AT THE emergency department of La Rabta hospital, a sprawling white complex built on a hill overlooking central Tunis, the staff dashing through cluttered corridors seem still to be in crisis mode.
A large crowd fills the cold public waiting area and a guard stands at the inner door to keep anxious parents and siblings from pushing their way towards the treatment cubicles.
When a taxi pulls up at the door, a nurse finds an improvised trolley – a long table with four legs and a cushioned surface – and drags it towards the car, making a sharp scraping sound as it passes over the hard floor.
One of the capital’s two main hospitals, La Rabta has found itself at the front line of Tunisia’s unrest in recent weeks, having to deal with the greatest emergency its staff have seen. Behind a desk piled high with folders and notes, department head Nèbiha Borsali- Falfoul says many of her medics slept in the hospital and worked for up to four consecutive days as the dead and injured kept arriving over the past fortnight.
Most of the victims were young. “One man was 70, but all the rest were around 20,” she says. “There was one young boy who went to watch the protest from the roof of a building. He was asthmatic. The tear gas reached him and he died there on the roof.”
In the middle of last week, she says, a sniper’s bullet skimmed a father’s nose and hit his young daughter walking beside him.
“All the victims were so young, mostly between 15 and 35,” says Malek Lakhoua (29), a fine- featured doctor who struggles to remain composed as he describes his experience of treating 15 patients the day before the departure of President Zine al-Abidine Ben Ali’se.
“They had bullets in the thorax, in the head, in the hip. Several had been hit in the back.
“The bullets had been very well aimed, bullets from elite police shooters,” he says.
La Rabta received 10 bodies and 53 injured patients in a two- day period during the violence in Tunis, while the city’s second hospital – Charles Nicolle – reported 30 dead.
One of the victims was a French photo-journalist who was hit apparently by a teargas canister while covering a protest in the city and who died of his injuries.
“We never experienced a situation like that at the hospital,” says Dr Lakhoua, crying now. “Disaster medicine is four pages in our training manuals. Over those days, the whole medical team lived through a horrible psychological trauma.”
Hospitals across Tunisia report similar stories. Some of the country’s worst violence occurred in the western city of Kasserine, where dozens of deaths were reported on the weekend of January 8th-9th, when police opened fire on protesters.
Messaoud Guessoumi, a gynaecologist who was called in to help the local hospital cope with the pressure, describes what he saw that weekend as a “massacre”.
“Between Saturday, Sunday and Monday, the three bloody days, there were 48 deaths,” he says. “Kasserine was the turning point of the revolution.”
Officially, 78 people died across the country during the past four weeks of unrest, although the UN has put the death toll at more than 100.
“Many victims arrived at the hospital with their skulls opened,” says Dr Guessoumi. “We operated on people in the corridors. I had to carry out three thoracotomies even though I’m a gynaecologist. The spinning bullets they used caused a huge mess.”
The dubious results of Tunisia’s rigged elections always showed that the deposed president performed particularly well in the city. “In Kasserine, we apparently voted 99 per cent for Ben Ali and a few months later he came to massacre us,” Dr Guessoumi says.
Many of the doctors in the emergency department at La Rabta look strikingly young themselves, and Dr Borsali- Falfoul is full of admiration for the skill and commitment shown by so many trainee doctors.
“There were doctors who were overwhelmed by it, but others handled it with extraordinary calm,” she says. “One young doctor, she volunteered and worked for four days non-stop, with extraordinary calm.”
Clearly exhilarated by the revolution’s success, her remarks that her junior doctors’ ability to rise to the occasion mirrored the determination and idealism of their friends and counterparts who took to the streets.
“They surprise us, the young people,” she says. “We always criticised them and now they’re giving us a lesson. They always had a lot of audacity, but they’re also showing elan and patriotism.”