In what one historian called "an understated plea for the world to not look away," a pediatrician who has provided care across the globe and in numerous war zones described in an interview with The New Yorker on Tuesday how over two weeks working in a hospital in Gaza recently, she saw firsthand how Israel's U.S.-backed assault on the blockaded enclave has created conditions unlike anything she has witnessed elsewhere.
Dr. Seema Jilani, a senior technical adviser at the International Rescue Committee, told journalist Isaac Chotiner about the life-and-death decisions doctors in Gaza are being forced to make on a daily basis, even as they try to keep their own families safe from Israel's relentless air and ground attacks.
Jilani arrived in central Gaza for a two-week assignment around Christmas Day and immediately began working alongside Palestinian doctors at Al-Aqsa Hospital in Deir al Balah, where she worked to save as many lives as she could as the facility faced a dwindling supply of medical equipment and medications including morphine—forcing them to rely on over-the-counter drugs like Motrin to provide pain relief to people with serious injuries and burns.
"Within the two weeks that I was there, I saw it go from a semi-functional hospital to a barely or nonfunctional hospital as a result of increasing violence in surrounding areas," Jilani told The New Yorker.
The U.S.-born pediatrician, who has treated civilians in Iraq and Afghanistan previously, described a one-year-old boy who was among the first patients she treated at Al-Aqsa:
His right arm and right leg had been blown off by a bomb, and flesh was still hanging off the foot. He had a bloodstained diaper, which remained, but there was no leg below. I treated the baby while he lay on the ground. There were no stretchers available because all the beds had already been taken, considering that many people were also trying to use the hospital as a shelter or safe space for their families. Next to him there was a man who was on his last breaths. He had been actively dying for the last twenty-four hours, and flies were already on him. All the while, a woman was brought in and was declared dead on arrival. This one-year-old had blood pouring into his chest cavity. He needed a chest tube so he wouldn't asphyxiate on his own blood. But there were neither chest tubes nor blood-pressure cuffs that were available in pediatric sizes. No morphine had been given in the chaos, and it wasn't even available. This patient in America would've immediately gone to the O.R., but instead the orthopedic surgeon bandaged the stumps up and said he couldn’t take him to the operating theater right now because there were more pressing emergencies. And I tried to imagine what was more pressing than a one-year-old with no hand and no legs who was choking on his own blood. So that, to me, was symbolic of the impossible choices inflicted on the doctors of Gaza, and how truly cataclysmic that situation is.
Doctors and nurses in Gaza are trying to provide care in a state of "chaos," Jilani told the magazine, with patients arriving at the few remaining functional hospitals "on makeshift stretchers, if you're lucky, or by an ambulance that was overflowing with people, [or] via donkeys."
Jilani's organization also posted a video of her speaking about her time in Gaza, where she saw one physician pitching in at the hospital after he had visited a friend who was there.
"That's the level of devastation but the level of commitment that the Palestinian healthcare forces is having right now," said Jilani.
Since Israel began its bombardment in October, Jilani and other humanitarian volunteers have gone to Gaza to help "fill in some gaps" left by doctors who have been displaced and forced to leave their homes to protect their families. As Jilani's assignment drew to a close, the situation at Al-Aqsa grew more perilous.
"Each day became more and more tense, with more and more people piling into surrounding areas looking for safe shelter," Jilani told The New Yorker. "I remember I was counseling new mothers on breastfeeding, and I looked out of the ward, and there were plumes of smoke rising in the air and bombs narrowing in on the hospital, and it felt very surreal. One day, a bullet went through the ICU. The next day, the road to the hospital had been deemed unsafe for us to use. And then the Israeli military dropped leaflets, designating areas surrounding the hospital as a red zone. Given the history of recent attacks on medical staff and facilities in Gaza, our team was unable to return, and people began evacuating the area in panic."
Soon after Jilani left Gaza, Al Jazeerareported that hundreds of patients and medical staffers were missing from Al-Aqsa after being "forced to leave" due to Israeli strikes in the area.
Jilani told The New Yorker that prior to the mass evacuation from the hospital, "there was a period of time when I believe they ran out of fuel."
"I don't know if that has been refreshed or not, but all I know is I can't stop thinking of whether my patients got out, my babies in the neonatal I.C.U. incubators," said Jilani. "Who would take care of them? The kids with facial burns: How are they going to be able to see enough, and be well enough to leave? So I don't know, and I wish I did have more information on that."
The United Nations Children's Fund (UNICEF) reported Wednesday that as Israeli forces have killed at least 26,900 Palestinians since October 7, 19,000 children in Gaza have been left orphaned. In addition to facing the threat of relentless bombings and ground attacks, the enclave's population is also "starving to death," the World Health Organization's emergencies director said Wednesday, with all 2.2 million residents "at imminent risk of famine" due to Israel's blocking of humanitarian aid.
While traveling to Al-Aqsa from Rafah, on the border of Egypt and Gaza, Jilani told The New Yorker that she witnessed "a sea of human tragedy," with huge crowds of displaced people "walking barefoot" or crammed into donkey carts or vehicles, with "looks of total resignation and abject despair."
"I'm a pediatrician, so I didn't expect to be of great use in a war zone," Jilani said. "I'm disheartened and really disturbed to say that I had many, many pediatric patients who were war-wounded, burned orphans, traumatic amputations, and that is something different than what I witnessed in Iraq, or elsewhere."
Dónal Hassett, a historian at University College Cork in Ireland, called Jilani's account "harrowing."