“No doctor wakes up in the morning and says, ‘I’m going to amputate a child’s leg without anesthesia.’
“You don’t want to see children suffering,” Dr Amber Alayyan of Doctors Without Borders, known by its French initials MSF, told Tel Aviv Tribune.
The measured cadences of the voice of the deputy director of the Palestine charity program suggest how inconceivable it is for her, as a doctor and mother, to cause pain to a patient and a child.
Yet this is the moral conflict his colleagues in Gaza face every day, minute by minute, as they attempt to treat unprecedented numbers of wounded streaming into the Gaza Strip’s barely functioning hospitals.
Your natural instinct is to care for people…to protect them. …You have been trained over and over again for years.
As doctors in Gaza are forced to make split-second decisions about who to save and who to let die, who to relieve pain and who they don’t have time to do so, it’s this innate instinct and their Hippocratic Oath which are attacked by the decisions. they never thought they would have to do it.
Overwhelmed by personal loss and struggling to function under relentless Israeli bombardment, this is the story of how medical staff are fighting to keep Gaza’s health system running.
How Gaza’s health system was destroyed
It’s almost midnight in Gaza and Mohamed S Ziara, a Palestinian doctor, is on a WhatsApp call with Tel Aviv Tribune. His tone is gentle and unaffected by the rumbling explosions and gunshots that can be heard in the background.
The plastic surgeon works shifts of 12 to 14 hours, six days a week at the European Gaza Hospital (EGH) in Khan Younis, where he treats up to 15 cases a day.
Ziara describes the health situation as “catastrophic”.
“This is unlike anything I’ve seen before, even with previous escalations and wars,” says Ziara, who has worked during Israeli attacks on Gaza since 2014.
He posted about the Israeli attacks near the EGH and the conditions inside on his Instagram account.
The extensive damage caused by Israeli attacks since October 7, following Hamas’ surprise attacks on Israel, has led to a shortage of medical personnel and supplies and an urgent need for fuel, electricity and water.
According to the World Health Organization (WHO), only 15 of Gaza’s 36 hospitals are partially functional – nine in the south and six in the north.
From October 7 to November 24, there were 74 Israeli attacks on health facilities and 30 hospitals attacked in Gaza, according to Insecurity Insight, a humanitarian association that gathers data on threats faced by people living in dangerous environments .
Northern Gaza, including Gaza City, bore the brunt of attacks on the health sector, but as the war progressed, previously designated safe areas south of Wadi Gaza came under attack. Israeli fire.
The map below summarizes Israeli attacks on the health sector in Gaza during the first seven weeks of the war.
The hospitals that were most often attacked are:
- al-Shifa Hospital – attacked 12 times
- Al-Quds Hospital – attacked nine times
- Indonesian hospital – attacked nine times
- Nasser Hospital – attacked three times
Insecurity Insight has documented at least 26 other hospitals throughout the Gaza Strip that were attacked by Israeli forces during the same period.
These repeated attacks took place as part of an October 13 Israeli order ordering all 22 hospitals in northern Gaza to evacuate to the south within 24 hours. The WHO called the order “impossible to carry out” and “a death sentence for the sick and injured.”
Israeli raid on al-Shifa hospital
One of the first hospitals to come under fire was al-Shifa Hospital, Gaza’s largest medical facility, located in the Remal neighborhood of Gaza City, where Ziara worked before EGH .
“I remember I was watching TV and the (Israeli) army spokesperson was asked twice about the possibility of bombing the hospital, and he said anything was possible,” Ziara said. .
Israeli soldiers flanked al-Shifa Hospital on three sides on November 15, then stormed the complex after Israeli accusations that it served as a Hamas command center.
“We have never seen any military action or military activity inside the hospital,” Ziara said, adding that he believed the threat against the hospital was just propaganda. the Israeli army. “We never thought they would arrive at the hospital and we would evacuate the patients and the injured.”
Several doctors, including Norwegian Mads Gilbert, who has worked in Gaza for several years, said they saw no evidence of military activity at the hospital during the war.
After the assault on al-Shifa hospital, several United Nations missions were carried out in cooperation with the Palestinian Red Crescent Society (PRCS) to evacuate patients and healthcare staff.
The same exercise was attempted more recently at hospitals in Deir el-Balah in central Gaza and Khan Younis in the south – namely Al-Aqsa, Nasser and EGH – due to ongoing hostilities nearby. .
Ziara says she witnessed drone attacks on al-Shifa hospital.
“They were shooting at people. They hurt many. They fired a missile at the hospital garden and killed about four people who were staying there, who had been evacuated or were refugees,” he said.
Attacks on health care and “war crimes”
Assaults such as those against al-Shifa Hospital have raised questions about the legality of attacks on health facilities. International humanitarian law, based on the Geneva Conventions, stipulates that hospitals are considered “civilian property” and benefit from de facto protection. Despite this ban, Israel continued to target health facilities and personnel.
“The UN has been very clear that hospitals, civilians and health workers must be protected, and we continue to call for their protection. They are not a target,” Dominic Allen, the United Nations Population Fund representative for Palestine, told Tel Aviv Tribune.
Human Rights Watch (HRW) said attacks on healthcare are “attacks on the sick and wounded”, which should be “investigated as war crimes”, according to A Kayum Ahmed, special advisor for the right to health at HRW.
According to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) and Insecurity Insights, there were at least 212 attacks on health facilities and health workers between October 7 and December 11.
The graph below shows a timeline of all incidents recorded over these nine weeks. Each point represents a recorded incident and is sized according to the number of victims.
