Gaza Hospitals Collapse and Medical Heroes Face Purgatory
City of Deir al Balah in central Gaza.
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Adamfoxie is thankful for the herculean efforts The New York Times Reporters and Reporters Connected to this publication make in Gaza.
Every day is a choice between who lives and who dies.
Doctors and nurses in Gaza’s teetering hospitals, which are nearing collapse without electricity and basic supplies, say they must now decide which patients get ventilators, who gets resuscitated, or who gets any medical treatment at all. They make snap decisions amid the screams of small children undergoing amputations or brain surgeries without anesthesia or clean water to wash their wounds.
Some veterans of wartime medicine in the Gaza Strip say conditions inside the overcrowded and impoverished territory are the worst they have ever seen, as entire apartment blocks, schools and hospitals crumble under an Israeli bombardment that has meted out a devastating civilian toll.
“Our teams are physically and psychologically exhausted,” said Basem al Najjar, the deputy of the head of Al Aqsa Hospital in the city of Deir al Balah in central Gaza.
Image Several men dig through the rubble of a home in Gaza destroyed by an Israeli airstrike.
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Some of the casualties of Israel’s bombardment of Gaza are believed to still be buried under rubble. Credit...Yousef Masoud for The New York Times
Two men carry a wounded person on a stretcher into a Gaza hospital, surrounded by a crowd of people.
Doctors say they are struggling to keep their patients alive with what few medical supplies they have.Credit...Yousef Masoud for The New York Times
“Some doctors remain a whole week in the hospital. Some of their families are brought to the hospital killed or injured. And some doctors go home and are killed there,” and then the bodies are brought back to the hospital, he said. He added that three of the hospital’s staff members had died at home, under Israeli military bombardment.
Israel has been bombing Gaza for weeks now in response to an attack on Oct. 7 by Hamas, the armed Palestinian group that rules the territory. The assault killed roughly 1,400 people inside Israel.
More than 9,700 Palestinians have been killed in Gaza and nearly 25,000 have been wounded, the Gaza Ministry of Health said on Sunday. The toll rises every day, with some of the casualties believed to still be buried under rubble.
An Israeli siege of the territory imposed after the Oct. 7 attack has also created crippling shortages of fuel, food, water medicine, and other basic goods. Much of Gaza is now without electricity after Israel cut off the supply and the main power plant ran out of fuel nearly four weeks ago. Israel is holding up fuel deliveries and sharply limiting humanitarian aid entering the territory.
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Doctors say they are struggling to keep their patients alive with what few medical supplies they have. Damage from airstrikes and severe fuel shortages have shut down nearly half of Gaza’s hospitals entirely, while the ones with their doors still open are providing minimal care, at best, doctors say.
A doctor dressed in green hospital scrubs fills out paperwork on a patient’s abdomen.
Out of space, doctors sometimes use patients’ bodies as makeshift tables to fill out their medical paperwork.Credit...Samar Abu Elouf for The New York Times
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A medical worker example a young boy on a table near a dirty wall. Two other children sit on the table, one with a cast on his leg.
Some veterans of wartime medicine in the Gaza Strip say conditions inside the overcrowded and impoverished territory are the worst they have ever seen. Credit...Samar Abu Elouf for The New York Times
A lack of freshwater supplies and iodine has left wounds filthy, with maggots nibbling at patients’ charred and torn flesh, according to interviews with doctors at four hospitals across Gaza. Without adequate water, doctors and nurses are unable to provide sufficient sanitation for their patients, to wash wounds or hospital bedsheets.
In some hospitals, patients arriving in cardiac arrest are not resuscitated, because medical staff choose to work on patients with a greater chance of survival instead. Few of the critically wounded get a hospital bed. Fewer still, a ventilator or anesthesia when operated on, including for brain surgeries, the doctors said. Anesthesia has been in short supply for about two weeks, doctors say.
On top of all those challenges, the hospitals have become temporary orphanages, too, according to the medical workers.
Thousands of Gazans fled south during a window given by Israel, the U.N. says.
In some cases, children have arrived at the hospitals after their entire families were killed in the war or watched as their parents died on hospital gurneys or tile floors. The medical staff have cared for some of the children until a relative can come to take them.
Dr. Najjar said that each day in his hospital starts with a fight to preserve dwindling fuel supplies. That struggle is shared by the 19 other hospitals that are still functioning, to varying degrees, in Gaza.
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Children receiving treatment in a hallway inside the hospital in Deir Al Balah. Credit...Samar Abu Elouf for The New York Times
And the pressure on those hospitals is mounting as they compensate for 16 hospitals that are now out of service, according to a health ministry statement on Thursday.
On Friday, an explosion near the entrance of Al Shifa Hospital in Gaza City struck a convoy of ambulances carrying wounded people preparing to evacuate to Egypt, according to a Hamas spokesman and the head of the hospital, Dr. Mohammad Abu Salmiya. Thirteen people were killed and many others injured, Dr. Abu Salmiya said, adding that paramedics and patients being evacuated were among the injured while the hospital sustained damage from the explosion.
Two other hospitals came under attack on Friday, according to the World Health Organization.
The Israeli military said it had carried out an airstrike on an ambulance “being used by a Hamas terrorist cell.” An Israeli military spokesman, Maj. Nir Dinar confirmed it was the same strike that had caused the explosion outside the hospital.
Doctors in two hospitals in Gaza said that, with nothing to power air-conditioners, the heat has gotten bad enough that it is making patients’ wounds fester. Medical staff need their diminishing fuel stocks to light up operating rooms instead.
In the Kamal Adwan Hospital in northern Gaza, surgeries are being done by cellphone flashlight, according to one doctor there. Vinegar is sometimes used to disinfect wounds, with no iodine left.
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A dark skyline with very few electric lights visible.
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Al Shifa Hospital, powered by generators, was nearly the only illuminated spot in Gaza City one October night. Credit...Mohammed Saber/EPA, via Shutterstock
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People lie on hospital beds and on the floor in a shelter at Al Shifa Hospital.
Wounded Palestinians and those seeking shelter in a makeshift tent outside Al Shifa Hospital in Gaza City, on Friday, after fuel ran out and electricity generators stopped working. Credit...Dawood Nemer/Agence France-Presse — Getty Images
The Gaza Strip has been plunged into darkness and cut off from the world after the territory’s only electricity plant ran out of fuel and as Israel’s military has cut telecommunications. Ambulance drivers say they often have to chase the sounds of airstrikes in order to know where they are needed.
With food in Gaza now so scarce, medical staff members say they eat only one meal a day, if the hospital can provide it to them, and sleep in the hallways with thousands of displaced people who have sought refuge in medical wards across the Gaza Strip.
“We are making hard decisions,” said Mohammed Qandil, an emergency medicine and critical care consultant at Nasser Hospital in Khan Younis, a city in southern Gaza.
“We choose who gets ventilation by deciding who has the best chance of survival,” he said. “For us as a team, these aren’t easy decisions. It’s a morally sensitive issue with a lot of guilt.”
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He paused, reflecting on growing international calls for Israel to agree to a cease-fire to allow humanitarian aid to flow into Gaza.
People asleep on cots on a tile floor.
Pressure on open hospitals in Gaza is mounting as many others are out of service.Credit...Samar Abu Elouf for The New York Times
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“The hospital doors are open, but the care we are able to give — it is negligible.” A man lying on a tile floor next to a medical cart, hooked up to IVs and a breathing tube. Doctors in Gaza say they are struggling to keep their patients alive with the few medical supplies they have. Credit...Samar Abu Elouf for The New York Times |
Patients are being tended by medical personnel in hospital bays.
Palestinians who were wounded in Israeli airstrikes received treatment at the Nasser Hospital in Khan Younis, southern Gaza Strip, in October.Credit...Samar Abu Elouf for The New York Times
“We have to make these decisions, but we don’t think it’s our fault,” Dr. Qandil said. “We think it is the fault of the whole humankind who are unable to deliver safe, continuous medical aid to us.”
He sighed.
“All the people who come here, we cannot save them,” he said, taking stock of the lives he watched slip away, many of which he said would have been able to save before the current conflict.
Hiba Yazbek contributed reporting.
Maria Abi-Habib is an investigative correspondent based in Mexico City, covering Latin America. She previously reported from Afghanistan, across the Middle East and in India, where she covered South Asia. More about Maria Abi-Habib
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