Medics learn to improvise for Gaza's endless hurt
In the heart of Gaza City, the wounded and their wailing families stream into Shifa Hospital without end.
Shifa, Gaza's largest hospital, has only an 11-bed emergency room and six operating theatres. Yet amid power cuts and the screams of the bereaved, doctors at the 600-bed facility have become masters of improvisation, spurred on by the seemingly unending conflict engulfing the coastal strip.
"If we are in the middle of an operation [and] lights go out, what do the Palestinians do?" asks Mads Gilbert, a Norwegian doctor who has volunteered at Shifa on and off for 17 years. "They pick up their phones, and they use the light from the screen to illuminate the operation field."
The wounded from Israeli strikes usually arrive in waves. More than 3,000 Palestinians have been wounded in the past two weeks, health officials say. Many, including the most serious cases, end up at Shifa.
A new wave of casualties arrives after daybreak yesterday, following a night of heavy Israeli tank fire on Gaza City's Shejaiya neighbourhood. Hospital guards shout at drivers to make room for the next vehicles, pushing back journalists and onlookers.
Some of the wounded are treated in a hallway near the emergency room. A medic bandages the foot of an emergency worker writhing in pain on a mattress on the floor. A little boy with shrapnel wounds arrives and the emergency worker slides off the mattress to make room for him.
Nearby, a woman cries hysterically. A man holds up a dead child, wailing. Another carries a teenage girl whose right arm is bloodied and broken.
Patients on gurneys line up outside the X-ray room. Relatives of the wounded, one in a blood-soaked white undershirt, argue over who will be examined first.
Dr Jihad Juwaidi says his six operating rooms fill up quickly and that even the seriously wounded have to wait for surgery, including a little girl with a fractured skull.
Choosing who gets treated first is gut-wrenching, says Dr Allam Nayef, who works in one of Shifa's intensive care units.
"Sometimes you have to select which one of them has the best chance to survive," Nayef says. "Easily in this rush, you can take a bad decision, that the one (patient) you thought will wait for you ... you won't find him when you finish your surgery."
The power goes off repeatedly as ageing generators buckle under daily rolling blackouts Gaza residents have lived with for years. Many items are in short supply, from gauze to adrenaline. They also lack spare parts, with bedside trolleys clattering down hallways on rusted wheels.
The war, which Israel says is meant to halt Hamas rocket fire, broke out during the Muslim holy month of Ramadan. Many in the hospital observe the dawn-to-dusk fast, despite the workload.
The crisis has brought colleagues closer, silencing any bickering, says Nayef, who hasn't been paid in months. "If we work just for salaries, none of us would be here now," he said. "We are here to serve because these patients, they are our families, our friends, our neighbours."