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Majed Jaber is one of many doctors in Gaza who have found themselves unable to reach the place they feel they most need to be – a hospital.
After Israel ordered 100,000 Gazans in the east of Rafah to leave their homes, in preparation for a ground assault, Dr Jaber's priority was to see that his family was safe.
He packed his bags reluctantly and went to the home of a friend, where he is now staying with his parents and others who lived at his own home.
As the sound of shelling grew closer, two thoughts went through his head, he told The National.
One was “I'm so sad that my home is going to be destroyed or taken over by an occupying force”, he said.
The other was “I wish I could go to the European Hospital” near Khan Younis, north of Rafah.
Dr Jaber said there was no transport to take him there safely, or to Al Hilal Al Emarati Maternity Hospital, where he has been working as a volunteer in recent weeks.
According to a doctor at one of Rafah's hospitals, foreign medical staff were ordered to leave their posts on Sunday.
“At some point, we were working on several emergency cases of civilians who had been wounded by Israeli strikes. Someone came in and said: 'I know you want to be heroes, but safety comes first'. In the blink of an eye, the staff left,” the doctor said.
One of the two patients on the treatment table at the time died, the doctor added.
Doctors Without Borders (MSF) said that it was relieving its staff from their duties at the Emirati Hospital, the Gaza Strip's only functioning maternity hospital, on Wednesday and handing their responsibilities over to Gaza's Ministry of Health.
MSF will be providing maternity services at the Nasser Hospital in Khan Younis, it said.
Avril Benoit, executive director of MSF USA, said that an Israeli military escalation in Rafah, where about 1.5 million people now live because of displacement from other areas, would turn the area into a “graveyard”.
Ms Benoit said MSF staff and patients were terrified.
Civilians ordered to flee eastern Rafah as Israel begins invasion – in pictures
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An Israeli soldier directs a tank near Israel's border with southern Gaza. Getty Images -
An Israeli soldier stands on a tank in southern Israel. Getty Images -
People flee the eastern parts of Rafah ahead of a threatened Israeli incursion. Reuters -
Palestinians leave ahead of a threatened assault on Rafah. Reuters -
Palestinians search for casualties in the rubble of a house destroyed in an Israeli strike in Rafah. AFP -
Palestinians carry an injured man who was pulled from the rubble of a house destroyed in an Israeli strike in Rafah. AFP -
Mourners next to the bodies of Palestinians killed in an Israeli strike in southern Gaza. Reuters -
Mourners at Abu Yousef El-Najjar Hospital in Rafah. Reuters
At a press briefing on Wednesday, Medical Aid surgeon Nick Maynard said the wounds that he had been treating showed severe infections and complications “as a direct result of malnutrition”.
Dr Maynard said people were suffering from a breakdown of their abdominal walls, due to a lack of food and of adequate medical care.
“These are awful complications from abdominal surgery from inadequate nutrition,” he said.
People have also been dying of survivable injuries he said.
Israel has taken over all crossings into Gaza, effectively blocking out an already underwhelming amount of much-needed aid, including food supplies.
Oxfam had described the influx of aid even before the border closures as a “drop in an ocean of need”.
Co-founder of MedGlobal John Kahler, who has been to Rafah twice since the war began seven months ago, said a deficit of calories would take its toll on people after around six to eight months.
“We are at a tipping point,” he said. “Now, the immunological system breaks down and infections and malnutrition start.
“The first effect of hunger is pain. A five-year-old can tell you this. A five month-old can't.”
MSF also said that the Rafah offensive would “further decimate” a “barely functioning” healthcare system.
Hospitals are either out of reach because of the high risk of travelling to them, or are under threat from shelling.
In a video shared by Glia Equal Care, an organisation that provides 3D printed medical equipment, an American midwife told of the dire conditions pregnant women and mothers of newborns endure in Gaza.
“Pregnancy during genocide means no prenatal care and a lack of diagnosis for prenatal conditions,” she said, speaking outside the Emirati Hospital in the undated video.
The midwife, identified as Bridget, said babies were born with congenital anomalies, or unexplained birth defects.
“We're seeing mothers who are too small or skinny or thin to be full-term. We're seeing babies who are too small and too little to be full-term,” she said.
Many mothers who came to the hospital to deliver their babies were seeing a healthcare provider for the first time in their pregnancy, she said.
