For days, from dawn to dusk, Professor Ghassan Abu-Sittah, a senior British-Palestinian plastic surgeon, is undergoing surgery after surgery at Gaza’s Al-Shifa and Al-Awda hospitals. He is running on adrenaline and decades of medical experience.
But every now and then, something knocks him completely off balance – it does. Not the merciless blood and gore, although he has seen more catastrophic injuries since arriving in Gaza on Monday than during any of the many wars he has fought in the past.
Or the stories of entire families hiding as the Israeli army razes neighborhood after neighborhood.
Nor the icy fear among his colleagues that their loved ones are among the dead.
“No, it’s the little human things that break your heart,” he says. Like when a patient comes in, covered in blood and mud, and you clean them up to assess where the wounds are… but then you see something, the braids, the pink elastic of a hairband or a bracelet. And suddenly you think, a little girl. Someone’s daughter. With half her face blown off.’
But there is no time to stay. The next case is already pending. And he after that. And then ten more.
Professor Ghassan Abu-Sittah, a doctor with Medical Aid for Palestinians (MAP), at Al Awda Hospital, Gaza, in 2018
All four operating theaters at Al-Shifa hospital in northern Gaza are already booked solid for the next 24 hours with patients who suffered horrific burns, blast injuries and shrapnel, limbs crushed by falling masonry. The corridors of the hospital are filled with carts and bodies.
“This is a tsunami of wounded people – a place of utter destruction,” says Dr Abu-Sittah, 54, who is working with the charity Medical Aid for Palestinians. “To give an idea of how bad it is, the entire hospital bed capacity in Gaza is 2,500. Today we have 6,500 injured.’
He speaks to me on Thursday evening, between operations, over WhatsApp video, from Al-Awda Hospital – just hours before the Israeli army announced to more than a million Palestinians that ahead of an expected ground invasion, they must evacuate northern Gaza and go to the southern part of the besieged territory. An exodus that the UN has warned would be catastrophic.
It is hard to imagine where on earth all those people could go; Gaza is one of the most densely populated territories in the world and much of it has already been destroyed. Let alone how the medical staff could think about evacuating an entire hospital and all those seriously ill children.
At the moment, however, Dr Abu-Sittah has just completed a procedure on a 19-year-old girl with shrapnel around her eyes and neck.
The line is not good, and every now and then he pauses to let the sounds of a nearby explosion fade.
Palestinian children injured in Israeli attacks have been brought to Shifa hospital in Gaza City
Dr Abu-Sittah arrived in Gaza on Monday morning, after a mad dash from London through Egypt before the border was closed.
“When I saw the news on Saturday, it was a no-brainer. I know the health service in Gaza, I have trained plastic surgeons here. And I know what is available, the facilities and the capacity of the staff. I knew it would be just awful.’
It was worse than he could ever imagine.
His most difficult case was a beautiful six-year-old girl. “Her mother – an obstetrician at the hospital – and her sister were both killed and the little girl… had half her face missing from the blast.” Meanwhile, the radiologist father at the hospital is in Jordan. ‘Only God knows when he will return. She is all that is left. It is non-stop. You feel more difficult when you have children yourself.’
Dr Abu-Sittah has three sons. One is 12, one is doing GCSEs and the other has just started university. He feels guilty leaving his family behind, but he knows he has to be there. His father is Palestinian – a refugee in Gaza in 1948 before moving to Kuwait, where Ghassan was born, and later to Scotland, where Dr Abu-Sittah studied medicine at Glasgow University and married his Scottish husband.
Between teaching and practicing in the UK, he has experienced multiple instances of war in Gaza, as well as in Yemen, Mosul in Iraq and Beirut in Lebanon.
A rocket explodes in Gaza City during an Israeli airstrike on October 8
On Monday night, when he arrived in Gaza, he stayed with friends nearby. Or was going, until the sirens sounded and they ran for cover. When he returned the next morning, the entire street had been destroyed.
Since then, he has been sleeping on a couch in the hospital and, like the rest of the staff, gets about four hours of broken sleep a night. “It’s too dangerous for anyone to go home,” he says. “So staff sleep wherever they can find a place.”
On Thursday, the day we speak, he had just been moved to the smaller Al-Awda hospital in the north – the area that will now be evacuated.
“They only have one plastic surgeon for the whole region and so many injuries, so I thought I would be more useful here,” he says.
His day began at dawn when he was called to the emergency room after the nearby Al-Shati camp was hit and entire families were being brought in. One, in particular, follows him.
“There was a baby with a head injury, a four-year-old girl who wasn’t going to make it and an 11- or 12-year-old boy with 30 percent burns, including his face,” he says.
“You’re trying to do all this, and the grandfather who survived is yelling, ‘This isn’t war, this is an execution!’
It doesn’t help that there are people everywhere. Not only patients and staff, but whole families, with nowhere else to go, who have joined the hospitals. “There are thousands in the Al-Shifa hospital complex. The corridors are full and those who can’t find a corner are just in the parking lot – whole families, sleeping in cars.’
Naturally, the hospital staff are terrified for their loved ones. “Between cases, you see everyone rushing to their phones to find out where they are – if they’ve had to move again, if they’re all OK. Everyone knows someone. Everyone is afraid to get to know someone.’
It can’t be easy for his family either. Not least because the borders are closed now. So he can’t leave, even if he wants to.
“My wife has been 22 years old. The kids have grown up with it – so when they saw the news they knew there was no doubt I was coming.’
However, he does his best to keep in constant contact. ‘Emojis, texts, lots of little messages. It’s the least I can do,” he says.
Meanwhile, in hospitals, patients are supported and energy and supplies are extremely low.
“The other day we had a 14-year-old girl with 70 percent burns at Al-Shifa hospital,” he says. “You have to clean the burns with an antiseptic to prevent sepsis. But there wasn’t enough antiseptic, so we took a bar of soap and just used it.’ He takes a deep breath.
“I think the whole system has a few days and then it will collapse – unless they open a humanitarian corridor.”
Now, Al-Awda Hospital is stopping operations at 9:00 PM to save energy. Soon the lights will go out everywhere except the operating rooms
And still the bombing continues. “The numbers are surprising. The destructive capacity of the Israeli army is indisputable. This is an army built to take on the Soviet Union. It is the strongest army outside NATO”, he says.
Although Dr Abu-Sittah is seasoned in the blood and gore of war, horror cannot help but touch his soul. “When you’re working, you’re running on adrenaline, but when you finish in the evening, the human part hits hard – all the kids.”
Because he knows better than anyone what awaits the survivors. He is a world expert in the treatment of war injuries, especially in children.
“They’ve lost a lot, already—their homes, often their entire families. And when I see them, I know they have a whole reconstructive surgery ahead of them. Surgery after surgery. Because a child’s growing body means you always have to keep coming back as your body gets scarred. It never ends.’
With that, the girl’s father with bullet injuries interrupts Dr. Abu-Sittah to say a hearty ‘thank you’ and his vacation is over.
He has a few more surgeries before lights out tonight. And tomorrow is another early start with several children with limb reconstruction and a man with exposed arteries in his thigh who needs urgent treatment – unless something worse emerges overnight.
Before he goes, I ask, what will happen when the Israelis launch their ground offensive?
‘I do not know. I just don’t know, – he says quietly. “I can’t imagine it being any worse than it is, but of course it will be.”
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