Despite Israel’s Destruction of Gaza’s hospitals, One Doctor Refuses to Give Up
The simplest blood test that can save one’s life has run out in most of the hospitals, which endangers the lives of hundreds of thousands of patients.
By Ola al-Asi
For over 23 months, Israel has intensified its military grip and genocidal campaign on the Gaza Strip, resulting in cataclysmic impacts on all signs of life and leaving displaced Palestinians surviving on a shred of Israeli- and US-controlled sources for aid.
Dr. Ahmed Adel is a Palestinian internal medicine and emergency room doctor with Doctors Without Borders who works at Al-Aqsa Hospital in Deir Al-Balah. Adel lost his house to Israeli bombing at the beginning of the war and was forced to the south until the first ceasefire in January 2024. He now lives with his family in Gaza City and has had to commute for two and a half hours to central Gaza, where he has been working since October 2023.
The arduous trip is exhausting due to the wrecked streets where no cars are allowed to transport people between the north and the south. People have had to use animal-drawn carts and other open-air means of transport. Adel arrives at the hospital exhausted, thirsty, and sometimes hungry, but he immediately starts his check-ups with patients and receives a nonstop flood of injured people into the ER.
“I can’t be late for the patients even when I am tired; I have to help them,” Adel told Prism. Adel is known among his colleagues to be diligent and keen about treating and studying the uncommon cases of injuries and infections.
“Before the war started, we used to receive patients into the ER room; every single patient used to take our full attention and follow-ups, all medical blood tests needed, and there were comfortable cots and sanitized tools ready to be used,” Adel said. “It was very rare to lose a patient back then.”
As of August, only 18 of Gaza’s hospitals and 10 field hospitals remain functional across the besieged territory, with 43% of them located in Gaza City. Bed occupancy far exceeds capacity in all Gaza hospitals, while Al-Aqsa Hospital only has three remaining beds in the intensive care unit, forcing doctors to sometimes treat patients on the floors of corridors or in the open yard outside the hospital’s buildings.
Those most affected by hospital overcapacity are vulnerable cases, particularly the elderly and children.
“When we receive children, I rush directly to them. I consider them the most fragile category. Most of the time, I used to place three to four kids on one cot due to the full capacity,” Adel said. “Other patients spend days on the floor of the hospital also for the same reason.”
A Decimated Healthcare System
Patients who suffer from high blood pressure and diabetes are among the most vulnerable to Israel’s bombing and the severe blockade imposed on aid. Elderly people with chronic diseases face a looming threat of death as they grapple with the scarcity of medicine and the lack of proper medical care at hospitals.
“Unfortunately, we sometimes lose a patient with high blood pressure as they arrive at an irreversible point and find no available ICU bed for them or the proper blood pressure medication that fits their health conditions,” Adel told Prism.
I experienced the effects of the decimated health care system with my mum when she had to undergo hysterectomy surgery in November 2024. Her health was deteriorating, and there was nothing that my family could offer or do. My mother suffers from high blood pressure and takes medication to control it; however, the medicines are hardly allowed into Gaza, and the Israeli military requires multiple layers of arbitrary approval and checking procedures to allow aid in. It is in itself a tiring journey between clinics, hospitals, and field hospitals in search of the medicine.
Any time without medication is dangerous for my mother, especially during times of fear and bombing—we could lose her when she gets scared and has no medicine to balance her blood pressure.
Booking an appointment for her hysterectomy was difficult as the hospital was always at full capacity. After the surgery, we found it even harder to get the post-operative medications, like antibiotics and stool softeners or laxatives. We were not lucky enough to find all of them or their alternatives, and so my mother’s post-operation recovery was prolonged due to a lack of nutrients. We could barely find dates with the skyrocketing prices in the market. Her body needed proteins to rebuild its tissues. Israel denies entry to fresh meat, chicken, dairy, eggs, and fresh fruits and vegetables; anything allowed in is just rations designed to keep us barely alive. We are living in a well-planned and systematic starvation orchestrated by the Israeli authorities, which our bodies could need years to recover from because of the long-term physical damage.
Adel witnesses the compounded effects of a lack of nutrition, medicine, and preventive care daily at Al-Aqsa Hospital, as well as the breakdown in sanitation and livable conditions required to stave off infections, bacterial illnesses, viruses, and diseases. Since June, there have been at least 94 suspected cases of Guillain-Barré syndrome (GBS) in Gaza, according to the World Health Organization. GBS is a rare paralytic disease that results from exposure to a poor sanitation environment, which leads to viral or bacterial infections.
“We receive patients with Guillain-Barré syndrome and can’t provide them with the (intravenous immunoglobulin) treatment, which we demanded from several organizations to help allow it into Gaza, but they couldn’t,” Adel told Prism. “Patients in this case are supposed to undergo plasma exchange, but the device is not available in Gaza either. So we doctors tend to do something very primitive called manual plasma exchange, which is not actually effective, but we try our best to just keep the patient living as long as possible.”
Israel’s genocide has resulted in shortages of qualified medical staff in Gaza; lack of hygiene, medical equipment, and even the simplest blood tests have led to the loss of many patients who were not lucky enough to be diagnosed or treated properly.
“We sometimes had to put patients in the postpartum rooms, where midwives had to deal (with them) and follow up with the patients,” Adel said. “In many cases, we lost the patients, as the staff there is not qualified to deal with such cases. There was once a patient who suffered from fatal blood acidosis. He eventually passed because he was treated at the postpartum department due to the lack of ICU beds in other hospital departments.”
The simplest blood test that can save one’s life has run out in most of the hospitals, which endangers the lives of hundreds of thousands of patients with chronic or life-threatening health conditions, leaving them to face imminent death.
“My colleague from the laboratory department always tells me to choose the most vulnerable and worst cases to undergo blood tests needed and adapt to what is available, due to the shortages in materials and chemical substances needed for blood tests,” Adel said. “We do not have the (complete blood count) test, liver tests, kidney function tests, or biological tests that can save the lives of many. Lack of a variety of medications, unfortunately, led to the loss of several patients.”
Adel recalled a patient, a 13-year-old girl named Yasmeen al Daour, who was diagnosed with meningitis and arrived at Al-Aqsa Hospital from an American-run field hospital.
“She needed to undergo a CT scan, which is not available at Al-Aqsa. We had to send her by ambulance to Yaffa Hospital,” he said. “The commute between the two hospitals takes about two hours. The patient couldn’t stand it and had brain damage due to cerebral hypoxia and passed away the next day; we couldn’t save her life.”
The lack of even simple medical equipment is life-threatening.
“I remember once I had a 32-year-old patient who was suspected of having gastrointestinal bleeding; in such a case, we used to directly use the gastroscope. But now that we don’t have it here, we are forced to only monitor the patient’s condition and intervene when necessary, and as there is a shortage in staff, I couldn’t assign a monitor for her. After an hour, she vomited blood, and she passed away,” Adel recounted, adding that the patient was a mother of three.
Famine Affects Medical Staff and Doctors
As famine has taken hold in northern Gaza, there are warnings that it might spread to the central and southern refugee camps. Doctors are among those affected by the famine; their starvation would lead to the collapse of the entire health care system. Some doctors have shown symptoms of malnutrition as they have worked nonstop for 23 months amid the scarcity of food supplies. This affects their physical performance, as some doctors faint and are unable to perform surgeries, which threatens the health of patients.
Adel treats hungry people, and he himself is hungry most of the time. At moments like this, he said he is heartbroken with nothing to say, and tries his best to treat malnourished patients.
“Most of the time, I can’t function well due to hunger. I sometimes spend whole days with one insufficient meal. On some days, I can’t stand on my feet or focus. When people tell me they are tired, I reply, ‘I am even more tired than you are’,” Adel said.
“I sometimes spend hours searching for food, even if it’s only a sandwich of falafel, which has become unaffordable. We used to have snacks and hot drinks during the day and night shifts, which are unavailable now; this affects our punctuality. I once was completely unable to follow up with a patient after hours of searching for food I couldn’t find. When I arrived in the room, I could barely focus or stand, I was so hungry.”
Recalling one particular interaction with patients under his care, Adel shared: “There were once two female patients who arrived at the ER room with very pale, skinny faces and sunken features. The sphygmomanometer did not fit their arms. I told them, ‘You have to eat something.’ They replied, ‘There is nothing to eat.’ Their blood pressure was 80/40 mmHg; the saturation solutions couldn’t help raise their blood pressure to a stable point.”
Doctors are Living in “Nonstop Trauma”
Since October 2023, medical staff in Gaza have been endangered in various ways as they have been killed, injured, or kidnapped.
“There are only three to four doctors usually in the ER room. We have to handle 50 to 100 people, including patients and their angry or scared and traumatized family members,” Adel said. “I once was physically assaulted by the victim’s relative, who (had) arrived at the hospital dead. He was accusing me of not treating him. I spent some time explaining that he arrived late and died on his way to the hospital. I understand his pain of losing a beloved one, but this is also harmful for a doctor to be under so many threats while on duty.”
When Adel was asked about his fears as a doctor in Gaza during the war, he told me that his fear takes different shapes and forms.
“I have recently had too many nightmares about death.” He said. “I can’t sleep well inside the hospital; I spend hours thinking of where the best corner or direction to rest and sleep in case the hospital is targeted or there is a bombing. Al-Aqsa Hospital has been bombed several times since the beginning of the war. I draw and imagine different worst-case scenarios if we were hit. It has become an obsession.”
Since the beginning of the war in October 2023, more than 1,500 medical staff have been killed in Gaza by the Israeli military, and over 339 health care workers have been kidnapped; 162, including 20 doctors, are still imprisoned inside Israeli detention facilities.
“Doctors are held hostage without charges, and they are being interrogated by torture. My friend, Dr. Osama T, 30 years old, was kidnapped from Nasser Medical Complex in Khan Younis, where he was working, by the Israeli military and released after 50 days of abduction,” Adel told Prism. “He told me that if they ever came to the hospital, I would prefer to be killed rather than kidnapped because of the torture he was subjected to in Israeli prisons, without any charges.”
Doctors are living in nonstop trauma just like the rest of the civilians in Gaza, but what makes it worse is that they experience it first- and secondhand all day long.
“Most of the time, I see disfigured faces and bodies. I have to deal with all kinds of injuries while ignoring the amount of agony I feel for them, so I can focus on their treatment, not on my personal trauma,” Adel said.
“I saw burned children whose limbs fell from my hand when I carried them. I see victims whose injuries are irreversible, and I can’t do anything for them, so I just give them ketamine to help them pass peacefully without feeling the pain. We receive many victims with headshots from the (Gaza Humanitarian Foundation) aid-distribution sites, of all ages. I witnessed unbearable and tormenting scenes at the ER room. Whenever I receive a call from my family, I hold my breath. I feel afraid even before taking the call. I feel afraid that something bad has happened to them.”
Dealing with constant, dreadful stress for over 700 days is agonizing and mentally draining for healthcare workers.
“Recently, I have had an anxiety disorder. I try to reach out for help and to ask my fellow colleagues about how they manage their feelings and stress. I know that I chose this path in life, and I know how exhausting it can be. But I never imagined this, even in my worst nightmares,” Adel shared with Prism.
“I keep asking myself some existential questions. I keep asking myself why I was born to live in an occupied country. Why do we have to face war and lose everything, and have to stand and start again, and lose everything again, and start over again? We are smart enough, brave enough, and good enough to live a peaceful life. Things are supposed to be easier for me; I am a hardworking person. I deserve to live a better life than this, considering the efforts I exert.”
“The rest of the world’s doctors share the same skin tone, language, and humanity above all. So why is it us in Gaza who have to live this? Is it that we are Palestinians?” he continued. “I try to console myself and pull myself together, but before I go to sleep, it keeps repeating in my head. I was once so tired and running in the hospital’s corridors from patient to another, I stopped for a moment and told myself, It’s all for Allah’s sake what I am enduring and doing.”
This article was originally published in Prism.
– Ola al-Asi is a Palestinian journalist and storyteller based in Gaza City, in the northern part of the Strip. She started her career life as an English language educator; Ola has worked with Gaza Sky Geeks-Mercy Corps as an English language mentor and at University College of Applied Sciences as a lecturer. She contributed this article to the Palestine Chronicle.