Independent Appeal: Where bits of old radios keep patients alive

It is a cramped and shabby office which doubles as a workshop. It is littered with bits of old radios and lined with what must be the most comprehensive library of medical equipment manufacturer's manuals - of every vintage - in the Middle East. Its occupant, an engineer named Samir Abu Nada, seems an improbable life saver.

Yet were it not for the extraordinary resourcefulness of Engineer Samir most of the 15 public hospital laboratories in Gaza would simply come to a halt. For he and his seven-strong team maintain and repair all the laboratory equipment in the territory.

Engineer Samir has become a master of improvisation. The Heath Robinson-looking contraption on which he is working is, in fact, a working electrolyte analyser - with some nuts and bolts sticking out of it, where the sleek touchpad should be. This is a vital piece of kit. It measures sodium, potassium and lithium levels in the patient's body. It is not only a diagnostic tool; it is needed, for example, 10 to 15 times during a normal cardiac operation to monitor the patient.

Yet the latest World Health Organisation report on Gaza shows that in just one hospital - Shifa, easily Gaza's biggest - 65 pieces of equipment across the full range of services (and nine types of drugs) are at "zero availability".

The main reason for this is that the ministry of health cannot pay its bills. Israel and the international community have blocked funding to the Palestinian Authority - because the party in power, Hamas, refuses to meet conditions set for it - including recognition of Israel. So ordering a vital spare part, let alone a new machine, is now all but impossible.

Some of the drugs and part shortages were supposed to have been made good through the Temporary International Mechanism, a fund run by the World Bank and supported by the European Union. But the bureaucratic nightmare of working with a ministry when European and US officials are not allowed to talk to the Hamas minister means it has taken months even to sign a memorandum of understanding.

So Engineer Samir routinely does the rounds of local radio and TV shops in Gaza City to hunt for the miniature transformer that would make kit like the electrolyte analyser usable. Handling numerous types of electronic circuitry has become stock in trade.

"If things were normal we would get someone in from the company and they would replace the board in a minute," he explains. "But at present we may take a week taking it apart, finding out how it works, and then we try and find a part that will replace the defective one."

This remarkable man seems to hold in his head each part of about 1,400 machines - which, maddeningly, because of haphazard donations, belong to countless different brands and models - and every spare part in Gaza's health system.

"If you ask him about, say, sample probes, he'll tell you that one has stopped working at the Nasser hospital in Khan Younis and two will need replacing at Shifa hospital in Gaza City in the next two weeks," says Christian Bunyan, the Gaza co-ordinator for the British medical agency Merlin.

But not even Samir Abu Nada's ingenuity can make up for all the shortages. Which is why Merlin, one of the three charities being supported by this year's Independent Christmas Appeal, is supplying some of the parts that he needs (as well as other desperately needed surgical instruments and hospital equipment). And in the process allowing Samir to do his job helping to save the lives of many of the patients who depend on the apparatus he services round the clock.

Last week Hilary Benn, the Secretary of State for Development, became the first British cabinet minister to visit Gaza since well before the second intifada began in 2000. He visited one of the hospitals whose laboratory equipment runs only thanks to Engineer Samir's improvised repairs - and the British charity which funds them.

"I applaud the efforts the NGOs and others are making to help and relieve the suffering people are experiencing here," Mr Benn said, endorsing The Independent appeal. "I hope people will give generously."