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"It's a nightmare at Al-Aqsa," said Samuel Johann, MSF coordinator in Gaza. "How many more men, women, and children have to be killed before world leaders decide to put an end to this massacre?"
Palestinian officials said at least 210 people were killed and more than 400 injured as the Israel Defense Forces conducted an operation in the central Gaza Strip on Saturday to rescue four of over 240 hostages taken by Hamas militants last year.
Israeli forces rescued Noa Argamani, Almog Meir Jan, Andrey Kozlov, and Shlomi Ziv—all attendees or security guards at a music festival that Palestinian militants attacked on October 7—from two locations in Gaza's Nuseirat refugee camp, according to the IDF. There are 116 hostages still being held in the Hamas-governed enclave, and at least 41 are believed to be dead.
Abu Obaida, a spokesperson for Hamas' military wing, said Saturday that "the enemy succeeded in releasing some of its hostages by committing horrific massacres, but at the same time, killed some of them during the operation."
CNNreported that spokespeople for Israel's police and military said an Israeli policeman from a counterterrorism unit was killed and estimated casualties from the operation at "under 100." The outlet also noted the higher death toll cited by Gaza officials and spoke with witnesses—including Abu Abdallah, who said that "dogs were eating people's remains. We pulled out six martyrs, all torn-up children and women, we risked our lives to get them to the hospital."
As The Associated Pressdetailed:
The bodies of 109 Palestinians including 23 children and 11 women were taken to Al-Aqsa Martyrs Hospital, where spokesperson Khalil Degran told The Associated Press more than 100 wounded also arrived. He said that overall, 210 dead had been taken there and to Al-Awda Hospital, saying he had spoken to the director there. Al-Awda's numbers couldn't immediately be confirmed.
AP reporters saw dozens of bodies brought from the Nuseirat and Deir al-Balah areas, as smoke rose in the distance and armored vehicles rolled by.
A baby was among the dead. Small children wailed, covered in blood. Bodies were placed on the ground outside, their feet bare, as more wounded were rushed in.
"It's a nightmare at Al-Aqsa," said Samuel Johann, Doctors Without Borders/Médecins Sans Frontières (MSF) coordinator in Gaza, in a statement. "There have been back-to-back mass casualties as densely populated areas are bombed. It's way beyond what anyone could deal with in a functional hospital, let alone with the scarce resources we have here."
In addition to killing more than 36,800 Palestinians and wounding over 83,600—according to Gaza officials—the IDF's eight-month retaliation for the October 7 attack has devastated civilian infrastructure across the besieged coastal enclave, including hospitals.
"How many more men, women, and children have to be killed before world leaders decide to put an end to this massacre?" Johann asked amid cease-fire and hostage negotiations mediated by Egypt, Qatar, and the United States—which has provided weapons and diplomatic support for Israeli Prime Minister Benjamin Netanyahu's war, despite nationwide protests, including on Saturday.
Karin Huster, an MSF medical referent, shared an audio recording about her experience at Al-Aqsa's emergency department Saturday afternoon: "Total chaos inside; the entire emergency room... was completely packed with patients on the floor coming from the bombings in Nuseirat. There were hundreds of patients, and we did whatever we could to stabilize them... And, thank God we were able to refer a bunch of patients to Nasser Hospital as well as IMC Field Hospital that is not far away from here."
"Despite the fact that the place was completely overwhelmed, it did an amazing job," Huster continued. "There is nothing, nothing at all that justifies what I saw today. Nothing. These children—the 3-month-old, the 7-year-old, the 12-year-old that died—the 25-year-old man, the 78-year-old woman, who all have horrendous injuries. Why did they deserve this? And why is the world looking on in silence? ...To what level of horror do we need to go before we finally do something, before we finally tell Israel that this is not acceptable?"
Chris Hook, MSF medical referent at Nasser Hospital, shared an audio update from there, saying that "we've received, coming close now to about 50 badly injured patients. There's people with multiple major open fractures of their limbs. We've got several unconscious children who are trying to be escorted through CT scan and on to intensive care."
"A few very bad burns have come through, and already four or five people who've required chest tube insertion, and things like this, for major injuries to the chest," he said, explaining that the hospital has a limited ability to perform CT scans, a shortage of pain killers, and a full intensive care unit. "More patients are arriving. It's a serious mass casualty incident that is occurring right now."
Council on American–Islamic Relations national executive director Nihad Awad said in a statement Saturday that "we strongly condemn the Israeli government's horrific massacre at Nuseirat refugee camp, where Israeli forces, some hidden in a humanitarian aid truck, reportedly slaughtered at least 200 Palestinian civilians while freeing four Israeli hostages who could have and should have been safely released months ago as part of a cease-fire agreement that Benjamin Netanyahu keeps torpedoing so that he can continue the genocide and stay in office."
"The Biden administration must be transparent about any U.S. involvement in this massacre and whether any Americans were in the units that carried it out," Awad added. "The administration also must stop funding these daily incidents of mass slaughter and instead use American leverage to stop the genocide, free all hostages and political prisoners, and end the illegal occupation of Palestine that lies at the root of the violence."
"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," said Dr. Seema Jilani.
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."