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“There is no way to save your child. He's going to die,” American surgeon, Feroze Sidhwa, told the mother of his two-year-old patient in Gaza who sustained fatal internal injuries after an explosion. “Please hold his hand. Please tell him you love him. Please pray with him”.
Pleading to save her child, Dr Sidhwa said he felt “cruel” every time he had to share similar news with a mother in Gaza.
A trauma and critical care surgeon at San Joaquin General Hospital in California, Dr Sidhwa visited Gaza in March to offer medical help. In a span of two weeks, he was seeing more than 200 patients in need of major surgery a day, he said.
Dr Sidhwa sent two open letters to the US government demanding a ceasefire and an arms embargo. The first was in July while the latest was in October- signed by 99 American medical professionals who also served in Gaza, and addressed to President Joe Biden. He sent the letter again three weeks ago to the incoming Trump administration, after failing to get a response from Washington.
“I'm not Jewish, I'm not Muslim, I'm not Christian, I'm not Arab. I'm not Israeli. I'm not Palestinian. So my actual concern with the conflict is the involvement of the United States,” Dr Sidhwa told The National.
US surgeon
The US is by far the largest supplier of weapons to Israel. Between 2019–23 it accounted for 69 per cent of Israel’s arms imports, according to a report by the Stockholm International Peace Research Institute (SIPRI).
The extent of damage that Israel is causing in Gaza would not be possible without the support of the US, he says. “It's not an Israeli attack on Gaza. It's a US-Israeli attack on Gaza.”
Since the start of the gruelling war in October last year, more than 45,300 people have been killed and more than 107,000 injured in Gaza by Israeli attacks, according to the latest figures by the Ministry of Health in the enclave. Most of those killed have been women and children.
“What's interesting to me is the involvement of my own government in committing crimes against people that have never done anything to me or to any other American, there's just no justification for them helping the Israelis do what they're doing to the Palestinians,” he said.
From marching against the Iraq war in 2003, to opposing the Afghanistan war, and serving as a medic in the Russia-Ukraine war, Dr Sidhwa is no stranger to political and humanitarian work, but his focus now is to convince his government to push for a ceasefire deal in Gaza.
“I live in a free society, no matter what anybody says, and if my government is committing crimes, it means I'm committing crimes.”
Total disaster
On his first visit to Gaza on March 25, Dr Sidhwa brought 850 pounds of medical supplies with him, as did every doctor on that plane, which he says only lasted for a week. Continuing Israeli siege on aid entering the enclave including medical supplies, has left Palestinians in dire need of supplies and medication.
“The European Hospital was probably the best resourced city block in the entire strip, and it was still an absolutely total disaster,” he said. Between 10,000 to 15,000 people were sheltering on the grounds of the hospital.
Although he was expecting to operate on an influx of patients with trauma injuries, that was not the case, he said. “Everybody who's bleeding to death in Gaza dies before they get to the hospital, and they don't arrive alive.
“I should have realised it before I went there, but I didn't until a few days in.”
With only four operating rooms at the European Hospital at the time and a non-stop flow of mass casualties into the hospital, the team of trauma surgeons were stretched thin. To help his patients as fast as possible with the little resources available, Dr Sidhwa started operating on patients in the general hospital ward in non-sterile conditions. He helped reduce their pain by giving them ketamine as an anaesthetic.
“[Surgery in the ward] is not safe, but there was just no other way to get it done, otherwise people were just dying of sepsis,” he said. “A woman's kids are watching while this is happening.”
Despite attempts to mitigate the lack of supplies, surgeons were limited in performing even the simplest operations. “I can bring scalpels, or I can bring sutures, or I can bring antibiotics, but I can't bring a whole operating room with me,” he said.
He recalls the case of Jury, 9, who sustained large wounds on her legs and backside. She was severely malnourished, making her look younger than her age. All she needed was good wound care and proper nutrition. Jury was one of the lucky ones who ended up fleeing to Egypt, where her mother was able to find her food and get her the treatment she needed.
“What about the other 50,000 kids just like her? They're all dead. They all died in a tent somewhere away from the cameras, away from the hospital, and they were just buried outside,” he said.
Hunger in Gaza
A UN report published this week suggests that it is highly likely that the food consumption and acute malnutrition thresholds for Famine (IPC Phase 5) have now been surpassed in North Gaza. In the absence of a change to Israeli policy on the entry of food and nutrition supplies to this area, The Famine Early Warning Systems Network FEWS NET expects non-trauma mortality levels will pass the Famine threshold between January and March 2025, with at least 2-15 people dying per day, it said.
“This is by far the worst food crisis the world has ever seen,” Dr Sidhwa said.
He believes that severe hunger and malnutrition are one of the reasons that the death toll in Gaza is probably higher than reported. “Eighty-six per cent (of people) in Gaza right now are in phase three or above. So everybody in Gaza is starving.”
Nearly half of Gaza's population are children under the age of 18, making them “uniquely vulnerable to deaths from starvation and dehydration,” Dr Sidhwa said.
A paediatric nurse practitioner, Asma Taha, and a signatory of Dr Sidhwa's open letter told the surgeon she saw newborns die of starvation and dehydration every day.
Babies who were born “relatively healthy,” would return two weeks later on the brink of death after their malnourished mothers were unable to produce breast milk,” Dr Sidhwa said.
After serving in several resource-depleted regions such as Ukraine, Haiti, Zimbabwe, the Dominican Republic, Burkina Faso, and the occupied West Bank, he reiterated his shock at the conditions in the enclave, saying he has never seen such a scarcity in food. “I have never once in my life thought for two seconds that with American dollars I wouldn't be able to find food. But there is no food in Gaza.”
A malnourished body that sustained injuries is much harder to treat than a healthy one. If the patient has no healthy food to consume, they develop infections, and with the lack of medical supplies, they could die, he explained.
At least 50,000 children have been affected by acute malnutrition in Gaza, according to the UN. The UN agency for children Unicef had previously warned that malnourished children were “dying before their families’ eyes”.
With no medical supplies, Dr Sidhwa recalled in horror having to make difficult decisions not to treat certain patients, such as a case where a patient came in with 80 per cent of his body burnt.
This injury would require skin grafts, but the material required is not available in Gaza. “You can sew things back together all you want, but if the body has no ability to heal because it lacks protein and calories, it has no ability to heal.”
While the patient was alive and breathing, he was in unimaginable pain. If he were to be medicated, he would need all the morphine in the hospital, taking away resources from others. “These are extremely brutal decisions … doctors are used to triaging, but not like this.”
