Gaza’s health care system was already in trouble. The war is turning it into a crisis | Opinion

The health care system in Gaza is collapsing.

I have been a critical care physician in the U.S. for 10 years. I have volunteered at multiple hospitals in Gaza during my medical missions with PAMA, the Palestinian American Medical Association, and have seen the health care system there firsthand. Before I explain the current severity of this disaster, it is important to understand that the health system in Gaza was already on the brink of collapse before this crisis started.

The suffocating siege imposed by Israel for the last 17 years, which has been classified by the United Nations and several human rights organizations as illegal, along with repeated Israeli military assaults, has left the health system in Gaza with extreme shortages in sub-specialized physicians, sophisticated equipment, and even basic sterility measures and medical supplies. For example, during the COVID-19 pandemic, hospitals faced an extreme shortage in crucial medical supplies such as ventilators,and sub-specialized physicians. Only five critical care physicians tended to a population of 2 million people. Imagine now a tenfold increase in patients in need of emergency care, resources and a safe place to be cared for.

Gaza cannot handle this, and for every second this continues without intervention, the more children and mothers are robbed of their lives, the more families are destroyed, and the more irreversible the damage becomes.

Civilians have always been the true victims of war, and the current escalation is no exception. I remember what our intensive care teams in the U.S. went through during COVID-19. We felt helpless while watching our patients deteriorate, and heartbroken when they sometimes died. Burnout was rising, and some ICU team members quit their jobs, while those who stuck around were forced to appraise human life, deciding who would get access to necessary limited resources. These struggles are amplified tenfold in Gaza, where there are fewer physicians, less resources, and the constant threat of military assault.

According to the Palestinian Ministry of Health, the Israeli military has killed many thousands of Palestinians, including many children, and injured tens of thousands more. These attacks spared nobody, with many of them directly crippling the health system. There have been hundreds of Israeli attacks have affected health care workers and institutions in Gaza, killing health care workers and putting hospitals and ambulances out of service. Patients are either sharing beds or lying with their bleeding wounds in the hospital hallways, awaiting even just a minute of care. Hospitals are operating at 150% of their capacity while deprived of essential operational needs like fuel, electricity, and water. Operating rooms ran out of surgical supplies and anesthesia, and the siege has depleted hospital warehouses.

There have been reports of surgeons performing surgeries on patients without anesthesia, using cellphone lights, operating in hallways, and providing care without adequate sterile measures. Once the hospital morgues overflowed, hospitals were forced to resort to ice cream trucks.

And this is all without mentioning non-urgent care patients. This attack on the health system will put the lives of all patients with chronic illnesses at grave risk. There are thousands of cancer and hemodialysis patients and tens of thousands of pregnant women — some due now, and some expecting to give birth next month.

There is no safe place in Gaza, and with ongoing air strikes and restricted movement, many of these patients will be unable to get to their badly needed chemotherapy or hemodialysis sessions or get to labor and delivery departments in a timely manner.

It does not take clairvoyance to understand that this disaster is going to be tremendously crippling to Gaza as a whole. Israel ordered more than 1 million Palestinians in the northern half of Gaza to leave their homes to the south, forcing displaced people to live with other families and in schools, mosques, churches and public spaces. These places are not prepared to host such vast numbers, and as sanitary conditions worsen, there have been reports of waterborne infectious diseases, including cholera.

Denying medical and humanitarian relief to Palestinians in Gaza, attacking health care workers and institutions, and depriving health care providers of necessities after 17 years of blockade and 56 years of Israeli military occupation is abhorrent and a recipe for disaster. The U.S. and the international community are endowed with the ability to stop this — to call for an immediate cease-fire, to stop the mass killing of civilians in Gaza — and yet they sit idle. It is deplorable and morally unjust to abandon Gaza, and it is the obligation of the international community to intervene and allow health care workers to do what they do best: Save lives.

Majdi Hamarshi is an intensive care unit physician in the Kansas City area and chairman of the board of directors of PAMA, the Palestinian American Medical Association. He co-authored this with Omar Hamarshi, president of PAMA Youth.