The Daily - The Doctors of Gaza

Episode Date: November 13, 2023

Warning: This episode contains descriptions of injuries and death.As Israel’s war on Hamas enters its sixth week, hospitals in Gaza have found themselves on the front lines. Hospitals have become a refuge for the growing number of civilians fleeing the violence, but one that has become increasingly dangerous as Israel’s military targets what it says are Hamas fighters hiding inside and beneath them.Today, three doctors working in the Gaza Strip describe what the war looks like from inside their hospitals and what they are doing to keep up with the flood of patients.Guests: Dr. Ghassan Abu-Sittah, Dr. Suhaib Alhamss and Dr. Ebraheem Matar, three doctors working in the Gaza Strip.Background reading: Gazans under bombardment have described a surge of severely injured children entering hospitals, doctors operating without anesthesia and morgues overflowing with bodies.Israeli officials say that Hamas has built a complex under Al Shifa, a major Gaza hospital. Hamas denies that it is operating from beneath the hospital, whose patients face dire conditions amid power cuts.For more information on today’s episode, visit nytimes.com/thedaily. Transcripts of each episode will be made available by the next workday.

From The New York Times, I'm Sabrina Tavernisi, and this is The Daily. They bombed the door of the hospital. They bombed. Thousands of people are out. Thousands of people. Thousands. People are out. Thousands of people. Thousands. As Israel's war on Hamas enters its sixth week, hospitals in Gaza have found themselves on the front lines. They are a refuge for growing numbers of civilians fleeing the violence, but one that has become increasingly dangerous as Israel's military targets what it says are Hamas fighters hiding inside of them and beneath them. Israel's bombing campaign has become one of the most intense in the 21st century. Gazan health officials say the death toll now stands at more than 11,000 people, higher than all previous wars between Israel and Hamas combined.

At the center of it all are doctors. Hello? Hi, Dr. Ahmed, this is Sabrina Tavernisi from The New York Times. Hello, Dr. Marwan Abusada? Yes, yes, please. The Daily has spent the past several weeks calling doctors all over the Gaza Strip, asking them what the war looks like from inside their hospitals. The attacks are continuous. They bomb a building and then we get a gush of casualties coming

at least 40 or 50 at one time. You hear the bombing now? You hear the bombing? Yes, I do. How they are working. We work hard. We work more than 18 hours per day. How they are living. Where are you sleeping? Are you going home? In the hospital.

Sometimes in the office, sometimes in the OR. And what they are doing to keep up with the flood of patients. I will show you just for one minute with a camera to see how many patients are waiting in the waiting room. Just one minute, please. Okay. Oh, my goodness. I see so many patients. Now, as Israel's military moves deeper into Gaza City,

the war is pushing hospitals to the brink of collapse. Today, three doctors on survival in Gaza. He's actually operating at the moment. Will you be able to call back in half an hour? Of course, of course. So you need to go to a surgery right now. Yeah, yeah, yes, I must go. Excuse me. Okay, of course. So you need to go to a surgery right now. Okay, thank you. It's Monday, November 13th. Hello? Hello, Dr. Abusita?

Yes, speaking. A few weeks ago, my colleague Jessica Chung called Dr. Ghassan Abusita, a British-Palestinian plastic surgeon. Hi, how are you? I'm good. How are you doing? Exhausted, but otherwise intact. Can you tell me a little bit about where you are right now? I'm in the operating room of Shefa Hospital. It sounds like a child is in pain.

She needs an amputation part of her foot. She's six, taken from underneath the rubber. How many patients are at the hospital right now? Around 1,600 to 1,700. But the hospital capacity is 600. So you can only imagine. The day she reached him, he was working at Al-Shifa Hospital in Gaza City, the largest hospital in the Gaza Strip.

Israel's army had not invaded Gaza yet, but its airstrikes had driven many from their homes, and Shifa had become a kind of refuge. Around 60,000 people were living there. If you walk through the hospital, it's turned into a tented city. On the floors at the entrance, there are families sitting. There are patients on the corridors, patients on mattresses on the floors, patients on trolleys, there are patients in the emergency room. It's just surreal. It's surreal how awful awful it is across the hallway from my operating room door there is a whole three generational family grandmother and parents and a sibling and

they have a little girl who's oxygen dependent she's like four and needs continuous oxygen so they're sitting next to a electric socket on the floor. There are some patients on mattresses with their injuries. It's miserably grim. And the smell. It's a public health catastrophe waiting to happen. This is cholera or typhus waiting to happen. Mm-hmm.

And are you sleeping in the hospital? In the operating room. Each operating room has a small area called recovery where we put patients right after the surgery just to monitor them until the anesthetic wears out. That recovery area is where I sleep. Are colleagues there also sleeping there? Everybody's sleeping here and some people have brought their families.

And where are they sleeping? Every available office, cupboard, storage room, corridor, whatever you can imagine. And how many patients have you been able to see today? What have you done today? I've just been operating all day. So burns, we brought in major burns patients, so patients with over 40% burns. We had a mother, her 11-year-old son who has full sickness burns to his face and his arms. We had a mother with burns to her legs and to his arms. We had a seven-month-old with burns to his legs and arms. But we also had this child with facial burns yesterday who doesn't look like he's gonna do well. What happened to him?

He's got over 60% burns. Burns to his face, to his hands, to his legs. He's 13, 12, 13. He was just whimpering. Whimpering. Do you try to calm them? Do you try to talk them through? Absolutely.

Absolutely. Absolutely. What do you usually say to them? Everything is going to be all right, even though you know it's not going to be all right. You tell them that once the surgery is done, their parents will give them the best meal that they like or get them some ice cream or whatever.

But these kids have been pulled from underneath the rubble a lot of them have seen family being killed there's very little that effectively you can say to them and they're absolutely petrified this six year old girl needs an amputation to her foot we'll be taking her next to the operating room. It's just been like that. This is carnage on an unfathomable scale.

I need to go. I need to go because the dad of the girl is here and we need to tell him that we need to do the amputation. Okay, absolutely. Thank you. Okay, good luck. Thank you. The Day After We Talked to Dr. Abusita, on Friday, October 27th, all communications to Gaza were cut. No phone, no internet.

It was about two days before we could reach anyone again. When we did, it had become clear that Israel had launched a ground invasion into Gaza. And the doctors we spoke to told us it felt like the war was getting even closer. Last night was horrendous. The bombing was just very close. And it was. Are you worried about the Israeli military

coming inside Gaza? There are forces coming closer to Gaza City now. This is actually awful. We don't want this to happen. Ten days ago, an Israeli airstrike hit an ambulance near the entrance of Shefa Hospital. Then, on Friday, the courtyard inside the hospital complex was hit. Israel maintains that the hospital conceals a major Hamas military compound, including passageways hidden underneath. It says the ambulance it hit, it was being used to transport Hamas fighters.

It also said that Hamas is hoarding fuel. Hamas has denied all of this. When we asked doctors about it, some said it wasn't true. I mean, for me, it's just a narrative to justify targeting the hospital. I mean, the thing about it is that under international law, it's still a crime to attack a hospital,

regardless of who you say is underneath the ground. Others said they didn't know. I only deal with patients. I don't know. All they knew was their reality in this war. That their corridors were filling up even more with wounded and dying people. Just as their supplies were running out. They were running out of disinfectant. may die because of infection in the wound. Why there is infection in the wound?

Because there is lack of antibiotics. They were running out of disinfectant and were resorting to what they had on hand. One of the things I have witnessed is seeing chloride used in wiping the floors or wiping the windows. We use it for the cleaning of wound infections. As an example, I've seen nurses and doctors

using vinegar to treat wound infections. And I am sure it is not enough. It will not treat anything. They said they were running out of medicine to operate on people. MSF released a photo. It was an amputation of the foot of a little boy on the ground with no general anesthesia. So he was just given sedative to fall asleep.

Part of what we do as doctors is relieve suffering. And if you can't treat patients with pain control, it's intolerable. They started rationing everything, particularly fuel, to run the generators. So many turned off the lights in their hospitals. The wards are dark. The corridors are dark. The communal areas, the lobby, the stairwells, they're dark. And so it's a nightmare because you don't know who you're stepping on while you're walking.

Some said they were even operating on people using their phone flashlights. Do you use light from your phone? How do you see? Yeah, yeah. That's basically it. That's the trick. You use light from your phone.

And they worried about how much time they had left. A hospital without fuel, this hospital without fuel and electricity, will turn from a hospital into a mass grave. I'm trying to find fuel for ambulances and electricity. And some of those we talked to were spending much of their days trying to find fuel themselves, including Dr. Suhaib Al-Hams, the general director of the Kuwaiti Specialist Hospital in Rafah, in the south of Gaza. I spent my days, since 6 a.m., trying to call everyone. I called the UNORWA, I called International Cross.

I called the Minister of Health. I called, I am trying to find another hospital if they can help me. They will stop my service here. The patients will die. How many calls did you make about fuel today for your hospital? Lots of calls, just a square. I spent my day just looking for water, for food, for food for my medical staff here. We don't have even bread for the last two days for the medical staff.

You don't have bread for the staff. That's what's happening here. But we have no options. We cannot leave our patients. We cannot leave our hospital here. And what about Hamas, doctor? You mentioned you're calling the Ministry of Health. Does Hamas help you with fuel?

Madam, you cannot ask me about Hamas. I am a doctor. I am an associate professor here. I am the head of surgery department in the faculty of medicine. You cannot ask me about Hamas, about jihad. You should ask me about the medicals. You can't ask Israel what they are doing here. They are killed off lots of honest people.

I won't answer anyone. You ask me about the political situation here. You talk about humanity. You talk about catastrophic situation here in Gaza, madam. You should deal with that. You should face that. One thing that we have heard, doctor, is that there are reports that Hamas had been sitting on a stockpile of fuel in the underground tunnels. Is that something that you've heard about? I didn't hear about it. I heard from the Israeli occupation. I didn't hear about that except from the Israeli occupation.

You hear that lots of doctors, professors, consultants, and medical students were killed here. Do you hear about the ambulances that were destroyed by the Israeli occupation? Do you hear about the hospitals that were destroyed by the patient? Do you hear about lots of that were destroyed by the patient? Do you hear about lots of children and women and pregnant women and citizens that were killed by the Israeli occupation?

And the whole world, that we call them the democracy, the democratic world, just watch us. Nothing, do nothing. Just support Israel. Support Israel. This is genocide here.

I wonder how they can do this. This is all our life. This is all our life. We have dreams. We have children. We have our own dreams. This is everything. They destroyed everything.

I can hear you're angry. I'm angry. I am exhausted. This is a bad dream. I hope I work from it. Just today, we received about 12 children and women, pregnant women. Two of them are pregnant. They reached the hospital dead.

They were killed. And we tried after they killed, we tried to do caesarean section after they are killed. They are trying to save their babies, but we cannot do that. Unfortunately, the fetus was killed also. We tried to save it. We tried. What was it like for you when you discovered you couldn't save the babies inside the mothers? Yes, I cried.

The only thing I can do is just to cry. the children. One of them was nine year old daughter. She lost her mother. She lost all of her family and she was silent. One of the nurses just stayed with her till the morning. And after that, it went with one of her families, one of her cousins. I hope that her cousin will take care of her. As the days went on, the war was forcing doctors to make impossible choices. Who would get treatment and who wouldn't?

Who got anesthesia and who didn't? Which wounds got disinfectant and which did not. A number of doctors talked about making the most impossible choice of all, whom to save and whom to let die. One doctor told us that it felt as if he was deciding on the souls of people. on the souls of people. Doctors also said that they found themselves in a strange new role. The hospital is full of children. Looking after children.

They keep on, like, running beside me, following me. Please, we want to draw. Please take photo for us. Two days ago, we got a patient with no one of her family alive. Lone survivors of bombings. She came alone, 11-year-old. She was disoriented.

No one knows the name. And she was in the recovery with no beds. The general manager of the hospital called me and said, I know this is not your case, but please, can you take care of this little girl? She has no one here. One doctor said that for children who were too young to speak, the staff would write unknown in marker on their bodies. A lot of children, their mothers, their fathers, without families. Some said their hospitals were starting to feel like orphanages, with children wandering the halls, looking for parents who were no longer alive.

Even there is a new medical term that we are having. It must be added to medical books. WCNSF. Wounded Child, No Surviving Family. Wounded Child, No Surviving Family. WCNSF. Yes. And it happens every hour. I have seen like dozens or even hundreds of WC and SS.

Ibrahim Matar is a resident ICU doctor at Al-Aqsa Martyrs Hospital in the middle of the Gaza Strip. And what happens to these children? Where do they go? Who cares for them after they get better? Who cares for them? Actually, there is no answer for this question. We don't even know their names sometimes. So who will care for them? So far, no one.

Who will care for them? So far, no one. I have seen two kids who are severely injured. Those two kids do not know that their father and mother and all their siblings have died. They were unconscious at the time of the bombing, and now they are conscious. They are receiving treatment, but simply they do not know. How old are the kids? a brain hemorrhage. But now they are both conscious and receiving treatment and they do not know that their family, father and mother, siblings, house, all are destroyed. Just we tell them that you're going to see them soon. Just in order not to make them feel sad.

It is painful hiding the truth. It is some sort of deceiving but sometimes you may do things that are not appropriate at that moment and may be appropriate later. That must be so hard, Dr. Mattar. Yes, it is. Pain is too intense here. This is an ambulance

is coming. Oh, what is that in the background? Now it is a new casualty and many paramedics are doing CPR and it is for a child., and it is for a child. Yes, it is for a child.

What are you looking at? Many paramedics are rushing the child into the emergency department, and they are doing CPR. It is a wounded child, and it seems there is no surviving family. WCNSF. Yes. How old is the child? It looks like 10 years old. What's happening now?

What's happening now? People, doctors and paramedics in the hospital are speaking about a new bombing. And there is dozens of new casualties are in the... In some time and they will reach the hospital. And new cases, we are now waiting new cases. How are you feeling? I did not go home since the start of the conflict. So I feel tired emotionally, physically, mentally, and in all aspects. I did not see my family since the 7th of October.

Where is your family? They are in the north of Gaza Strip. They did not leave the north. Are they okay? Thankfully, yes, they are okay. So far, I don't know what is happening later. Are they okay? Dr. Mattar, is the child okay? What is happening with that child? Dr. Mattar, is the child okay?

What is happening with that child? I may enter the department and ask about them. Just give me a few seconds. Okay. Stay on the line. Hello. Hi. Yes, I've seen the kid. The one who is being brought by the ambulance. Is he okay?

No, he's not okay. He's having a severe head trauma. We could see the brain matter through the wound. You could see his brain through the wound. He's still alive, but he's having what doctors say brain death. He's unconscious. He's having large crack in his head so we are now as doctors in the ER department are thinking of giving him assisted mechanical ventilation or not

so the IC doctors in charge may not intubate him because they may think this is a hopeless case. Because if they did, there will be no good result. So this is now a situation of choosing between which cases will benefit from treatment or not. Your colleagues are deciding whether to try to save him. Yes. And that must be such a difficult choice. It is. What is your biggest fear at this moment? In this conflict, the first thing is that I don't want to die in a cold blood.

I am an innocent person. The second thing is I'm afraid on my family. I don't want my family to get injured or to die because they are also innocent. We are afraid on our families more than we are afraid on ourselves. And we don't just want to die in cold blood. What do you mean, we don't want to die in cold blood? I mean that we are not targets. We are not targets. We as normal civilian humans, we need a ceasefire.

We need the conflict to end and to have a normal life. A normal life that includes staying safe at home, drinking clean water, seeing my friends, doing techniques, sleep in a calm room, sleep without the sound of bombings, going to work, playing football or soccer with my friends, going to the beach. Every day I used to go there and smell a breeze of the beach and listen to the sound of waves, listen to music. I miss listening to music. I am a music lover and I love poetry. I miss writing about love, about dreams. I was going to the gym before the conflict started. I miss going to the gym. Actually, the gym I go to has been destroyed today. I don't know why.

So, I miss going to the gym. How old are you, Dr. Mattar? I am 27 years old. I'm still a young doctor. You are. Just, I need normal life back. Now I can see the child who I told you about is being taken to the place of dead people.

You see the child being taken where? Into the place of dead people. Oh. They took the child you told me about to the morgue. Yes. My friend who was working with him, he is giving me a sign that he is dead. It is sad.

It is very sad. It is a young child. Yeah. because they're young child yeah young child what is your friend doing now? He returned to the ER department to see new casualties. There is no time to get sad over every case. Thank you for giving me the chance to listen to me. Thank you for sharing yourself. You're welcome, my friend.

It's my privilege. Good night, and wish a good night for me also. Be safe tonight. Thank you. Thank you. Over the weekend, Israeli tanks and troops were closing in on Shifa Hospital, Gaza's main hospital, where Dr. Abu Sita had been working, and where Israel claims that Hamas has a base. On Sunday, Israel said it was securing a route for civilians and patients to leave

and claimed it had offered the hospital fuel to help keep it operating. The tens of thousands of refugees who had taken shelter there have already fled. But many seriously wounded patients remain inside. We've lost all contact with Shifa. I have no idea what's happening there. Dr. Abusidda has also left Shifa and is now working at a nearby hospital, one of the few in Gaza that is still accepting new patients. And we've run out of ketamine here.

I'm having to do major, major wound dressing changes with nothing, with the patients screaming, but because they've been so neglected, some of them are beginning to get infected and to rot. The situation is so bleak. Everything is collapsed. Gaza's health ministry said on Sunday that 23 out of the 35 hospitals in the Gaza Strip are no longer functioning. Here's what else you should know today.

Eric Adams, pressured the New York Fire Department to allow the opening of a Manhattan high-rise housing the Turkish consulate general, despite safety concerns with the building. The Times cited three people with knowledge of the matter and said that the alleged pressure took place weeks before Adams' election, two years ago. The FBI is examining Adams' intervention as part of a broader public corruption investigation that led to the seizure last week of the mayor's electronic devices. Today's episode was produced by Lindsay Garrison, Rochelle Bonja, and Jessica Chung. It was edited by Lisa Chow and Liz O'Balin, with help from Ben Calhoun. Fact-checked by Susan Lee and Rochelle Banja.

Contains original music by Rowan Nemisto, Pat McCusker, and Dan Powell. And was engineered by Alyssa Moxley. Special thanks to Tagrid Alhodri, Neil Collier, Huayda Saad, Raja Abdurrahim, and Vivian Yee. Our theme music is by Jim Brunberg and Ben Lansford of Wonderly. That's it for The Daily. I'm Sabrina Tavernisi. See you tomorrow.