Rieke Hayes was only a few days into her six-week rotation at Red Cross Field Hospital Rafah when a stray bullet shot through her bedroom window. The Irish physiotherapist was not surprised.
Since her arrival in the southern Gaza Strip, just two days after the collapse of the fragile ceasefire between Israel and Hamas, fighting in Rafah had rapidly intensified.
“We tried to build walls on the south side of each [hospital] tent to try to stop bullets coming in but absolutely every ward had been hit by a bullet at some stage now, even my physiotherapy tent,” she says. “You never know if you’re going to get hit, it’s Russian roulette. It’s constant, it’s unpredictable. By the time you hear a bullet, it’s probably too late.”
Originally from the village of Murroe in Co Limerick, Hayes studied physiology in Cork before moving to Scotland, where she trained as a physiotherapist. Since 2017, she has worked with the International Committee of the Red Cross (ICRC) in disaster and conflict zones across the globe, including stints in Bangladesh, Nepal, North Korea, Iraq, Yemen and Ukraine.
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With expertise in trauma orthopaedics, Hayes was keen to work in Gazaand requested a transfer to the war-torn strip. She first travelled to the European Gaza hospital in Khan Younis in May 2024, but was evacuated a month later. In March 2025, she returned, this time to the 60-bed Rafah field hospital.
Since June, the facility has been overwhelmed by an almost daily influx of “mass-casualty incidents” – dozens of patients arriving with gunshot wounds who said they came from the Gaza Humanitarian Foundation distribution centres. These US and Israel-backed, military controlled distribution sites have been handing out food to thousands of Palestinians since late May. However, according to Gaza health officials, hundreds have been wounded or killed by gunfire while trying to access the life-saving supplies.
“The first day there were 48 people, that’s enough to trigger a mass-casualty incident,” says Hayes. “But a week later it was 179 cases, numbers we’d never seen before. We couldn’t keep up.’”
Hayes has also cared for injured children at the hospital, including a six-month-old called Malek hit by shrapnel from an explosion at his home. “The beauty of a six-month old is he’s entirely oblivious to the destruction around him,” she says. “But just before we left we had two young girls, aged nine, who were hit by stray bullets. They were just lying there in the ward, staring at the ceiling. They’re not interacting, they don’t want to move. They’re in shock, they’ve lost so much.”
With the influx in patients, Hayes had to support doctors and nurses in the emergency department during mass-casualty incidents. “There’s people screaming and there’s blood everywhere, it’s every hand on deck. I was patching up wounds, taking vitals, holding people down who were having seizures. We have a tech guy who was carrying stretchers to the wards and bodies to the morgue, absolutely everyone had to help.”
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Hayes says her Palestinian colleagues – from the hospital carpenter and cleaner to surgeons – are “phenomenal people”. “They’re all hungry, all their families are affected. The only thing separating them from our patients is a bullet.”
On June 12th, the home of a nursing colleague was hit by an air strike shortly after she finished a shift at the hospital, says Hayes. “She was readmitted that same night to the ward where she usually works, with her six-month-old baby. Her eight-year-old son was killed.”
Only this week, one of Hayes’s colleagues texted to say her home was destroyed in an air strike. “She’d made it this far into the conflict, she hoped she’d hold on to her home. Now she, her husband and their three children are displaced. She’s completely lost her way, she’s bereft.”
Gaza is different from other conflict zones “because there’s no discernible frontline where the fighting is concentrated,” says Hayes. “Essentially you are on the front line, because everywhere in Gaza is the front line.”
With foreign journalists still prevented from entering Gaza, many healthcare workers feel a responsibility to report back to the rest of the world, she says. “There’s a lot of pressure to be the people that convey that information and make sure what we say is accurate and factual. I’m not comfortable doing interviews but I feel it’s an extension of my duty of care, to actually say what I’ve seen. And it’s just horrendous. Nobody is safe, there’s no end in sight.”
“Palestinians are famous for their resilience but after 20 months of starvation and displacement, there’s only so much a person can take.”
Hayes recently returned to Cork for a break but is due to travel back to Gaza in August. She admits she has “mixed feelings” about returning.
“I’m still waiting for confirmation that I can return. If I don’t it will be a mixture of relief but predominantly guilt,” she says. “I’m exhausted but I think not returning would feel like abandoning my colleagues. Being there takes the load off them and shows somebody cares.”
