A Brief History of Field Hospitals in Tahrir Square

27 November 2011

Statement no. 84 by the Supreme Council of Military Forces on 24 November announced the establishment of a military field hospital in Tahrir Square to provide medical assistance to protesters wounded as a result of state-induced violence. The step, which was both too late and unwelcomed by Tahrir protesters, came five days into the deadly attacks on protestors that left dozens killed and thousands wounded by central security and military forces.

Since Saturday, 19 November, more than 12 makeshift hospitals have been established in the square and floods of doctors, nurses, pharmacists and other health professionals have swarmed in to offer their services. The swiftness and efficiency with which the hospitals are established and managed bears little resemblance to the make-shift hospitals characteristic of the initial uprising in January. Nine months of experience that followed the beginning of the revolution has made hard-core emergency medics out of young doctors. Alongside the field stations of the Arab Medical Union's Relief Committee and the Egyptian Red Crescent were those of the much fresher Tahrir Doctors, an organization established a few months ago in response to the growing need for disaster and emergency medicine.

The confident and organized doctors that I met in Tahrir this past week are the same overwhelmed, uncertain ones I met ten months ago while investigating the health system’s response to injuries incurred by the revolution. It is as if the episode of 25 January was a pilot test for disaster medicine in Egypt and to the principle of medical neutrality, which was violated both from the within and without the medical sphere. Medical neutrality ensures the protection of medical personnel, facilities and the impartial treatment of the sick and the wounded. Back in January and February, doctors at public and private hospitals were coerced into handing over or reporting injured protesters to state security personnel – some doctors even volunteered. State security ordered and threatened doctors against treating protesters, and security forces directly interfered with access to hospitals. Ambulances were scarce and often refused to take in injured protesters, and are even reported to have carried weapons and ammunition into protest areas. Hospitals were overwhelmed with more injured people than they could deal with. Dusty disaster management guidelines, where they existed, were dug out of broken drawers.

In the midst of all this, it was the young doctors' performance that struck me the most. The first ones to show up at emergency wards, not in answer to any official calls, were the younger doctors and interns who went to the hospitals on the mere intuition that massive protests would mean massive casualties. Crippled by lack of experience, proper guidance and resources, they managed to give an outstanding performance in the face of extensive challenges. While many cases went unreported in the first few days, doctors later found ways to preserve evidence and document injuries in whatever way they could, knowing that someone must be accountable for them. The security threats and lack of confidence in state-owned health facilities also meant that injured protesters were more reluctant to go to hospitals – hence the creation of makeshift hospitals in Tahrir.

Makeshift field hospitals have come a long way since then. Doctors can now be seen setting up medical stations around Tahrir before any major protest or sit-in. More than 12 filed hospitals were established in Tahrir since 19 November. There is no scarcity of medical personnel and donated medical supplies are in abundance. The evolution of makeshift hospitals was also coupled with a shift in the understanding of medical neutrality. Months ago I met with doctors who proudly reported they had "captured" a thug or reported a suspicious-looking patient. Today, doctors at the field hospital in Tahrir are crossing over to the other side of the battle in response to news of injured security officers, even if it means risking their own safety. On Sunday, field doctors rescued an intruder from the hands of angry protesters and managed to get him out of Tahrir in an ambulance. Ambulances which had once denied medical help to protesters are now seen traversing the man-made rescue passage that clears the way for the dead and the wounded out of Mohamed Mahmoud Street, a major scene of recent violence. The doctors once reluctant to give testimonies or have their names mentioned are now coming forward with first-hand accounts of the atrocities they witness and experience.

The rise of an organized movement of professional medical personnel who are performing their ethical duty of alleviating suffering with diligence has not gone unnoticed by perpetrators of violence. It is a sad affair that security forces, too, have shifted the way they target protesters by hitting where it hurts the most: targeting field hospitals where the injured are taken for swift medical intervention. Since 19 November, there have been numerous accounts of targeted attacks on field hospitals by tear-gas, making it exceedingly difficult for doctors to perform their duty. A number of doctors were recently arrested on duty and at least one was killed after being asphyxiated by tear-gas. Medical supplies are confiscated by military officers and field hospital tents were burned down during a Tahrir raid on Sunday. It is no surprise, then, that news of a military field hospital was faced with so much skepticism.

Irrespective of whether the attacks on medical neutrality were deliberate, they must be seriously investigated. “I don’t know which is more tragic, the intentional targeting of medical facilities or the accidental nature of these attacks,” said Dr. Mahmoud Farrag, one of the field doctors I met. "Even if the attacks were out of carelessness, someone must be held accountable."

- Published at Al-Masry Al-Youm.