As I walked into the emergency department at Gaza’s European Hospital for the first time in May of 2024, I was immediately overwhelmed by what can only be described as immense human suffering.
When I chose to go into a war zone as a nurse trained in disaster relief on a medical mission with an American nonprofit, I anticipated that I would be treating gruesome injuries in a very low-resource setting, under the constant threat of violence. What I did not anticipate was that I would witness the eradication of a society through a deliberate blockade of the essentials of daily living, including food, clean water, sanitary products, and medications.
Image courtesy of Abeerah Muhammad. Upon entering Gaza through the Rafah crossing, our UN convoy drove past miles of parked aid trucks, filled with lifesaving supplies that were denied entry by the Israeli regime. As an emergency and critical care nurse, I was able to treat some patients only because I brought eleven 50-pound suitcases of medical supplies and medications with me into Gaza from the United States. Even with the tools I brought with me, I struggled to keep my patients alive: the hospital did not have sufficient specialists or advanced diagnostic capabilities and was inundated with mass casualty incidents.
Toward the end of my two-and-a-half-week-long mission, I used up all my supplies. I witnessed so many patients die needless and painful deaths because the medications or supplies that could have saved their lives were sitting in trucks just miles away, deliberately held up on the Egyptian side of the Israeli-controlled border.
My colleague — orthopedic surgery resident Dr. Abdullah Ghali — entered Gaza a month before I did, rotating between the operating room and the emergency department. Besides the numerous shrapnel injuries and gunshot wounds he treated — many of them afflicting children — he was astounded to witness a different kind of casualty: chronic illnesses having gone untreated since the start of the genocide. This meant, for instance, that treatable conditions — such as diabetes — were disproportionately resulting in amputations, due to the lack of available basic medications and treatments. The numerous mass casualties — along with tens of thousands of Palestinians taking refuge in a 200-bed hospital — made the grim situation all the more chaotic.
Image of Dr. Ghali operating in Gaza. Courtesy of authors. On Oct. 15, 2024, the World Health Organization (WHO) announced that the Israeli military agency COGAT (Coordination of Government Activities in the Territories) had banned at least seven international medical NGOs from entering the Gaza Strip until further notice, without explanation for the denial of access. The WHO said that this blockade has impacted at least eight organizations and 50 specialists since August. This ban came days after evacuation orders and increased attacks on northern Gaza by the Israeli Occupation Forces (IOF). At the time of this announcement, physicians and nurses from the banned international medical NGOs were on the ground in Gaza, actively treating victims of Israeli airstrikes. This included the survivors of the attack on Al-Aqsa Martyrs Hospital, where patients were burned alive.
For years, these NGOs have been working in Gaza, providing life and limb-saving surgeries and other medical treatments through emergency medical teams (EMTs). In addition to placing highly-trained health care professionals, these NGOs provide medicines, prosthetics, and medical supplies, and facilitate medical evacuations. According to the WHO, without the support of these groups, there is expected to be at least a 29% reduction in health care services. The banned organizations have collectively cared for thousands of patients across Gaza.
Since the seizure of the Rafah border crossing on May 6, 2024, Israel has imposed additional restrictions on the entry of personnel and aid through the Kerem Shalom border crossing, including denying access to medical professionals of Palestinian descent. In stark contrast to the eleven suitcases of medical supplies I brought in through Rafah, medical personnel were allowed to bring along only one suitcase of personal items through Kerem Shalom. This ban on NGOs serves as a punitive escalation of restrictions, intended to harm the trapped Palestinian population even further.
Gaza’s hospitals have struggled with a shortage of supplies and staff for decades due to the Israeli land, sea, and air blockade that has been in place since 2007. Gaza’s health care infrastructure is fragile, with only 35 hospitals stretched beyond capacity and a total of 3,412 beds catering to a population exceeding two million people. Over the last year, international medical NGOs have provided crucial support to the health care sector in Gaza which has been targeted, despite being under the protection of international law. The UN Independent International Commission of Inquiry released a report earlier this month, bringing attention to the systematic targeting of health care facilities by the Israeli military during the past year in Gaza. The report detailed that the IOF have deliberately killed, detained, and tortured medical personnel, all while targeting ambulances and preventing medical evacuations.
In September, the Gaza Ministry of Health published a report in which it detailed that nearly 1,000 Palestinians working in the health sector have been killed, creating a severe shortage of medical personnel across various specialties. Almost all of the hospitals in Gaza have been subjected to some kind of attack by the IOF, while some — such as Al Shifa Hospital — have been completely put out of service.
While in Gaza in May, I had the opportunity to visit the then-abandoned Nasser Medical Complex and mass grave site, where my colleagues and I saw remnants of human bones, body bags, discarded zip ties, fragments of bulldozed ambulance cars, and a destroyed dialysis center, clearly bombed.
Image courtesy of Abeerah Muhammad.International NGOs play a crucial role in supporting the crumbling health care sector in Gaza and alleviating the suffering of a civilian population largely made up of children. Banning these organizations amid a massive man-made humanitarian crisis undermines the mission of the WHO and sentences thousands of Palestinians to death. Additionally, with the absence of international journalists and the continued targeting of Palestinian journalists and their families in Gaza, health care workers serve as independent observers of the numerous violations of international law committed by Israel. This ban comes shortly after 65 health care workers who recently returned from Gaza published an opinion piece in The New York Times regarding the targeting of children in Gaza via sniper shots to the head. Obstructing access to health care is not only another violation of international law: it also violates the terms of medical neutrality, in which medical services and personnel should not be interfered with during armed conflict.
We, as medical professionals, cannot stand by as Gaza’s health sector crumbles under the weight of military aggression and widespread political indifference. The Israeli regime’s strategy of blockades, carpet-bombing, and terror has created the greatest health care crisis and humanitarian catastrophe on Earth today. Without urgent intervention, the death toll will only continue to rise — it has already risen as we write these words. We urge every member of the medical community to take a stand against the flagrant violation of every principle our profession is founded upon.
