Inside Geneva – Final Summer Profile: ICRC Physiotherapist Rieke Hayes

Podcast: Inside Geneva
Host: Imogen Foulkes (SWI swissinfo.ch)
Guest: Rieke Hayes, Physiotherapist, International Committee of the Red Cross
Date: September 30, 2025

Overview

In this episode, journalist Imogen Foulkes sits down with Rieke Hayes, an Irish physiotherapist working with the International Committee of the Red Cross (ICRC). The conversation explores Rieke’s journey from Ireland to some of the world’s most challenging crisis zones, including North Korea and, most recently, Gaza. Rieke shares candid insights into her work rehabilitating people with traumatic injuries, the realities for both patients and medical teams in conflict zones, and what keeps her motivated despite immense challenges.

Main Discussion Points & Insights

Rieke’s Path to Humanitarian Work

• Initial Aspirations and Career Shift:

  • Rieke never planned to become a physiotherapist; as a child, she wanted to be an astronaut.
  • A pivotal year during Irish secondary school, in which she worked with young adults facing learning and physical disabilities, made her realize her interest in healthcare.
  • She began in the NHS but found herself unfulfilled in outpatient physiotherapy. Instead, trauma, intensive care, and the humanitarian sector drew her in.
  • “[At first] I would have a little clinic, do outpatients…back pain, neck pain. Turns out I really, really did not enjoy that setting.” (03:28–03:42, Rieke)

• Entering Humanitarian Physiotherapy:

  • Participated in UK Emergency Medical Team training for disaster response.
  • Discovered humanitarian physiotherapy could be a full-time career.
  • Volunteered in Bangladesh and Nepal (spinal cord injuries) before joining the ICRC.
  • “It’s a good kind of testing ground because if it doesn’t work out you can just go back home… but no, I loved it.” (04:18–04:32, Rieke)

Working in Resource-Limited Field Hospitals

• Adaptation Shock & Ingenuity
  • Moving from Western healthcare settings to lower-resource contexts was initially jarring.
  • Experiences in Bangladesh revealed that centers there could sometimes offer more patient-centered rehab than affluent systems.
  • “I was a bit taken aback…Oh my God, this isn’t the standard I would expect. But actually…[Bangladesh] was phenomenal…they might actually do better in terms that you have your whatever, three months stay there with spinal cord injuries and they have a little village built so that…when it comes close to discharge, you and your family can have a practice run of living independently…” (05:33–06:38, Rieke)

First Humanitarian Mission: North Korea (DPRK)

• Surprise Posting & Environment

  • Received a deployment email unexpectedly:
    • “I got this email: ‘Would you be willing to go to DPRK in two weeks?’ I didn’t know what DPRK was—so yes, North Korea. And I went, of course, yes.” (00:21–00:38/06:57, Rieke)

• Work and Interactions

  • Focused on prosthetics, orthotics, and rehabilitation for amputees—patients included civilians, military, and frostbite victims.
  • Noted North Korean resilience:
    • “They were quite vague about how they got their amputations…always very hardy people, do not complain…‘No, no, no. I’m good to go.’” (07:25–08:37, Rieke)
  • Life in Pyongyang and cultural surprises (e.g., “Burger Kim”):
    • “Everything is very often things for show…They have a Burger Kim. Not Burger King. Burger Kim—and Kim. Fried chicken.” (09:09–09:28, Rieke)
  • Despite restrictions, Rieke was granted relative freedoms, including a North Korean driver’s license, and experienced great hospitality from locals.

Current Work: Field Rehabilitation in Gaza

• Returning to Gaza

  • Multiple missions post-October 7th conflict escalation; each time, conditions deteriorated.
  • “The first time I went into Gaza, it was last year… Rafah was still relatively intact, but now it’s…complete rubble.” (00:38–00:52/10:45–10:59, Rieke)

• Complexities of Field Medicine

  • Hospitals overwhelmed, with thousands displaced and seeking shelter on hospital grounds.
  • “You had people cooking on the wards, in the corridors…took me a little bit aback because I wasn’t realizing how much the IDP camp would affect actually work inside the hospital.” (11:18–11:39, Rieke)

• Nature of Injuries

  • Most injuries are from high-velocity trauma, shrapnel, bullet wounds—far more complex than typical Western cases.
  • “They’re mostly open wounds…you’ve got the fracture which is much more severe…it’s a very high velocity object which has caused it and has splintered the bone…” (12:35–13:20, Rieke)

• Extreme Resource Gaps

  • Chronic shortages of mobility aids—crutches, wheelchairs, walkers—due to deliveries being blocked or confiscated.
  • “We had an order in since November 2023, but it never came…we had crutches waiting, we had frames waiting, wheelchairs waiting, but we didn’t have them.” (14:52–15:33, Rieke)
  • Patients discharged into tents with 20+ relatives, making infection and proper recovery nearly impossible.

Crisis Response & Personal Impact

• Expansion of Professional Role

  • During mass casualty events, Rieke’s role shifted from rehabilitation to emergency trauma care.
  • “I was stopping bleeding rather than rehabilitating…my initial six weeks…mass casualty incidents were usually about 40 people…we could absorb that…When I came back…174…244 was the highest we had and you just couldn’t recover from that.” (16:41–17:59, Rieke)

• Emotional and Mental Toll

  • “Do you ever get depressed or angry?” (18:20, Imogen)
  • Rieke discusses the need for focus:
    • “I know I can do something about it…You don’t really have time to be depressed and upset…” (18:32–19:24, Rieke)
  • Most overwhelming: chaos, screaming, family anguish, and realizing many patients don't survive after discharge.
  • Guilt is strongest when home, knowing the crisis endures:
    • “It’s not reliving the mass casualty incidents, it’s getting through the border and leaving people behind…” (20:17–20:33, Rieke)

• Commitment to Return

  • Rieke is clear she’s ready:
    • “Yeah, yeah, yeah. The organization is aware that I’m ready to go back and when I’m ready to go back…” (20:49–20:54, Rieke)
  • “Unfortunately, it’s always worse…March was worse than when I was there last year…June was by far the worst I had experienced…” (21:00–21:20, Rieke)

Patients’ Experiences & Small Victories

• Life-Altering Injuries and Adaptation

  • Ahmed, a 19-year-old engineering student:
    • Suffered multiple severe shrapnel wounds—leg shortened by 10 cm, abdominal injuries, bilateral arm fractures (13:35–14:27, Rieke)
    • Despite lack of equipment, Ahmed started walking using homemade crutches. His brother, once a patient himself, walks beside him—“the two walking wounded” (21:55–22:38, Rieke)
  • “They rely wholly on their family members to carry them. And that’s the grim reality of it. We don’t have wheelchairs to offer…” (21:55–22:13, Rieke)

• Motivation and Recognition of Colleagues

  • “[There are] many stories like that where…you’ve put them on the path to being independent and being more capable of surviving this. But…you’re also sending them back out and you’re hoping they survive the war.” (23:17–23:40, Rieke)
  • “The staff in the Rafah field hospital…I’m not just talking about the international staff, I’m talking about the Palestinians. They are incredible…phenomenal job…they have the capacity to do it…I can relax a little bit and sleep…I don’t need to worry about my families while I’m working. But they…they have their families to be worried about. They are all living in tents and yet day after day they come into work and they still do an incredible job.” (23:40–24:44, Rieke)

Notable Quotes & Moments

• “I think now there’s an additional 350,000 people who’ve now evacuated there. Like, where are they going to stay?”
  — Rieke, on the ongoing displacement crisis in Gaza (21:32–21:42)
• “It’s not reliving the mass casualty incidents. It’s getting through the border and leaving people behind. And I’m still in touch with them…and then I worry, of course, that things are worse, and then I’m not there helping. And then I feel guilty. That’s what I wrestle with the most…”
  — Rieke, processing the emotional challenges of leaving Gaza (20:17–20:42)
• “The little food that they have, they’re sharing with you, and they banter with you. And I’m impressed that they can still have a sense of humor despite everything that goes on. They really are astounding to work with, a real privilege.”
  — Rieke, on working with Palestinian colleagues (24:12–24:44)

Key Timestamps

• 00:38–02:03 – Rieke introduces herself and her journey to physiotherapy
• 03:14–05:04 – Early career direction and first field experiences
• 05:33–06:47 – First impressions of field hospitals and contrasting rehabilitation styles
• 06:53–10:24 – Rieke’s mission in North Korea, adapting to culture and clinical practice
• 10:45–12:14 – Rieke’s first impressions on arriving in Gaza
• 12:35–15:33 – Nature of war injuries in Gaza, and challenges with resources
• 16:41–17:59 – Shifting from physiotherapy to emergency trauma care in mass casualty events
• 18:32–19:24 – Personal coping mechanisms, focus during crises
• 20:17–20:42 – Emotional impact post-mission and the sense of guilt
• 21:00–21:42 – Displacement, worsening conditions, and future outlook
• 21:55–22:38 – Stories of resilience: Ahmed and his brother
• 23:17–24:44 – Motivation and admiration for local and international colleagues

Tone & Closing Reflections

Rieke Hayes shares her experiences with humility, resilience, and a deep sense of responsibility. Though her stories are harrowing, she highlights moments of hope—whether it’s a patient walking again or simple acts of kindness among colleagues amidst crisis. She repeatedly emphasizes the remarkable dedication of Palestinian medical staff and her own resolve to return to the field, despite the immense difficulties.

This episode is a moving look at both the challenges and rewards of humanitarian health work in some of the world’s most difficult environments.

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