Author: Hima Bindu Thota, MD
Initially, this paper was titled “The Integration of Spirituality in Palliative Care in the Gaza Strip.” In light of our current reality, and with the approval of the leadership, this paper will be a pivot from the original plan, and I title this paper, this lament, as “On This Land, there is a Life Worth Living.”
My name is Hima Bindu Thota. I am a general surgery resident. I am Indian and Christian so my tie to the Holy Land and the people that it holds is another story for another time. My eyes were opened when my feet first landed in the West Bank in 2014. Palestine is why I went to medical school. Palestine is why I am a surgical resident. Palestine is where I hope to serve as a surgical oncologist to be with the people who changed my life. Palestine is why I believe Jesus Christ is who He says He is.
A friend told me “You cannot understand Palestine until you have witnessed Gaza.” There was an opportunity to join a team with the Palestinian Children’s Relief Fund in August 2023 that was working to establish Palliative Care in the Gaza Strip. We trained nurses, doctors, pharmacists, psychologists, and physical therapists about the principles of palliative care at Turkish Palestinian Friendship Hospital, the only cancer hospital in Gaza, under the leadership of the legendary trauma surgeon, Dr. Sobhi Skaik. The same hospital was hit by an airstrike on October 31, therefore terminating the only cancer hospital in Gaza.
I also spent time with the ER and surgery department at Al-Shifa Hospital. It was there that I was introduced to the surgery residents, including a woman named Maysaa. There is only one board- certified female general surgeon in the Gaza Strip. Al-Shifa was training the next 4 women. Maysaa took me around Al-Shifa and showed me her world through her eyes, a world not so different from my surgical residency in New Jersey.
In my proposal, the initial intent was to discuss spirituality as an essential component of palliative care within the Gazan context. During my two weeks in Gaza, we explored what spirituality looks like here, how this is expressed in a Muslim context, how the values of this society offer meaning in the face of the ongoing siege and losses, how healthcare teams can integrate spirituality and spiritual pain as part of a holistic assessment, and how spiritual care can be an integral part of multidisciplinary palliative health interventions.
I wrote in my initial proposal, “We had our last class with the students in Gaza on August 16, 2023, unbeknownst to us what would transpire on October 7, 2023. My hope is by the time of the CMR conference, the war will be over, and I will also be able to report on what the medical team was able to apply in real time. My paper will be a reflection on the integration of spirituality in times of long-suffering and terminal illness, which was primarily the context in which we were teaching these principles, but also a reflection on the integration of spirituality in times of trauma and war.”
But the war did not end. Some of my colleagues are still alive, others, I am not sure. As of 1 week ago, some have fled to Egypt after paying over $30,000 to Egyptian fixers, the greatest exploitation of humanity. Others are sleeping in tents in south Gaza, awaiting their death. The long-suffering and terminal illness that I thought to talk about became short-suffering and instantaneous death.
We are not in the space to reflect on what we have learned – we are amid lament.
