A woman in the forefront and Palestinians running on the Al-Aqsa Hospital grounds in Gaza

Dire conditions in Gaza's few functioning hospitals, UK doctor says

Healthcare professionals are struggling to treat a staggering number of patients in Gaza. The World's Carolyn Beeler speaks with Nick Maynard, a surgeon who recently returned to the UK after leading an emergency medical team in Al-Aqsa hospital in central Gaza.

The World

Two-thirds of Gaza's hospitals are closed. 

Those still open are barely functioning and incredibly crowded. 

Recently, Israel and Hamas have struck a deal to allow more humanitarian aid into the territory. As part of the agreement, medicines will reach the Israeli hostages abducted by Hamas. In return, Israel will allow more basic supplies into the Palestinian territory.

Doctor Nick Maynard is a surgeon from Oxford, England, who recently led an emergency medical team at the Al-Aqsa Hospital in central Gaza.
 
"Every square meter was covered with patients and their relatives, some of them on beds, many of them lying on the floor in the reception areas, on the stairs, all through the wards," Maynard told The World.
 
Al-Aqsa Hospital is small. Maynard said the standard patient capacity is between 150 to 160 hospital beds, and when he was at the hospital, "they had about 7- or 800 patients, [and] thousands of relatives and other people sheltering there."

The World's Carolyn Beeler spoke with Maynard to learn about his experience working at the Al-Aqsa Hospital and its dire need for more supplies and doctors.

Carolyn Beeler: What about the supplies that you did or didn't have? What was it like performing surgery when, I imagine, you were missing some critical items?
Dr. Nick Maynard: We always had enough anesthetic agents to put the patients to sleep, but we often had no pain relief to give them. So there [were] many days when we had no morphine or other strong painkillers. We had one day when we had no running water so we couldn't scrub up properly. We had to just use alcohol gel on our hands. On another day, we had no sterile drapes to cover the patients with. Had to make our own drapes out of gowns. So, very challenging.
Can you share the story of one of the patients that you cared for?
I mean, there were many tragic cases. The one that will really stick in my mind was a 6-year-old boy that I discovered lying on the floor of the emergency department. The process of triage had collapsed completely. No one had seen him, and he had terrible burns covering his body and a head injury. The most life-threatening thing I saw was he had an open chest wound where you could see air being sucked in and out, and that could be a rapidly fatal condition. So myself and one of my colleagues bundled him up and took him into the resuscitation area, which was already packed. There were no beds or trolleys, so we just laid him on the ground and spent about an hour and a half resuscitating him and putting in chest drains, giving him fluids, dressing his burns and he was certainly better at the end of that, but he obviously had life-threatening injuries. The tragic end to the story is that I don't know whether he survived ... It was such chaos in the hospital. Despite searching for him the next day, we were not able to find out whether he had survived. And to this day, I don't know whether he's alive or not.
Wow, that must be very hard, as a doctor, not to know what happened to your patient.
Yeah. Very tough.
What about the conditions that you were working in? Was this a frightening place to be operating?
I don't want to say we got used to it because that sort of, in a way, diminishes it. I don't really mean that. We were listening to explosions all the time when we were there. We didn't get any decent night's sleep for a whole two weeks because of the recurrent bombings and the machine gun fire that we heard all the time. But, you know, we managed to get on with the job. And indeed, when there was an attack on the hospital a couple of weeks ago, we were rapidly withdrawn.
So your mission was cut short because there was increasing Israeli military activity at the hospital where you were working?
Yes. Unfortunately. I think it was the 5th of January. I was operating all day on a severely injured young lady with blast injuries to her abdomen and chest. I came out to the operating theater at about 3 p.m. to hear that there had been a single missile attack on the intensive care unit. So, we left that day, and each evening, the process our team had to go through was to essentially get permission from the liaison part of the Israeli Defense Forces to go to the hospital. To get their agreement that it would be de-conflicted for us to travel there and work in the hospital. We were told that night that the area was no longer de-conflicted. That there would be military activity, and therefore, it would not be safe for us to go.
I understand that all the doctors from abroad at the Al-Aqsa Hospital had to leave. The head of the World Health Organization has called that hospital the most important one remaining in central Gaza. Who is remaining to treat patients there?
Virtually no one. It is clearly not able to function as a proper hospital anymore.
You probably saw some of the video released by the Israeli military showing hostages being brought into the main hospital in Gaza City back on Oct. 7. Did you ever see Palestinian militants inside the hospital where you were working?
No, I didn't, and I spent two weeks in the hospital, in every single part of the hospital, all day. We were based in the operating theater; we went to all the wards, all the different departments, and I never saw any evidence of any Hamas militants in the hospital.
So the Israeli military says that Hamas does operate in hospitals and has tunnels running under them. But you're saying you personally didn't see any evidence of that?
I personally saw no evidence whatsoever. I've worked in Gaza for many years. I worked in [Al-]Shifa Hospital, prior to this conflict, on many occasions, and I've never in all my years going to Gaza and operating in the hospitals, I have never seen any evidence of Hamas militants in the hospitals. The one caveat is that I, of course, have no idea what's going on in the tunnels underneath. But in the hospitals, I've never seen any evidence of that.
Al-Shifa Hospital is where pictures supplied by Israel suggest that there were entrances to Hamas tunnels in the hospital. But you didn't see any of that?
No, I didn't. I was last in Shifa Hospital in May of [last] year, carrying out a major surgery with my colleagues there. I know [Al-]Shifa hospital well. I've walked all around the hospital over the years. I don't know what's going on underneath it, but I certainly saw no evidence of any Hamas militants in the hospital. And I did go throughout all [the] different departments in the hospital.
Can I ask how you're holding up after going through such a challenging experience?
Thank you for asking that. The small group that [was] together, we've talked a lot. We've met up since we got back. We've shared [and] had shared experiences. We've talked about our experiences. I've got a hugely supportive family, but it's taking time to process a lot of it. I think we’re just sort of working our way through it. But the override, you know, we've had many, many mixed emotions since we left Gaza. A lot of distress, a lot of, you know, flashbacks to what we saw. We've all felt guilt, as well, for leaving, which might be irrational, but I think we've all felt the guilt and, most importantly, a desperation to get back out there as soon as we can.  And I'll be going back in early March, I hope.
So, you do plan to go back?
Most certainly. Most certainly. Yes.

This interview has been lightly edited and condensed for clarity.

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