An Australian doctor coordinating medical aid to Gaza has expressed horror at the “huge proportion of children being killed or maimed for life” as the UN Security Council postponed another vote on a ceasefire resolution .
Dr. Natalie Thurtle, who helped oversee MSF's response until last week, said it was “very confronting for colleagues trying to provide healthcare when it is possible to be shot through the hospital window.”
When the reported death toll in Gaza exceeded 20,000 and France called on Israel to “cease” large-scale military operations, Thurtle said it was “impossible to mount a meaningful response to this catastrophe due to the continued military activity.”
“Every day there are more and more patients being created by the situation, so the overwhelm is absolutely massive and people don't have a safe place to go,” she said in an interview with Guardian Australia.
The Australian government, along with more than 150 countries at the UN General Assembly, voted last week for a ceasefire between Israel and Hamas and for the immediate and unconditional release of all hostages.
While Israel is open to a “pause” in fighting, Prime Minister Benjamin Netanyahu said he was determined to destroy Hamas militarily and as a political force in Gaza in response to the October 7 attacks.
“We are raining fire on Hamas, hellfire,” Netanyahu said on Wednesday.
Thurtle, an emergency physician usually based in Tasmania, was in East Jerusalem from early November until last week to help coordinate Doctors Without Borders' medical operations in Gaza.
She was in daily contact with doctors in the besieged area as they planned their healthcare responses and described an “incredibly chaotic environment” that was “extremely difficult to manage.”
The few hospitals that were still operating were full of patients and internally displaced people, Thurtle said.
“And now it's increasingly incredibly unsafe, as evidenced the attack on the Nasser hospital a few days ago, the siege and now the encirclement of al-Awda hospital by Israeli forces,” she said.
Thurtle said between 150 and 200 patients arrive at Al-Aqsa Hospital in central Gaza every day, but “about a third of these patients are dead on arrival, which is very difficult because many of them are children.”
“Certainly when you talk to colleagues and see the images that they see, the number of children being killed or maimed in this conflict is very extreme,” she said.
“Unfortunately, there is a lot of misinformation about that, but that is certainly what we are seeing on the ground – that a large proportion of children are being killed or maimed for life in this conflict.”
Her colleague Chris Hook, leader of the Doctors Without Borders medical team in Gaza, said this week that doctors at Nasser Hospital were “stepping over the bodies of dead children to treat other children who will die anyway.”
Thurtle said MSF spoke out because they felt they had a responsibility to explain what its staff saw and experienced, as “there is a tremendous amount of commentary from people who are not directly witnessing what is happening on the ground ”.
“I think we have been accused of a loss of neutrality during this conflict, but it is important to note that reporting what is directly perceived as health workers does not constitute a loss of neutrality,” she said.
Israel has repeatedly said that Hamas operates inside and among hospitals.
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The Palestinian death toll in Gaza has passed 20,000, including about 8,000 children and 6,200 women, while more than 52,000 people have been injured, according to the territory's government media office.
The US and Israeli governments have previously pointed to the fact that Gaza was ruled by Hamas as a reason to treat the figures with skepticism, but UN officials and human rights groups have said the figures were generally reliable.
A article in the medical journal Lancet said there was “no evidence of overpricing”.
Thurtle said MSF could not verify the total number of deaths and injuries in Gaza, “but especially considering the numbers arriving at the facilities where we work, these numbers are not outlandish at all.”
Israel has said it is targeting Hamas and doing “its utmost” to prevent civilian deaths, including by issuing evacuation warnings where possible.
Asked whether these statements matched the situation on the ground, Thurtle said healthcare infrastructure was “systematically targeted.”
Doctors Without Borders said two people were killed in Gaza City while traveling in “clearly identified MSF cars” on November 18, which “considers that all elements point to the Israeli army's responsibility for this attack.”
“We know that MSF has been targeted before, and nothing can excuse its consistent and ruthless targeting and decimation of Gaza's healthcare infrastructure,” Thurtle said.
Israeli Ambassador to Australia Amir Maimon has said he has assured the federal government that his country is trying to prevent civilian deaths, while arguing that Hamas was using the people of Gaza as a “human shield.”
Foreign Minister Penny Wong said Australia has “consistently affirmed Israel's right to defend itself” in response to the October 7 Hamas attacks, when 1,139 people were killed in southern Israel.
“We hereby said that Israel must respect international humanitarian law,” Wong said last week. “Citizens and civilian infrastructure, including hospitals, must be protected.”
The Prime Minister, Anthony Albanese, told the Lowy Institute that he was “a strong supporter of both Israel and the rights of Palestinians to justice.”
“I don't think anyone has the perfect template right now, but it is very clear that the distinction the world needs to make between Hamas and the Palestinian people is important,” Albanese said.
French President Emmanuel Macron said on Wednesday: “We cannot allow the idea to take root that an effective fight against terrorism means crippling Gaza or attacking the civilian population indiscriminately.”