Gaza’s collapsing health system is one of the goals of Israel’s genocide

Rotting wounds, starvation, babies born in tents without anesthesia, the spread of infectious disease, and the severe lack of medicine are all part of the new normal for over two million people living in Gaza. 

Last week, the Gaza-based Palestinian health ministry said that about 600,000 people in the northern Gaza Strip no longer have access to any kind of healthcare. It also warned that medicine fridges and the only oxygen plant in Gaza are at risk of shutting down due to the systematic lack of fuel. The World Health Organization has said that Israel is “systematically dismantling” the health system in Gaza. Save The Children has reported that Israel’s attacks on the health sector in Gaza have been higher than in any other conflict — at the rate of 73 attacks per day.

But one of the most major blows that Gaza’s health system suffered was in early April, following a two-week Israeli siege of al-Shifa Hospital, leaving the medical compound completely and permanently non-operational. The aftermath of the siege revealed that a massacre had occurred. Mondoweiss gathered testimonies from survivors of how it was carried out by Israeli soldiers, which included rounding up people in the hospital, separating them into groups identified by differently-colored bracelets, and executing one of the groups before burying them in mass graves.

Al-Shifa was the largest Palestinian medical complex in all of historic Palestine. Founded under the British Mandate in 1946, it grew over the years until it became the Gaza Strip’s primary medical hub, housing 25% of its medical staff. It was the beating heart of Gaza’s health system.

“Al-Shifa was the center of all medical services in the Strip. It was the ultimate destination for complex medical conditions,” Nebal Farsakh, a spokesperson for the Palestinian Red Crescent Society (PRCS), told Mondoweiss. “It was also the training center of a large number of medical students and practicing junior doctors.”

“During previous wars, al-Shifa was a hub for receiving complicated injuries and the overload from other hospitals, as it had the most complete equipment and a wide range of specialized doctors in most medical fields,” Farsakh added. “Yet, al-Shifa was repeatedly overwhelmed during the Israeli assaults of 2008 and 2014, which were much shorter and caused much less casualties than the current assault.” 

“My 19-year-old cousin, Anas Abu Rass, lost his leg after bomb shrapnel hit him while he was sleeping in his bedroom,” Huda Amer, a resident of Gaza City who continues to live there with her family, told Mondoweiss. “For this critical wound, in normal conditions, we would have taken him to al-Shifa. Now he is being treated in a small primary health care center where they don’t have the equipment, and they had to amputate his leg.”

“Most patients who have scheduled surgeries on the public health insurance list were treated at al-Shifa. Now, they are all waiting their turn in the remaining overcrowded hospitals and getting whatever help they can in small clinics, like my cousin,” she added.

The second largest hospital in the Strip after al-Shifa was the Nasser Hospital in Khan Younis. Israeli forces besieged the hospital for weeks at a time between February and April, targeting Palestinians inside with sniper fire. In mid-February, Israeli forces raided the hospital and forced medical staff and patients alike to leave its premises, arresting hundreds.

The Israeli army withdrew from Khan Younis in early April. After the withdrawal, Palestinians found hundreds of bodies buried in mass graves in the hospital’s vicinity, a repeat of al-Shifa. Many of the bodies unearthed from the scene had medical catheters still attached to their bodies, indicating that they had been patients. Others were found with their hands bound by zip-ties with Hebrew labels on them. Mondoweiss gathered testimonies from people who visited the mass graves searching for missing relatives who had disappeared months earlier. Some were able to identify them and put the mystery of their disappearance to rest. Others were not quite so lucky and were left wondering about the fate of their loved ones.

A dying health sector

Inside what remains of Gaza’s hospitals, things are worse than one can imagine. Patients and the injured are strewn on the floor as doctors move between them in an attempt to provide treatment to whoever they can. Patients’ families carry plastic bags filled with intravenous medications and raise them high so that they continue to flow. The majority of stitching and suturing operations are performed without anesthesia. Most drugs for chronic diseases are not available in hospitals or private pharmacies. All kidney patients have suffered for months due to the cessation of their dialysis treatments. Many have died.

The stories coming out from Gaza City of doctors and nurses who had to operate on their family members without anesthesia are haunting. In a video posted on social media, Dr. Hani Bseiso recounts in pain how he made the difficult decision to amputate his niece’s leg with a kitchen knife.

“I had difficult choices: to let Ahed bleed to death or to use the capabilities available to me and treat her,” Dr. Bseiso says. “I decided to close my eyes and my heart, bite down on my pain, and do what could not be done.” He performed the operation on their home’s dining table. On hand was a kitchen knife, a dish sponge, water, and soap.

Other than al-Shifa, all other hospitals in northern Gaza have been destroyed, including Beit Hanoun Hospital and the Indonesian Hospital. All of them were stormed by the army, their equipment ransacked, their beds burned.

Muhammad Zaqout, General Director of Hospitals in the Gaza Strip, says that while 35 hospitals were operating inside the Gaza Strip before the war (13 of which were government hospitals), only 4 hospitals now remain open in the entire coastal enclave.

“The hospitals that are still operating are the al-Aqsa Martyrs Hospital in Deir al-Balah, with a capacity of up to 140 beds; the European Hospital in Khan Younis, with a capacity of up to 240 beds; and al-Najjar Hospital in Rafah, with a capacity of up to 65 beds,” Zaqout said. “There is one specialized hospital for maternity, which is the Emirates Maternity Hospital. The rest of the hospitals in the Gaza Strip all stopped working and were stormed, destroyed, or burned.” 

“There is also no hospital left for children in the Gaza Strip,” Zaqout adds. “All of which have gone out of service, such as al-Nasr Hospital in Gaza City.” 

“The few remaining hospitals in the Gaza Strip that are still operational have only faced increased pressure,” Zaqout said. “The European Hospital, now the largest hospital operating in the Strip, has increased its capacity for patients from 240 beds to nearly 800 beds due to the ongoing pressure on the health sector in the Gaza Strip. Thousands of displaced people inside the hospital transformed many departments into housing departments.”

The European Hospital has become a gathering hub for displaced people’s tents. The corridors, patient rooms, courtyards, and entrances are all crowded.

Organizations, institutions, and countries are trying to establish field hospitals in different areas of the Gaza Strip, in addition to hospitals and medical clinics such as the Jordanian field hospital in the city of Rafah. Still, Zaqout points out that these field hospitals cannot provide essential medical services that people rely on, explaining that they do not have a source of generating oxygen.

Despite the vast number of injured people as a result of the repeated bombing of all areas of the Gaza Strip, the health ministry in Gaza can coordinate the discharge of 20-30 injured people daily for treatment abroad in hospitals in Egypt, Qatar, Turkey, and other countries. But the number is minimal compared to the number of wounded people who are in urgent need of treatment outside the Gaza Strip.

“The situation is very catastrophic. Hospitals cannot accommodate the wounded, and the numbers transported for treatment abroad are small and not proportionate to the number of injuries,” Zaqout maintains. “The health sector is terrible and is getting worse due to repeated threats from the occupation to the remaining centers. If these hospitals stop working, they will turn into mass graves, as with what happened in Nasser and al-Shifa.” 

“The Israeli army destroys the hospitals and prevents them from being restarted,” he adds. “It prevents the re-entry of the medical equipment it destroyed and prevents everything we need to restart hospitals. The occupation is deliberately destroying the entire health sector inside the Gaza Strip.”