GUEST ESSAY
Oct. 29, 2023 (NYTimes.com)
By Hussam Abu Safyia
Dr. Abu Safyia is a pediatrician at Kamal Adwan Hospital in northern Gaza.
At Kamal Adwan Hospital in northern Gaza, we are no strangers to treating victims of airstrikes over the years. The team all too often must rush into the emergency room, all hands on deck, ready to treat shrapnel wounds, burns and blood loss. In the early days of the current Israel-Hamas conflict, our hospital of only 80 beds was quickly overrun. On Oct. 17, following the explosion at Al-Ahli Arab Hospital in Gaza City, we were flooded with dozens of wounded and dying victims. By the next day, our patient roster had grown by nearly 120. We knew it would be another sleepless night, another in a string of far too many since the violence started 10 days earlier.
As many as three to four children had to share single beds, and many more were forced to settle for the floors. Some patients from the hospital explosion came in screaming in pain, but others were silent, in shock or beyond saving. With anesthesia, iodine, alcohol, blood and even gauze running low or entirely gone, we had a dwindling supply of tools to help ease the human suffering. The people who flocked to Kamal Adwan to sleep in our hallways or even the parking lot, believing it safer than their homes, were no doubt as frightened as we were.
As I write this, the hospital is on the precipice of true disaster. We are down to the last gallons of fuel necessary to run the electric generators, despite our most stringent efforts to ration it since the start of hostilities. Lights are off most of the time, elevators are out and patients are carried between floors. When the fuel runs out, we will no longer be able to function at night after the sun goes down. Most of the tools and equipment needed to run a modern hospital like ventilators, defibrillators and our neonatal units will become useless. When the generators fall silent, we will be relegated to practicing medieval-level medicine. Without an urgent resupply of fuel, the lights will go out permanently, and our hospital could turn into a morgue.
Kamal Adwan is far from the only hospital reaching its breaking point, as doctors like myself desperately cry out for more aid to Gaza. I’m a pediatrician at Kamal Adwan, part of a team of nine MedGlobal doctors and humanitarian aid workers that have been on the ground in Gaza since 2018. In that time we’ve seen our share of tragedy, suffering and shortage, but nothing could have prepared us for the horrors of the past few weeks. My team and I have divided our time between caring for patients and locally sourcing and distributing medical supplies, food and fuel to 11 different hospitals — $1.3 million worth of resources since the violence began. And it is still not nearly enough.
Most of us have chosen to remain in northern Gaza, defying the evacuation orders because we’re unwilling to leave behind our patients, for many of whom evacuation would mean certain death. Abandoning them now would be a violation of my Hippocratic oath as well as basic human decency. My wife and six children have also stayed at the hospital with me since the violence began. I’ve tried to convince them to head south, but my wife told me that we will either live or die together. Many Palestinians in north Gaza feel the same, risking their lives at home rather than face the prospect of becoming refugees in the south.
Doctors are no strangers to tragedy or death and are trained to steel themselves against it, but the pressure we’ve been under these past few weeks is beyond any training. One of my colleagues lost his father and brother to an airstrike in the first week of the fighting; another saw his dead son wheeled in by an emergency crew. At a professional level, a personal level and most fundamentally a human level, the people of Gaza and the medics who care for them are at a breaking point. Like our patients, especially the children, this conflict will leave every one of us traumatized.
Even so, we are treating our patients to the best of our ability with the bare minimum of electricity, medicine and supplies. We sterilize wounds with vinegar, previously unthinkable in our modern intensive care unit. Drinking water ran out days ago, and the water we do have isn’t potable, contributing to a rising tide of intestinal infections and diseases not seen in Gaza in years. Our morgue filled to capacity within the first week and we’ve had to store many dead children in a nearby tent, praying that the decomposing bodies don’t contaminate the water wells or spread further disease. We fear an outbreak of cholera and typhoid. We fear for the long-term mental health impacts on the children in our care. Their little bodies are quick to injure and quick to heal, but their minds and spirits will need a lifetime of care to overcome what they have seen and experienced.
On Oct. 20, as I finished operating on a girl who had lost her leg, I stepped into the hallway and my wife was there to hug me. Our home, she told me, had been destroyed in an airstrike on an adjacent building while I was in surgery. The hospital is now our only home. At night, I go to my office and close the door to cry, away from the eyes of my patients and family.
It may be hard to understand why any of us are still at the hospital, running our resupply routes and struggling against a sea of despair. The answer is hope. As Kamal Adwan Hospital and Gaza itself run out of everything — food, water, fuel, medicine — the one thing we have not yet run out of is hope. I see it in my fellow doctors and the MedGlobal team risking their life every day to drive the streets of Gaza delivering supplies. I see it in the eyes of our patients — not all, but many. There’s a resilience and tenacity at the heart of the human experience that’s stronger than any horrors men can inflict on one another.
Through that hope, we make an urgent plea to the rest of the world to send more aid into Gaza. In order for hospitals like Kamal Adwan to continue functioning, we desperately need more resources — especially fuel for our generators. If we cannot turn the lights back on and keep lifesaving equipment running, too many of our patients will end up needlessly dying.
We hope that people will read our story and share in our desires: for a cease-fire, for a full opening of border crossings so that the wounded and sick may leave and lifesaving supplies can reach the tired, hungry and the displaced. For a normal life of peace where hospitals in the region see Israeli and Palestinian patients side by side, unburdened by grief, separation and war. We need the world’s help to sustain these hopes and bring this senseless violence to an end.
Hussam Abu Safyia is MedGlobal’s lead physician in Gaza. He is a pediatrician at Kamal Adwan Hospital in northern Gaza.
