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Four cancer patients in the Gaza Strip have died within hours of being taken to other medical centres after the closure of the enclave's only specialist cancer hospital.
As Israel's siege and war continue, the medical infrastructure of the Palestinian enclave is on the brink of collapse.
At least 16 of the strip's 35 hospitals have gone out of service because of shelling or lack of fuel, the Health Ministry in Gaza said, while other facilities warned supplies were dwindling.
Turkish-Palestinian Friendship Hospital director Dr Subhi Skeik told The National on Friday that it “ran out of fuel on Wednesday and anywhere between 50 to 70 patients were taken to other, already overloaded facilities, like Al Shifa, Al Aqsa and Dar Al Salam hospitals”.
“It was a choice between keeping them in the facility without electricity, waste management or machines for chemotherapy, or risking their lives by transporting them and getting them potentially killed in an air strike.
“If we get fuel, we will become operational again,” said Dr Skeik, now stationed with his staff at Dar Al Salam Hospital.
The closure of all borders has also eliminated patients' chances of receiving cancer treatment in the occupied West Bank, Israel or Jordan.
“This was already a long and drawn-out process with many rejections,” said Dr Skeik. “Now, patients no longer have the option of travelling abroad for treatment under the Ministry of Health’s sponsorship, as we used to do in the past.”
Other stories of survival and life-saving work have emerged during the war.
In one video posted by the Palestinian Red Crescent, a paramedic is emotional as he holds an infant he has just rescued.
Spokesman for the Palestinian Red Crescent in Gaza, Mohammad Abu Msabbah, said the war was taking its toll on paramedics.
“One of our crew members went to his home and discovered that his father was killed [in a strike],” he said. “Another evacuated his family thinking it would be safer, but they were killed anyway. Imagine not being able to go say goodbye.”
The Palestinian Red Crescent has lost four of its crew members and four volunteers since the war broke out on October 7.
Others, such as British-Palestinian surgeon Dr Ghassan Abu Sitta do not know when, or if, they will see their families again.
He says he has “made peace” with his difficult decision to leave the comfort of his UK home to help in Gaza.
“I have made my peace with the idea that things can go very wrong and I would not see my family again. But we all make our bed.”
If “you feel you can make a difference, you feel the need to be there”, said the 63-year-old father of three.
Dr Abu Sitta has been working mostly in northern Gaza's Al Shifa Hospital, which has been long under threat of Israeli bombardment.
In just under a month of war, more than 9,000 Palestinians have been killed, including 3,760 children, according to the Ministry of Health.
More than 21,500 Palestinians have been injured and are being treated using increasingly rudimentary methods and tools, as medical supplies run out.
“You’re continuously trying to balance what you can do with what you have,” said Dr Abu Sitta, who has been working relentlessly over the past few weeks.
“Everything needed for the treatment of the … wounded people is running out,” he said. “This started with the antiseptic solution. We're using bottles of washing-up liquid, which I get from the shop so that the [antiseptic] liquid we have is saved for blades, sutures and dressings.
“Numbers [of injured] keep increasing. Ambulances never stop.”
On October 19, Dr Abu Sitta, who has been documenting his experience in Gaza to a growing number of followers on social media, posted a photo of a bottle of rose-flavoured vinegar with the caption: “Vinegar from the corner shop to treat pseudomonas bacterial wound infections. It's come to that.”
Since the start of Israeli bombing, Gaza's hospitals have been turned into bloody shelters.
In the northern Al Shifa Hospital, new terminology has been given to the type of cases being handled.
“WCNSF = Wounded Child, No Surviving Family. It's a thing in Gaza,” Dr Abu Sitta wrote on October 15.
At least 44 medical staff members have been killed in the war so far. Al Shifa itself is under threat of closing, too, and the Ministry of Health has made an urgent plea for fuel donations to the hospital before its main generator runs out.
About 50,000 people have sought refuge in the compound of the hospital, Dr Abu Sitta said.
“It has turned into a shanty town with cardboard, tarpaulin, tents and people sleeping on mattresses on the floor,” he said.
“These internally displaced people are living in the stairwells and corridors of the hospital”.
He said there were about four times the number of wounded than there are beds in the hospital.
“The wounded are on mattresses on the floors, on trolleys, everywhere you can imagine,” he said.