At Gaza Hospital, Chaos and Desperation
Israel's Strategy Of Dividing the Strip Hinders Relief Efforts

By Sudarsan Raghavan and Reyham Abdel Kareem
Washington Post Foreign Service
Tuesday, January 6, 2009

JERUSALEM, Jan. 5 -- Mohammed Alwan applied pressure to the wounds of the young man in a corridor of Gaza City's Shifa Hospital on Monday. Blood flowing from his body turned the surgeon's gloved hands crimson.

"Khalas," a voice said, Arabic for "It's over."

The doctor refused to give up. He pumped the man's chest, hoping to resuscitate him. A few minutes later, the man died.

"What can I say?" he said in a fatigued voice. "I have seen this scene many times. I've been here four days straight and I've yet to go home."

As Israeli tanks and infantry push deeper into Gaza, an already dire humanitarian situation has worsened. The Israeli government has imposed what Palestinians call a siege on the coastal strip -- restricting deliveries of food, medicine and other staples -- since Hamas took Gaza by force from the rival Fatah party in June 2007. On Monday, Israel's military strategy of dividing the strip in two further hampered Gazans ability to reach hospitals and relief efforts.

The air assaults and ground clashes have paralyzed much of what makes the strip of 1.5 million people work -- hospitals, water and power systems, markets and roads.

About 550 Palestinians have been killed and more than 2,500 have been reported wounded in the 10-day offensive; Palestinian health officials estimate that many of them -- between 24 and 30 percent -- are women and children. Most are at Shifa, Gaza's largest hospital.

Doctors there are working day and night on floors soaked with blood to help the rapidly mounting numbers of wounded. In the halls and corridors, screams and uncontrolled sobbing, along with the sounds of bombs and mortars, punctuate conversations.

"The numbers of killed and wounded are rising. Every minute we have a bombardment," said Hassan Khalaf, the director of Shifa Hospital. "The number of cases is overwhelming us. No hospital in the world can handle this."

It's become too dangerous for his staff to retrieve victims. Eleven members of his medical staff have been killed since the offensive began. "They were in ambulances," Khalaf said.

For the past three days, there has been no electricity. The hospital's emergency generators have been working around the clock. Even before then, when electricity was sporadic, the generators were working 16-hour-days. The hospital, he said, has only two days of fuel left.

"Electricity and communications are down over much of the strip both on account of lack of fuel and damage to critical infrastructure," said Maxwell Gaylard, the United Nations' humanitarian coordinator for the Palestinian territories. "Over a million people are currently without power, and over a quarter million without running water, some for up to six days."

Khalaf said there are also shortages of medicines, medical tools, nitrogen for anesthesia, monitors -- nearly every item imaginable. Many essential staff members, especially nurses, have been unable to come to work, cut off by the fighting, Israeli tank positions and fear.

"Those in the middle of Gaza Strip could not come to work because the Israeli tanks have cut the strip into two pieces," Khalaf said.

Fawzi Nabulsia, the head of the hospital's intensive care unit, said he hasn't worked since the ground invasion began Saturday. He lives south of Gaza City near the former Israeli settlement of Nitzarim. Israeli forces are now in the area, blocking the road between his house and Gaza City, Nabulsia said.

"Maybe you can speak with the Israelis and ask them to allow me to go to hospital," he said over the telephone, his voice tinged with desperation. "We are in crisis."

Khalaf said hospital staffers who live north of the city, where some of the heaviest fighting and attacks have unfolded, are too fearful to leave their homes. "Moving along Gaza's streets is dangerous," he said.

Inside Shifa Hospital on Monday, its doctors struggled to cope. Imad Majdalawi had handled 20 operations in 24 hours. In virtually every case, he had to fix broken bones, treat burns and cuts, and stop bleeding. "The worse thing I saw was the burns," he said.

In one case, he wanted to send a patient who lost one of his eyes in an Israeli bombing to an eye hospital. But his request was turned down: the generator for the surgical theater in the hospital was needed to fuel the emergency room.

On Monday, he was treating Ghadeer, a 14-year-old girl whose hands were covered in gauze. Blood seeped through it. She was crying and shaking. Her mother and four brothers had been killed an airstrike. She didn't know this.

"I am cold. I can't move," Ghadeer moaned.

Majdalawi soothed her. "Don't worry Ghadeer. Everything will be fine."

But there was no anesthesia or even the appropriate scissors and thread to help Ghadeer. "We are leaving patients in pain," Majdalawi said.

A neurosurgeon, Rami al-Sousi, was engaged in a delicate operation to pull shrapnel from 5-year-old Salim al-Ar's head. The boy would survive. Sousi has two small children but he hasn't seen much of them in the past three days. Ninety percent of the patients he treated were civilians, he said.

"Yes, I'm tired. But I forget everything when I save lives," Sousi said.

Abdel Kareem reported from Gaza City.

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