Gaza
Tens of thousands with life-threatening illnesses are “defenseless” after months without treatment, doctors say
Fri Jan 19, 2024 4:54 p.m. GMT
Healthcare in Gaza is “decimated” as medical staff are exhausted after three months of war and are forced to remove shrapnel without adequate pain relief, perform amputations without anesthesia and watch children die of cancer because of a lack of facilities and medicine lacking.
Dozens of interviews with doctors and medical staff in Gaza reveal a catastrophic and deteriorating situation as health services struggle to cope with tens of thousands of victims of the ongoing Israeli offensive in the territory and the impact of the acute humanitarian crisis.
Attention has focused on the direct casualties of Israel's military offensive in Gaza, but medical professionals are increasingly concerned about the war's indirect casualties.
Tens of thousands in Gaza are suffering from chronic life-threatening illnesses that have gone without treatment for months and are now “without defenses” as their bodies weakened by malnutrition, cold and fatigue, doctors say. In one incident described to the Guardian, a child with a brain disorder died hours before a UN team arrived with vital medicine.
A Palestinian cancer patient being treated at Nasser Hospital in Khan Younis in November. Photo: Mohammed Salem/Portal
Cancer specialists told the Guardian they had been unable to treat patients in urgent need, including children with leukemia or tumors requiring immediate life-saving surgery.
“We have nothing to give them. We cannot operate and we have no medication at all,” said Dr. Subhi Sukeyk, the general director of oncology in Gaza, who is also the general director of the Turkish-Palestinian Friendship Hospital in Gaza City. The hospital's main oncology department had to close at the beginning of November.
“There are people with cancer that attacks their liver, bones and lungs. I have to explain their condition and that there is nothing we can do. We have leukemia patients, including many children, who have died. They have no defense mechanism, no immune system and are very vulnerable in this environment.”
Hospital damage in Gaza during the Israeli offensive – a visual examination
Sukeyk said a man brought his son to him every day for three weeks. The boy has a rapidly growing tumor in his throat that will soon block his breathing. “Every day they come and every day I have to say there is nothing we can do. I'm a surgeon. I could easily perform this operation but we don't have any facilities. It’s terrible,” Sukeyk said.
Of Gaza's 36 hospitals, only 15 are still open and only three are undamaged.
According to Palestinian health authorities, 350,000 people in Gaza suffer from chronic illnesses and have little access to medication. A big problem is mental illnesses, for which there are hardly any medications left, as well as medications to treat high blood pressure.
Even in the overcrowded, unhygienic conditions, diseases spread quickly. “Everyone is coughing. “The children all have diarrhea or chest infections and there is also a lot of hepatitis A now,” said Hussein Awda, 37, who has been living with his family in a UN vocational school west of Khan Younis since his house was destroyed and many relatives who have been too were killed at the beginning of the war.
A child is evacuated from Gaza to receive treatment in Egypt. Only a few could walk this way. Photo: Anadolu/Getty Images
Attempts are being made to reopen Al-Shifa Hospital, the largest in Gaza, which became the center of a fierce propaganda war last year when Israel was accused of targeting the site. Israeli officials denied this, saying Hamas had built a command complex beneath the hospital and used its facilities.
The hospital, which the World Health Organization described as a “death zone” after largely ceasing operations following raids and occupation by Israeli troops in November, has resumed basic care.
Dr. Marwan Abu Saada, the director of Shifa Hospital, said he hoped to open an intensive care unit next week, but fuel, electricity and medicine were still in short supply. “The main oxygen generators are destroyed, so we have to rely on cylinders,” he said.
A big problem is medical care. Due to restrictions imposed by Israel, there is almost no fuel in Gaza and therefore almost no transportation. A U.N. administrator in Khan Younis said he was looking for a donkey to take his father, who was having a heart attack, to the hospital.
In December, a doctor in Gaza City had to amputate the lower part of his niece's leg on a table at home without anesthesia after she was injured when the house was hit by a shell and an intense Israeli fire in the area led to an attempt dangerous to reach Shifa, which is usually a six-minute drive away. “Unfortunately I had no other choice. “The choice was either let the girl die or do my best,” Hani Bseiso said.
“Staff is exhausted”: Doctor describes conditions in Gaza hospital – video
Day-long communications blackouts, some imposed by Israel, are also causing serious problems by preventing those in need from calling ambulances.
Palestinian Red Crescent (PRC) crews go to locations where airstrikes or grenade attacks are occurring when they see or hear them. But there are major concerns for others, such as women in labor, according to Nibal Farsakh, a spokesman. There were several reports of women having to give birth at home or in tents without medical care. Others cannot be reached because of the fighting.
“[The ambulances] is not allowed to enter Israeli military zones. They will shoot at us. There are people whose family members have been injured and who tell us about it, but we cannot reach them. “There are people who keep dead relatives with them for days because they cannot go outside to bury them in their garden,” Farsakh said.
Farsakh said 14 ambulances were destroyed and 19 damaged in the fighting over three months, leaving about 24 operational. Eight PRC employees were killed and 29 injured.
The Israeli offensive in Gaza followed a Hamas attack in Israel on October 7 that killed 1,200 people, mostly civilians. Since then, according to Palestinian health authorities, nearly 25,000 people have died in Gaza, about two-thirds of them women or children. About 60,000 were injured.
People search for survivors after an Israeli airstrike on the Nuseirat refugee camp in Gaza. Photo: Doaa AlBaz/AP
Israel has said it tries to avoid civilian casualties but that Hamas uses the local population as human shields by building military infrastructure between and among them. Hamas denies this.
Israeli officials said they would not fire on ambulances transporting civilians, but some had been used by Hamas to transport fighters or weapons.
The population of Rafah, on the border with Egypt, has more than quadrupled to 1.3 million, served by a small general hospital with about 40 beds, a few private clinics and a handful of field hospitals that can only provide very basic care.
“We only have our clinical judgment to make the diagnosis. Maybe we can do an x-ray or ultrasound, but nothing more. We went back 30, 40 years,” Sukeyk said.
Israeli government spokesman Eylon Levy said on Wednesday that additional field hospitals were expected to become operational in the coming days.
In recent weeks, Israel has said it has moved to less intensive military operations that would minimize civilian casualties and allow more aid to reach Gaza. However, strikes have intensified in the densely populated areas of Rafah and Khan Younis, where there are fears the major Nasser Hospital will be forced to close.
An injured man is taken to Nasser Hospital in Khan Younis this week. Photo: Haitham Imad/EPA
“What the conflicting parties say and what we see on the ground are very different. There are constant airstrikes, artillery shelling, tank movements and naval activity. There is a discrepancy between rhetoric and reality and we are seeing the humanitarian consequences,” said William Schomburg, the head of the International Committee of the Red Cross (ICRC) in Gaza.
On Thursday, Netanyahu told reporters that Israel would allow only the absolute “minimal” aid needed to prevent a humanitarian crisis.
Earlier this week, Philippe Lazzarini, head of the United Nations Relief and Works Agency for Palestine Refugees, said only more supplies could reverse the “deteriorating humanitarian situation in Gaza.”
Leaving the territory is also a problem. Before the war, Israel treated patients who needed chemotherapy. Since the conflict began, this has been impossible and only a handful have been allowed to leave Gaza to seek treatment in Egypt.
More than 2,000 people are diagnosed with cancer in Gaza every year, including 122 children, Palestinian authorities said last week.
Medics prepare premature babies for transfer to Egypt after they were evacuated from Al-Shifa Hospital in November. Photo: Haitham Imad/EPA
Sukeyk said he wrote referrals for 2,500 patients, but only 300 to 400 remained.
A British doctor described scenes at Al-Aqsa Hospital in Deir al-Balah in central Gaza. James Smith, who traveled to Gaza with the non-governmental organization Medical Aid for Palestine, said that the hospital, like other medical facilities, had been converted into a shelter for thousands of displaced people, staying in whatever space was available. The 250-bed facility accommodated 700 patients, each with relatives, including children. Few wanted to leave after treatment, so the emergency room had become an “inpatient ward.”
The crowds and noise made palliative care for the dying very difficult, Smith said. “There was very little space to optimize pain relief, dignity or comfort. The conditions were very tight, very loud.”
Fears are growing for Gaza's largest remaining hospital as Israeli troops bomb Khan Younis
Many victims came in droves of relatives calling for help for their loved ones, but others were alone, especially young children whose entire families had been killed or disabled. “A six-year-old boy was brought in alone, wrapped in a blanket. He had severe burns on his face and, among other things [very serious] chest wound. Luckily we found him, otherwise he would have died,” Smith said.
Due to limited options, it was necessary to wait several days before operating on burn victims. A lack of vital supplies meant some spent their final hours in agony.
“A child was brought along [very deep] Burns on the face, torso and many limbs. Somehow she was still alive and clearly in excruciating pain. What she needed was painkillers [painkillers] but we couldn't give them,” said Smith, who returned from Gaza two weeks ago. Ultimately, the girl was intubated and sedated.
Israeli officials said Hamas had put Gaza's most vulnerable citizens at serious risk by cynically using hospitals for terrorist activities. “In particular, it is well documented that Hamas uses hospitals and medical centers for its terrorist activities by establishing military networks within and among hospitals, launching attacks and storing weapons within hospitals, and using hospital infrastructure and personnel for terrorist activities.”
On Wednesday, Netanyahu promised that the conflict would continue until Israel achieved its war goals: the return of the 130 hostages that Hamas kidnapped on October 7 and who are still in Gaza, and “the elimination of Hamas and the… “Ensuring that Gaza never again poses a threat to Israel.”
Sukeyk said he hoped the war would end soon. “The people of Gaza deserve to live like others and do not deserve to die every moment like they are now.”
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