A Florida doctor in Gaza: wasn’t prepared for so much death and destruction

On March 18th, I travelled to Gaza to work at the European Hospital–one of the last remaining semi-functional hospitals for more than two million people in the besieged and devastated Palestinian enclave.

The decision to join this medical mission to Gaza was relatively easy. There’s the obvious risk of life going to the most unsafe area in the world–a war zone where Israel is carrying out one of the most brutal military assaults against a primarily civilian population.

The devastation I had seen in the media was too gut-wrenching not to seek a way to lend a helping hand to those suffering from this genocide.

I trusted in God, and my family was incredibly supportive despite their appropriate fears. I did my best not to let any thoughts or fears paralyse me from the work that needed to be done.

Only after I reached Gaza did I realise that the situation was truly like what others had shared on social media and elsewhere–an apocalyptic horror movie.

Tents and campsites were stacked against one another. Every square inch of the hospital’s floors was taken up with makeshift tents where displaced families have found a temporary safe haven.

Rubble was strewn all over the streets, and sewage overflowed from clogged drains.

The smell in the air as I walked into the hospital’s emergency room for the first time was an odd blend of charred skin, blood, and death.

Gaza’s children are now much thinner and shorter than they ought to be due to deprivation of food and nutrition.

A sense of foreboding and gloom hung over the entire enclave.

A rude awakening

On the first night there, I quickly caught on to the psychological trauma and exhaustion being heaped on the people of Gaza.

Our limited sleep was disrupted by Israeli drones that would start circling above in the early evening hours and continue into the late morning, just a constant hum that reminded everyone that death could rain down on anyone at any time.

Their bombs and explosives that would shake our buildings would coincide with the times of Suhoor and Iftar, the times in Ramadan when we would begin or end our fasts.

I was under the naive presumption that in the emergency room, I would only be dealing with trauma. However, I quickly realised that the healthcare system had collapsed six months into this purposeful targeting.

We were being flooded with overwhelmed patients requiring refills for their chronic prescriptions. People with illnesses and diseases (strokes, appendicitis) had nowhere else to go except the same place mass casualties came into.

I had to discharge patients with gallbladder and bone infections that would typically require urgent surgical management.

I remember one of my first mornings. I was attending to patients with standard ER complaints when I faced my first mass casualty event.

I triaged the first patient quickly when I suddenly noticed people bringing in the injured and dead and placing them on the floor–-lots and lots of them. I was in disbelief, I looked over at my colleague, and we both stood in shock for a few seconds before realising what the mission ahead of us entailed.

Children were invariably the worst sufferers in such mass casualty incidents.

I saw children with horrifying burns. Many were severely concussed. Shrapnel from incredibly powerful explosives often caused life-threatening injuries in children—like ruptured eyes or brain matter falling out of heads.

Despite our training and regular exposure to trauma and death as ED physicians, none of us were prepared as humans for these kinds of atrocities.

Many children slowly died without the presence of any family members, a loving hand to squeeze.

Those who survived these experiences will carry long-term psychological and physical scars. Many children lost body parts and will perhaps never be able to function normally.

Those with broken bones, degloved wounds, or lung collapse would bravely and quietly lie on hospital floors during their admission without appropriate pain relief or beds due to lack of supplies.

The emotional and physical trauma inflicted by Israeli soldiers is beyond what any human should endure.

Six months of war in the densely-populated enclave has also led to a massive outbreak of hepatitis A and scabies among neighbours.

Due to the scarcity of supplies, we were forced to reuse a lot of medical equipment for procedures. Combined with a lack of clean water and poor sanitation, infections were rampant. Infection control is no longer present despite its necessity with such significant traumas.

The limited healthcare available simply cannot tolerate any more stress.

No time to grieve

Amid the death and destruction all around us, there emerge powerful stories that stand as proof of Palestinian resilience—the true heroes who dedicate what remains of them to a better world.

One such story is of one of my medical students, Karam, from central Gaza.

He recalled how his house was attacked shortly after Israel launched their offensive on Gaza. He only remembers waking up in the ICU. Now, he lives in a tent, volunteering daily at the European Hospital, without any official recognition for his time.

His medical studies are on hold, and he has no idea when the war will end and when and if his medical school will ever be rebuilt.

During my time in Gaza, Karam’s nephew drowned trying to rescue someone who had gone out to retrieve humanitarian aid dropped into the sea. Karam still showed up to the Emergency Department the next day to volunteer and learn.

Then there is Ansam, an emergency room nurse who previously worked at the now-destroyed Al Shifa hospital. She was threatened with rape by Israeli soldiers during the military invasion of the healthcare facility.

For several months now, she has been separated from her elderly father, who is in northern Gaza. Despite her worries about her future, her father’s safety, and his ability to find food, she still comes to work, her head held high, ready to serve.

The targeting of hospitals is a war crime and genocidal. It is globally unacceptable by any means to purposefully attempt to destroy those who help heal. The staff I worked with thoroughly warned me that if an invasion were to occur of the European hospital, I should be prepared for any eventuality as the Israeli military would typically target the physicians first.

For survival, people need food, safety, water and healthcare – all things that are being purposefully attacked in Gaza, forcing people to either remain steadfast and die or desperately seek a way to leave their homeland.

The death toll in Gaza is 32,000 and counting. Numbers are easy to read and recall. The downside is that statistics take the human element out and make each injury or death marginally less in value in the next life lost.

As advocates of peace, the most important thing we need right now is to remind the world that Palestinians deserve to be humanised.

Palestinians seek a future for their children and a safe place to rest at night. They want and deserve the ability to dream. These basic human rights have been ripped away from them.

There must be a ceasefire now, and civilians and aid agencies must be protected. Israel must be held accountable for its war crimes, and we must all do our part in speaking out against what we have witnessed.

I’m thankful and fortunate to see my family and friends again, and to return to my comfortable bed and house–things we too often take for granted.

But with that comes a deep sense of guilt and privilege leaving Gaza, leaving behind patients and colleagues I built a connection with and love for –knowing that their next day is not promised.