At Shifa Hospital in Gaza Strip, Dr. Jamal Salja and other surgeons wash their instruments with soap because they are not sterilized. The infection is ramp-prolonged. The foul smell of medical waste is overwhelming. And flies are everywhere.
Without painkillers, patients moan while lying on metal beds lined up in the hallway. There is no electricity or ventilation in the heat, but worrying visitors leave fans with bedridden relatives with cardboard boxes.
It was once the largest hospital in Gaza and the cornerstone of its health care system. The shell of the previous self After 22 months of war. The seven-soccer-sized hospital complex was frequently bombed, with two Israeli raids and Food lockdownmedicines and equipment. the Exhausted staff work 24 hours a day To save lives.
“That’s so bad, no one can imagine,” said Sarja, a 27-year-old neurosurgeon who, like countless doctors in Gaza, trained at Shifa after medical school and hopes to end his career there.
But when the present is all consumed, the future is difficult to think about. Sarja and other doctors are overwhelmed by the wartime caseload that shows no signs of mitigation. As a patient, I’ve become more challenging in the last few weeks. Abdominal malnutrition causes the body to die.
Shifa was originally part of the British military post, which opened in 1946. It has developed over the years, boasting the largest specialized surgical department in Gaza, with over 21 operating rooms. Currently there are only three and very little functioning.
Because Shifa’s operating room is always full, surgery is also performed in the emergency room, with some injured people having to turn their backs. The bombed building is filled with patients and approaches a courtyard surrounded by mountains of tiled rubs.
Sarja fled North Gaza at the start of the war. And I just returned to Sifa at the beginning of this year. While working at another very busy hospital in central Gaza, he was monitoring Shifa for his worsening condition.
“I saw the photo,” he said. “But when I first came back, I didn’t want to go in.”
Young doctors and war
After graduating from medical school in 2022, Sarha trained at Shifa for a year. That’s when he and his friend Bilal decided to specialize in neurosurgery.
But everything changed on October 7, 2023, when Hamas attacked Israel and the Israeli retaliation campaign began.
During the first weeks of the war, Sarha was an intern at Shifa. As Israel blocked internet services in Gaza, one of Sarja’s jobs was to bring scans to doctors around the complex. He had to evacuate there and survive thousands of displaced people, then go up and down the stairs when the elevator stopped working.
He left his family as Israeli forces moved to northern Gaza. Bilal, who stayed in Gaza city, was killed several months later, Sarja said.
Shortly after Sarha left, Israeli forces raided Sifa for the first time. November 2023.
Israel said the hospital served as the main Hamas headquarters and control centre. However, it provided little evidence beyond a single tunnel with two small rooms under the facility.
We had similar arguments when attacks and impressive. Medical facilities in Gaza Even as Causes of casualties from the war. Israel says it is making every effort to deliver medical supplies and avoid harm to civilians.
Under international law, if a hospital is used for military purposes, it loses its protected status. Hamas refused to use the hospital for military purposes, but its security officers often see inside it, placing parts of the hospital in public.
Israeli Army I returned to Shifa in March 2024ignited a two-week battle in which the army said it had killed about 200 militants that it had reorganized there.
The hospital was left in abandoned. The World Health Organization said that three hospital buildings have been extensively damaged, destroying most of the equipment, including their oxygen plants and 14 baby incubators.
While all this was happening, Sarja worked at a hospital in central Gaza, where he performed over 200 surgeries and procedures, including dozens of surgeries on the fractured skull. Some surgeons spend their lives without seeing it.
When he returned to Shifa as a resident of a neurosurgeon, he felt that the building he was using (which was being rehabilitated) was haunted.
“They destroyed all our memories,” he said.
The shrinking hospital is growing to the limit
Shifa had 700 beds. Today, there are about 200 patients, almost as many patients as they are on the mattress on the floor, the hospital manager said. Some beds are located in storage rooms or tents. An extra 100 beds and three more operating rooms are available for rent from nearby facilities.
The hospital once employed 1,600 doctors and nurses. According to Shifa’s management manager Rami Mohana, there are now about half of them. Gaza and Being troubled by extreme food anxiety, The hospital could no longer support staff, and many workers fled to help their families survive. Those who remain are rarely paid.
A recent morning in a ward that turned to a storage room, Sarja checked Mosab Al Dibs, a 14-year-old boy suffering from severe head injuries. malnutrition.
“Look how bad you’ve got?” Sarja said, pulling Ardibus’s frail arm.
Ardibus’ mother, Shahnes, was disappointed. “We’ve known Shifa since we were kids. Anyone who goes to it can get better,” she said. “Now, anyone who goes to it is lost. There is no medicine or serum. It’s a hospital just by name.”
Patient bandages change in rare cases due to a lack of basic supplies like gauze. Gel foam will be distributed to stop bleeding.
According to Mohana, Shifa’s three CT scan machines were destroyed during the Israeli raid, so patients will be sent to a nearby hospital if one is needed. Israel has not approved replacement of the CT scanner, he said.
Patients wait hours, sometimes days, for the surgeon to prioritize caseloads and arrange scans. While waiting, some patients died, Salja said.
A few months after no pneumatic surgical drill to cut bones, Shifa finally got it. However, the blades were missing and spare parts were not available, Salja said.
“So it could take more than an hour to cut the bones of the skull, not ten minutes,” he said.
When asked by the Associated Press about equipment shortages at Shifa, Cogat, the Israeli military agency responsible for aid coordination, did not address the issue. The military said it would “consistently enable the continued functioning of health services through aid organizations and the international community.”
An unforgettable moment
Since his days at a hospital in central Gaza, Sarja has been unable to shake the memory of a woman in her 20s who has arrived with a curable cerebral hemorrhage. The hospital wouldn’t accept her because there was no bed in the intensive care unit.
He wanted to take her to another hospital by ambulance, but due to the risk of being attacked by Israel, the technician would not go with him to operate her ventilator.
“I had to tell her I had to leave her to die,” he said.
Other stories have a happier ending.
When the girl bleeding from her head arrived at Shifa, Sarha’s colleague stopped it with his hands until the gel foam was fixed. The girl, who temporarily lost her eyesight, greeted Sarja after a successful recovery.
“Her vision was better than mine,” Salja said with glasses on, breaking a smile.
“Sometimes we seem to live like a stray. We deal with the patient while we sleep and wake up and ask.
