Opinion

Many children in Gaza need amputations. We can treat their physical wounds but not their mental anguish

When new patients come to the emergency room they are treated on the floors by doctors who kneel in blood to try and save their lives. This can’t continue. We need a ceasefire now

An injured child is treated at Nasser Hospital in Khan Younis. Photograph: Haitham Imad/EPA

Isabel Simpson
Fri Jan 26 2024 - 11:55

Following more than 110 days of all-out assault and siege by Israeli forces, Gaza’s healthcare system has now virtually collapsed, at a time when the medical needs are soaring.

There is no safe place left for Gaza’s inhabitants – as bombing, sniper fire, drone strikes, and evacuation orders have pushed the population and most of those providing desperately needed medical care to a small area in the south.

The organisation I represent, Medecins Sans Frontieres/Doctors Without Borders (MSF), provides emergency medical care and urgent surgical treatment in five hospitals in southern Gaza, where most of Gaza’s 2.3 million inhabitants have been forcibly displaced. The medical response is on the brink.

No conflict is the same. I have witnessed much human suffering as part of my work providing healthcare with MSF during brutal wars in Bosnia, Chechnya, Sri Lanka and Iraq. In Gaza, the scale and intensity of its bombardment and the rate of indiscriminate killing, injury and maiming unleashed on a civilian population is like nothing I have seen before. Gaza and the hospitals I worked in during 2006 are now unrecognisable.

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With heavy bombing and fighting moving closer to the area around Nasser hospital, Khan Younis, injured civilians cannot access urgent care as the roads to and from the hospital have become too dangerous. Colleagues providing surgical and medical assistance at the hospital which has been operating at three times its capacity can hear bombing nearby. Staff are unable to evacuate along with the 850 patients and thousands of people who have taken shelter in the building. We are concerned for the safety of people inside.

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MSF surgeon Dr Aldo Rodriguez worked at Al Aqsa hospital in the centre of Gaza and reported bombs falling near to the hospital two to three times a day, followed by a rush of injured or deceased arrivals. Patients arrive with serious injuries and burns, severe brain trauma, often unconscious, and missing limbs. He performed between 20-25 surgeries each day, the majority on children under the age of 12. These were very young patients often one or two years of age and now the sole surviving members of their family, leading the medical team to use the acronym WCNSF, “wounded child, no surviving family.” Many require amputations, often an arm, or a leg at the level of the groin. Unaccompanied children are everywhere in the hospitals, devastated by what they have been through. Some say they were playing just before they were hit. After the amputation they are left depressed, not wanting to talk.

As the medical needs of the population multiplies, opportunities to provide life-saving care are shrinking. We are running out of hospitals in which to work. Only 13 out of Gaza’s 36 hospitals are still partially functional: nine in the south and four in the north. Hospitals are running out of basic medical supplies and fuel for generators to run vital equipment, while bombing close to the hospitals makes it more dangerous for patients to access healthcare.

The lack of access to healthcare for so many Palestinians is indescribably tragic and will have long-lasting consequences. It is an urgent matter of life and death for war-wounded children who require life-saving surgery, pregnant women who need emergency C-sections and the tens of thousands of people with devastating wounds.

Many of our staff have lost their homes, family members and friends. Food and water is scarce and sleep almost non-existent. Telecommunications is regularly cut by Israeli Forces and there’s no petrol for vehicles which makes moving around by foot the only option.

More than 337 healthcare staff have been killed in Gaza since early October, including dedicated MSF doctors and our staff’s family members who have been killed in hospitals, in our vehicles, in shelters or in their homes. This is despite our locations and movements being flagged with Israeli Forces on each occasion.

Our staff on the ground tell us that Gaza is in ruins with collapsed buildings, rubble, landslides, makeshift shelters and a human sea at aid distribution points whenever scant supplies arrive. There is a constant buzz of drones that Israel uses to keep Gaza under surveillance.

In Khan Younis, thousands of people are sheltering in the hospital compound which is considered by the population to be safer. There are no more beds, all are occupied by patients. When new patients come to the emergency room requiring urgent care they are treated on the floors by doctors who kneel in blood to try to save their lives. Our head of mission Léo Cans, working at the similarly overcrowded European Hospital near Rafah described a chaotic scene: of an overwhelmed operating theatre running at full capacity with exhausted medical staff.

Cans told us about Mariyam, a seven-year-old girl who was badly injured in bombing that killed her mother, brother and sister. Her right leg had been amputated and her face was partially burned. By her side was her aunt who was badly injured by a bullet fired from a helicopter. The nurses had to change her bandage without anaesthetic due to the shortages. Mariyam screamed in pain for half an hour. By the end of the procedure, she was crying for her Mum. For survivors, on top of the intense physical pain, are layers of mental suffering

Conditions for Palestinians crammed into the south are beyond catastrophic. With nowhere left to go and denied access to the most basic of human needs: water, food, shelter, medical care – those spared death by indiscriminate bombing or shelling risk a death by disease, hunger or exposure to the weather. The indiscriminate bombing must stop now along with the relentless attacks on civilians and civilian infrastructure. Hospitals, medical facilities, ambulances and medical staff must not be targeted.

We reiterate our call for an immediate ceasefire to spare the lives of civilians and to restore the full flow of humanitarian assistance into Gaza. We need to massively scale up support to the healthcare system, which is stretched beyond any measure.

The Government of Ireland must now step-up its efforts and with other states use every opportunity to influence the Government of Israel to bring an end to its campaign of brutal human suffering. The very survival of Palestinians in Gaza depends on it.

Isabel Simpson is Executive Director of Médecins Sans Frontières/Doctors Without Borders Ireland. Médecins Sans Frontières/Doctors Without Borders (MSF) is an independent international medical organisation that provides healthcare to people affected by war, epidemics and disasters.

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