As Gaza hospitals collapse, medical workers face toughest decisions | ET REALITY


Every day is a choice between who lives and who dies.

Doctors and nurses in Gaza’s teetering hospitals, which are on the verge of collapse without electricity or basic supplies, say they must now decide which patients receive ventilators, who are resuscitated or who receive any medical treatment. They make quick decisions amid the screams of young children undergoing amputations or brain surgeries without anesthesia or clean water to wash their wounds.

Some wartime medical veterans in the Gaza Strip say conditions inside the overcrowded and impoverished territory are the worst they have ever seen, as entire blocks of apartments, schools and hospitals crumble under an Israeli bombardment that has caused a devastating number of civilian casualties.

“Our teams are physically and psychologically exhausted,” said Basem al Najjar, deputy director of Al Aqsa hospital in the central Gaza city of Deir al Balah.

“Some doctors stay in the hospital for a whole week. Some of their families are taken to the hospital dead or injured. And some doctors come home and kill them there,” and then the bodies are returned to the hospital, he said. He added that three hospital staff members had died in his home under Israeli military bombardment.

Israel has been bombing Gaza for weeks in response to an Oct. 7 attack by Hamas, the Palestinian armed group that rules the territory. The attack killed approximately 1,400 people inside Israel.

More than 9,700 Palestinians have been killed in Gaza and nearly 25,000 injured, Gaza’s Health Ministry said on Sunday. The number of victims increases every day and it is believed that some of the victims are still buried under the rubble.

The Israeli siege of the territory imposed after the October 7 attack has also created crippling shortages of fuel, food, water, medicine and other basic goods. Much of Gaza is now without electricity after Israel cut supplies and the main power plant ran out of fuel almost four weeks ago. Israel is delaying fuel deliveries and drastically limiting the entry of humanitarian aid into the territory.

Doctors say they are struggling to keep their patients alive with the few medical supplies they have. Damage from airstrikes and severe fuel shortages have completely closed nearly half of Gaza’s hospitals, while those that still have their doors open provide minimal care at best, doctors say. doctors.

The lack of fresh water and iodine supplies has left wounds dirty, with maggots gnawing at patients’ charred and torn flesh, according to interviews with doctors at four Gaza hospitals. Without adequate water, doctors and nurses cannot provide sufficient sanitation to their patients, wash wounds or hospital sheets.

In some hospitals, patients who arrive in cardiac arrest are not resuscitated because medical staff prefer to work with patients with a higher chance of survival. Few critically injured people get a hospital bed. Even less so, a ventilator or anesthesia during an operation, even for brain surgeries, doctors said. Doctors say anesthesia has been in short supply for about two weeks.

On top of all those challenges, according to medical workers, hospitals have also become temporary orphanages.

In some cases, children have arrived at hospitals after their entire families died in war or watched their parents die on hospital gurneys or on tile floors. Medical staff have cared for some of the children until a family member can come pick them up.

Dr. Najjar said every day at his hospital begins with a fight to preserve dwindling fuel supplies. That struggle is shared by the other 19 hospitals still operating, to varying degrees, in Gaza.

And the pressure on those hospitals is increasing as they compensate 16 hospitals that are now out of service, according to a Health Ministry statement Thursday.

On Friday, an explosion near the entrance to Al Shifa hospital in Gaza City hit a convoy of ambulances carrying wounded people preparing to evacuate to Egypt, according to a Hamas spokesman and director of the hospital, Dr. Mohammad Abu Salmiya. . Thirteen people were killed and many others injured, Dr. Abu Salmiya said, adding that the injured included paramedics and evacuated patients, while the hospital was damaged by the explosion.

Two other hospitals were attacked on Friday, according to the World Health Organization.

The Israeli military said it had carried out an airstrike against an ambulance “that was being used by a Hamas terrorist cell.” An Israeli military spokesman, Major Nir Dinar, confirmed that it was the same attack that caused the explosion outside the hospital.

Doctors at two Gaza hospitals said that with nothing to power the air conditioners, the heat has increased so much that it is causing patients’ wounds to become infected. Medical staff need their dwindling fuel reserves to light operating rooms.

At the Kamal Adwan hospital in northern Gaza, surgeries are performed with the flashlight of a mobile phone, according to a doctor there. Sometimes vinegar is used to disinfect wounds, without leaving iodine.

The Gaza Strip has been plunged into darkness and cut off from the world after the territory’s only power plant ran out of fuel and the Israeli army cut off telecommunications. Ambulance drivers say they often have to follow the sounds of air raids to know where they are needed.

Now that food is so scarce in Gaza, medical staff members say they only eat one meal a day, if the hospital can provide it, and sleep in hallways with thousands of displaced people who have sought shelter in medical wards in Gaza. the entire Gaza Strip. .

“We are making difficult decisions,” said Mohammed Qandil, an emergency medicine and critical care consultant at Nasser Hospital in Khan Younis, a city in southern Gaza.

“We choose who receives ventilation by deciding who has the best chance of surviving,” he said. “For us as a team, these are not easy decisions. It is a morally delicate issue and with a lot of guilt.”

He paused, reflecting on growing international calls for Israel to agree to a ceasefire to allow humanitarian aid to flow into Gaza.

“We have to make these decisions, but we don’t think it’s our fault,” Dr. Qandil said. “We believe that it is the fault of all humanity that it cannot provide us with safe and continuous medical help.”

The sigh.

“We can’t save all the people who come here,” he said, taking stock of the lives he saw lost, many of which he said could have been saved before the current conflict.

“The hospital doors are open, but the care we can provide is negligible.”

Hiba Yazbek contributed reports.

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