An Australian doctor who coordinated medical aid to Gaza has expressed horror at the “huge proportion of children being killed or maimed for life” as the UN security council again delayed a vote on a ceasefire resolution.
Dr Natalie Thurtle, who helped oversee the response by Médecins Sans Frontières until last week, said it was “very confronting for colleagues trying to provide healthcare when it’s possible to be shot through the window of the hospital”.
As the reported death toll in Gaza passed 20,000 and France called on Israel to “stop” wide-scale military operations, Thurtle said it was “impossible to set up a meaningful response to this catastrophe because of the ongoing military activity”.
“More and more patients are being created by the situation every day, so the overwhelm is absolutely massive and people don’t have any safe place to go,” she said in an interview with Guardian Australia.
The Australian government last week joined more than 150 countries in voting at the UN general assembly for a ceasefire between Israel and Hamas and also for the immediate and unconditional release of all hostages.
While Israel is open to a “pause” in the fighting, its prime minister, Benjamin Netanyahu, said he was determined to destroy Hamas militarily and as a political force in Gaza in response to the 7 October attacks.
“We’re raining fire on Hamas, hellfire,” Netanyahu said on Wednesday.
Thurtle, an emergency physician usually based in Tasmania, was in East Jerusalem from early November until last week to help coordinate MSF’s medical operations in Gaza.
She was in daily contact with doctors in the besieged territory as they planned their healthcare response and she described an “incredibly chaotic environment” that was “extremely difficult to manage”.
The few hospitals that remained in operation were full of patients and internally displaced people, Thurtle said.
“And now, increasingly, it’s incredibly unsafe, as evidenced by the attack on Nasser hospital a couple of days ago, the siege and now the surrounding of al-Awda hospital by Israeli forces,” she said.
Thurtle said between 150 and 200 patients were arriving at al-Aqsa hospital in central Gaza each day, but “about a third of those patients are dead on arrival, which is very hard because many of them are children”.
“Certainly from speaking to colleagues and seeing the images that they’re seeing, the volume of children killed or mutilated in this conflict is very extreme,” she said.
“Unfortunately, there’s a lot of misinformation around that, but that is certainly what we’re witnessing on the ground – that there’s a huge proportion of children being killed or maimed for life in this conflict.”
Her colleague Chris Hook, who is the MSF medical team leader in Gaza, said this week that doctors at Nasser hospital were “stepping over bodies of dead children to treat other children who will die anyway”.
Thurtle said MSF was speaking up because it felt it had a responsibility to explain what its staff were seeing and experiencing, given that “there’s a huge volume of commentary from people who are not directly witnessing what’s happening on the ground”.
“I think we have been accused of loss of neutrality during this conflict, but it’s important to note that reporting what is being directly witnessed as healthcare workers does not represent a loss of neutrality,” she said.
Israel has repeatedly said Hamas operates within and beneath hospitals.
The Palestinian death toll in Gaza has passed 20,000, including about 8,000 children and 6,200 women, while more than 52,000 people have been injured, according to the media office of the territory’s government.
The US and Israeli governments have previously pointed to the fact that Gaza was ruled by Hamas as a reason to treat the figures with scepticism but UN officials and human rights groups have said the numbers tended to be reliable.
An article in the Lancet medical journal said there was “no evidence of inflated rates”.
Thurtle said MSF could not verify the overall death and injury toll in Gaza “but certainly with what we are seeing in terms of numbers arriving at facilities where we’re working those figures are not outlandish at all”.
Israel has said it is targeting Hamas and that it is “doing its utmost” to avoid civilian deaths, including by issuing evacuation warnings when possible.
Asked whether those statements matched the situation on the ground, Thurtle said healthcare infrastructure had been “systematically targeted”.
MSF has said two people were killed in Gaza City when travelling in “clearly identified MSF cars” on 18 November and that it “considers that all elements point to the responsibility of the Israeli army for this attack”.
“We know that MSF has been targeted previously, and that nothing can excuse the consistent and relentless targeting and decimation of healthcare infrastructure in Gaza,” Thurtle said.
The Israeli ambassador to Australia, Amir Maimon, has said he has assured the federal government that his country was seeking to avoid civilian deaths, while arguing that Hamas was using the Gaza population as a “human shield”.
The foreign affairs minister, Penny Wong, said Australia had “consistently affirmed Israel’s right to defend itself” in response to the Hamas attacks of 7 October, when 1,139 people were killed in southern Israel.
“In doing so, we have said Israel must respect international humanitarian law,” Wong said last week. “Civilians and civilian infrastructure, including hospitals, must be protected.”
The prime minister, Anthony Albanese, told the Lowy Institute he was “a strong supporter of both Israel and the rights of Palestinians for justice”.
“I don’t think anyone has the perfect template at the moment but it’s very clear that the distinction that the world needs to draw between Hamas and the Palestinian people is an important one,” Albanese said.
The French president, Emmanuel Macron, said on Wednesday: “We cannot let the idea take root that an efficient fight against terrorism implies to flatten Gaza or attack civilian populations indiscriminately.”
