Gaza City – In the neonatal intensive care unit of al-Shifa Hospital, a premature baby with a full head of thick black hair lies on his back in an incubator, his diaper nearly eclipsing his tiny body. A pink plastic tag around one minuscule ankle identifies him only as “Son of Maryam al-Harsh”.
The 10-day-old baby is, according to the neonatal unit head Dr Nasser Bulbul, a symbol of “victory against this ugly Israeli aggression”.
“On October 13, we got a call from the Kamal Adwan Hospital in northern Gaza about a badly injured pregnant woman who was taking her last breaths,” Bulbul said. “There was an air attack on her home, and her entire family, all 10 members including her husband, were killed.”
An emergency caesarean section was performed on the dying woman, who was 32 weeks pregnant, and her baby boy was pulled out of her womb, alive and with a faint heartbeat.
The baby was transferred to al-Shifa, where he was immediately put on mechanical ventilation, along with 54 premature infants.
“He is recovering,” Bulbul said. “We took him off mechanical ventilation after six days, and three days later, we can see that he has cerebral ischemia, which is an acute brain injury that results from impaired blood flow to the brain. This is the result of his mother dying before he was born.”
No relative has come to claim the baby, but Bulbul and his team of nurses all take care of him.
“Every time I check up on him, I’m gripped with sadness and pain,” the doctor said, pointing to the traumatic event that ushered in the birth of the boy.
“But as long as he is alive, he gives us strength and hope that we shall overcome these terrible days. Even patience to endure the horrors we see on a daily basis.”
Israel launched its latest offensive on the Gaza Strip on October 7 in revenge for an attack on Israel by the armed wing of Hamas that same day.
The air bombardment of Gaza has continued relentlessly and Israel imposed a total siege on it, cutting off water, electricity and fuel from the sole power plant.
Doctors have warned of the devastating consequences of such actions, saying that hundreds of patients who rely on respiratory machines will die. Fuel in hospitals has run out, and while some were forced to shut down, others like al-Shifa have been running on solar-powered generators.
With the Gaza Strip’s healthcare system on the brink of collapse, it is hard to know whether the besieged territory’s 130 premature babies in the enclave’s seven neonatal ICUs will survive, as the health ministry warned that they are in imminent danger if fuel does not reach hospitals soon.
“Without fuel to power the mechanical ventilation machines, all of these babies will die within five minutes,” Bulbul said bluntly. “There are 10 ventilators, but seven are out of service.”
On Sunday, UNICEF spokesperson Jonathan Crickx said out of 120 neonates in incubators, about 70 are on mechanical ventilation.
“If they [babies] are put in mechanical ventilation incubators, by definition, if you cut the electricity, we are worried about their lives,” Crickx told the AFP news agency.
🚨 URGENT UPDATE: Doctors in #Gaza have issued an urgent warning that the lives of 130 premature babies are in imminent danger if fuel does not reach hospitals soon.
1/4 pic.twitter.com/JiVFQIdOwJ
— Medical Aid for Palestinians (@MedicalAidPal) October 21, 2023
Medical Aid for Palestine (MAP) has called on world leaders to demand Israel urgently allow fuel to enter the Gaza Strip.
“A failure to act is to sentence these babies to death,” MAP’s CEO Melanie Ward said. “The world cannot simply look on as these babies are killed by the siege on Gaza.”
In a statement, the Gaza government media office stressed the necessity of opening the Rafah border crossing permanently, to bring in life supplies and humanitarian needs, especially fuel.
A total of 34 humanitarian aid trucks have entered the Gaza Strip, which is still below the minimum required by the catastrophic humanitarian reality, the statement said.
“Twenty more [aid convoys] are expected to enter today, which means a total of 10 percent of the rate that was entering the Gaza Strip daily before the aggression,” it added.
Hospitals in north Gaza, where tens of thousands of internally displaced Palestinians have taken refuge, have received repeated Israeli military warnings to evacuate.
Tedros Adhanom Ghebreyesus, the director-general for the World Health Organization, said it is “impossible for these overcrowded hospitals to safely evacuate patients”.
“They must be allowed to perform their lifesaving functions. They must be protected,” he added.
The 17-day Israeli war has killed more than 5,000 Palestinians – almost half of them children – and has wounded more than 15,000 others.
A further 1,500 people are missing under the rubble, including 830 children.
Bulbul said that all 55 neonates in al-Shifa Hospital weigh less than two kilos and are under 37 weeks. One baby is 26 weeks and weighs 880 grams.
Other than fuel, another problem is the lack of basic treatments that these premature babies need, which can be lifesaving, the doctor explained.
“Within the first two hours of being born, premature babies need basic treatment to survive, most notably [synthetic] surfactant which helps to reduce respiratory distress syndrome,” he said. “It’s a lifesaving treatment and, without it, we have to deal with complications regarding mechanical ventilation, and as a result, the babies will spend longer in the incubators, at risk of bacterial infection which can kill them.”
Bulbul said that even before the Israeli offensive began, there was a lack of antibiotics, such as ampicillin and gentamicin, which are
effective against all the bacterial agents causing community-acquired sepsis.
“The lack of these treatments pains us more than the Israeli air attacks,” he said.
The neonatal unit is run by four doctors, but three of them are in the southern Gaza Strip and cannot come to al-Shifa Hospital because of the damaged roads.
Bulbul himself has not seen his family since October 7, and has been practically living in the hospital. Occasionally, if the communications network allows for it, he calls his family every two or three days, checking up on them in their home in Nuseirat refugee camp in the centre of the Gaza Strip.
“I and my team of nurses and other medical staff haven’t had a day of rest, and we all work round the clock, despite being affected by the tragedy all around us,” he said. “It’s difficult to continue working under all this bombing, as we carry so much pain in our hearts, but we have no choice but to continue working and to try to save the lives of these babies.”
