Gaza: No safe place as people are being crushed by intense, continuous bombing

Treating the war wounded is complicated as blasts from explosive weapons and collapsing buildings create multiple, simultaneous injuries on many parts of the body. In Gaza, Israel’s complete siege makes it impossible to access essential drugs, including pain management drugs which are critical in surgical interventions, and the medical tools needed to repair shattered and burned bodies.

“The lucky few that survive, have life-changing injuries. Many injured people suffer from extreme burns, major fractures that won’t heal properly and may go on to require amputations”, says Hook.

In Al Aqsa hospital, in Gaza’s middle area, an Doctors Without Borders team have been providing emergency surgery and outpatient care. From 1-11 December, approximately one in three patients (640 over 2,058) have been announced dead on arrival. On 6 December, the number of people killed arriving at Al-Aqsa hospital surpassed the number of injured.

The hospital staff strive to maintain effective hygiene protocols and lower the risk of infection for patients while facing a lack of essential supplies and equipment – this is a remarkably difficult task, yet a critical one, as a soaring number of infections can quickly turn into an additional medical challenge for both the patients and the overwhelmed health workers.

A scorched-earth policy that leaves no safe space for people, constant attacks and repeated evacuation orders given by the Israeli forces to entire neighbourhoods, and the total siege imposed on the Strip have made it extremely hard for people to access healthcare, and for medical staff to provide it. From 1 December, Doctors Without Borders had to suspend its support to three health clinics in the south and reduce its presence in Nasser hospital. An end to the continuing displacement of people is imperative to allow the sick and the wounded to receive the care they urgently need.

Infections peak as the healthcare system reaches breaking point

While the risk of violent attacks for civilians in Gaza persists, infections resulting from poorly treated wounds are rising fast, putting lives at risk.

“The risks of infection are incredibly high because of the conditions that people have to live in and the fact that there just isn’t the ability to provide the long-term in-hospital care that these patients truly need”, says Hook.

In the European hospital, a small medical team from Doctors Without Borders, recently started treating patients who were injured at the beginning of the war and whose wounds have now become infected due to the lack of medical care.

There are only a few primary health care facilities, including Al-Shaboura clinic supported by Doctors Without Borders – currently open in the south, meaning that there is little treatment available for infectious diseases like respiratory infections, diarrhea, chicken pox, lice and scabies, which spread uncontrollably in overcrowded shelters, adding to the risks for displaced Palestinians.

Appalling living conditions and widespread hunger

Shelter for displaced people is another pressing need of its own, as newly displaced add to the already high numbers of people living in desperate conditions. “As you go through the streets south of Khan Younis and near Rafah, you see the temporary shelters expanding further and further as more and more people arrive. The general conditions for most of these people are appalling: they live in temporary structures made of a few pieces of wood banged together and covered in plastic sheeting, without insulation from the earth or the concrete ground. They struggle to find enough water to meet their hygiene needs.” The flimsy shelters are now constantly struggling, battered by the strong winds and heavy rain.

With more people arriving in the south, food is becoming harder to find and the little food that is available is too expensive for people to buy.

During a seven-day truce in November, Nasser hospital had a brief respite from receiving patients with violent injuries and was instead overwhelmed with diabetic and other chronic patients who were not able to access the medical care they needed during the fighting. This would change again when hostilities resumed on 1 December. This time with even greater intensity. We don’t know what has become of those chronic patients once the facilities were overwhelmed by mass arrivals of war-wounded, nor how they will be able to survive.

On 17 December, the maternity ward of Nasser hospital came under fire. One patient was killed, while the others were wounded in this attack. Attacks on healthcare must stop now.