'A humanitarian crisis by design': Volunteer surgeon describes catastrophic repercussions of Gaza war


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As a reconstructive plastic surgeon specialised in conflict medicine, British-Palestinian Doctor Ghassan Abu Sitta has seen every ugly face of war in the halls of the hospitals where he volunteered to treat the wounded since the first Intifada in Palestinian Territories and Gaza strip in 1987.

Though he had treated hundreds during the first and second Intifada in Palestinian territories and for four wars in less than a decade in Gaza strip, the intensity of the Israeli bombardment and daily casualties in the most recent offensive on the enclave made it different from previous conflicts, despite its relatively short term.

"You're watching man-made humanitarian catastrophe. This is not a natural disaster. This is not a volcano or an earthquake or a tsunami. This is an area that's been kept under siege and kept in humanitarian crisis by design," Dr Abu Sitta told The National in a side meeting room between non-stop surgeries in crowded Al Aoudeh hospital in Jabalia.

  • Israeli artillery in action as the escalation continues between the Israeli army and Hamas at the Gaza Border. EPA
    Israeli artillery in action as the escalation continues between the Israeli army and Hamas at the Gaza Border. EPA
  • Mourners attend the funeral of Palestinian Rashid Abu Ara, 16, who was killed during clashes with Israeli troops in village of Aqaba near Nablus, north of the West Bank. AFP
    Mourners attend the funeral of Palestinian Rashid Abu Ara, 16, who was killed during clashes with Israeli troops in village of Aqaba near Nablus, north of the West Bank. AFP
  • A heavily damaged house in a residential area in the city of Yehud, in central Israel. AFP
    A heavily damaged house in a residential area in the city of Yehud, in central Israel. AFP
  • Parents of Palestinian man Abdulsalam Al-Ghazali, who was killed amid a flare-up of Israeli-Palestinian violence, react during their son funeral in Gaza City. Reuters
    Parents of Palestinian man Abdulsalam Al-Ghazali, who was killed amid a flare-up of Israeli-Palestinian violence, react during their son funeral in Gaza City. Reuters
  • Residents look at a car that was hit in an Israeli air strike, on the main road in Gaza City. Three people who were in the vehicle died. AP
    Residents look at a car that was hit in an Israeli air strike, on the main road in Gaza City. Three people who were in the vehicle died. AP
  • Palestinians mourn the death of relatives outside a hospital in Beit Lahia following a series of Israeli air strikes on the Hamas-controlled Gaza Strip. AFP
    Palestinians mourn the death of relatives outside a hospital in Beit Lahia following a series of Israeli air strikes on the Hamas-controlled Gaza Strip. AFP
  • Israeli Arabs treat a sheep that was wounded by a rocket fired from the Gaza Strip, where nearby a father and his daughter were killed, in the village of Dahmash near the Israeli city of Lod. AP
    Israeli Arabs treat a sheep that was wounded by a rocket fired from the Gaza Strip, where nearby a father and his daughter were killed, in the village of Dahmash near the Israeli city of Lod. AP
  • An injured man receives treatment at the scene after a rocket launched from the Gaza strip struck in Giv'atayim, Israel. Getty
    An injured man receives treatment at the scene after a rocket launched from the Gaza strip struck in Giv'atayim, Israel. Getty
  • A man looks at the damage in the aftermath of overnight Israeli air strikes on Gaza. EPA
    A man looks at the damage in the aftermath of overnight Israeli air strikes on Gaza. EPA
  • A Jewish man at a burnt-out synagogue after overnight riots between Arab and Jewish residents in Lod, Israel. EPA
    A Jewish man at a burnt-out synagogue after overnight riots between Arab and Jewish residents in Lod, Israel. EPA
  • Relatives of Palestinian Rashid Abu Arra, 16, who was killed during clashes with Israeli troops in the village of Aqqaba near Nablus at the hospital morgue in Tubas in the occupied West Bank. AFP
    Relatives of Palestinian Rashid Abu Arra, 16, who was killed during clashes with Israeli troops in the village of Aqqaba near Nablus at the hospital morgue in Tubas in the occupied West Bank. AFP
  • Rubble from the Hanadi tower after an Israeli air strike on Gaza City. EPA
    Rubble from the Hanadi tower after an Israeli air strike on Gaza City. EPA
  • Israeli security forces pass burnt-out vehicles in Holon near Tel Aviv. AFP
    Israeli security forces pass burnt-out vehicles in Holon near Tel Aviv. AFP
  • A huge crater in Gaza City caused by the Israeli air strikes. AFP
    A huge crater in Gaza City caused by the Israeli air strikes. AFP
  • A broken mannequin near a tower building in Gaza City that was hit by Israeli air strikes during the flare-up of Israeli-Palestinian violence. Reuters
    A broken mannequin near a tower building in Gaza City that was hit by Israeli air strikes during the flare-up of Israeli-Palestinian violence. Reuters
  • Fires at sunrise in Khan Yunish after an Israeli air strike on targets in the southern Gaza strip. AFP
    Fires at sunrise in Khan Yunish after an Israeli air strike on targets in the southern Gaza strip. AFP
  • Palestinian rescuers move an elderly woman from a building in Gaza City after Israeli air strikes in the area. AP Photo
    Palestinian rescuers move an elderly woman from a building in Gaza City after Israeli air strikes in the area. AP Photo
  • Palestinians evacuate after their tower building was hit by Israeli air strikes, in Gaza City. Reuters
    Palestinians evacuate after their tower building was hit by Israeli air strikes, in Gaza City. Reuters
  • The remains of a rocket, destroyed by Israel's Iron Dome aerial defence system, which was fired by the Palestinian Islamist group Hamas from the Gaza strip. AFP
    The remains of a rocket, destroyed by Israel's Iron Dome aerial defence system, which was fired by the Palestinian Islamist group Hamas from the Gaza strip. AFP
  • An Iron Dome aerial defence system battery is seen in the foreground as fire rages at Ashkelon's refinery, which was hit by Hamas rockets the previous day, in the southern Israeli city. AFP
    An Iron Dome aerial defence system battery is seen in the foreground as fire rages at Ashkelon's refinery, which was hit by Hamas rockets the previous day, in the southern Israeli city. AFP
  • Palestinians stand next to the remains of a tower building which was destroyed in Israeli air strikes, in Gaza City. Reuters
    Palestinians stand next to the remains of a tower building which was destroyed in Israeli air strikes, in Gaza City. Reuters
  • A Palestinian man holds an injured girl awaiting medical care at al-Shifa hospital, after an Israeli air strike in Gaza city. AFP
    A Palestinian man holds an injured girl awaiting medical care at al-Shifa hospital, after an Israeli air strike in Gaza city. AFP
  • People take shelter in the basement of a building in the Israeli city of Tel Aviv as alarm sirens wailed after 3:00 a.m. after rockets were launched towards Israel from the Gaza Strip. AFP
    People take shelter in the basement of a building in the Israeli city of Tel Aviv as alarm sirens wailed after 3:00 a.m. after rockets were launched towards Israel from the Gaza Strip. AFP
  • Israeli border police vehicles drive past an extinguished burnt vehicle in Lod near Tel Aviv, after rockets were launched towards Israel from the Gaza Strip controlled by the Palestinian Hamas movement. AFP
    Israeli border police vehicles drive past an extinguished burnt vehicle in Lod near Tel Aviv, after rockets were launched towards Israel from the Gaza Strip controlled by the Palestinian Hamas movement. AFP
  • An Israeli police officer gestures to a Palestinian woman and her daughter, frightened by clashes outside of the Damascus Gate to the Old City of Jerusalem. AP Photo
    An Israeli police officer gestures to a Palestinian woman and her daughter, frightened by clashes outside of the Damascus Gate to the Old City of Jerusalem. AP Photo
  • Israeli firefighters walk by a car with a fallen tree on it after it was hit by a rocket fired from Gaza towards Holon, Israel. Reuters
    Israeli firefighters walk by a car with a fallen tree on it after it was hit by a rocket fired from Gaza towards Holon, Israel. Reuters
  • Palestinians inspect a destroyed Hanadi tower after Israeli airstrike in Gaza City. EPA
    Palestinians inspect a destroyed Hanadi tower after Israeli airstrike in Gaza City. EPA
  • Arab Israelis gesture and wave Palestinian flags during the funeral of Mousa Hassouna in the central Israeli city of Lod near Tel Aviv. Hassouna was killed during clashes with Israeli security following an anti-Israel demonstration over tensions in Jerusalem. AFP
    Arab Israelis gesture and wave Palestinian flags during the funeral of Mousa Hassouna in the central Israeli city of Lod near Tel Aviv. Hassouna was killed during clashes with Israeli security following an anti-Israel demonstration over tensions in Jerusalem. AFP
  • Rescuers rush to help among the rubble in front of Al Sharouk tower, that collapsed after being hit by an Israeli air strike, in Gaza city on Wednesday. AFP
    Rescuers rush to help among the rubble in front of Al Sharouk tower, that collapsed after being hit by an Israeli air strike, in Gaza city on Wednesday. AFP
  • Palestinians view the smouldering remains of Al Sharouk tower, which collapsed after being hit by an Israeli air strike. AFP
    Palestinians view the smouldering remains of Al Sharouk tower, which collapsed after being hit by an Israeli air strike. AFP
  • Smoke and flames rise from Al Sharouk tower, as it collapses after being hit by an Israeli air strike in Gaza City. AFP
    Smoke and flames rise from Al Sharouk tower, as it collapses after being hit by an Israeli air strike in Gaza City. AFP
  • Al Sharouk tower block collapses after being hit by an Israeli air strike. AFP
    Al Sharouk tower block collapses after being hit by an Israeli air strike. AFP
  • A man peers out to survey destroyed buildings in Gaza city, following Israeli air strikes. AFP
    A man peers out to survey destroyed buildings in Gaza city, following Israeli air strikes. AFP
  • A plume of black smoke rises into the air in Khan Yunis, in the southern Gaza Strip, following an Israeli air strike on the area, which is controlled by the militant Hamas movement. AFP
    A plume of black smoke rises into the air in Khan Yunis, in the southern Gaza Strip, following an Israeli air strike on the area, which is controlled by the militant Hamas movement. AFP
  • Parts of a broken mannequin lie scattered near a building that was hit by Israeli air strikes in Gaza city. Reuters
    Parts of a broken mannequin lie scattered near a building that was hit by Israeli air strikes in Gaza city. Reuters
  • A Palestinian woman mourns her son Rasheed Abu Arra, who was killed during confrontations with Israeli forces, at his funeral in the village of Aqaba, near the West Bank town of Tubas. AP Photo
    A Palestinian woman mourns her son Rasheed Abu Arra, who was killed during confrontations with Israeli forces, at his funeral in the village of Aqaba, near the West Bank town of Tubas. AP Photo
  • Women mourn at the funeral of Palestinian Rasheed Abu Arra, who was killed during confrontations with Israeli forces, in the town of Aqaba, near Tubas, in the West Bank. Reuters
    Women mourn at the funeral of Palestinian Rasheed Abu Arra, who was killed during confrontations with Israeli forces, in the town of Aqaba, near Tubas, in the West Bank. Reuters
  • Israel's Iron Dome air defence system intercepts a rocket launched from the Gaza Strip, above the southern Israeli city of Ashdod. AFP
    Israel's Iron Dome air defence system intercepts a rocket launched from the Gaza Strip, above the southern Israeli city of Ashdod. AFP

Dr Abu Sitta entered the battered Mediterranean coastal enclave as part of the international Medecins Sans Frontieres’ (MSF) medical dispatch through the Rafah border crossing a few days after the offensive started.

MSF is one of the world's leading independent organisations for medical humanitarian aid, providing medical treatment to people caught in the crisis.

He has been moving between Al Shifa and Al Aoudeh hospitals for the past week to treat the wounded and try to save their limbs or restore their movement as much as possible.

The nature of the injuries was more related to buildings collapsing on top of people, blast burns, shrapnel wounds and people's bones crushed under the walls of their houses

“Cyclical wars have kept Gaza strip and its people at a level of life that is beneath what is a proper life, it's closer to death than it is to life,” he said.

An Egypt-mediated ceasefire on May 21 ended an 11-day war between Gaza militants and Israel that killed 253 Palestinians, including 66 children, and wounded more than 1,900 people, the Gaza Health Ministry said.

Ten Israeli civilians including two children were killed and 119 were wounded by rocket fire from Gaza, medics say.

The Gaza conflict was preceded by weeks of violence in Jerusalem, in which hundreds of Palestinians and dozens of Israeli police officers were hurt. Protests initially focused on eviction orders against Palestinians in Sheikh Jarrah and a ban on gatherings at the Old City's Damascus Gate during Ramadan.

During the conflict, Gaza's housing ministry said 1,500 housing units were completely destroyed, another 1,500 housing units had been damaged beyond repair and 17,000 others suffered partial damage.

“The nature of the injuries was more related to buildings collapsing on top of people, blast burns, shrapnel wounds and people’s bones crushed under the walls of their houses,” he explained.

Since Hamas took control of Gaza in 2007, the enclave has been under a crippling air, sea and land blockade, imposed by Israel and Egypt, which has only made the situation more catastrophic.

“This is a health system that has been put under so much pressure, the equipment that's well beyond its use, and needs to be replaced. But the pressures of these continuous cyclical wars and Covid-19, let hospitals barely provide the basic services,” he said.

But despite his lifetime of experience treating conflict injuries and operating on children, knowing their long and agonising path to healing still shakes him up.

Children constituted 40 per cent of those injured in the recent Israeli offensive on Gaza.

“I've been doing this for quite a while and I know that this wounded child will require a lifetime of surgeries because their body is growing and therefore they need continuous reconstructive surgery until they reach the adult body,” he explained.

A diabetic young girl was one of these cases. She had lost half of her nose and one side of her face by a shrapnel.

“That's what the war does and that's what the siege does, it maintains people in this zone of diminished life,” Dr Abu Sitta said.