Just a few days after arriving at a hospital outside Rafah in the Gaza Strip, Dr Omar El-Taji – a urologist who usually works in Manchester – was woken up at 2am to operate on an urgent case. “A man in his 30s was brought in after his entire building was bombed,” he says. “He had an open wound to his abdomen, his hand was falling off, and his ankles were completely mangled.”
The man was quickly taken into the operating room. “The shrapnel had completely sliced through him – I had never seen anything like it,” says El-Taji.
The patient survived the surgery, but died two days later after he went into renal failure due to sepsis as there was no dialysis available. “This would not have happened in a healthcare system that was adequately resourced,” he says.
El-Taji was part of a group of international doctors who spent three weeks in Gaza, operating under the umbrella of the World Health Organization. It has given them a first-hand look at a health system that has been shattered by Israel’s continuing offensive in Gaza, where two dozen hospitals are no longer operating.
The team of medical workers arrived at the European hospital near Khan Younis at the beginning of May with suitcases filled with essential items, including medication, surgical instruments, and boxes of Quality Street. “For the kids,” says El-Taji.
“I thought I was mentally prepared,” he says. “But what we witnessed in Gaza was beyond anything I could have imagined.”
About 36,000 Palestinians in Gaza have died since Israel started its military offensive last October, according to the health ministry in the Hamas-run territory. There have also been more than 400 reported attacks on healthcare facilities and personnel and, according to the ministry, at least 340 healthcare workers have been killed.
A spokesperson for the Israel Defense Forces said it was “committed to mitigating civilian harm during operational activity” and “respecting all applicable international legal obligations, including the law of armed conflict”. They said IDF lawyers were also “on hand at all levels of command to ensure that strikes comply with international legal obligations, including proportionality”.
As the doctors made their way into the hospital for the first time they say they found thousands of desperate Palestinian families packed into tents and cardboard shelters. Inside, they say they saw displaced families occupying corridors and stairs, making it difficult for them to even get in.
“Nothing, absolutely nothing, justifies what we have witnessed here,” says Dr Mohammed Tahir, an orthopaedic surgeon from London. “People bring in their children, who are dead on arrival, and want us to try to resuscitate them – even though their bodies show no sign of life. They then leave carrying the limbs of their dead children in cardboard boxes.”
For the doctors, making triage decisions was one of the hardest aspects of the mission. Often decisions had to be made instantly, which in some cases meant leaving severely injured patients to die in order to preserve dwindling resources.
The foreign doctors worked alongside Palestinian doctors, many of whom were themselves displaced and living in tents outside the hospital. A key part of the mission is to teach and train local medical staff and students.
“The Palestinian medical students are the real heroes,” says Tahir. “They have had their universities destroyed and flock to us for any knowledge we can impart that may help them, help others. They are young volunteers, who aren’t getting paid, but turn up to work every day, trying desperately to prop up a failing health system because the world has failed them.”
One day, the doctors say they visited the sites of the destroyed Nasser and al-Shifa hospitals, where the mass graves of hundreds of Palestinians were recently discovered, many stripped naked with their hands tied, according to reports published by the UN human rights office.
“It was apocalyptic,” says Dr Laura Swoboda, a wound care specialist from Wisconsin. “The sheer destruction was unlike anything I’ve ever seen. Decomposing bodies still stuck beneath the rubble. All around us, we could smell death.”
As she walked among the debris, Swoboda says she saw overturned ambulances and a burned-out dialysis centre; medical supplies scattered everywhere and the sound of black body bags flapping in the wind. “There were notes scribbled on the walls of theatre rooms by doctors who had been hiding there,” says Swoboda. “And then in the rubble, I came across a human finger. It was like a horror movie.”
When Dr Ahlia Kattan and her husband Dr Sameer Khan decided to join the mission, their parents offered to babysit. After months of seeing horrific videos of injured and dead Palestinian children on their social media feeds, the couple from California were left wondering, what if these children had been their own.
During their time in Gaza, the couple, who are both anaesthetists, saw hundreds of patients – the majority of them women and children. But there was one case in particular that Kattan says she cannot get out of her mind.
“One day I went to the emergency room and lying on a stretcher was a small boy, the exact same size as my four-year-old son; his ashened baby hands were becoming toddler hands,” says Kattan.
“His name was Mahmoud and he was a victim of an Israeli bombing campaign that left more than 75% of his body burnt. His eyebrows were singed off, his hair smelt of smoke.”
Mahmoud lay crying in pain as Kattan unwrapped his wounds; an ultrasound revealed a shattered spleen and crushed lungs. “We did not have the resources to save him and he died in front of us – cold and in pain with no one who knew him,” she says, holding back tears. “I wish I could have protected him. He was only four.”
As Israel began its assault on Rafah in May, the doctors say bombs started landing a few hundred metres from their clearly marked safe house. Loud explosions shook the walls of their rooms while outside, the sound of artillery fire became constant. One night, the doctors decided it was no longer safe and scrambled out, still wearing their scrubs, and moved into the European hospital, where they slept on the floor.
From there, the doctors say the situation steadily worsened. The hospital became low on fuel and the generator often stopped working during surgeries, plunging theatre rooms into darkness. The medical supplies the doctors had bought were also running out. Since their evacuation, they say no one has been able to replace them – leaving the European hospital with even fewer workers to look after patients with increasingly fewer resources.
Despite the danger they faced, since returning home, many of the doctors have had mixed feelings about leaving Gaza.
“As I woke up for the first time without the sounds of airstrikes and gunfire, my thoughts immediately went to those I left behind” says El-Taji. “We can’t look away. In the face of such immense suffering, we all have a duty to act.”
