The Doctors Without Borders team's precarious Christmas Eve dinner at Al-Aqsa Hospital didn't even take place. Carolina López, the humanitarian organization's emergency coordinator at this health center in Deir al Balah – central Gaza – and her team prepared to open the cans they eat every day and prepare hummus, the typical chickpea paste. , oil and spices that are eaten as a spread. But the festival had to be postponed: In one of the bloodiest episodes of the war, Israel bombed the Al Maghazi refugee camp. Within a very short time, the hospital center was filled with the wounded and dead.
“We had heard several bomb attacks and suddenly the ambulances arrived,” recalls this 49-year-old development worker from Zaragoza. “One of our doctors and two of our surgeons went to the emergency room to analyze the situation. After a while they brought in another surgeon. The operating rooms worked all night, case after case, as patients kept arriving. I remember the stress, you could hear crying and screaming… There were many injured people that night; That happens often. There are quiet days when we receive 30 wounded, but the majority we have 70, 80, 100…”
Many of those who arrived that night came from the neighboring Al Maghazi refugee camp. According to the UN Relief and Works Agency for Palestine Refugees (UNRWA), 33,255 residents crowded into its narrow streets, spread over an area of just 0.6 square kilometers. The Israeli army warned later in the day that it would intensify its offensive, using its sophisticated war machinery against another camp in central Gaza, Al Bureij, and seven other neighboring neighborhoods. The statement urged the population to seek refuge further south in Deir al-Balah, where the hospital where López works is located.
But the Israeli Defense Forces' evacuation warning said nothing about Al Maghazi. People didn't leave. Several residential buildings collapsed as a result of the bombing. 106 people, including many women and children, were killed in one of Israel's largest mass killings of civilians since October 7. The Israeli military even claims it has launched an investigation to find out what might have gone wrong. Five days after the massacre, there are no answers.
“After issuing the notification, the next day they began to position themselves in the area and the bombing and ground fighting began to intensify,” continues López, who arrived at the hospital ten days ago. “That day we received around 200 wounded and 130 people arrived dead, most from Al Maghazi but also from other cities. They bombed buildings that collapsed and there were many families in them.” The attacked field is only 2.5 kilometers from the health center. Four minutes by car, 30 minutes on foot.
A woman and a child were injured in an Israeli attack at Al-Aqsa Hospital on December 30. – (AFP)
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Al Aqsa is the referral hospital for the central Gaza Strip. It has not been attacked since the start of the conflict and has managed to continue to care for victims, despite this area being precarious due to siege on land, sea and air. This center, which under normal conditions has 240 beds, had to expand it to 684 due to the huge influx. Staff have already staffed two neighboring schools, creating space for an additional 190 patients. The mortuary was also expanded.
Between December 1 and 27 alone, the hospital treated 2,557 injured people and received the bodies of 1,176 deceased. Of all those treated during this period, 34% were women and 24% were under 15 years old. Two out of three patients are displaced people from the north and other places in the Gaza Strip. “Many of them are burned by fire or by the heat generated by explosions. We also have many fractures and compression injuries of people recovered from the rubble who require chest or extremity surgery,” explains López.
Flood of people seeking protection
In Al Aqsa, as in other hospitals, many are seeking refuge that they cannot find in their homes or in the places where they have fled. Some had to flee more than once. The Spanish woman talks about the difficulties of getting along with all these people. “Ever since they heard about the impending bombings, people have been seeking shelter. Even though other hospitals have been attacked, people feel safer here. The hospital is doing what it can because it needs space for those admitted. There are also their families,” he continues. “There are patients who are here who have nowhere to go and don’t want to go. When the doctor dismisses them and tells them to go, they respond, “Where?”
“It's quite difficult to work here at the moment,” López continues. “We are trying to keep only the patients inside, but the terrace and the various entrances of the hospital are full of people. Many people set up plastic tents and climb under them, packed tightly together. I couldn't quantify it, but we have a lot of people inside and the ambulances are constantly arriving. The surrounding streets are also full. It’s an odyssey what people in the hospital have to deal with every day, not just the doctors and nurses, but also the Ministry of Health staff.”
This Friday, Al Aqsa received the first truck of medical supplies in many days. “The supplies are still arriving in droves and we are adapting to what we need to be able to work,” the aid worker continues. “We lack the essentials, the compresses and gauze that are used to treat wounds and most often disinfect them.” “The situation is no longer as serious as it was at the beginning, when some colleagues told me that they were treating wounds with maggots. Now we fight infections every day. Today we are very happy because we received the statistics and found that they have decreased significantly.”
Another problem facing the population is the lack of food. “There's a lot of traffic in this area with cans that we basically eat. “Chickpeas, beans, tuna…” says López. “In other places there are oranges, tangerines and some tomatoes or onions, but the problem is that everything has risen sharply,” he adds. “People who have work can afford it, but those who have nothing rely only on the help that can be given to them.” The United Nations and the World Health Organization have warned that nearly all of Gaza's population is suffering from malnutrition affected and there is a risk of famine in some areas.
Lack of staff security
The problem is not just about healthcare and food. Also human resources management. López is coordinating a team of 60 people, most of whom are doctors and health workers from other hospitals in the Gaza Strip who have traveled here. “Many had to flee with their families and find a place here, in the schools of Deir al Bala, where they can take refuge, find a place to sleep or send them to Rafah. [la ciudad fronteriza con Egipto]. Despite this, and although this is not the first time they have moved – some have done so eight or ten times – they continue to come to work every day,” continues the MSF coordinator.
“It is exciting to see that they are also lifting people's spirits and making jokes… Even though they are not safe anywhere and we cannot guarantee their safety from where they live to here, they come and go every day and risk their lives. “ continues the Spaniard. “They don’t know if they will find their family when they return, but there they are, at the bottom of the ravine.” López remembers how one of his team members arrived at the hospital injured one day, accompanied by his wife and children: “ Every day we have someone who has suffered the loss of someone close to them.”
The MSF team he leads does special work with children. “You see them with their wounds, with their bandages, with their pain and yet they come to you and smile at you. We have a mental health team that is trying to do a minimum because we don't have space and can't do one-on-one counseling or open a shop for it. We work on the psychosocial part through drawings and games. It's amazing how they react.
However, the development worker, who worked in Gaza in 2019 and has experience in MSF missions in Mali, Congo, Haiti, Burundi, Bangladesh and South Sudan, among others, believes that the aid provided to all these people is not enough. . “We are doing what we can, but as long as there is no ceasefire we will not move forward,” he says. “We cannot continue to work in this way, without the ability to protect health workers, with people who have to constantly move… With people who now that it is cold, have no food, no water, nothing to wear.” “Under these circumstances it cannot be said that there is real humanitarian assistance in Gaza. I don't know if that will change in the future.
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