‘Am I in heaven?’: Doctor reveals trauma of Gaza children caught in war

“Am I in heaven?”

The words still ring in Mohammed Ashraf’s ears as he remembers the Palestinian girl, about seven years old, her face pockmarked with shrapnel wounds when she was brought into the hospital.

Over the ten months since Israel launched its brutal war in Gaza, the 28-year-old Palestinian emergency doctor has treated hundreds of people with injuries, some severe, others not so.

He has seen death all around him – "many, many horrible scenes during the genocide", as he puts it – at the al-Shifa Hospital and Kuwait Hospital, where he volunteered with the non-profit Doctors Worldwide Türkiye. Ashraf, who is from Gaza, is now based in London.

But the girl’s innocent question still haunts him.

"Despite the severity of her injuries, she was remarkably calm,” Ashraf recalls the fateful day in November.

“When I told her I was the doctor treating her, she asked me to come closer," Ashraf tells TRT World during a recent interview in Istanbul. “Unable to open her eyes, she whispered, ‘Am I in heaven?’"

Ashraf asked her why she thought so, and she replied, “My mom told me if we are attacked, we will go directly to heaven.”

Ashraf says he had a lump in his throat as he listened to the girl’s innocent reasoning.

"‘Heaven is a very nice place. There is no noise, no chaos over there,” the doctor quotes her as saying. “‘But I'm hearing a lot of loud voices, and there is chaos around me. I'm not sure if my mom lied to me or not."

Ashraf gently reassured her, "No, you are not in heaven. Your mom didn't lie to you. You are in the hospital. That is why there are a lot of loud voices."

The girl seemed to take comfort in his words. "Okay, that's fine. At least my mom didn't lie to me."

A few hours later, the girl succumbed to her wounds and "went to that calm place, she went to heaven," Ashraf says.

Israel’s indiscriminate bombing of the besieged enclave has taken a heavy toll on minors, with a recent estimate putting the number of children killed in Gaza since October 7 at over 16,300.

This is almost 41 percent of the nearly 40,000 people killed in Gaza since Hamas’ cross-border operation targeting Israel.

Doctors under stress

With almost the entire healthcare system crippled by relentless Israeli bombing and months of siege leading to an acute shortage of life-saving medicines, the medical fraternity has been struggling to provide care to thousands of injured people.

For Gaza-based Palestinian healthcare workers like Ashraf, the experience has become even more traumatic because of the close personal ties to many of their patients.

Over the past several months, there have been several instances of doctors facing the trauma of personal losses in the line of duty.

Dr. Hany Al-Faisal, a Palestinian doctor, appealed to the world to end the injustice and brutality in Gaza as he was amputating his 16-year-old daughter’s leg on his dining table without anaesthesia.

Another Palestinian surgeon lost his child after having to amputate his leg – also without anaesthesia – due to a lack of medical supplies caused by Israel’s devastating genocidal war.

For doctors in Gaza, the war has become very personal, Ashraf says, recalling the times he had been caught up in it.

"I have declared the death of my friend, and I have declared the death of my uncle as well," Ashraf says.

"I was (also) the one who recognised the body of my middle school teacher, Dr. Omar Farwana. And after five minutes, I recognised the body of his daughter, Dr. Ayah Farwana."

He also had to constantly worry about his family, wife and two-year-old daughter, who had to evacuate to the South. His wife was a paediatrician at Al-Nasr Children's Hospital before the war.

"My wife's hospital have been attacked before my hospital. So she went to her dad's home and took my daughter to the South,” he says.

“Many times I've tried to reach hospitals in the South to ask them if there are any people who came with the same name (as my wife and daughter), if they have been attacked or injured, just to make sure that they are alive.”

'Saw my daughter's face in every single kid'

Staying away from his family for long periods of time had left Ashraf with a sense of dread over their fate. And this panic manifested during his dealing with injured children.

"There was a very young boy," Ashraf recounts another story, his voice heavy with emotion, "I think he was like one-and-a-half years old."

The boy had come in with his intestines exposed, the contents spilling out of his tiny body. Yet, he was awake. His eyes were wide open, staring up at the doctor.

Ashraf had seen many horrific injuries before, but this was different. Most of his patients are either unconscious or unresponsive, "but this kid," he says, "while I'm trying to resuscitate him, he was staring at me, his eyes wide open."

The boy's gaze was piercing. Ashraf wondered why he wasn't crying. Was the pain too severe for him to express? Or was he too young to understand what was happening to him? The uncertainty gnawed at the doctor as he worked desperately to save the child.

The chaos of the hospital often blurred the lines between the children he treated and his daughter. Ashraf couldn't help but project his fears and hopes onto each patient.

"I saw my daughter's face in every single kid I treated," he says.

Despite his experience of working through earlier attacks on Gaza, Ashraf says, “This time, it was horrible. The injuries that I have seen, I haven't seen before."

Although he studied in medical school, the degrees of burns and the nature of the injuries were beyond anything he had ever encountered or read about in textbooks.

He expresses bewilderment and horror at the types of weapons used, "I don't know what kind of weapons have been used to attack these kids."

"What about the adults, the civilians who have been attacked as well?"

He recalled a particularly devastating case involving a pregnant woman. "I have a video while we are doing an urgent laparotomy. We opened a lady's abdomen to get her foetus out of her uterus after she passed away, to make sure that we can at least save one life."

But it was too late.

"She came in from under the rubble after four hours, and the foetus as well has been killed."

The traumatic experiences had shaken even veteran health workers, with many carrying deep emotional scars.

Still, they had no choice but to keep moving, driven by the need to save as many lives as possible amid the devastation.

"There's no time to grieve, there's no time to cry,” he says.

"There is no coping mechanism that can handle this kind of trauma; it's far beyond our capacity."