Healthcare in Gaza is in a state of acute trauma

On October 7, my morning began like any other, at least on the surface. As a surgical resident who takes great pride in his job, I did my rounds with patients amid the usual hustle and bustle of the hospital, and then scrubbed in to operate on an emergency case alongside one of my mentors.

When I felt the metal coldness of the scalpel in my hand, however, perhaps for the first time in my career, I did not feel a thrill. I did not experience the profound joy that normally comes with the opportunity to improve a person’s life on the operating table.

My attending surgeon sensed something was amiss, and asked me what was wrong.

I shared with him the news I had received from my mother back home: the bombing had started. Gaza, my home, was under attack.

He listened, and tears started to form in his eyes. When I saw him, a non-Palestinian, share my pain, something cracked in me, and I broke down.  He hugged me and told me, “Your family will be OK. We are all with you.”

I really appreciated his solidarity, and the solidarity I have since received from many of my American colleagues. Today, I am the only Gaza-trained surgical resident in the United States, and it is not easy.

I am emotionally drained and engulfed in worry. Watching the assault on Gaza from a far, I feel helpless, broken.

I know it is an immense privilege to be working and training in the American system. However, since October 7, I feel as if my existence is divided between two completely different, disconnected worlds.

I spend my days worrying about and caring for my patients here in America. Will Mr Jones get shot again after being discharged? Did Ms Lopez’s insurance approve the surgery she needs?

But as I do my best to help them and their families, I simultaneously agonise about my family, my loved ones, and my struggling colleagues back home. How will my widowed, elderly mother be able to walk miles to safety, under intense bombardment, with her crippling arthritis – a condition that has largely been left untreated because Israel repeatedly refused to grant her an exit permit to seek treatment abroad?  Will she and my other relatives find food, shelter? When will I be able to hear their voices again?

My family in Gaza has been under intense Israeli bombardment since October 7. They’ve walked for miles from the now destroyed north Gaza to the south, moved from shelter to shelter at least six times, but could not find safety, because Israel’s air raids are sparing no place in Gaza, including areas designated “safe” by the Israeli military itself.  At one point, they sought refuge in the courtyard of al-Shifa Hospital, but eventually Israel attacked there, too – a war crime under international law. Our family home, the setting of my most cherished childhood memories, where we held my brother’s wedding and my father’s funeral, has also been destroyed.

My family is now homeless. They are afforded no dignity and are forced to live in a makeshift tent, as my grandparents once did, after they were expelled from their village during the Nakba.

In 1948, my grandparents were pushed out of their village, Hammama, where they lived a peaceful, prosperous life side by side with their Jewish neighbours. After they were kicked out of their homes, their identity and their political rights were erased and they were made into permanent refugees. After this catastrophe, after this grave crime, my family somehow managed to build a new life from scratch in Gaza. But every bombing campaign, every attack on our home reignites the trans-generational trauma we acquired during the Nakba. And now, my family is once again displaced, in a tent, unrooted and uncertain about the future.

In this latest assault on Gaza, I lost many members of my extended family, including three cousins, to Israeli bombardment. Two other cousins were abducted for no reason. My surviving family members are living horrors that defy the imagination. The situation is especially traumatic for the children. My nephew Adam is now afraid of the dark and has developed night terrors and incontinence.

I have not been able to video chat with my family for over three months due to telecommunication difficulties. My brother managed to send me a picture of himself and my family members over a month ago, after managing to connect to an Egyptian phone service via roaming. Looking at the picture, I was aghast at how much weight they all had lost, almost skin on bone. In just a few weeks my mother’s face had also wrinkled, almost beyond recognition.

Since October 7, more than 30,000 people – more than two-thirds of whom women and children – have been killed in Gaza. Some 70,000 others have been injured and at least 1.7 million people have been displaced.

Every day, I worry about my family, and I worry about my people. But as a surgeon, who knows well how healthcare is the main lifeline of any society, I also worry about Israel’s relentless, illegal attacks on Gaza’s healthcare system.

At the time of writing, only 12 out of Gaza’s 36 hospitals are partially functioning. My medical school, Islamic University of Gaza, has been destroyed, along side the only cancer treatment centre in the Strip. This means thousands of medical students will not be able to continue their studies in Gaza and cancer patients have lost their already limited access to cancer care for the foreseeable future.

The Israeli attacks on healthcare are not merely targeting infrastructure either. According to a recent report by The Healthcare Workers Watch – Palestine, more than 400 healthcare workers have been killed in Gaza since the beginning of the war.  These include the former dean of my medical school, Dr Omar Ferwana, and several mentees including Dr Israa Al-Ashqar, a very kind anaesthesiology resident, and Dr Ibtihal Al-Astal, an outstanding intern.

Furthermore, the Israeli military abducted at least 110 healthcare workers in Gaza. The families of these healthcare workers, who were abducted from their places of work, are unaware of their current whereabouts and do not even know whether they are dead or alive.

I wanted to become a surgeon ever since I can remember. Not only just a surgeon, but one of the most skilled surgeons in all of Palestine. From an early age, I understood the burden of preventable death carried by all Palestinians living under occupation, and I wanted to do everything I can to help my people. I never wanted to go abroad and stay there, I never dreamed of using my surgical training to break free from the open-air prison we’ve all been confined to. My surgical training has always been part of my social contract with my people – my goal has always been to learn as much as I can, then return home to use that knowledge to help my people.

Since beginning my training in the United States, I had the opportunity to return home twice, to teach basic surgical skills and Advanced Trauma Life Support to medical students in Gaza. Now, as I helplessly watch from afar the attacks healthcare workers endure, I receive updates from these former students. They tell me about the inhumane conditions in which they are working, including the lack of essential medications like anaesthetics needed for amputations on children. They tell me about their colleagues who have been injured, killed, or abducted by the Israeli military.

It is difficult to express how painful it is to listen to their testimonies, and watch their suffering and the suffering of the people they try to treat under despicable conditions, from a far.

Thankfully, here in the US, I am surrounded by patients, families, students, co-residents, nurses and residents who recognise the ever-deepening struggles and suffering of the Palestinians in Gaza. They not only support me but also speak up against these injustices that they do not affect them personally. They work tirelessly to ensure targeted attacks on healthcare workers like those we’ve seen in Gaza does not become the norm. Many of them have called for a permanent ceasefire to stop the attacks on Palestine’s healthcare workers and infrastructure.

Their moral clarity and fortitude give me strength and hope for the future.

And yet, sadly, are in the minority. The medical community at large has been utterly silent about, or even complicit in, the ongoing attacks on Palestinian healthcare. Several hospitals and academic institutes issued one-sided statements supporting the Israeli regime and censored their students and staff who spoke up against the genocide it is committing in Gaza and the West Bank.

This indifference breaks my heart, but does not break my resolve. As a Palestinian surgeon, my dream has always been to use my training and knowledge to build an independent and competent healthcare and eduction system in Palestine – one that would allow us to competently train our own physicians, respectfully treat our own patients, and help our nation prosper and reach its immense potential.

Despite the death and destruction we are now witnessing in Palestine, I have not given up on this dream. However, I know my dream cannot become reality without achieving justice and a long-lasting peace based on equity, dignity, and equal rights for all. For this, I call on the global medical community to join me in demanding a ceasefire and an end to the attacks on our colleagues, on hospitals and other medical facilities in Palestine. I know dreams can still become reality, but only we speak up in one voice against this assault on our profession.

The views expressed in this article are the author’s own and do not necessarily reflect Al Jazeera’s editorial stance.