FOLLOWING the horrifying events of October 7, I was asked by Medical Aid for Palestinians UK to lead the first UK Emergency Medical Team (EMT) into Gaza to provide humanitarian aid.
We entered via Rafah on Christmas Day last year and worked at Al Aqsa Hospital in Deir al Balah in middle Gaza for two weeks. I struggle to find the words to describe the true horror of what I witnessed in Gaza. I spent most of my time operating on terrible explosive injuries involving the chest and the abdomen, but also some time in the emergency department.
Al Aqsa Hospital was operating at three to four times normal capacity, and together with relatives and other Gazans who had been displaced from the north and who had sought refuge in the hospital or grounds, there were nearly 10,000 people there, in a hospital designed for 150.
It is impossible to describe the overcrowding - every square foot of the hospital was covered by patients and their relatives, some in beds, most on the ground. I saw appalling injuries, particularly terrible deep burns and multiple traumatic amputations in children, the like of which I would never have expected to see in any healthcare setting.
We had to operate with very limited instruments, suture materials and dressings. There was often no pain relief and antibiotics, and the infective complications we saw were appalling. On some days there was no running water, so we had to scrub up using alcohol gel, and on many days, there were no sterile drapes to use whilst operating so we had to make our own from gowns and other materials.
The number of casualties coming in at times was so high that the triage process broke down completely, and patients died due to a lack of triage and capacity to treat them – patients who would have survived in a health care system which had not been systematically targeted and dismantled. Our work at Al Aqsa Hospital was cut short by two days after a missile attack by the Israeli Army on the intensive care unit whilst I was operating.
We stayed in a building in Al Mawasi, west of Khan Younis. The land, air and sea attacks by the Israeli military were continuous, and it was impossible to sleep properly at night because of noise from the aerial attacks, once being woken when we had eventually fallen asleep by a huge explosion barely 2km away and the house shaking.
On several nights we were kept awake by ground machine gun fights less than 1km away. A week after we left Gaza the house where we were staying in was directly targeted by an Israeli F16 aerial attack – miraculously the MAP team that had replaced my team suffered only minor injuries.
I returned to Gaza with MAP in April and May of this year and spent a further two weeks at Al Aqsa Hospital. We saw the devastating effects of the malnutrition and famine in Gaza which is now leading to many deaths. This has a particular impact on patients recovering from trauma surgery with many complications developing.
I treated many appalling infective complications of surgery, most of which were as a direct result of the severe malnutrition we saw. Two tragic cases illustrate the severity of the problem.
Tala (16) and Lama (18) were two young women with shrapnel injuries. Both were very malnourished when they arrived at the hospital, both had laparotomies to repair the damage, both developed severe infective complications and bowel breakdown, and both died under my care. They both had clearly survivable injuries, and in my view, malnutrition was a major contributor to their deaths. It is likely that malnutrition will lead to many thousands of ‘excess’ deaths over the next few months.
I have witnessed with my own eyes incontrovertible evidence of hospitals being directly targeted, and healthcare workers being deliberately targeted and killed. Many healthcare workers have been abducted and tortured by the Israeli military, including two young healthcare workers with whom I worked and from whom I took detailed testimonies of their extreme daily torture.
I have witnessed with my own eyes incontrovertible evidence of hospitals being directly targeted, and healthcare workers being deliberately targeted and killed
— Prof Nick Maynard
Sary is a young operating theatre nurse who was abducted whilst evacuating from the Indonesian Hospital in December and imprisoned for 62 days. Haythem is a young doctor who was abducted from Nasser Medical Complex whilst evacuating in January and imprisoned for 51 days. Both described to me how they were stripped naked, blindfolded and handcuffed with their hands behind their backs, and beaten daily throughout their incarceration, often up to 12 hours each day. They were not allowed to lie down throughout their imprisonment, dogs were frequently set upon them, and both have permanent scars and disabilities resulting from their torture.
I left Gaza via the Rafah crossing on May 6, surrounded by continuous bombardment by the Israeli air and ground forces – we were the last group to get out of Gaza before the Israeli army invaded the Rafah Crossing, and the crossing has remained closed since then, making ever more difficult the further entry and exit of any humanitarian aid or emergency medical teams.
Friends I have made over many years have been killed, and most of the hospitals I have worked in over 14 years have been destroyed. Rebuilding the healthcare system in Gaza will take many years and with MAP I will be helping with this rebuild. We will need volunteers from all aspects of healthcare – all fields of medicine and nursing, physiotherapy, and other allied health professionals.
The work that Professor Nick Maynard describes at Al Aqsa Hospital was made possible by an incredibly generous legacy donation by one of Trócaire’s donors. Find out more about Trócaire’s work at trocaire.org
