Yasser Khan is an ophthalmologist at Trillium Health Centre and William Osler Health Centre, an associate clinical professor at McMaster University, and a lecturer at the University of Toronto.
As an ophthalmic plastic surgeon, I’ve volunteered my services during humanitarian crises for the past 20 years in more than 40 countries. But nothing prepared me for the humanitarian catastrophe that is Gaza during my 11-day visit there last month. The extent of traumatic injuries suffered by Palestinians in Gaza is of a magnitude and severity I’d never witnessed before.
In short, Gaza is hell on Earth.
In the immediate aftermath of Israeli strikes, mass casualties flooded the European Gaza Hospital (where I was working) with horrific injuries. Children as young as two years old arrived with crushed limbs requiring double amputations. A six-year-old girl had to have her shattered eye removed. Mothers screamed in the ER, clutching their cold, dead children whose bones protruded due to chronic starvation.
A 45-year-old woman with both eyes ruptured, both legs amputated, and both arms severely fractured briefly clung to life. Her husband, son and two daughters had already been killed by a missile attack. She later died.
A baby with massive head trauma lay on the ER floor for hours, forgotten amidst the chaos. Her mother, a UN worker, was undergoing an amputation. Her seven-year-old sister and aunt died from an Israeli strike on their home while they slept.
Doctors and nurses were overworked, unpaid, hungry and demoralized as they struggled to treat the wounded without basic medical supplies or medication. No one could cope with this level of casualties and trauma.
Gaza’s health care system has suffered a catastrophic collapse owing to a confluence of many factors: bombings and attacks on hospitals; health care workers who have been injured and killed; lack of medical aid, supplies and food; and the disruption of essential services.
Once a lifeline for its population, the health care system lies in ruins. The devastating attacks by the Israel Defence Forces have damaged 94 health care facilities, including 26 out of 36 hospitals, according to WHO information released in January. On Thursday, Israeli troops entered Gaza’s Nasser Medical Complex, putting more patients and medical workers at risk.
Health care workers have become targets themselves, a blatant violation of international humanitarian law, gutting their efforts to aid the civilian population. Heroic doctors, nurses and other medical staff risk injury and death while carrying out their duties. The psychological toll on the remaining health care work force is immeasurable and has contributed to the collapse of Gaza’s health care system.
Compounding the crisis is the wholesale destruction of sewage and sanitation facilities, along with water pipes. Sewage contamination has created a perfect breeding ground for water-borne diseases. In addition, rainwater is mixing with the remains of thousands of bodies that are decomposing beneath the rubble of bombed buildings, causing bacteria to leach into sewage and water systems.
The continuing siege of Gaza has choked the flow of basic essential medications, including antibiotics, painkillers and insulin. Chronic conditions such as diabetes and hypertension, among others, are left untreated, while patients with cancer are dying. Preventable diseases are on the rise, while vulnerable populations, including children and the elderly, are increasingly at risk.
Behind the statistics and news headlines lies the harrowing human suffering of the people of Gaza. As of Jan. 1, more than 1,000 children had one or more limbs amputated – many without anesthetics to numb the pain. What will happen to these children? Almost two million people in Gaza are now displaced, homeless and fearing further Israeli missile strikes. UNICEF says that at least 17,000 children are unaccompanied or separated from their families owing to disease or death.
The war on Gaza and the collapse of the health care system is a humanitarian tragedy of colossal proportions. The international community must stand together to demand a permanent ceasefire, provide emergency aid, medical supplies and personnel into the territory. Health care workers must be protected, and accountability for violations of international law is crucial to ensuring their safety.
Long-term solutions are vital to rebuilding and sustaining Gaza’s health care infrastructure and allowing its people to access appropriate medical treatment. This should include investments for rebuilding hospitals and clinics. Sustainable health care development will require collaboration between Palestinian civil authorities, international organizations, and Egypt and Israel.
Mental-health support should be a central component of rebuilding the health care system, given the deep psychological trauma inflicted on Gaza’s population. Finally, there must be comprehensive public-health initiatives to address sanitation, clean water access, and disease prevention. If we are genuinely committed to human rights and international law, we must act at once to address the health catastrophe in Gaza and provide Palestinians with the dignity and care they deserve.