‘Massive destruction’: Israeli strikes drain Gaza’s limited health services

In her bed in Gaza City’s Shifa hospital, 25-year-old Aya Aloul recalls the moment her 66-year-old father, Moeen, one of Gaza’s few neurologists, was killed in an Israeli strike, one of two key Palestinian medical staff killed within hours on Sunday.

Covered in wounds and bruises caused by shrapnel and falling masonry, she described the bombing of the family’s home in the Rimal neighbourhood. “I get scared,” Aya told the Guardian on Monday, “so, since the war began, I’ve slept next to my parents’ bed, putting a mattress on the floor.

“I was lying awake chatting with a friend on WhatsApp while my mum and dad were sleeping, when suddenly the sound of the bombing started violently. Within a second it was black. I couldn’t see anything, and I found myself on the ground in the street.”

The shops below the building where her family lived had been hit by an Israeli munition, and Aya and her parents were left trapped in the rubble.

“There was a lot of concrete on top of me. My mother was next to me under a lot of rubble too … I got out and I tried to free my mother, but I could not.”

“I ran until I found a street with lights on, and started screaming loudly. Then neighbours came and I asked them to get my mother out.”

Aloul’s mother was eventually dug out, but her father was killed in the attack, one of 42 Palestinians to die that day.

Also killed in the same barrage was Dr Ayman Abu al-Auf, the Shifa hospital’s head of internal medicine and the head of its coronavirus response, who was also buried in rubble from a collapsing building in Gaza City’s al-Wehda Street on Sunday.

Later that morning colleagues at the hospital held an impromptu funeral to commemorate Abu al-Auf, who also taught medicine in several Palestinian universities in the Gaza Strip and was responsible for training new doctors at the hospital.

Injured Palestinian children receive medical care at al-Shifa hospital Photograph: APAImages/Rex/Shutterstock

Describing the loss of Abu al-Auf, Ashraf Al Qidra, a spokesman for the Palestinian ministry of health in Gaza, said: “His absence will undoubtedly affect the internal medicine department, and his great experience in his field will have an impact on the treatment of patients in the Gaza Strip.

“There has been a depletion of resources over the course of the year of the corona pandemic, and now this aggression has drained our limited health capacities significantly. We will be in a dangerous situation as a health system within days if this continues.”

While the deaths of the two senior doctors on Sunday have attracted the most headlines, Gaza’s medical system has been damaged in other ways.

01:17 Palestinian girl, six, pulled alive from rubble after airstrike demolishes her home – video

According to a bulletin by the UN’s Office for the Coordination of Humanitarian Affairs, as of noon on Saturday, four hospitals run by Gaza’s ministry of health had sustained damage, along with two hospitals run by NGOs, two clinics, a health centre and a facility belonging to the Palestine Red Crescent Society.

According to Palestinian health officials, damaged facilities included the Hala al-Shawa clinic, which is no longer operating, as well as the Indonesian hospital in the northern Gaza Strip and the Beit Hanoun hospital, which have also been damaged.

Riyad Eshkuntana kisses his daughter Suzy’s hand as they are treated at a hospital after being pulled from the rubble of a building Photograph: Mohammed Salem/Reuters

The medical facilities were damaged in what some emergency workers have described as destructive violence that surpassed even the 2014 war that lasted 50 days.

“I have not seen this level of destruction through my 14 years of work – not even in the 2014 war,” said Samir al-Khatib, an emergency rescue official in Gaza.

And while some respite was offered by Egypt’s decision to open the southern Rafah border crossing to evacuate the wounded, the situation remained critical.

Also among the facilities damaged on Sunday was a clinic run by Doctors Without Borders (MSF), which also said that a clinic that provided trauma and burn treatment had been hit by an Israeli missile in Gaza City.

Even before that strike, the MSF medical coordinator, Dr Natalie Thurtle, had warned of the danger facing Gaza’s already depleted health system. “The 14-year Israeli blockade on Gaza means that the health system here lacks many of the things it needs to treat people even during normal times,” said Thurtle last week.

“Yet every few years it is called on to deal with a huge influx of wounded: 11,000 injured during the 2014 war; more than 7,000 shot during protests in 2018 and 2019; and now already hundreds injured in bombings and dozens dead since [last] Monday.”

An injured Palestinian man arrives at al-Shifa Photograph: Mahmud Hams/AFP/Getty

While Israel has accused Hamas in the past of using medical facilities as a cover for its activities, the situation in Gaza is complicated by the fact that fighters with militant groups often rely on civilian hospitals for treatment, while the ministry of health in Gaza is run by the Hamas government.

While Gaza has a number of hospitals, and often well-trained and dedicated staff, equipment is often ageing and basic.

Among those who have raised urgent concerns has been the International Committee of the Red Cross, which has called on both sides to respect the urgent medical requirements of the people of Gaza. “In the past seven days in Gaza, we’ve seen extensive air strikes and also rockets going out from Gaza to Israel,” a spokesperson inside the coastal enclave told the Guardian.

“There has been a massive destruction of infrastructure, including areas next to hospitals and damage to roads beside them. That’s why the ICRC called on leaders in the UN security council to exert influence on all parties, so that medical teams, ambulances and civil defence teams can access hospitals and injured people.

“In Gaza the health system was already facing serious problems of shortages of medicines, and the medical teams working through the escalation have already had a year of working through the pandemic.

“Medical staff were already exhausted and are now having to deal with a huge influx of injuries. Medical facilities are protected under international humanitarian law and should be respected by both parties, which includes allowing ambulance crews to access the injured.”