Hours, a few days at most.
There is only so much time left for the medical centers and hospitals in Gaza before they collapse under the huge onslaught of incoming patients, due to the lack of water, basic medical supplies and above all the exhausted supplies of electricity in the generators.
Unless they quickly gain access to humanitarian aid, it means a clear death sentence for some of Gaza’s injured or chronically ill patients.
Everyone will die
“Hospitals will turn into cemeteries. There are injured people, very seriously injured people whose lives depend on oxygen. There are babies in incubators whose lives also depend on electricity. There are also other patients…Those who have cancer and cannot leave for treatment or chemotherapy. There are patients on dialysis who can lose their lives. There are patients with common ailments, there are pregnant women, there are elderly people who need medical help on time and are missing out on that opportunity,” described already last Wednesday, a worker of the International Committee of the Red Cross (ICRC) in Gaza Hisham Mhanna directly from the situation in the hospitals in Gaza.
ICRC regional director for the Near and Middle East, Fabrizio Carboni, made a similar statement on Thursday. “As Gaza loses electricity, so do hospitals, putting newborns in incubators and elderly patients on oxygen at risk,” he was quoted as saying by the British BBC.
Hassan Chaláf, the medical director of al-Wafa Hospital in Gaza, appealed last week to the possible tragedy of several dozen hospitalized newborns connected to devices. “These newborns will not be able to survive…because they are dependent on electricity and equipment in every way…They are very tiny. They are very weak,” he said.
Hell on earth
They don’t hide, they don’t run, without food, without water and isolated from the rest of the world. Israel’s retaliation against Hamas terrorists hiding in Gaza is also hitting Palestinian civilians hard. The world is also talking about “collective punishment”.
According to him, chronically ill patients are also at risk. For example, only 1,100 patients are dependent on dialysis machines, he further stated for the al-Jazeera news server.
A few days later, however, the situation is even worse. Health officials in Gaza warned on Sunday that thousands of people could die due to critically low fuel in generators – which power hospital equipment and thus save human lives – and similarly due to a lack of basic supplies, the AP agency reported.
No electricity, no food, no water
At Násir Hospital in the city of Khan Júnis in the south of the country, intensive care rooms are full of injured patients, mostly children under the age of three. There were 35 patients in the intensive care unit who needed artificial lung ventilation, and another 60 patients were on dialysis, AP journalists approximate the reality there.
If the fuel runs out, “it means that the whole health system will be shut down…All these patients are at risk of death if the electricity supply is cut off,” said Mohamed Kandil, a doctor in the intensive care unit there, as children moaned in pain in the background.
The situation in the hospitals in Gaza (which was not good even before the escalation began) is getting significantly worse after the Palestinian civilians begin to feel the commitment of the Israeli Defense Minister Yo’av Galant. He announced a plan for a “total siege” of the Gaza Strip a week ago. “No electricity, no food, no water, no fuel,” the minister said plainly. On Thursday, Israel suggested it would resume supplies if Hamas released all the people abducted from the Jewish state.
The “collective punishment” imposed by Israel on Palestinian civilians in Gaza has nevertheless earned criticism from international and humanitarian organizations that are trying to deliver at least the most basic aid to isolated Gaza.
The head of the UN Office for the Coordination of Humanitarian Affairs, Martin Griffiths, said on Monday that the organization was in “deep negotiations” to get first aid to Gaza. This is happening nine days after the Israeli counterstrike, writes the British BBC.
Choose who survives
“If the area is completely cut off from water and fuel supplies, I can’t imagine the functioning of the healthcare system,” anesthesiologist Emilía Tomaníková from the humanitarian organization Médecins Sans Frontières describes to Nauzal.
She has experience from missions in, for example, Gaza, the Central African Republic, Haiti or Yemen, where she experienced extreme working conditions. But what could happen in Gaza in a matter of hours or days is, according to her, a catastrophe of unprecedented proportions.
🔊”Today, for the last two hours, we’ve been looking for drinking water. They’ve been shelling all day. We don’t know what will happen tomorrow or where we will go.”🔊
Soundbite from our colleague Dr. Mohammed Abu Mughaiseeb, MSF Deputy Medical Coordinator in Gaza ⤵️ pic.twitter.com/ENa7EWuFCG
— MSF International (@MSF) October 15, 2023
“You can’t say that nothing can be done from a certain point, but the quality of the chance of survival goes down sharply,” he continues.
Because without the basic provision of hospital operation – the functioning of machines, energy and water – patients will begin to die in large numbers, and exhausted doctors will have to decide who they will help to survive and who, on the contrary, will die. “We choose who survives based on the chance of survival based on a team decision. We don’t always have the same opinion. Discussions are difficult, but the patient always gets a chance if, for example, only one member of the team sees hope and can justify it medically,” says anesthesiologist Tomaníková from her own experience.
In some medical facilities in Gaza, the practice the doctor mentions is a reality. Even doctor Mohamed Kandil from Násir Hospital had to make this difficult decision. He told the Al Jazeera server that he already had to choose which patient would be helped to survive and which would not. He added that 60 patients go to them in one hour as a result of Israeli rocket fire – that is, one every minute. He describes the situation as catastrophic.
Nevertheless, other hospitals are also preparing for the disaster. For example, the largest hospital complex in Gaza al-Shif, according to its director, Dr. Muhammad Abu Salim, has supplies for the next four days at most, thanks to generators. He made this claim last Wednesday, as reported by the American newspaper The New York Times. Even then, the hospital took the first measures and limited energy consumption to only necessary services.
The already mentioned al-Wafa hospital also has energy reserves for a maximum of “a few days”, as confirmed by medical director Khaláf. But if supplies are not restored soon, the hospital will be nothing more than a “mass grave,” he added.
Health workers continue to prepare for the worst. Doctor Tomaníková states that if hospitals are faced with a large influx of patients that exceeds the capacity of the facilities, they often apply circulation rules. “In short, if we get a severe brain injury, in our region we would deal with it with a procedure with doctors with different expertise – anesthesiologists or neurosurgeons. But when we have limited resources, unfortunately patients do not have access to treatment and it cannot be solved,” he explains.
But he adds that at least something can always be “done”. “To clean a wound, to bandage, to soothe pain, or to give comfort.”
Even war has rules
In addition to the wounded, Palestinians fleeing from Israeli shelling often go to hospitals. They live in the belief that hospitals and medical centers are safe from him. But even that is not the rule, as international agencies and humanitarian organizations point out.
“One of the hospitals we support was hit by an airstrike and damaged. Another airstrike destroyed an ambulance with wounded right in front of the hospital where we work. The MSF team was operating on a patient and had to leave the hospital in a hurry,” MSF said in a statement on Tuesday.
Last week, the UN Office for Palestinian Refugees in the Middle East also reported on the destruction of medical facilities after Israeli rocket attacks.
Analysis: Factors that led to the failure of Israel’s defense
A surprising and brutal attack by the Palestinian movement Hamas on Israel left over a thousand dead, and Israelis are rightly beginning to ask who is responsible for the failure of the security apparatus.
Humanitarian organizations and international agencies therefore continue to appeal mainly to Israel and neighboring Egypt to adopt a quick solution that will ensure the supply of the necessary humanitarian aid and prevent hospitals and medical facilities from finding themselves in a situation where their patients will die needlessly.
According to the international community and humanitarian organizations, Israel’s decision to “besiege” the Gaza Strip is in violation of international agreements.
“I recognize Israel’s legitimate security concerns, but at the same time I remind it that military operations must be conducted in strict accordance with international humanitarian law,” UN Secretary-General Antonio Guterres said of the situation in Gaza.
“The collective punishment of the civilian population is a war crime, as is the use of starvation of civilians as a weapon of war. Imposing further restrictions on Gaza’s access to basic services is tantamount to a death sentence for many residents, cutting them off from water, food and medicine. By shedding the blood of civilians from Gaza, Israel will achieve neither the protection of Israeli civilians nor justice,” the Czech branch of Amnesty International said, for example, in response to Israeli Defense Minister Jo’av Galant’s reaction.
“The Geneva Conventions and international law speak very clearly in this regard. Civilians and humanitarian workers are never and nowhere the legitimate targets of an attack,” Tomáš Bendl, a humanitarian worker from the Médecins Sans Frontières organization, recently described to Nauzal.
Rely only on yourself
Before that happens, however, medical workers in Gaza will be dependent primarily on their own skills and experience. “Everyone deals with it differently. It is a big help when a person is not alone in this (decision and procedure in hospitals in aggravated situations), but there is a discussion with other members of the team. Paradoxically, the fate of severely injured patients with little chance of survival is easier from a decision-making point of view than when you have a patient with a survivable diagnosis and perhaps even the option of surviving without permanent consequences. You know all the things you could do for him at home, but you can’t here. In this case, the decision is very sad,” describes the anesthesiologist Tomaníková, what may be waiting for the medical workers in Gaza.
Since the beginning of the counterattack in Gaza, the Israeli army has defended itself by targeting all places associated with Hamas, including the homes of its members, the American newspaper The New York Times wrote. It claims that it is not in its interest to target civilians who are “not its enemies”. For that reason, Jerusalem also called on half of the population of the territory shortly before the weekend to move to the south of Gaza for safety.
However, the UN, WHO and humanitarian organizations warned that this could not be achieved in the 24-hour ultimatum that civilians received from the Israeli army with regard to a possible and planned ground operation. It must be added that Israel has not announced it yet.
Some medics in Gaza have refused to leave medical facilities in the north of the country, arguing that they do not want to leave their patients who cannot safely evacuate without care – among them the elderly or newborns.