Cancer Nursing Under Occupation: A Conversation with Gerry O’Hare

In 2012 Gerry O’Hare’s son Liam was a student at Edinburgh University. Alongside some fellow students, Liam was planning a trip to Palestine. 

His interest piqued; Gerry had a notion to join the trip. Liam (quite reluctantly) agreed. 

“I was the oldest person on the trip by far. I ended up making good friends with the bus driver, Musa.”

By then, Gerry was a good twenty years into his nursing career, serving as an advanced nurse practitioner in oncology with NHS Greater Glasgow and Clyde.

 The purpose of the trip was to give the students a sense of perspective of the realities of life under occupation in the West Bank.  It is perhaps unsurprising that a veteran nurse, hard-wired to alleviate suffering and protect dignity and autonomy, Gerry was moved to action.

“For me as a cancer nurse, I wanted to know how health care, and specifically cancer care was managed under an occupation.”  

Gerry reached out to local hospitals and training institutions to help answer this query. 

The Dean of Nursing at Bethlehem University, Mariam Awad, welcomed an exchange with an international colleague.  It was a fruitful encounter, one that over the past decade has led to the development of the first Postgraduate Diploma and eventually a Masters in in Cancer and Palliative nursing care in Palestine. The program has garnered multi-agency support from the European Oncology Nursing Society, Glasgow City Council, Medical Aid for Palestinians, and Glasgow-based charity Spirit Aid. It has facilitated the (vital) exchange of students for clinical placements between Glasgow and the West Bank.

Gerry adds that the decision to develop training aimed specifically at nurses was tactical and deliberate. “Working as a nurse, I’ve always been aware that nurses are not always given the training opportunities they deserve. This less so now than the in 80s, but it remains true here and also in the West Bank of Palestine and Gaza.  The fact remains that you may have the best doctors in the world, but unless you have a well-trained and competent work force to implement that care, it’s not going to have an impact.”

The basic principles of cancer nursing are largely universal. “The care provided by a good cancer nurse in Scotland and a good cancer nurse in Palestine is almost indistinguishable- based on empathy, clear communication, knowledge of treatment protocols and management of side effect including symptom management,” O’Hare observes.  

However, when the impact of the occupation is taken into consideration, things begin to look quite different.

“Being able to attend a breast clinic is a massive issue in the West Bank.  The patient may only need to travel a short distance, say 15 miles, the distance from Glasgow to Coatbridge. But they need to travel through armed checkpoints and get back again. If they close a checkpoint once they’ve already past it, how do they get home? The same challenges with travel are also encountered by health care workers.”

The problem is further compounded by the impact of the Israeli occupation on access to diagnostics and drugs. 

“Everything in the West Bank and Gaza enters via Israeli control. You may get access to some chemotherapy drugs, but this will suddenly stop. A patient may have already embarked on a course of treatment. What does the practitioner do with the remaining chemo drugs? Do they choose which patients get the chemo drugs? Do they share what’s left amongst the patients and nobody gets the appropriate dose?”

In 2019, with the cancer nursing program in the West Bank firmly and successfully established, Medical Aid for Palestine (MAP) asked Gerry to be part of a multidisciplinary UK group to carry out an assessment of breast cancer services in Gaza. “Initially MAP were more focused on the support of acute services: such as A&E and burns, women and children’s health but it is worthwhile to note that the occupation see sustainable healthcare as more of a threat”.

The project to support breast cancer services in Gaza involved the building of links, rapport and relationships between clinicians in Scotland and Gaza. In 2018  Dima Al Haj, the daughter of a senior doctor that Gerry had worked with in Al Shiffa Hospital, stayed in Gerry’s family home for two months while completing a Masters programme at Glasgow University. Gerry’s partner, Roseann Maguire, described Dima as a lovely girl, who “became part of the family.”

As much as Dima loved the freedom of Glasgow, she was determined to return to Gaza to serve the people.  “On her return to Gaza, Dima found love, gave birth to a beautiful little boy, and embarked on a career with the World Health Organization (WHO)”. Gerry became a close family friend, meeting Dima and her new husband and child on each return visit to Gaza

From the 9th of October 2023, Roseanne texted Dima daily. 

Dima’s responses became increasingly sparse.  Their final exchange read as follows. 

“How are you surviving?”

“No words to express. This is about my little boy. I hope he lives to see better days”

In the days following, Gerry and Roseanne would learn that Dima had been killed in a rocket attack on her family home in Gaza, alongside her six-month old boy and 48 members of her family. It was a home that Gerry had been welcomed into. Gerry adds that it was a “detached family home, surrounded by land, far from any potential targets”.  It perhaps goes without saying that no explanation has been provided.

Since 7th October 2023, according to official estimates, 47 000 Palestinians have been killed, 111 000 injured and 10 000 are believed to be beneath rubble in Gaza. Amnesty International has deemed it a genocide. 

Deputy medical co-ordinator for Medecins San Frontieres Mohammed Abu Mughaiseeb notes those who are excluded from these figures. “We don’t count the people who have died as a result of medical services. A lot of people who had cardiac problems died. A lot of people with renal failure died. A lot of people with cancer- both children and adults died from a lack of treatment and services.”

On the 21st of March 2025, Israel blew up the Turkish-Palestinian Friendship Hospital, the only specialist cancer hospital in Gaza. It was the pride of the Ministry of Health in Gaza, once with up to 30 000 patients under its care. 

The IDF claimed the hospital was used by Hamas, but there is no evidence to support this claim.

At the time of writing over 1048 health care workers in Gaza have been killed by Israel in the line of duty.  Attacks on medical staff and facilities are in direct contravention of international law.

The British Medical Journal describes the healthcare system in Gaza as “completely eviscerated.”

All of Gaza’s medical facilities have been or partially or entirely destroyed, along with the vast majority of its medical and imaging equipment.  The capacity to re-build has also been targeted. All 12 universities in the Gaza Strip have been reduced to rubble, including all nursing and medical schools. 

Gerry describes feeling tearful and overwhelmed on a regular basis: “Watching in real time the hospitals I worked in being destroyed, the nurses I worked with being displaced, some of them being killed, their families being killed and horrible life changing injuries inflicted”. 

As the threat to Gaza amplifies, Gerry remains committed to action.

“No one could say we didn’t know what was going on”. 

To get involved with the Scottish Palestinian Healthcare Partnership visit: https://scotpalhp.org/

Gerry O’Hare is a Clinical Nurse Specialist for NHS Greater Glasgow & Clyde. 

Uma Rebecca Nada-Rajah is a writer and critical care nurse for NHS Scotland. 

Human Rights watch Israel: Immediately Restore Electricity, Water, Aid to Gaza | Human Rights Watch, 2023. Available: https://www.hrw.org/news/2023/10/21/israel-immediately-restore-electricity-water-aid-gaza [Accessed 28 Mar 2024].

List, J.M. (2008). Medical Neutrality and Political Activism: Physicians’ Roles in Conflict Situations. In: Allhoff, F. (eds) Physicians at War. International Library of Ethics, Law, and the New, vol 41. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-6912-3_14

Mahase E. Gaza’s health system is “completely eviscerated”—what happens now? BMJ 2025; 388 :r361 doi:10.1136/bmj.r361