I entered Gaza as part of a team of MSF specialists on November 14. We were met with scenes of alarming desperation. Trapped civilians. No fuel, no food, no water. No ambulances. Attacks on hospitals are a fact of life. And people are becoming more and more desperate.

My first hours in Gaza were marked by the constant buzz of the drones Israel uses to surveil the enclave. The stressful, loud sound can be heard non-stop, all day and even at night. I also saw landslides, collapsed buildings. Even though I knew about the dire conditions in Gaza ahead of time, it was still shocking to see everything in ruins and people looking for food under the rubble and waiting in endless lines to get some bread. There isn't a place in Gaza that doesn't have a shattered building. 

Prepared to provide as much medical support as possible, the team went to work at Nasser Hospital in Khan Younis. At the time, Nasser had become the largest functioning hospital in Gaza following relentless attacks on Gaza City’s Al-Shifa Hospital in the enclave’s north. But it had twice as many patients as it could handle, and people were setting up tents to shelter from the air strikes and shelling elsewhere. Some patients have had their homes destroyed and have nowhere to go after being discharged. Many get stuck in the hospital, where at least it’s warm and there is drinking water.

On day three, a missile landed in a refugee camp less than a kilometer away from the hospital. We felt the building shake, the windows creaking. Within 10 minutes, ambulances started arriving, and in less than an hour we received 130 patients. The saddest thing was that more than half of them arrived lifeless. About 30 children died that day. Instead of seeing children playing or napping, what we saw was heartbreaking: children in very poor condition, with some amputations that will require long-term, intensive physiotherapy

A week later, after treating as many patients as possible, the team moved to Al-Aqsa Hospital in Gaza’s Middle Area, where there was also intense bombing. It has a capacity for 200 stretchers, but because of the high number of patients, the hospital had to set up 650 beds. There, our team supported triage—the process of identifying patients according to the severity of their condition—and carried out consultations and surgeries, managed wound care, and provided physiotherapy and mental health care for patients dealing with war-related trauma. 

On January 6, however, MSF had to evacuate our staff from Al-Aqsa after the area received evacuation orders from the Israeli military. Prior to evacuation, drones and snipers injured family members of our staff, a bullet heavily penetrated the intensive care unit, and intense fighting impeded staff from accessing the hospital as it got closer to the facility. MSF has urged Israeli forces to protect the patients and staff still working and being treated inside the hospital. On January 7, a drone targeted the administrative building of the hospital and people in the hospital courtyard.  On January 10, 40 people were killed and more than 150 injured by airstrikes on buildings located at the very entrance of Al Aqsa hospital. Al-Aqsa remains the only partially functioning hospital in Gaza’s Middle Area, serving a large community in Deir Al-Balah, including several refugee camps.

It’s not easy to move around within Gaza, not even to get to work. The morning we moved to the Middle Area, two Israeli tanks cut the main route and divided the south of Gaza into two parts. So many people were stuck where they live or work, without access to food and other supplies on the other side. The only way to cross was through one road next to the beach, but without a car and gasoline, people were trapped. And we all had to deal with frequent telecommunications cut-offs.

In the Middle Area, drones and bombings were present 24/7. Every day, two to three times a day, bombs would fall not far away, followed by a rush of injured or dead arrivals at the already overcrowded hospital. The attacks were very powerful and those affected arrived with severe brain trauma, unconscious, and without a leg or an arm. Many patients were dealing with the loss of close relatives or their house on top of the physical pain.

Some of my most trying moments in Gaza were during the 20 to 25 surgeries I performed each day. I had very young patients who were the sole surviving members of their family and arrived at the hospital alone. I had cases of children one and two years old, victims of bombing, with traumatic amputations of the leg, at the level of the groin. Due to the high number of children arriving without any family members, we began to use the acronym WCNSF, meaning ‘wounded child, no surviving family.’

Every day, I saw these children alone and devastated. Some said they were playing just before they were attacked. After the amputation they are left depressed, not wanting to talk. It's a dramatic situation because it's not just surgery—it’s everything that comes after that. Even if they are discharged, they hang around because they don't know what to do and have nowhere to go. They may get better physically, but mentally they are destroyed.

Before I left, the people I met in Gaza asked me to share what I saw and did during my time there, and the pain they are in. They want people around the world to know what is happening to the Palestinians of Gaza and what they are going through. I saw for myself the heartbreaking aftermath of three months of this terrible war. Each and every day, more lives are being lost and the human desperation deepens. This siege and the indiscriminate violence it begets must stop now.

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