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.
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.
“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.