RAFAH, Egypt -- It's a 2 1/2-hour journey that should take 30 minutes. A hair-raising sprint on dirt roads through bombed-out cities and military checkpoints, all while coping with the ever-present threat of gunfire or a stray bomb.
Such is the ordeal faced by paramedics ferrying patients out of Gaza -- where hospitals are overflowing because of the conflict with Israel -- into neighboring Egypt. Ambulances run by the Red Crescent, the Islamic world's equivalent of the Red Cross, have been busy transporting amputees, spinal cord patients, burn victims and other severe medical cases.
On Wednesday, Israel and Hamas observed a three-hour pause in fighting to allow the delivery of humanitarian aid such as food, fuel and medical supplies into Gaza. Similar lulls will occur in the future, Israel said.
The pauses "will help the movements of the ambulances," said Hesham Hassan, spokesman for the International Committee of the Red Cross. "But three hours is not enough."
Nearly 3,000 Palestinians have been wounded since the war began Dec. 27, along with 690 dead, according to Associated Press figures based on interviews with Palestinian health officials. Ten Israelis have been killed, Israel's government has said.
Abdel Bassam El Sharafi, 40, often accompanies the wounded in ambulances. The Gaza City doctor was injured in the first week of the fighting when a piece of shrapnel lodged in his back, yet he presses on in spite of the pain.
The most dangerous part of the 25-mile trip from Gaza City to Rafah, El Sharafi said, comes each time they encounter an Israeli army checkpoint.
"We usually stop," he said, "and wait until they wave us through. Last time they shot in our direction."
Hakim El Habashi, a paramedic from south Gaza, noted that slow ambulance response times have led many Gazans to transport the wounded in their own vehicles. This prevents the injured from getting adequate medical care during transport, he said.
Ambulance drivers operate in the extreme stress of a live combat zone, with mortars and rockets often shaking the ambulance and rattling its patients.
"There is a risk on the road from the Israeli bombings," said Ahmed Abdel Wahab, a health official at the Rafah border crossing.
Since the conflict began, Egypt has allowed only medical supplies to cross its border into Gaza. There are signs, though, that the Arab state is loosening its policy slightly as baby formula and dried milk were among the goods permitted to cross Wednesday.
Still, the situation in the Gaza Strip, home to 1.5 million Palestinians, remains critical.
"If electricity is not restored," said Hassan of the Red Cross, "the hospitals, which are running on generators, will soon be unable to provide basic services."