the people, children and families who are trapped by it.
One of them is Richard Villar, a 70-year-old top war surgeon who lives in Bowness and who has spent part of this year working on the frontlines in Gaza to carry out complex operations on severely injured people.
Richard has worked in over 30 active war zones over the years and he first set foot in Gaza in 2018, during The Great March of Return, where he operated on severely injured people during the protests.
This year, he was contacted by Medical Aid for Palestinians, which asked him to return to the region to help.
Richard said: “I thought long and hard about returning and thought, ‘well, I know Gaza. Let me go’. I went in March and came back in April and while I was there it was a very different Gaza to the one I’d seen before.
“I’ve only ever seen Gaza in conflict anyway, but this was far more aggressive than anything I’ve seen before and the type of injury was also totally different.
“I formed part of an emergency medical team, which comprised of six of us and I was the only surgeon. Some of us met online before we went but most of us met for the first time at Heathrow airport.
“We initially went to Cairo to do basic training, which you think would be all medical, but it wasn’t at all. It was what to do when someone throws a grenade in the room and what to keep in a grab bag because you never know when you’re going to have to move in a hurry.
“I think somewhere inside you there’s some neural connection that persuades you you’re going to be okay when you go.”
Richard entered Gaza just after seven volunteers from World Central Kitchen were killed in an Israeli air strike.
He added that most of the people working in Gaza’s 36 hospitals are volunteers, as most of the region’s medical staff have either died or left.
Richard worked in central Gaza, alongside other unpaid doctors and nurses in a 200-bed hospital overrun with 700 patients, many of whom were women and children.
He said: “I remember we all sat down and thought ‘what should we do? Is this a a sign that we should not go into Gaza?’ But we decided at the end of the day we should go.
“We felt that if you go skiing and there’s an avalanche, as the avalanche comes down, it then leaves behind some stable snow for a period before it reaccumulates, and the same applies to Gaza.
“But once you’re there, it’s at that point you realise where you are and that you’ve got to focus and keep your head together.
“Patients were littered absolutely everywhere, there’s no logic to it, and where we were was largely a maternity hospital anyway, and most of the nurses were midwives, so there was virtually nothing on the wards in terms of care.
“There was a very high infection rate, lots of amputations, but what was clear among this is that the Palestinian people were pulling together.
“So even though you may not have had nursing care on the ward, the Palestinian families were looking after each other and before you even spoke they would get out that squidgy gel we use to sanitise hands in UK hospitals.”
Alongside the constant war threats – Richard and his fellow volunteer doctors also faced dire conditions, including limited medicines and equipment, while basic necessities like clean water and sufficient food were considered luxuries.
Richard added: “It’s it’s an unhappy place you in some respects you are blessed to be a doctor. I guess because it’s very clear, as a medic what your focus is. You’ve got the situation in front of you and the political situation remains seperate.
“We all back in this country pass comment on it and we sound very wise with how things should be resolved, but as a doctor, you don’t do that.
“You are solely concerned with helping people. In fact, one of the reasons why an old bloke like me is valuable is firstly, in that part of the world, you’re in a society where age is respected.
“Secondly, I was trained when we didn’t have quite the resources we have now and that’s quite helpful. I found myself using techniques I hadn’t used for 40 years.
“But because you’ve got very little equipment, very little medicines are getting there, even if it’s donated, the infection rate is huge. I mean, we’re talking about massive.
“Throughout all of that, of course, you’ve got you’ve got drones flying overhead all the time and you can hear them. They call them zanana, which is the word for sound a mosquito makes, but basically all the time you have it.
“You of course couldn’t really go outside for very long also because the zanana would have a bead on you.
“Then there’s the regular fighting within a couple of kilometres all the time and there’s intermittent explosions extremely near and very occasionally gun gunfights immediately outside your window.”
Richard, who specialises in hip and knee surgery, said that the injuries and complex surgeries he faced in Gaza were different to other war zones he’s faced.
He added: “The first time I went to Gaza in 2018 it was largely gunshot wounds, so it was in essence an entire generation being crippled.
“But fast forward to now and we’re facing explosive injuries and very few gunshot wounds.
“With missiles, it doesn’t matter how good you are with aim, or how accurate the targeting, if you’re in a built-up area and you are in Gaza, you get multiple injuries.
“It was quite common for people to lose limbs and have at least two or three injuries at a time. That looked something like losing a leg and having a broken arm at the same time.”
He added that while people and families in Gaza were concerned for getting better, they would more regularly ask him about the outside world.
Richard said: “They weren’t asking if I could look after their broken leg, they were asking me, ‘what does the world think? Do you know what other people think?’
“I told them exactly what people were thinking here, because they didn’t know, they are mostly deprived of all contact with the outside world.
“I remember one woman who said to me ‘tell the world about me’. Generally speaking I try to keep people under wraps, as that is what doctors do.
“But I said okay. She had a very difficult clinical problem and I didn’t quite know what to do because I needed to talk to other doctors, as we frequently do that, so I put it on LinkedIn.
“To my surprise I had 98,500 impressions and every last one of the comments was clinical. But we leave the politics to the politicians, as a doctor, you are a doctor.”
Richard estimates that over 12,000 people are waiting for medical evacuations from Gaza, as resources even in neighbouring country hospitals are extremely limited.
He added he believed that because those injured in war often require several operations, over a million operations were needed for people in Gaza.
Richard said: “I couldn’t turn around to my grandchildren and say I just watched it happen. As a doctor, if you have the skill to help, then you help. In my case, I had to be a war surgeon.
“When I’m there, I realise I’m in the right place. If you ever have any doubts about whether you’re doing the right or wrong thing, all you do is look into the eyes of a patient and you know straight away you’re doing the right thing.
“I’ve never really volunteered for anything, it has always come to me. I lecture and speak in public a huge amount and someone said to me about four or five years ago, who’s going to take over once you’re gone?
“I’m sure a lot of people will take over, but if you’d said to me at the very beginning of my career that it would have ended up like it has now, I would have said you must be joking.
“I just seem to have developed a skill which is appropriate for that sort of environment.”
During Richard’s time spent working in Gaza this year, he kept a record of his experiences, which he is now set to publish as a book – Gaza Medic, A War Surgeon’s Story 2024.
It’s a rare first hand account of the aggressive conflict the region is currently facing – and is one of the first books of its kind.
He said: “I started to write the book when I was there and I thought, is it a good thing to write a book? I don’t know if it is. But it’s one very good way of ensuring you don’t bury memories you’re busy trying to forget.
“It was mostly written on the floor under the windowsill of a room in central Gaza. I then got back, read it, thought good heavens this is terrible, so I rewrote it and kept the same structure but now it reads like an actual book.
“But I don’t know of anybody else that’s done it really, most people go in and they don’t want to be seen.
“They go in and they stay in the hospital because it’s the only safe place to be and even that’s not without risk. I didn’t do that, I went to the hospital, but I commuted every single day across Gaza.
“I did that because I wanted to see how Gaza felt, I wanted to see the sewage in the streets. I wanted to see the people selling the food that has been donated as a humanitarian gift.
“I wanted to see the people returning to care units when the Israelis said they’d left only to be bombed and shot in the process. I wanted to see all that to understand it.”
Richard said that coming home from an active war zone was a process he has had to slowly get used to over his time spent working in hostile environments.
He said: “The first thing you think about is how the National Health Service is actually very good. I think everything is relative, but you almost want to kiss the ground.
“It’s a wonderful feeling as you fly over England and see the green fields, and landing you sort of feel a cocoon around you, I suppose, and you feel warm that you’ve come home.
“I think now my own family has seen me do this enough times, so they just give me distance, and they let me settle and over time it does, but it sort of carries on for quite some time too.
“Yes you go out there for two and a half weeks, or whatever you can, but it goes on for a lot longer when you get back and even now for me, it’s still going.”
Richard’s expertise in the surgical field is recognised worldwide and his book, Gaza Medic, will be published by Pen & Sword in October.
He has also previously published books including Knife Edge – Life as a Special Forces Surgeon and Winged Scalpel – Surgeon at the Frontline of Disaster.
