Reflections & Updates by Dr. Ahmad Yousaf, who is part of a three-physician team on a medical mission organized by Heroic Hearts.
Dr. Ahmad Yousaf is a double board-certified physician in Internal Medicine and Pediatrics. He
serves as a hospitalist and ICU medical director, where he leads teams in caring for the most
vulnerable patients and contributes to hospital committees focused on quality, policy, and community
health.
Beyond the hospital, Dr. Yousaf is passionate about global health and refugee medical missions. He
has previously provided care to displaced populations from Syria, Afghanistan, Myanmar, and
Venezuela. This marks his second medical mission to Gaza.
He is also a proud husband, father of three, and a dedicated Brazilian Jiu Jitsu brown belt.
Content Disclaimer
Some updates may contain graphic material, including images and videos of injuries, hospital scenes,
and dire humanitarian conditions. These are shared solely to raise awareness and to provide an
unfiltered view of the reality on the ground. Viewer discretion is advised.
Salam everyone.
I will be sharing content on this chat. There is still about a 40% chance I am not allowed entry into Gaza at this time based on the last 4-5 doctor groups that have gone in with various organizations. The primary issue in Gaza today is not bombing and gunfire, it’s famine. EVERY message I’ve received from the people there on the ground in the last 48 hours are asking for food for themselves or their children.
Just take a second and please pray I get in. At this point the docs are carrying food, which may be the most important thing we do for the few people we can affect. No point in growing this group more than this at this point, but if I get across, I’ll be on a different local number and I’ll share info from that number. I leave tomorrow, but crossing day is Tuesday inshAllah. Pray for Gaza.
Landed in Chicago with a connecting flight to Jordan in a few hours. I am still fearing the possibility they deny me entry, as they have 40% of the doctors who try to get in that make it to this stage of the process. For this reason, I do not know what to share other than my feelings:
Last night was one of the worst feelings I’ve ever felt in my life. On one hand, I received messages from my contacts in Gaza from my last trip— requesting food, power banks to charge their phones so they can still communicate, phones and charging wires. Simultaneously, I’m only allowed to take one bag with me, as the IDF restricts all mission workers to ONE suitcase for 2–4-week trips. I’m supposed to fill one suitcase and a book bag with enough of those things to help two million people who are actively starving. It won’t be enough for 10 people. It’ll never be enough. How much protein to feed dying children? How many vitamins to restore nutritional stability? One damned suitcase when most of us would take our houses to give if we could. Since the last time I was there a year ago, the restrictions have worsened and a vast majority of people who could see what’s happening have been restricted access. We have been given orders that we are only allowed to take $3,000 USD, 2 cell phones, a couple of power banks and laptop with personal items to last the 2.5 weeks mission in Gaza. All the aid agencies have requested we save space in our bag for medical supplies, but none of us have any space, It is a feeling of desperation and failure, of shame on behalf of all of us.
One medical student from Gaza I keep in touch with, Ruba, messaged me when I asked her what I could bring her: “Maybe a piece of chocolate - we don’t get food, there is no sugar anywhere and… and a power bank because my phone battery is dead.” Lina stated: “If you asked me six months ago, I may have had things to request, but now… I don’t even know what to ask for. The situation has gotten so bad.”
Mohsen: “Don’t worry about anything, I just want to see your face.” Alaa: “I hate to ask for anything because I’m just happy you are coming, but I have no friends coming here for me and my phone is almost completely dead, and the charging wires barely work.”
I know many of you wanted to contribute to this trip but given I am only allowed to take a bag of things, I couldn’t accept most of what was offered for fear I would not be able to get it to whom it was intended. Our hands are all tied, by design.
Many children of Gaza will die of starvation in the next few weeks. Hell, most of the medical staff is at extreme risk in the next few weeks and one of the heroes in my life (she’s on this very chat) told me as she cried as she exited Gaza two days ago:
“Our colleagues in Gaza are going to die from lack of food, and there is nothing we can do about it other than cry for them. Their homes have been destroyed; their voices have been snuffed out by the purposeful elimination of reliable communications. And now they sleep hungry, waiting for what feels like the inevitable end. It feels hopeless and a worldly happy ending feels impossible.”
The only feeling I have in this moment as I type this is dread… dread that we are going to watch these people die on social media and not be able to do a thing about it. Dread that I cannot get into Gaza to be with them, even if it’s just for two measly weeks, The people of Gaza deserve to know the world has changed since the start of this, and that there are people that love them and dream of them and cry for them and fight for them. They deserve so much more. I hope, through this chat, if I get in inshAllah, you’ll get a chance to hear their voices and feel their humanity in its greatness… to know their names and be inspired by them.
For the last year, going back is all I’ve been thinking about. Surely selfishly, because I know what I gained from being near the people of Gaza last year. I felt their presence, like EVERY doctor who has gone has felt, and it has changed what life, and this world means to us. I know, more than anyone, that trips like this one don’t change much. They don’t stop bombs from dropping or fill empty stomachs. They don’t remove the tears from mourning mothers or the pain from injured, burned children. We may have a minuscule impact on a few people we are fortunate to treat that give us more than we could ever give them EVERY time, and that’s it. Ultimately, someone needs to record what is happening and share it with the world so that no one can ever say: “It never happened.” The people of Gaza will one day speak for themselves, and I cannot wait to listen. Pray that day is close and that this hardship and stain on our humanity ends now. Next update will be when I land in Amman inshAllah and we get the next wave of denials from COGAT (the Israeli military arm that controls access to Gaza for humanitarian aid workers). Pray I get into Gaza, there is no place I’d rather be on earth.
Unfortunately, I just got word that the IDF has blocked the ingoing humanity need bus that I was scheduled to go on for July 22nd. That’s the only information I have received on this point, and I have no idea if they’re going to open another opportunity up or for training. Just waiting for word. No explanation, no reason provided. Nothing.
Will have to wait to see if they reschedule the entire envoy for another date or if they just prohibit everyone from going at all. If you are wondering what is happening, well here it is - they are blocking doctors from entering arbitrarily. No medicine, no food, no baby formula are allowed in… nothing. I’ll keep this chat open until it’s confirmed they are not going to reschedule. Will stay optimistic until then.
If I cannot get in in the next few days, I will leave everything donated and purchased by all of us, including meds and electronics with the organization to take in with the next group allowed in. I trust Heroic Hearts to do their best to take in everything they can if we are rejected.
It has begun to sink in a bit that the power dynamic is such that people willing to do anything to give people food and medicine are being blocked by people who would much rather them starve and die from not having these very available, simple things.
If you’re shocked, you are not alone, because to imagine that there are children on the other side of this border crying to their mothers for food, and the food sits here in the truckload and can’t get to them…it is just devastating. If you thought being an American somehow would open doors for us (four American docs with an org based out of Chicago), you are wrong. Our very own ambassador to this country rolls his eyes at protesters crying for the allowance of humanitarian aid and food.
I wish I had better words than sadness and anger, but that is the reality today. I’ll keep everyone updated tomorrow the moment I learn something, and I’m sorry on behalf of all of us.
To share a message sent to one of my medical mission friends who keeps in touch with her Gaza nurse friends: “I wish you were here so I could forget how hungry I am.”
A small moment of goodness on this sad evening: When a friend of a friend found out I was in Jordan and my trip got delayed, he demanded he take me out to dinner and he bought a friend that wanted to meet me. That friend, after eating dinner with us, insisted on paying and said the following:
“Listen, I feel so ashamed I cannot help them (the people of Gaza). I want to give more but there is no way to get anything in. I would buy them everything to give you, if I could, to feed the starving families. But I can’t, so let me do this… let me fill you with some calories so you can give more of what you have in your bag to them if they let you in.
I held his hand and cried with him for a few seconds. I never met this man before this day, but I love him. I was reminded that despite the immense amount of evil we are witnessing, that the rest of humanity still lives in all of us. There is a small sliver of hope that despite the envoy being cancelled and all the aid workers being denied that we could potentially get in Thursday with the next scheduled envoy.
I know so many of you, like me, would do anything to help. The images are devastating. The messages from Gaza are desperate, and our reality is unforgivable. At this very moment, here is what you can do to help:
Write to your senator or congressman and request that food and medical aid be allowed into Gaza. Demand that international neutral news agencies be allowed in. Demand that not another dollar goes towards bombing and then restricting food to babies in Gaza. Tell every person you know that an American group of doctors have been denied entry to help starving and dying kids on 7/22/25.
It might take you 30 seconds, and it might not make a difference today. But it will chip away at the collective conscious of those who have the ability to make this living disaster end.
You think you understand faith until you interact with the people of Gaza. Me and you may say the words, but they live it.
I had to break news to one of the medical students I taught last year that I could not get in today and I could not bring the few small things she asked of me yet. I swear this is her response. Mind you, she is a 23-year-old kid who hasn’t eaten food in days.
Just one example. There are two million made of the same stuff this girl is made of. There is nothing like them on this earth. Today, they have no idea where their next meal will come from or if they’ll be shot on the food distribution lines.
The WHO can only take two out of the four scheduled team. We don’t know what to do. We haven’t chosen two yet.
Pragmatically, the vascular surgeon needs to go. He has a skill set that’s in dire need. There is a second surgeon in Egypt (en route from the states) who is waiting for word, but he may want to wait for personal reasons. I honestly don’t know what to do. If we decide I’m an odd man out, I may need to wait until Tuesday to see what’s going to happen but have very little chance to go. Everything happens for a reason, and ego or selfishness cannot play a role in the decision to cross now…or wait…or possibly not go at all.
If there was ever a time to trust in the One who got us this far, this is it. However, I struggle in this moment to not lobby to go. I’ve decided to hold my tongue and just defer to the leader of the group. It’s not about us and sure as hell isn’t about me. It is about the people on the other side of the wall and what we can offer. May God open a way if it’s good for them and good for us and keep us far if it is not. Just as my friend Rubah said: “Say, nothing will ever happen to us except what Allah has written for us.”
Salam. Connected with the exiting doctors who just finished last mission. They warned us there is absolutely no food left anywhere.
They also made us aware that the Gaza Humanitarian Foundation (the organization created by the IDF to distribute food) is creating “food traps:” People desperate for food line up for food distribution at one of two sites (one in the north and one in the south) and are randomly shot at by IDF indiscriminately. They’ve seen a significant increase in trauma related to the food distribution sites. One doctor described it this way: “It seems they have a quota to kill a certain number of people every day, and instead of going into the population centers, they are baiting them out with food.
People know it’s risky, but it’s the only source of food. They have no choice but to risk being shot at. Age/gender indiscriminate, the number of victims were countless the last week. This is pure brutality and just evil.
My group leader has chosen the vascular surgeon and myself as the two doctors to enter tomorrow morning, pending a final round of approval. He will enter with the CT surgeon who is waiting in Egypt on Tuesday, God willing, with the next envoy. Once I get finalized approval about twelve hours from now, I’ll update this group.
Salam, I’ve been approved by COGAT (the IDF arm that controls entry) which is supposed to be the final approval required for entry inshAllah.
The vascular surgeon with me was also formally approved. We are praying that the leader of our team, an ER physician from Dallas, gets approved as well. Unfortunately, the CT surgeon was denied access completely and we have not been given a reason or explanation.
I’m cautiously optimistic that in 12-15 hours or so, I’ll be in Gaza. It’s hard to articulate the feeling, to know what is happening there… to feel scared, not for myself but for what I know I will see. Simultaneously, I am immensely grateful that we have the opportunity to be with them, to hear from them, and to simply be in their presence. There is no communication allowed during the travel process, the IDF escort through Israel, or at the entry point in Gaza. Likely, the next time I’ll communicate here is when I’m inside.
Alhamdulillah! Our group leader just got approved. I watched him fall in prayers of gratitude (literally fall in prostration) and in tears when we all found out together from the message. How do I explain to you that the people of Gaza inspire this in us? Dr. Farhan has been to Gaza five times already and he crumbles in front of me in happiness to go back to that place with those people.
I’m so sorry everyone. We just got a message from the WHO that they’ve cancelled the trip because of security reasons. We don’t know what this means. I don’t exactly have words. Just five hours before the bus arrival.
Salam. I just found out about thirty minutes ago that they’ve rescheduled the bus (in about 30 minutes). Fortunately, we have been packed for four days and have all made it to the bus station now.
From here, we take a Jordanian bus to the border, then go through customs, then a bus through occupied Palestine all the way to Rafah entry point into Gaza called Kareem Abu Salem.
There’s a mother checkpoint there to enter Gaza proper and then we get to our hospital. Next message you’ll receive from me inshAllah is from the hospital.
The last few days I’ve been dark here because I didn’t want to take everyone on the emotional roller coaster we were on. But it looks like it’s real now, inshAllah.
While I’m on this bus, I’ll share a couple of notes over the last few days. We were in limbo as a group without any meaningful comms whatsoever from the WHO. We knew there was a chance for entry Sunday, but there was an equal chance it was just going to be cancelled.
The last few days, I was reminded about the rest of the humanity in people in contrast to the absolute inhumanity and dehumanization coming out of Gaza.
When people found out I was in Jordan (literally some random people, friends of friends and their friends), my colleagues and I were flooded with messages hoping we could take supplies into Gaza, everything from vascular catheters, bone cement, medications and the recurrent request to take money. Simply anything. The hearts of people are aching, and the helplessness of knowing that there are children dying every day from food deprivation just a few miles away, has everyone scrambling to find a way to help. But they cannot… and our bags can only fit so much. Don’t get me wrong… our bags are full passed their capacity and the zippers are ready to fail, but what else do we have to offer??
One man, I literally don’t know his name… an OMFS surgeon from Jordan met me in the street in front of the hotel. His car was full of supplies thrown about in his back seat: “Please, even if it’s just one thing, take it. I hear there’s no sugar; I have some of that too.”
I took something from him and apologized I couldn’t take more because I didn’t have space. He grabbed me and hugged me. He hugged me like I was his long-lost family…like I was Gaza, in his arms. He sobbed on my shoulder and said: “You are the lucky one.”
And I know I am… all of us in this bus know that we are the lucky one. Gratitude doesn’t begin to explain what should come from us in this moment. My trip may be shorter than intended, but by the Grace of God, we go...
The next day may be a whirlwind of re-orientation and settling in so be patient with my comms. I’ll send a message when I’m safely at the hospital inshAllah.
I’m at the Israeli checkpoint. They noted some meds in one guy’s bags and are now checking EVERY bag as we speak. They are confiscating diabetes medicines, blood pressure medicines, power banks. Just throwing them in the garbage… God forgive us.
My bus, full of twenty-four aid workers… is deflated. Knowing we saw medications, surgical supplies and even food supplies get discarded… as we embark onwards to a land of two million people who have absolutely nothing. We all knew it was a risk they would do this, and we know, by repeated evidence (including my own prior experience) that they are not only limiting meds - they are taking it. They are not only limiting nutrition, including baby formula - they ARE TAKING IT AWAY AT THE BORDER.
This chat, inevitably, will become uncomfortable. The truth is so painful here and will likely be so profoundly untenable from a humanity perspective. You might try to avoid it. I’m begging you as someone you personally know, for the sake of real people (including babies) that are dying in this moment from an immediately reversible/man-made phenomena: do NOT close your eyes/ears to the suffering of Gaza. The majority of the world has for seventy-six years. Instead, share the information from my firsthand account. Find other firsthand accounts (from neutral sources like aid workers, physicians, nurses…). I plead with you to speak about what you learn over the next 2 weeks from this chat with at least two people (outside of your echo chamber).
Unfortunately, you won’t be able to get a journalist’s opinion because they are banned from entering Gaza by the IDF. I still have chocolate for Rubah. I still have a stethoscope for one of the medical students on the ground. I still have a power bank for nurse Alae. l have some charging wires and as many protein bars as could possibly fit in a bag that evil was not allowed to see somehow. The greatest evil in the world cannot overcome the signs of His mercy… and no one in the world is more in tune with this than the People of Gaza.
I have been sitting at the Kisufim border entry into Gaza for the last two hours or so on the bus. We are surrounded by IDF soldiers and Humvees. Nothing too crazy otherwise. It is surreal observing these soldiers from the windows silently. Many of them American (in mannerism at the very least). They make jokes, swat at flies, pace around the vehicle annoyed at the delay and likely their obligation to babysit our bus. A bus, I remind you, full of humanitarian aid workers primarily from the U.S. and Europe… already screened multiple times remotely, and in-person and searched (multiple times, bag by bag) to enter to provide whatever means of aid to the most desperate of situations you can imagine. In front of us is the wall… the infamous wall that separates Gaza. The concentration camp— from the rest of the world. The wall is mostly high barbed wire fence where we are, with the occasional tower.
We pass through the gate, down a long dirt road to a large parking lot where we are supposed to go from Israeli bus to UN vehicles to finally enter Gaza. We are in what I suspect is an additional buffer area… humvees literally encircling us. It’s absurd, there is nothing around except dirt and sky, and them and us. It feels performative to say to the least… M16s and armored vehicles in a demilitarized parking lot that acts as an access point to starving people. The coordinator of the bus supposes the delay could be because of all the meds/food we tried to bring in and the associated concerns/time issues that arose as a result.
We can’t take pictures, so I won’t. Instructed by the coordinator: “Don’t interact with the soldiers.” That’ll be easy… none of us want to, I promise.
I remind you, this exhaustive process… is to allow eight doctors and about sixteen aid workers (Oxfam, MSF, UKMed, Medglobal, Heroic Hearts, etc.) to go in and do some work for the dying population of Gaza. We are ONLY allowed to enter when the 24-person bus that entered 2-4 weeks ago leaves— ensuring a static number of foreign eyes within Gaza.
To end this reflection on a slightly positive note and to give you a taste of the emotions within this bus as I type… beyond the post-acolyptic/Mad Max vibe of this entire entry process… when they previously stated they were going through our bags at the last checkpoint and confiscate everything that wasn’t strictly for personal use, they climbed into the bus initially asked:
“Just to make it easy, if you have anything in your bag you’re not supposed to (like medications, extra food, an additional cell phone, power banks etc.), please raise your hand.” To this point, I wasn’t really sure what the non-doctor staff did in these situations…
When asked to raise our hands if we had hoped to sneak in a medication or a few calories:
EVERY DAMN ONE OF US DID. How could we not with what we know. We looked at each other on the bus… all from various backgrounds, nationalities, ethnicities and languages… some with tears in their eyes (tears of pride that this was the obvious answer for any human being who knows what’s happening and tears of sadness that we were going to lose vital supplies that could save lives on the other side). The heaviness in the chest I felt with these absolute strangers who I just met a few hours ago… translates into the exact opposite force at play here all around us. This isn’t a Palestinian problem, or an Arab one or a Muslim one or a Christian one, or even a geopolitical one… it is a human one. As I type this last word, I see the UN vehicles pulling up for us to transfer. Pray for the wonderful people of Gaza.
I arrived safely at the hospital around sunset. It was a 14-hour process, but we made it. I hugged the first few people I recognized on site. Sorry for the poor video, the glass was bulletproof, and terrain was rough. This was en route— just a glimpse at the global destruction.
We had just arrived at the hospital after connecting with the workers of the NGO that we came to work with: Heroic Hearts. These people are absolutely amazing. I’ll share more about them later inshAllah.
We are staying, at least for the next few nights, in the middle area of Gaza called Deir Balah. It has been the “green zone” for most of the 2+ years of the invasion of Gaza.
As we entered the area in the hospital we will be housed in, we came across a woman and her 3-year-old child. He was adorable, but in a full arm cast. She realized we were doctors and had an opportunity to ask: “My son was injured in a blast and had abdominal surgery and was having some issues with the wound.” One of the surgeons with us peeked at the wound as he distracted him with a cell phone (universally effective tool!) and very quickly we learned this woman had lost her older son in the same bomb blast: “Istashad. Two weeks ago.”
He was a young man. The bomb dropped on his house. The words came out flatly, matter of fact… and without any big emotion. This is life here.
I am going to take this opportunity to explain this concept for those to whom it is foreign. The word “Shaheed” relates to someone who died in the cause of God (a martyr) but its deeper linguistic meaning comes from a word that means to witness. Now take a step back and try to appreciate what is being said. One who dies in a manner that is honorable (in the way of or in duty towards God, has become a witness). Gazans don’t say he “died,” no, he has become a witness (in this world and the next) and, in the Islamic faith, we are commanded: Don’t perceive that the shaheed are dead, nay, for they are alive with their Lord, sustained (and in bliss).
The woman walked away grateful for the doc who checked on the little boy now slightly pissed that someone touched his dressing… and then it hit us… the baby was not the woman’s child. It was her grandchild. The bomb that killed her son, also killed her daughter in law and three of her other grandchildren.
This little boy was the survivor. In just the few moments back in Gaza, between the sweetness of the reunions, we are starkly reminded about what defines this invasion: indiscriminate bombing, dead children, widespread destruction in the backdrop of a deconstructed healthcare infrastructure. And now, within the context of a famine … one in which wound healing is nearly impossible.
Our Vascular surgeon, Dr. Shadman got called emergent to the OR. We heard an explosion around 2AM and a few patients came in, specifically a 4 year old girl with a vascular injury. He rushed back into our room and opened his suitcase. “I need my Doppler, there was a kamakazee drone that blew up a house that this little girl was in. It completely severed her brachial artery and it was a difficult repair.” He found his Doppler and ran back out towards the OR.
I rounded in the ICU today and will share just a couple of the patient stories, each one more devastating than the last:
Abdullah, age 7, day 72 of hospitalization. His mother stays next to his bed like a silent guard, her tears dried a long time ago. Abdullah was playing in the street with a couple of other boys when a rocket dropped 20 feet from him. Shrapnel shredded through his cervical spinal cord leaving him quadriplegic. He also suffered a liver shrapnel injury, and b/l pneumothoraxes and burns. He has since surface empyema requiring decortication and is vent dependent. Over the last week or so he seems to finally understand a bit of what’s happening. His mother said to me that the only word he seems to say is: “Ya Rab”. (Oh, my Lord). He blinks at me when I stroke his face, the age of my own son, half his size and now forever a prisoner of his body.
Amal, 17 y/o Female with a blast injury. Her entire family was killed (16 other souls) in the same explosion. Her right hand self-amputated, her face (see picture) and massive intracranial hemorrhage. The nurses handle her like their daughter, gently. As she moves, disoriented to the darkness of a reality that has her as the sole survivor of her entire extended family.
Important to appreciate the surreal environment of Gaza. The vast majority of the time here, there is the buzzing of drones above our heads… loud… the sound similar to a lawnmower in your yard… the constant presence of surveillance and death overhead. The kids are so used to the sound they move as if it does not exist. They pause when the sound stops, and then we hear the sounds of explosions in the distance… and then the buzzing comes back and everyone starts to move again. The bombs drop in the distance every 20-30 minutes or so (not sure if it’s tank shells, F16s or other). People are exhausted.
Abdullah, Age 7. Quad.
Amal, Age 17. TBI
GHF Update
Multiple MCIs (Mass Casualty events) happened throughout today:
There was a rapid influx of gunshot wound patients this late afternoon… all teenage boys… shot in the legs. As we stabilized them, I asked: “Where were you when this happened?” “GHF, getting food.”
If you are not familiar with the GHF, today is the day I ask you to explore what it is, who runs it, what they are doing based on eyewitness testimony and the absurd propaganda they subsequently deploy.
People are starving and desperate and the GHF has two major distribution sites for food. The only two that are approved for ANYONE in ALL of Gaza. Families, desperate for food, often send their boys to wait in line all day to get a bag of flour. The doctors at our hospital note: EVERY day since the start of GHF as the only distribution center, the IDF soldiers shoot into the crowds - which results in significant mortalities (some days over 100 people) and multiple mass casualty events. I saw this with my own eyes today. Six teenage boys ranging from 13-18 years old shot in the legs.
Every one of the patients stated they were waiting in line in the sun (100+ degree F weather) until quadcopters came flying overhead and then they lowered and began firing at all their legs. Many ran, some were trampled, and some were hit by quadcopter fire. The injured that survived ended up on the floor of the ER writhing in pain in an environment with no morphine, limited blood products and no sterility. Tibias and femurs shatter by gunfire and a few vascular injuries putting limbs at risk for amputation.
On top of it, the kids were gaunt… no muscle mass… cachectic. A good portion of them will be maimed forever. Their households will lose the young boys who they depend on to help carry things and future heads of households will now require assistance themselves to survive their injuries and likely a lifelong disability. The injuries were all similarly aimed… everyone in the room recognized the strategy.
This is likely just my first post about GHF but there was a glimmer of hope that international pressure has allowed a few trucks into Gaza in the last 24 hours. The fear is that it is temporal and just another tactic. I cannot tell you how many times in the last day I’ve heard some version of: we just want the war to be over so we can breathe again. The famine has been the final straw. The social fabric is breaking as parents hear their children moaning for food. People will risk everything for something to put in their bellies.
I had a chance to meet my brother Amro, an ICU nurse here at the hospital. He has the same smile… but he’s shrunk. Just last year, everyone would brag on him being super strong with a muscular build… and now, he’s lost all of that. I had bought an XL pair of scrubs for him because he had been wearing the same one for months. But he probably should be wearing a medium at the least. My heart melted when I saw him. He is one of the most sincerest guys I have ever met in my life… just stuck here. Before this invasion, he had plans to go to Belgium and he already learned to speak the language. When I tell you he lights up a room, I mean it in a way nobody I’ve ever met could compare. There is too much potential and light in Gaza for it ever to be snuffed out.
We went to the north per request of the WHO for extreme need. I landed at Shifa hospital in the part of Gaza known as Gaza city. Driving up that street (Rasheed St.) in the current context is like driving between heaven and hell. To the left, the beach and the serene ocean… waves lapping against the sand, the sun glistening off the water, absolutely majestic. To our right (east) is the absolute devastationscape… crumbled buildings, residual walls riddled with bullet holes, twisted metal half buried in the dirt… lives that once were. Entire apartment complexes leaning on one another like exhausted brothers… hollow, empty, and quiet. But if you pay attention carefully, you’ll see that the inhabitants of paradise reside on both sides of Rasheed. On one side the kids still splash at the water’s edge even though they’ve been told they cannot swim at risk of attack by the IDF warships. On the other side, within the rubble, between spaces made by rocket blasts, these same heavenly inhabitants have re-established homes upon/within the ruin… somehow. As you watch the videos, you may hear our guide explain what the buildings used to be… how some of those buildings were used as checkpoints by the IDF… and now what’s left… almost nothing.
Khaled, one of the sweet men I have met since being here for just a few hours, stood next to me as we toured the area. We bumped into the ICU doctor I’ll be working with for the next little while and they recognized each other: Khaled reminded the doctor that has met earlier this year when Khaled’s sister presented to the EGH (European hospital now destroyed) after a bomb had fell on her house and killed her three children. They hugged again… “she ‘istashad’” he said, then nodded at each other… semblances of warm grimaces on their faces, trying to smile in kindness. Smiles in Gaza are resistance. To speak of the dead in this manner is to honor them and to resist the enemies that try to wipe them out
They first took us to meet the director of the hospital. A tall, bald man who has a presence about him when he walks in the room. Everyone obviously respects him dearly. He sat at the head of the table and briefed us on what Shifa was and what it is now. One of the other admin members jumped in to explain the ongoing onslaught. He then paused for a moment… almost catching his breath. The director of his hospital had just learned in the last 2 days that his daughter, her husband and all of their children that were displaced were killed in an airstrike. He turned his laptop around and the background of his screen was a collage of all those who died. He named them all… his voice broke… but he adjusted himself, made a prayer for them and then got back to business.
One day, when this is over… the grounds of Shifa will be a memorial to the genocide. The mass grave in the courtyard… the destroyed NICU where premature babies were left to die under forced evacuation orders… where thousands of souls were lost and a large portion of the healthcare workers of Gaza were murdered. This place will also be the memorial that represents the rebirth of Gaza from under this tyranny. We saw workers rebuilding AT THE SAME TIME we could hear bombs dropping in the distance. You cannot defeat a people who think this way. May God have it so that the persistence and bravery that these people display discourages the One day, when this is over… the grounds of Shifa will be a memorial to the genocide. The mass grave in the courtyard… the destroyed NICU where premature babies were left to die under forced evacuation orders… where thousands of souls were lost and a large portion of the healthcare workers of Gaza were murdered. This place will also be the memorial that represents the rebirth of Gaza from under this tyranny. We saw workers rebuilding AT THE SAME TIME we could hear bombs dropping in the distance. You cannot defeat a people who think this way. May God have it so that the persistence and bravery that these people display discourages the IDF from continuing their onslaught with the knowledge that their plot will never be fulfilled.
If I could bottle the helplessness and chaos of the Shifa ER this evening, it would poison all of humanity. Hundreds of people stuffed into a space made for much less. There were patients unconscious on the floor with multiple organ system injuries (brain trauma, penetrating chest wounds, vascular injuries of the limbs). At least an influx of 50-60 patients in an hour per the ER director that looked unphased: “This happens every time a supply truck enters. The IDF sit from their tanks and fire the people.” The injuries include large blast injuries consistent with this version of events but the struggle is… Shifa (and all of Gaza for that matter) has no way of taking care of people this sick. There is no more healthcare infrastructure left… there are only two operating rooms… and in this ER at 10PM, I see at least 14-15 emergent life threatening needs for surgical intervention. A vast majority of these people are going to die of VERY treatable issues… and we know it… and there is nothing we can do. Frantic family members begged us to re-evaluate their declining family member (one with an open skull fracture who is certainly going to die this evening in a hospital without a neurosurgeon available). We bandaged some wounds, stabilized some bleeding, consoled some families and watched others die in front of us.
Dr. Ahed is an ICU doctor I had the chance to sit with for a bit of time right before writing this post. He is an absolutely brilliant human being… eloquent, artistic in his choice of words and poignant. Every word he said to me this evening stuck to my heart in the most painful way. We spoke about our children and he mentioned he had three himself. He went on to explain that his one-year-old was severely malnourished (paraphrased): “These kids have never had a childhood… haram… my one year old spends most of his time picking up food from the floor to eat. My other kid’s whole life is planning around getting food or water for the day. Their clothes are falling apart… and I’m at the hospital 60% of the time with patients I cannot help. We have lost hope. The situation is impossible when you cannot think about anything other than feeding your kids.” Dr. Ahed is skin and bones himself… he speaks thoughtfully, and I could tell he picks his words carefully— he doesn’t want anyone to feel bad for him. He just wants the siege to stop and wants the chance to take care of his family. It’s that simple - stop the attacks and let people take care of themselves without blocking the aid.
((Patient in Aqsa hospital)- Taqwa (pictured below): 28 y/o F in the first trimester of her pregnancy, presents with an explosive injury. She suffered a large intracranial hemorrhage and required a craniotomy. She has since been extubated and is clinically stable but has not recovered cognitively. She opens her eyes and moves spontaneously, but not purposefully and does not follow commands. She also has a component of hemiparesis. Her baby in her womb also suffered the same blast and pregnancy outcomes in these contexts are bleak. Not even the unborn are safe here.
Mahmoud, 10 y/o (pictured below): he was an IVF baby. His parents’ only successful pregnancy after years of trying everything. Now s/p traumatic brain injury, he appears to be in a traumatic vegetative state. His parents never leave him. He is/was their pride and joy.
Looking for the light in the darkness. Nurses Ibtisam and Tahreer: “You can remember us by our names… mine means smile (she then shows her big beautiful smile and all the nurses laugh) and hers means FREEDOM… we all need freedom.” These ladies represent the remaining backbone of the broken healthcare infrastructure… their spirit, despite displacement and tragedy, is what keeps everything moving. I’ll share their individual stories further in the coming days.
Muhammad Balata, 12-year-old, orphaned last week after his father died from cancer (untreated for 2 years in the context of the siege). He was at the food station and was crushed between two distribution carts that resulted in c1/c2 cervical fracture, mandibular fracture and respiratory failure. He received an emergent airway and inevitably a tracheostomy. Over the last few days, he has developed a persistent cough with any feeding. At his bedside today, the team performed trach exchange and had him swallow a small amount of distilled water with betadine (as a dye) and it was immediately coughed out of his trach. It is quite clear he likely has some type of stenosis causing persistent aspiration or he has developed a trachea-esophageal fistula…. This is a death sentence in Gaza. If you see his picture below, you will see the extent of his malnutrition. The surgical skills/supplies are not available here to fix this and I simply could not remove my eyes from this boy’s face. He was scared, his mother by his side was broken and the fact that he will die of an extremely treatable (though admittedly complex) disease process is absolutely infuriating and unacceptable. When this boy dies, he will not be counted in the official war casualty numbers (nor his father), despite both dying as a direct consequence of military policies of the IDF that prevent them access to care and strategically result in their deaths. Anyone still supporting these people need to take a long, hard look in the mirror about what they are supporting. This child deserves so much more from the rest of us. And, with tears in his eyes as we finish up manipulating his new trach, I ask him: “How are you feeling?” He responds with the word that defines the Gazan people: “Alhamdulillah.” (All praise is to Allah).
The supply situation here is abysmal. No medical supplies have entered Gaza in over 5-6 months, and rationing has only helped so much. And the north (where I am), the situation is significantly worse. I watched a skilled ENT surgeon place a trach in a patient and then “sterilize” his supplies with soap and water and some betadine and use them again on another. He joked that Gaza has no supplies alive except him (his body). His clinical skill was amazing…I saw him do 3 trachs in less than an hour.
Dr Haitham, general surgeon (see him below). I met him a year ago on my first trip and he’s wasted away. He walked in to meet me, exhausted while trying to get some meds for his elderly father who suffered a femur fracture from an explosion that destroyed his neighbor’s house. Haitham has been home trying to rehab him, but he notes he can’t get him enough food to get him strong enough to stand and he’s worried he will become bed bound. On top of this anxiety, Haitham has two kids, 6 and 8… and he is always worried whether or not they will have food tomorrow. Every doctor I meet looks like Dr. Haitham (AND THESE ARE THE DOCTORS). Surviving like this is impossible… it needs to change now
I was walking through the chaos of the ER when a med student (assuming I was a foreigner by the way I walked) started to speak to me. Her energy is next level. She has the personality of a neurosurgeon-bound medical student… gunner all the way. She asked me if I need a translator. I’m 50/50 with my Arabic, but just for an opportunity to have her with me and give her an excuse to wear an NGO vest and stay within the hospital system, I said of course. The smile on her face, to simply be allowed to stay in the hospital, was amazing to behold. She’s 20, in a war zone, her brother istashad just 2 weeks ago, and all she wants is to be here. To learn. She is thinking about a future in Egypt where she can complete her med school one day inshallah. I am constantly in awe of these people. I will say this 100 times maybe here. They are undefeatable… because of who they are and what they carry in their hearts.
Mohammad balata, tracheo-esophageal fistula. 12 years old.
The prayers and words of reminder above a patient bed
A father in the morgue. I walked by and every hair on my body rose to attention. The body, a small child… a father helpless spending his last few moments…I asked the man who cleans the bodies: what happened? His response: Hunger… starvation. So many…every day. May God make him a witness on a day in which justice will be absolute and may his family be granted patience and the knowledge they will see him in a place in which hunger does not exist.
Dr. Haitham, may God protect him and heal his ailing father
I was introduced to Tarek today. Some people weren’t made for this world. This man is both a nurse and an engineer. He works in the belly of the hospital fixing anything and everything mechanical… Oxygen delivery systems, air circulation systems for the OR, ambulance parts, light fixtures… everything… he was one of the many that survived the siege of Al-Shifa hospital. He is already living the life of someone on the other side of this world that has been hell to him… and with a kind smile on his face. He mentioned he was with civilians and doctors alike hiding on the ground as military units rounded up healthcare workers like cattle, stripped them down and then killed them or arrested them. Like everyone else in the pictures I’ve taken, he’s lost a tremendous amount of weight in the last two years, and his body habits are telling. Regardless, he smiles at us and thanks us as if we have done something worthy… and we just try to sit under the shade of blessing of being in his immense presence
I reunited with my brother, nurse Alaa, today. If I could share the extent of my happiness in writing upon seeing him, the internet would break. He used to be the head-teaching nurse at Aqsa hospital last year when I visited and his upbeat demeanor despite the surroundings was unreal. The light in him was dimmer than that time. He looked exhausted, and his mother and sister were both injured in an explosion about 9 days ago. Now home, he has not been able to work as he is caring for them. He’s single, and I used to joke that he was the most eligible bachelor in Gaza. But now, he is stretched to the limits of his ability to just stay afloat. Today, he was a man of few words (paraphrased): “The situation is too hard. I do not know what happens next.”
The ER at Shifa during a mass casualty event is overwhelming. The MCIs last night were back-to-back and it got so bad at one point, that the ER director said to close the doors of the ER. A combination of critical cases involving bullet wounds of the chest and abdomen. One man had an entry wound in his upper back through his trapezius and an exit through the inferior part of his mandible. Using an ultrasound we had brought with us, we could see that his neck vascular had somehow been avoided. He’ll live tonight. Another young man had a hemopneumothorax, chest tube was placed and 1300cc of frank blood drained into the CT bag. He will not survive this night… we have no Cardiothoracic surgery and even if we did, the three operating rooms had concurrent exploratory laparotomies that would require at least a couple of hours to close up before the next patients could even be evaluated.
I sat for some time with Dr. Ghazal and Dr Abdelwahab… both ICU doctors. Young fathers themselves, we argued about the playing styles of Barcelona and Real Madrid… about Mo Salah at Liverpool and the disappointment of all of Gaza about his general silence on the massacres and starvation in Gaza. We shared pictures of our children, and they made sure to show me pictures pre-invasion, because their kids looked happier and healthier. Then they began to tell me how the last two years had changed so many of the people around them. The constant, repeated trauma had made people around them bitter and apathetic. Another international doctor from Rhode Island tried to explain that what they experienced as a people has been so much worse than what the world had ever seen. The constant bombardment, the restriction of food and water, the targeting of healthcare staff. This has never happened so brazenly and openly… live on Tv… and the feeling that the world abandoned them was inevitable. We spent some time telling them about all the people we knew that would be with them if given the chance. That just as the world leaders had ignored them, the people were on their side. I know how many tears have fallen on their behalf just in a place like Arkansas. And tears don’t bring food or an end to this human-made disaster, but people love them. Gaza has every excuse to hate the world, and yet, I never hear anger from them in these conversation… just exhaustion.
Tarek, an angel walking amongst us.
Dr. Abdelwahab (left) and Dr. ghazal (right)….
Barcelona vs Madrid. :)
One hundred degrees, the smell of blood and death and sadness and panic. This is after the initial rush after the mass casualty incident at the feeding station in which IDF soldiers opened live rounds on the crowds. Men are tasked to get food from the distribution sites and when they let in - few trucks for a few hundred thousand people… and then shoot upon the desperate… you get 400+ ER admissions… anyone with an injury that wasn’t immediately life threatening (including non-limb threatening fractures) were discharged home to fend for themselves.
In the distance, another smoke plume rises…
f16 targeted civilian infrastructure
next to
Al-Ahli hospital. The injured will
never reach us.
My brother for life, Alaa. The moment I left Gaza last time, his voice/face had been
seared into
my heart. Seeing him now and wrapping
my arms around his small
frame
destroyed me.
He mercifully tells me he is fine. He is not.
The devil tricks us into thinking that the work being done is fruitless, that because we do not see immediate results, it is useless to even try. And yet, we learn from everyday life: what a drip of water can do to a valley over time, what impact even the invisible wind can have on a gigantic mountain. There’s a famous saying about doubting the impact of one person on an issue and then thinking about trying to sleep in a large room if you know there is one tiny mosquito in the room. Be the mosquito, don’t stop talking. Don’t stop resisting on behalf of these people. Don’t stop making “them” lose sleep with the fact that justice is inevitable, even if just on a timeline much larger than our lifetime. This is what I learn from the persistence and struggle of the Gazan people. I see them breaking and they need to know we will never give up on them. They need to hear us, and they need to know we hear them.
Right outside where we are sleeping in the hallway of the hospital, I saw some third-year medical students… 21-22 year olds… boys and girls who risk their lives to come learn despite the actual and real risk to their lives. I caught them before their lesson and asked to speak to them for a few moments. I told them, on behalf of all of us, that we love them. That they inspire people they’ve never met. That one day, we will be able to do them justice for their brilliance and what they’ve already taught us in their courage and resilience. Every one of them in this hallway could walk circles around those who want them dead, if given the chance. This is the future of this place. They need to be protected until this is over, and this needs to be over now.
I met with two of my friends from Jazeera English, Hani and Khaled. Hani interviewed me a year ago in front of Aqsa hospital. We spent a lot of time together then, in front of his media tent. About two weeks after I left, the IDF drones bombed those tents and killed some of his colleagues. Khaled is the behind-the-scenes man. When I met them today, their energy was different…Hani told me, “Every day I wake up, I just send a message to my wife and children (currently in Cairo since the beginning of this thing 22 months ago), and say: ‘Alhamdulillah I’m still breathing.’ The last thing I want is that they find out I died from the news.” These journalists have been picked off one by one specifically because NO international news agencies are allowed in Gaza and these were the few that were here and have been here since it started broadcasting any news from the inside. We sat for a while and talked about their situations, and they told me how they are at the end of their rope, and every day is just a struggle to find motivation: “We don’t even react to the misery the same way.” When giving them a hug, I told them I’d see them soon to help them in any way with what I’m seeing in the hospital. Khaled replies: “We’ll see you, either here at Shifa or in Jannah (paradise).” He wasn’t smiling when he said this, this wasn’t dark humor to him, this is his reality every day for trying to push forth the truth.
Patient in ICU: Salah, 15-year-old male, s/p TBI. His father stands next to his bed. He was shot in the head by a quadcopter at the site designated to get food and was brought in two nights ago. He had a neurosurgical procedure to evacuate the intracranial hematoma he suffered along with removal of fragments of the bullet lodged in his brain. He survived, but continues to live on the edge with an extremely poor prognosis. His face is covered by netting to prevent the flies in the ICU from sitting on his face. His father holds his hand like an injured bird in his hand. He knows what’s coming, and there is nothing any of us can do to change it.
14-year-old, Ahmad… same injury as Salah, but significantly better prognosis. He also was struck in the head by shrapnel, this time at the food station, and suffered a spreader skull fracture and bleed. He also had a craniotomy and evacuation of hematoma yesterday, but he was quickly extubated and is very responsive. He says two words to me: “Alhamdulillah” (all praise is to God) and “athshaan” (thirsty). I gladly request the nurse to get him some water. He has some residual L sided weakness but should survive the injury assuming his wound can heal.
Hani (left) and Khaled (right)
May God grant them long lives in service of Him, their families and Gaza. They have risked so much the last 2 years, the world owes them immensely for preservation of the truth.
Salah, 15 y/o mentioned above. They put netting on intubated patients faces to prevent flies from sitting on them. The room ventilation systems are broken and so flies are a constant problem because of access through poor seals in ventilation.
Ahmad, 14 y/o M. May his thirst be quenched forever in a place better than here in this bed.
Sat down with two first year ICU fellows: Aseel and Abeer. They are both 26 years old and spoke to me about their dreams before this war started. One wanted to do psychiatry and the other pediatrics… but the bombardment paused all those dreams, and limited them to this specialty as there were few places left to learn formally. “We miss our routine, our rooms, our beds, our normal things… we never thought we’d be in a situation like this… living displaced… feeling hunger… fearing for our families.” Aseel’s home was destroyed, and she has since moved two additional times and had to walk about 45 minutes to the hospital. “We stopped caring about the different things that happen… things don’t make us happy, and they don’t make us sad… we just survive.”
Sumaya and Alaa are night nurses in the ICU… beyond being the best kind of nurses (night ICU nurses are a special breed anywhere in the world), they additionally hold a classic ICU sense of humor despite everything around them. They make jokes with one of the male security guys about how obese he was before the war, that losing the 30kg was probably good for his health. They note how nursing during a holocaust means less oversight from their supervisors to hassle them (especially at night). We get into some deeper conversations about their plans after the war: “I might try to go to Turkey,” says the formerly obese security guy…” Both ladies get a little stiffer in this moment. Alaa: “I’ll stay here in this land no matter what with my husband and daughter.” Sumaya nods in stern agreement… “Same with my husband and 4 kids. We are not going to leave and start over from zero because someone else tries to force us.” Damn right.
Anwar is an ER doctor here at Shifa. One-on-one, he is thoughtful and analytical. 32 years old now, I met him a year ago when I visited the middle area when he was a second-year resident. Now, as a physician in the chaos of the ER, he’s an absolute machine. He moves through patients triaging, assessing, barking order at nurses, telling the mildly ill to go home… “Do you see what’s happening around you?” He tells one family that bought in a man with a small wound on his arm… “better you go home and treat yourself.” He takes his gloved finger and explores the left bullet gluteal wound to assess how deep, turns the patient over and sees the exit wound… “hamdulilah, no vascular injury)— “CT, now!” Shifa has no working CT machine… the two it had had been destroyed during the sieges of the hospital… patients have to take their family INTO THE RED ZONE, to another hospital and waiting line for a scan… and pray the injury isn’t so severe that the patient doesn’t survive the trek and back. After a few hours we sat down in the lounge for a 5 minute break… one of the guys from Ahli hospital (about a 10 minute drive from where we are pre-destruction), came in and informed us the situation was even worse… Anwar’s face changed and he quickly pulled out his phone… the color drained from his face and sweat beads collected on his forehead as he waited for the phone to connect… ring 1… ring 2… ri… “hello?” Anwar sighed the biggest sigh of relief… “Mama, habibti, how are you?” His mother seemed unaware of his concern… she lived neighboring Ahli… she said she was fine… Anwar smiled, hung up the phone and literally collapsed into the couch. It’s not fair… unjust to the extreme… this man has to try and carry the world on his back in this ER AND has to simultaneously be fearful for his entire family that have nowhere to escape to from the red zone.
- I tracked him as the next wave of mass casualties came from the food distribution sites. Again… mostly young men and boys trying to get food for their families… bullet holes in their chests, in their bellies, in the backs and lower extremities. We quickly checked for internal bleeding with ultrasound (FAST exam) … positive, positive, negative… teenage boys screaming for their mothers, writhing on the floor, disoriented. One 16-year-old lay in the middle of the hall with his head wrapped, he had a large wound on his arm pouring blood on the floor. I wrapped his arm which appeared to be caused from shrapnel (he’ll need an xray to assess if there is any residual shrapnel but otherwise appears to have avoided bone and major vessel). I unwrapped his head and my mind did not process what I was looking at. He had brain matter extruding from his skull through an open fracture. He was awake and talking to me. My understanding of his prognosis changed in a second… he was going to die here.
After trying to settle the 16 y/o boy down, I walked further down the ER hallway and noted an older man agonally breathing on the floor. Agonal breathing is the medical term for the death rattle. A nurse walked behind me… “He’s been black tagged.” Meaning… he’s dying and there is nothing we can do. He was alone on the floor, lying next to an 8-year-old patient with his mom who was wide awake and looking on. Everything about this reality is a disgrace.
I started working with Anwar on another patient with a bullet wound to the groin. We couldn’t pass a Foley catheter, and it was likely there was a false lumen from the bullet track. “He’s still breathing!!” We heard a woman scream. The “black-tagged” man’s family had found him… agonally breathing on the ground. When people go to the food distribution sites, and don’t get home, their families begin visiting all the ERs in the area and the morgues. After a frantic search, the man’s wife, brothers and son found him. Imagine walking upon the person you love most in the world, lying in the cold ground in the ER… with 30 other people in different stages of dying. His wife screamed towards us: “Please come help!! He’s still breathing!” I got down on the ground next to his grieving wife… listened to his lungs… he still had a pulse… pupils were fixed and dilated. I guided her eyes to his and shined the light, showed her there was no pupillary reflex. I explained that his mind was already too damaged to live, and these breaths are the “last breaths.” She lowered to his ear… “Habibi, say La illaha illa Allah”. This is the end every Muslim prays for…that our last words are this declaration of our faith. The room altogether began to repeat… La illaha illa Allah… Between tears and weeping, they found a small amount of solace in knowing they were with him in these moments to remind him (in a place unseen), the words that defined his life and would define his end.
Two children (brothers at the morgue). Their families waiting for the third, a cousin murdered at the GHF station in Rafah. His body en route from the south. Look at those around him. Look at their faces, their ages… look at their nutritional status. 13-year-olds and 14-year-olds… (these two) were shot for being in the red zone by quadcopter. The other one coming from Rafah is 17 years old. Normally, the process for washing the body in Islam includes washing the whole body and wrapping it in a shroud. When someone dies “shaheed” (a witness in this world and the next), they are simply wrapped, sprayed with perfume and buried. There is no space in the graveyard and any space available is expensive. They will be buried together as a family.
This man lay in the ICU with a chest tube from a large hemopneumothorax… they must both be in their 20’s… the patient complained of pain when he coughed… all we have is paracetamol (Tylenol equivalent) … I explained to him that he needs to take deep breaths and that coughing up the phlegm would be good for him, even if it hurt a bit… his wife was like a cheerleader here which is why I couldn’t help but take the picture… she forced a smile and an excited voice telling him he was getting better and that he just needed to cough harder. This is not the love story we dream of, but it is the love story of Gaza. May Allah grant her the strength to endure what is to come in her beloved’s recovery.
Mariam Yousaf is a 22-year-old medical student working as a translator for one of the NGOs. I found her guiding another volunteer doctor to our quarters and had a chance to appreciate just how brilliant she was at such a young age. She said she wants to do vascular surgery when the war is over because she likes to use her hands and because she saw how many vascular cases that were unable to be treated resulted in the death of many patients she interacted with. She’s confident and has an edge and very quickly I told her she would indeed make a fantastic vascular surgeon :). Her home was destroyed, and she lives with her family in an apartment they are currently renting in a partially destroyed place. Every day I get discouraged about this place I meet a Mariam and am reminded of what the enemies of this place are after. Her very presence: a super educated, well rounded, articulate and confident young woman is everything they want you to think Gaza is NOT… and the place is absolutely full of them. All preconceived notions about the “savages” in Gaza and their women being locked up in the dungeons of the Middle Ages are absolute garbage. All I have seen here is Mariam and so many like her. May God protect her and make her success in this life despite the adversity, a sign for the rest of the world. She gets extra points because she shares my last name and I told her because of this; I am officially her uncle for life.
This little boy fell from a second story room to the ground where his family was staying. His family lives in one of the destroyed buildings and unfortunately, there is no anterior wall to the room. He somehow got in and he fell >15 feet to the street. He didn’t lose consciousness, and he appears to be miraculously unharmed except for a couple of scratches and abrasions. He was pretty mad at me for pressing on his tummy, and so I bribed him with a lollipop. This also didn’t work but he had a death grip on the lollipop which means he was neurologically intact so that was good, I guess :).
I had a chance to reunite with my friends Fady and Mahmoud. Both were big boys a year ago and have since shrunk 20+ kilograms since the beginning of the war (45 lbs). Mahmoud shared the ridiculous story of how he survived a direct strike on his house (see below). He was on the roof when his house was marked in the north about a year ago. This is when the north was all red zone… the rest of his family had followed the evacuation order, but his father refused… “I am staying here even if I die here, this is my home.” Mahmoud stayed back with him so his older father was not alone. They began bombing around their home and so Mahmoud went to the roof to see where the strikes were happening in their neighborhood. He got to the roof at which point a rocket struck and collapsed his home killing his father who was still inside. He miraculously survived the wreckage (see below) and gradually rebuilt a few walls to provide some type of home for him and his brother. They always rebuild.
I cannot separate the religious experience from this mission. This land, these people are tied to the source of so much of the world’s religious history, it bleeds out of them at every turn. There is faith built into every reaction. Every patient says: “Alhamdulilah” (All praise is to God) as a response to any hardship… with the death of someone, literally anyone, comes the words “hasbunallahu wa ni3mal wakeel” (we rely solely on God, and He is the best caretaker). Every prayer here is in congregation… janitor, doctor, person who sees us in the street, joins in. Everyone makes dhikr (repeated remembrance of God). You see their mouths moving as they go about the day… family members of the dead and dying constantly in prayer. Faith is what defines this place. It is surreal that these people are the ones being tested in this manner, that they are the ones who have been demonized. Every place I go, someone tries to give me something even though they have nothing. They hear I’m from America and they light up because they assume America hates them. I tell them no; our governments all behave in a manner unlike the people they represent. If the people of America knew what was really happening, they’d be here with you on your side. Some days… I just don’t know
Apparently special envoy Witkoff visited the GHf site in Rafah yesterday and some permanence display of aid distribution was performed for him and the ambassador. It amazes me that men so apparently intelligent remain comfortable being swindled and played in the manner the average American politician does. All while their signatures sign off on the death of the innocent. They need to come into Gaza and see what’s happening for themselves. They need to visit the ERs and ICUs where hundreds of people present every day with bullet and shrapnel injuries from the food distribution sites from IDF ammo. They need to send people to witness it for themselves so that the one-day displays of fake humanitarian aid distribution is not all they see as the reality. Do not get played for a fool. There is a reason you hear Gaza screaming… just listen.
Farah, another 6th year medical student, currently works for Heroic Hearts which is the NGO that coordinated our entry. She’s 23 years old and wants to be a general surgeon when the war is over. She was so anxious that the traveling doctors were getting what they need, I had to sit her down and tell her: “Listen, we are here for you… not the other way around. We know how hard it is to coordinate anything in this chaos…” She relaxed for like a minute and then went right back to frantic work and patient coordination. She could probably run the hospital with enough time and experience, MashAllah.
If I could tell you that I’ve shared the worst, I would… but I would be lying.
Rozan, age 24, works as the director of the tent clinics for the NGO Heroic Hearts. Initially, she spoke to me like she could have been a broadcaster for a major news agency, recording all of the amazing work the organization has done to try and provide medical care during this crisis. She’s accompanied by Ahmad (also 24) who does not speak much English but smiles the ENTIRE first 10 minutes we met each other. He smiled so big I could not help but smile back MashAllah. It took a little bit for Rozan to finally realize I did not need to be sold on the wonderful work she did, and I could see her posture relax and we sat down. I pulled out some stuff from my bag to share with them. We started talking about what they’d been through. Ahmad, after signaling Rozan to look away, lifted his shirt and showed me a large exploratory laparotomy scar and an entrance and exit wound from a quadcopter bullet. He put his shirt down, and Rozan returned to the conversation, but I could tell she had already become emotional. Ahmad, obviously her friend and colleague, spoke on her behalf for a second while she collected herself: “Her whole family isthashad 1 month ago.” Her parents and three sisters, all at once. She has one brother who is studying in Egypt (he got out before the siege that blocks escape). I could not find my breath to say a word of condolence… hasbunallaha wa ni3mal wakeel. There was no lady with us to give her the hug she deserved as she collected herself and the three of us sniffled ourselves back to a moment of control. She showed me their pictures and told me their names.
Surely, if Ambassador Huckabee or special envoy Witkoff met these people and saw their humanity, and even more, the light they have to offer to the world… surely, they would rethink their blind support for the side that strips these young people from their families and leaves them orphaned and alone. Surely, these people who call themselves followers of God… see in this vulnerable young woman, enough of a reason to admit fault and adjust course. How many more Rozan’s need to exist before action is taken? I sat next to them for a while. Thank God I had not given away all my coffee yet because Rozan mentioned coffee, which she has not had in many months. It was her late father’s favorite thing. When I handed her some packets of instant coffee, she crumbled. The world does not deserve this girl and her friend, Ahmad. She dreams of the day this war is over, and she can get to Egypt with her surviving brother and feel like she has a family again.
Learned today that 100 trucks of food came in today. All flour. People raid the trucks frantically. Some organized crimes try to take more and then sell it in the streets. There is consensus amongst the medical staff here that certain gangs have relationships with the IDF and are allowed first access to the trucks at these points (because they do not get shot at). Everyone else is shot at by the IDF. This is directly from the head of the civil defense, a politician who has not eaten anything substantial himself in multiple days. In a context where every police station and security system has been destroyed (both physical structures and organizational structures), there is no one to defend the civilians… with no weapons and no systems in place. The prisons have been destroyed… the government buildings have been razed… all of the police are dead or hungry like everyone else. The systematic destruction of the social fabric has allowed the worst elements of society to find some footing, further exasperating the already massive problems
One ophthalmologist (see below) described the scenario like this: “They (Israelis) are drowning us in water, but they keep the water level at the edge of our lips. Occasionally we go under… and then they send supplies for a few days… and we can breath for a couple of seconds…” But, they are still short of breath and struggling. I saw some bread today in the street in the hands of some of the children, Alhamdulillah. To clarify, these shows of “access to food” are performance. These people are completely nutrient deprived… and when they are fed simple flour and water, it doesn’t move the needle. There are no minerals/vitamins, no fruit, no vegetables, no milk, no eggs and obviously no meat. They are grateful they can fill their bellies with something… but the desperation of those who understand the greater picture from a public health perspective, and that this only kicks the can down the road instead of resolves anything is palpable. There needs to be unfettered aid access… there is simply no other answer.
Sorry for poor audio… try to listen. (Video Clip) This is Al-Ahli hospital, the Christian hospital in Gaza. It was bombed very early in the war… destroying the ER and has been bombed multiple times since. In the beginning, the IDF denied it was them, stating they were the most moral army in the world… since they’ve bombed EVERY HOSPITAL IN GAZA and say, alternatively, they deserve it. Do not let them get away with the argument that the people of Gaza deserve their hospitals to be bombed.
“Make your legs steadfast in the dirt, for you will remain here as this land is your land, oh young man, this country is our country.”
I am going to share a bunch of candid pictures of children on the streets of Gaza.
Observing them… with their small frames but very adult mannerisms… the childhoods completely stripped away, but their innocence still shines through in moments.
Watched many children carrying containers of water… often their solitary task for the day is to walk to the water distribution station and fill a bucket/container of potable water… and return home for their family.
I’ve seen them drag their buckets, hoist them over their shoulders… wrestle with them as there are times the weight of the water is heavier than their malnourished bodies… but if they catch my eye, they smile… if I make a silly face or sneak them a lollipop, their postures immediately change into something more fitting for their fragile ages….
Other kids roaming the streets… finding rocks to play with… like they don’t hear the drones overhead… like they haven’t lost everything they ever had… like they have a future that looks better than now… like the entire world has not ignored their suffering… or worse… pretend they do not even exist…
One of the hospital administrators complaining about the lack of action from the international community (paraphrased): “Who do you think is raising these kids? Their hunger raises them, the ones who keep trying to kill them are raising them? The world that ignores them is raising them?” Imagine just how strong they will be to survive this.
What comes of children raised in such an environment except wonders for the world to behold.
They’ve destroyed every house of worship… mosque and church.
Deema and Mohammed - 22-year-old 5th year students shadowing me in the ICU. I had met Deema last year when she was shadowing my brother, Nabeel Rana (a vascular surgeon from North Carolina). We spoke about the difference since the year I saw her last (paraphrased): “My cousins were evacuated from Gaza at the beginning of the invasion to Spain because they are citizens there. It feels like we were not worthy of being saved (she speaks of herself and her 5 younger siblings). Why are we not deserving of living normal happy lives? Growing in our education? Not living and always being scared or hungry? This is what leaves us angry at the world… they do not even acknowledge we are human beings here just because of where we are born.”
Mohammed tells me he wants to be an orthopedic surgeon. He reminds me we met last year but that he was much chubbier. His classmates tease him and say his new weight (16kg lighter, 35lbs) is good because they can see his face better now. He’s a humble kid, but his classmates talk him up: “He’s the smartest one in our class!” He blushes with a soft smile. “I just want to go somewhere else to study, maybe the UK or Germany… honestly anywhere… anywhere where I can actually start a life… maybe we’ll change our minds when this is over… but we can’t see how we can live here with the way things are.”
Dr. Ahmad A. came from the Boston area with an organization called Rahma. He is a pulmonary critical doctor I’ve had the pleasure of working with the last week or so and tomorrow is his exit date. He expresses extreme sadness this evening and I caught him hand feeding a very sick patient some food and water he had. He said, “I don’t want to leave this place and think about this patient asking for water and food and nobody is able to give him any…” but we both know that’s exactly what will happen
Dr’s. Yusuf, Yaseen and Hadeeb are like the terrible trio in the ICU… they literally joke the entire time they are put on the same shift, speak about their futures getting married to girls far away from Gaza when the war is over and they argue about whether or not each one is a competent doctor. I sat in the doctor’s lounge with them and for a few minutes, the conversation could have been any conversation in any lounge amongst 3-4 guys in world… well outside the context of what we were dealing with during the day. Dr. Hadeeb wants to marry a girl from Pakistan and asked me to help find a match. He actually had been accepted to a vascular surgery master’s program in Pakistan before the war started, but his life was put on a standstill like everyone else. He pulls up his Facebook and jokes about me adding some of my friends in Pakistan to get the marriage process started. I told him he’d have to work on his Urdu first, and then we’ll make the magic happen.
Dr. Yusuf wants to come to America and practice medicine. He asked me what it’s like for a resident in America, if he could find a job while he did research and would he be able to find a place to live. He said, “Listen I know America is the land of the free, but why are there so many people living on the street or very poor?” Honestly… good question. He then asked me if his broken (but relatively eloquent) English was adequate to work… and I told him he’d spoke more articulately than most people I know born there . He puffed on his vape and laughed so hard he almost choked himself.
We visited Rozan’s family’s grave site today. It was the first time she went and one of the employees of Heroic Hearts and I wanted to be with her so she did not have to be there alone. It was the grave of her father and her youngest sister (age 7), buried in a single grave… mostly in parts with limbs missing. “They found them on the couch next to each other under the rubble.” Her mother and 2 sisters are buried deep in the red zone (also in a single grave) and so it was not reasonable to visit them today. We prayed at the gravesite… a place that gets more than 20 bodies a day as I write this… we saw many families burying their own families during the time we were there. Rozan is alone here, and there are no words that can convince her that there are a thousand people on this chat that would do anything to support her. Because even if I tell her, she’ll never see the support. Any money, material support, food for her specifically, medications… anything… is forbidden to enter… blocked by the IDF. You could try to enter and you’d be murdered or detained on sight. When we parted from each other, I gave her something from the little money I was allowed to have with me and told her, as her Amu, the moment I was able, I will help her more (along with so many of the people I know). She cried and said, “This reminds me of when my father, Allah yarhamu, used to give me money for things to enjoy… but I cannot accept it.” Wallahi, the dignity these people show is absolutely incredible.
Shame and anger are all I felt today.
I reconnected with my beloved brother Dr. Nidal (aka Abu shadi). As is the theme of these two trips split a year apart, he is skin and bones now compared to a year ago. He works between IMC and Ahli hospital, and he has the kind of swagger that books are written about. He started, “Everything my family ever built is destroyed. I took my father to look at our old home and it was in rubble. He’s 80 years old and he asked if we could at least rebuild a part and save some of the olive trees (the IDF specifically uproots olives trees in Gaza and the West Bank… I’ll let you explore this evil independently). So, we rebuilt some tents… and right after Israel violated the ceasefire, the first thing they did was come and destroy what we rebuilt. My father was broken. He knows he’s too old to see in his lifetime the ability to truly rebuild what their family had. They are never going to leave us the f**k alone. We need to leave this place… there is no life here. My 7-year-old daughter, Mona… she’s never been to school… she remembers a time when I would bring her a bag of candy every week and asks me why I stopped doing so…She deserves a future. My one-year-old, Shaadi, deserves a life better than this, and I am one of the people with a little bit of money… imagine the others…”
Dr. Abu Shaadi walks around the hospital and knows every single person by name and they respond to him like he’s family. He knows the cleaner, the radiology tech… he hugs the main nurse… he introduces me to the two OGs of all intensive care in the ICU These two two doctors (Dr. Abu Ibraheem and Dr. Waheeb) are two docs that retired well before the invasion but came back to work when it started. They stayed in the north at Indonesia hospital during the raids and bombing and just kept going. Dr. Abu Ibraheem: “They kept trying to kill me but God wanted me to keep working… I guess.” We all laughed at his dark humor. These are the giants of men who have educated so many of the doctors in Gaza through decades of restriction, bombing campaigns and occupations. Their pure existence is resistance of the highest order.
This is where they bring the dead at Ahli hospital… listen to the mother mourn her child behind the sea of men trying to support her… Rozan turned to me right after this video ended and said: “I know this experience.” Too many women know this experience here. I wish I could play the voices of mourning mothers and widows to our ambassador, to Envoy Witkoff… to the entire senate. It should haunt them the way it does to us. When is enough?
Today we went with Heroic Hearts to see some of the amazing work they do in Gaza. They employ local Gazans who take care of foreign doctors like me while we are here but before the war, they also primarily manage local institutions like food pantries, medical clinics and even shelters. Since the beginning of the war, they’ve helped establish tent cities for the displaced… try and set up education for a small group of children whose schools have all been reduced to rubble and run an orphanage (along with the continued clinics and food pantries). They used to have over 50 food pantries pre-invasion… now have just 9… and they are extremely expensive to run AND in the context of the restricted supply of aid… not able to be consistent. As I’ve told you… the current game, it seems, is to let in tens of trucks intermittently instead of the 500+ daily required to restore nutritional stability to the starved population of Gaza. The primary meal, when able to be delivered… is bread or pasta. I get asked often, where should I donate… I can tell you from this experience that Heroic Hearts employs sincere and wonderful Gazans, and the work they do is real. It’s never enough in this context… but it is something… and more than that, it is resistance. The system of money delivery to Gaza is expensive and out of every dollar you send, $0.60 goes to Gazans and the other $0.40 gets eaten up in fees… but 60% of something is better than 100% of nothing and these orgs provide food safely and help consistently (plus the employees they employ can then support their families).
- One such man is Abu Khaled (Abdulnaser). He speaks English about as good as I speak Arabic so we understand each other quite well in the opposite language. He told me today… the moment I met you, I knew I loved you and Wallahi that is reciprocated. He’s married with 5 kids and used to be an accountant before the war. His countenance first appears pretty stern… until he smiles… and then you see the deep wrinkles in all the places you’d expect from someone who smiles all the time. He keeps trying to get me coffee and when he does, he tells me: “We got ripped off… this is mostly cooked with chickpeas.” (FYI all Gazans are absolutely nuts about coffee. You’ll hear it here often. This is the worst part of the war because they stopped all the food, and more importantly, the coffee. They’ll joke: “What kind of evil stops people from drinking coffee?” Abu Khaled, like everyone on this team of HHO employees, is malnourished. He puts his kids first and so any food he gets goes to his wife and kids and he doesn’t seem to consume anything. He just keeps going.
I’m going to take a moment to better explain for the full context of how bad things truly are in Gaza. There is NO sugar to be found. No coffee. There has not been chocolate in 5 months. They haven’t eaten a meaningful amount of fruits in over 8 months. When they get aid, sporadically as it comes, they get rice and flour. Beyond the food stuff, every pair of shoes I see on people are in their last days. There are no new shoes in Gaza for 22 months, no new clothes… they latch onto what they have and move on. All the kids exchange slippers as they grow with other kids so they have some type of footwear. There are no socks. There are no necessities… AND there are NO luxuries. There is no Nutella… no peanut butter (my friend told me he hasn’t tasted peanut butter in 12-14 months). There is NO NEW phones… every phone in Gaza is over two years old… and when you are displaced 3-4 times, your phones have a crack, a useless battery and poor reception. All the charging wires seem to be fried. All the laptops are at the ends of their ropes. The vehicles have been using “dirty gas” and so there are constant issues with vehicles functioning (and very few to begin with). Clean water is a challenge to find. Tap water in Gaza comes from the ground which is salty because of the proximity to the ocean and so typically needs a filtration system to drink: All the filters are out of date, everywhere. There is little to no Tylenol, no cough syrup for sick kids with URIs. There is no consistent supply of chronic medications, so blood pressures and blood glucose levels are out of control. There is no perfume or deodorant coming in. Toothpaste is blocked too. Feminine hygiene products are extremely rare, and even soap is missing. There is NO refrigeration in Gaza except in small amounts in hospitals (none in people’s homes). When it gets dark out, it is dark everywhere except the hospital that has its generator systems. Gaza is not just being starved of food, it’s being starved of life itself.
On a personal note, I absolutely hate to do humanitarian media pieces on the mission trips (this is not just for Gaza, but for every place I’ve ever worked). Most doctors hate doing it but we are requested to do so by the NGOs to show the work on the ground and get some PR for fundraising needs. I appreciate the necessity, but it always feels bad. It feels worse in Gaza. These beautiful children that the world has neglected are so excited to meet us and say thank you. When we’ve done nothing right by them. Every aspect of their childhoods have been stripped away by us, the ones in charge of their wellbeing… and yet in these moments, it feels as though they get exploited again to bring in funds. The feeling does not make it true and HHO really does an amazing job. The kids and families are left to rely on humanitarian organizations instead of just being allowed to live the lives they deserve to live, and to provide for themselves the way they used to just months ago. I fear the day we have to face these beautiful children in front of God and we are asked about our neglect. That we eat and drink and move on with life, while they cry and ache and feel alone.
We visited the orphanage (you’ll see a dancing clown with a lot of children). Every one of those kids has lost either their father or both parents since the start of the war. There were hundreds in the small room. The HHO had a little party for them, and we attended as guests. One of my colleagues and I broke down at one point. I couldn’t help thinking about the injustice of this situation and my own kids. Being born in one land should not confer such level of oppression. Yousef, one of the young volunteers who is like my little bro at this point, squeezed my hand and said: “Stop crying, don’t show the kids they are sad. Give them a moment of enjoyment. He was absolutely right. My feelings do not matter here. I hugged him and told him so, then tried to dance and play with the kids for a bit. They laughed and smiled and were curious… like every kid in the world. They came up to me to shake my hand or give me a high five. Dr. Farhan lifted one child on his shoulders. She looked like she had the time of her life for a few moments. The Gazan staff at the orphanage actually had huge smiles and happy tears in their eyes seeing us be silly. The world needs to simply be of service to these kids. The event ended with all the surviving widows and orphans receiving hygiene kits (soaps, detergent and toothpaste, etc.). I later asked how much an event like this costs in the current environment of scarcity including the gifts and food: $5,000.
This is the tent city for displaced people. One of hundreds of such tent cities. This one holds most of the people from Beit Lahya. I was told: “These are the kindest people in Gaza. If you give them something, they will always split it in two and immediately demand you share it with them.”
This was the party at the orphanage. The kids performed a dance with the clown and then we all danced together. You cannot see to the right of this picture because I couldn’t hold myself together, but there were a couple of hundred kids all sitting and clapping with mothers or aunts or whoever survived with them.
This was the party at the orphanage. The kids performed a dance with the clown and then we all danced together. You cannot see to the right of this picture because I couldn’t hold myself together, but there were a couple of hundred kids all sitting and clapping with mothers or aunts or whoever survived with them.
On a personal note… my exit day has been pushed to the 12th of August. This gives me 2.5 weeks total in Gaza. I could tell you this makes me sad, but in my heart of hearts, I already fear the day I depart from this place and these people. Their situation will likely not have changed and may be significantly worse with the insanity of Netanyahu now confirming what we’ve known ALL ALONG AND SCREAMING AT THE VERY TOP OF OUR DAMN LUNGS: Israel will attempt to completely occupy and displace the inhabitants of Gaza. They will try to do the same in the West Bank shortly thereafter.
These people…are the best people on earth. Their belief and resilience are so prolific it would change the world if they weren’t caged like animals. Their men are full of love and compassion and uphold the type of service to their families and communities we write about in books. Their women are stronger than most men I’ve ever met outside this place, brilliant, dignified and kind.
How can I leave them in this state? How can we all leave them like this? I feel desperate typing this because I am. I cannot believe it. My brain cannot fathom that we have, as Americans, supported, condoned and funded this… through multiple administrations, parties, houses of congress and beyond. It does not feel possible that what my eyes see every day has historically been supported and lauded by majority of America, for far too long. I know the narrative has shifted. I know the truth is revealing itself. I know people are waking up to what we have wrought, but if there is no action, there will be nobody left to save.
Content Warning: The following images and videos contain graphic medical content. They are being shared to show the horrific realities of suffering on the ground in Gaza. Viewer discretion is advised.
Kids being kids. I can hear them arguing about Messi vs. Ronaldo… like any kids in the world.
Another 8-year-old with two bullet wounds to the legs. The first superficial, the second through and through in the upper thigh concerning for vascular injury risk… fortunately… pulsed intact. He’ll keep his leg as long as his wounds heal.
This is Ghassan. A little over a month ago, he was sitting in a shaded area at the beach when an Israeli rocket dropped within 30 meters of him. It carried him several feet in the air, killed the friend he was sitting with, amputated his left lower leg and shattered his right lower leg to smithereens (see Xray). The picture of him on the floor in shock moments after the explosion, next to a deceased woman he had never met (may God have mercy on him) has gone viral because of the shocking reality of the IDF death movement across Gaza.
I sat down with him and his two older sons, all absolutely brilliant engineers who speak several languages including English, Arabic and some Spanish (he has a brother who is a professor in Spain). Ghassan’s wife was traveling before the invasion started so he has not seen his beloved wife for 22 months and she attends every Palestinian protest in Atlanta (where she stays with one of her other sons) until she can come home to her husband. He was simply flabbergasted: I have an injury that requires a lot of physician and post-procedural support and rehab, and they keep limiting food so I can’t eat meat to get the protein I need to get strong enough to walk again. I need to walk again.
I woke up this morning to chaos outside the window. Another few dead, more mourning families. More anger. More screaming at the world and into the heavens. More prayers, and then calm. Then I watch them carry another body (maybe 2 this time) on their shoulders to the graveyard. I’ve been here just a little while and the sheer volume of dead is hard to process. I think it’s also important to remember that every one of these deaths changes the lives of their families forever. One student told me: “They think we are just numbers, but we are people.” This trip, in contrast to the last, is defined by the current targets of the IDF… young men and boys. The world has looked at this conflict and has always assumed that if you are male and young, that your life means nothing, that your death is inevitable… or even worse - deserved. I’ve seen 14-year-olds here take on the responsibility of entire families… carrying the burden of feeding them, getting them water and keeping their women safe (mothers, sisters, aunts, cousins and grandmothers). I’ve seen 20-year olds’ stress about how they will move a disabled elder (from prior attack) from one tent to another when an evacuation order is sounded…and the answer is simple: they will find a way to carry them. The entire world is on the back of the shabab (young men/boys) of Gaza. I used to wonder how, in history, we learn about historical figures in their young teenage years leading nations and the masses. I always thought it impossible, until I met the boys of Gaza… and it makes complete sense. Luring this group to the food distribution sites to specifically pick them off or maim them is no accident. The IDF, for 76 years has always played the long game… and destroying a generation of potential resistance and social stability is par for the course. What they fail to realize is the ones left behind only gain more resolve to exist, to preserve, and to resist.
One of the water tankers came next to the hospital and there was a mad dash of people from everywhere to get some clean drinking water. Remember that all it would take to prevent this chaos is simply Israel turning on the water (which they have controlled the entire time and since the beginning of the occupation). One conversation with our president, or our ambassador… could change all the people you see having simple access to drinking water. Unfortunately, the little news I see shows me that we, at least our government, is doing the exact opposite. Doubling down on complicity. The evidence of the crimes against humanity are so apparent here it would make you sick. I swear… I wish I could bring them face to face with the misery in the ER… to smell the blood of children, to hear the moaning of the hungry, wounded and dying, to feel the pain of a mother watching her children die for simply trying to feed her… to experience the panic of hearing your whole world lie on the cold ER floor breathing their last. Maybe then they’d stop shaking hands with the devil who did this.
Yousef, age 31 and my sidekick from Heroic Hearts, used to be a chef. He had a restaurant in the north… and then the war started and, of course, the IDF destroyed everything. He has two beautiful children, Yaffa (aka Fufu) and Yara (aka YouYou). He told me that EVERY single one of his restaurant staff members have been killed since the start of the war. We scrolled through his phone, and he showed me his old store… full of beautiful, smiling faces as they cooked for their people, some pictures even after the war started when there was still some food to cook… and he’d whisper: “God have mercy on them.” Meaning they were gone forever. Because of him, a part of me comes from Jabaliya, where he is from. We walked in the streets to the middle of Gaza to look at the markets where sugar gets sold at $200 per kilogram because there is none… and most of the tables remain empty… “No one can afford this… not even those that had good money before the war.” Yousef is not a man of many words, and he keeps his eyes down, deeply thinking most of the time… unless he’s speaking about his daughters or about the days he used to cook in his restaurant. Then, he lights up: “I was the only one cooking pizza like the Italians. I went and learned in Europe how to do it, and Gazans used to love the food I made…” He hits his vape and then his eyes return down to the ground… “Satada3oon alyawm hatha, inshAllah.” This day will return, by the will of God.
A video Yousef showed me. I asked him if I could share it. It’s most of his friends and coworkers at the restaurant that are all now shaheed. He mentions one, Riziq: “This was my best friend in the whole world. We were walking together when he was killed and I survived and I don’t know why he was chosen. After this is all over, inshAllah, I will build a restaurant and name it after him.”
Water tanker outside the window
I previously mentioned “Abu Khaled” from Shu’jaiya. I had one-on-one time with him today and had a chance to really hear what he has been through. We were sitting around each other in the dark as the hospital power went out and we had some downtime. One man amongst us mentioned “the worst day of his life” being the day he found his own brother in the rubble… limbless, faceless… and mentioned how hard it was to get him out to bury him by hand.
Abu Khaled… had a smile on his face… but this was not a smile of happiness… it was intense pain. He nodded… he said a prayer for the young man and his brother who had passed and said… “I have a story for the worse time in my life.” (Paraphrased from Arabic and broken English) “My elderly mother was injured when her house was bombed. I ran to her and found her injured. She was frail, already in her 70’s and now severely injured with blood everywhere so I picked her up in my arms and carried for almost two kilometers to the place we were staying. I stepped foot into the house we were staying in and by the time I walked from the door to the bed to put her down, she was gone. I never felt more pain in me than this moment. Since then (he puts his hands out like he’s carrying someone in his arms), anytime I carry anything… it feels like I’m carrying her and my body cannot hold her. I feel her in my arms now.
The worst part is that my sister was injured in a rocket attack on her home days later. I brought her to my home to take care of her massive injuries and at this time, there were no hospitals to care for her. She died after three weeks of agony. Anytime I helped move her or helped her to the bathroom she would scream in pain and say it felt like she had shards of glass in her back. She died this way, and the day she died… I could not cry because her two young daughters and son were with me and I needed to care for them and show them strength.” He looked at me, with his deeply sunken but still kind eyes. He looked down at his phone and tapped the screen to show the background… his mother… “I never even had a chance to mourn her because there was always something next.” We spent the next hour talking about his 1.5 years living in a tent… the winter with rain pouring through the tent… the time the tent he was living in was bombed by rockets… the way he told his then 5 year old son that if he heard a bomb blast, instead of being scared… he would make him clap with a big smile as a way to make the fear go away. He showed me pictures of his little baby Sham, and how she had only ever known life in tents until just a few months ago when they finally found a room to rent that he could afford for now.
I sat shoulder to shoulder with him on the floor… scrolling through his life… making jokes about the absurdity of his situation. He did not cry… I did, but Alhamdulilah it was too dark for him to notice. Abu Khaled needs a vacation… and coffee that isn’t made of chickpeas… and food for his children… and a chance to sit at his mothers’ grave. He needs a safe place to live. He needs to care for his orphaned nephew and nieces. He deserves a life. He deserves to live. He deserves more than all of us.
Good news today - likely secondary to international pressure - many food trucks were allowed in the north for consecutive days.
Because of this, two immediate things changed: Firstly, the price of food dropped dramatically (still very expensive compared to pre-war, BUT I heard many patients, families and friends explain to me they might be able to comfortably buy things they could not for their families).
Secondly, there were far less patients from the food distribution sites. If there is food getting in, there are less young boys/men having to trek to the food distribution sites directly and significantly less risk of being fired upon by the IDF soldiers that lure them out there with minimal aid distribution.
THIS IS WHAT INTERNATIONAL PRESSURE CAN DO. It’s this simple. The next step is to keep the flow of aid consistent, to stop the bombardment and to allow international journalists in NOW.
Shrapnel and Shards of Glass
When I left Gaza last year, I left my heart therein, When I returned this time, I could not find it anywhere, But as I searched, I learned it had broken into many pieces, For I found a part of it with each person from whom I asked of it.
I found it in familiar hands, worn and tired, And within arms that had not yet embraced me until now, How did you get this? I asked, The same answer from every soul: it was always here, forever with me.
Take care of this piece, ya Abu Khaled, it will only be happy in Shuja’iyya with you. And this shard, oh Abu Yara, it is better rested in the soils of Jabaliya. Ya Abu Omar, shroud this one and dig it deep in the rubble of Gaza city with you, For I, Abu Ibraheem, will forever have the best bit of me buried with it.
Remember, as Israel/Netanyahu now have had the Knesset approve plans to “take over” all of Gaza, that this was the plan from the very beginning for anyone even remotely aware of what/who Israel is.
It seems now, in the panic of the truth slipping out, they would like a chance to alter the crime scene before anyone else sees what has been done.
Do not let them. Do not allow them to cover up these crimes, and to erase what they’ve done here. Do not ignore what I, and every other physician on the ground has screamed out on behalf of the Gazan people.
- I’ll be moving south tomorrow, so this morning has been full of goodbyes to those in the north. The mood is heavy, because if Israel acts on the re-invasion of the north and re-displacement of everyone, the people are exhausted and know they have no meaningful place to go. They’d rather stay in the tents and hollow buildings up here than be moved again. The air is thick with anxiety, just as they got a little bit of food these two days. It comes with devastating news. The people share that they feel like they are being psychologically tormented. You can hear the spy planes flying above me as I type this, and the occasional food drop plane… and then finally explosions in the distance. Hope, fear and destruction… intertwined. I stand on the side street with children as they look up to identify the nearest roaring sign. One nurse tells me, “We would not need planes to drop food if they simply let the trucks drive in. The planes drop food in the ocean and some of us die drowning. Sometimes they drop on the tents and kill people… why is aid killing people?”
- One of my favorite students, Deema, who I have spoken about earlier, came to find me to say goodbye. She demanded she walk me to a small shop that had souvenirs made in Gaza and she insisted on buying me a gift to take home. We walked there together, the way an uncle and his niece would. We argued over it, and for the most part, I won. However, she ended up buying me a prayer rug. “Pray for us.” Every time my face touches this, I will. As we walked back to the hospital down the block, we spoke about her plans to try and get her out to the U.K. She had already been accepted to an Oxford educational program but cannot go because she’s trapped. “I know, Dr. Ahmad, that you will tell our stories, but can you please just mention that even though they’ve tried to drain our energy, this generation in their early 20’s will not stop. Our motivation will keep driving us to finish. We just need help to fight the people preventing us from doing those things.” I asked her for a picture, and she said, “I’m happy you like taking pictures.” I laughed. The truth is, I hate taking pictures in my personal life. But here, in a world where every force has tried to silence, smother and block out the Gazan people, I hope these pictures bring the light in their eyes to you. She expresses: “Is it okay if I call you if I get sad? Everyone here is too saturated with their own sadness to understand or to listen.”
4 years old and the sole survivor of his family. He rolled up with his uncle and went to town on this lollipop I had. He literally would not say a word as his little mouth gripped every last flake of crystal sugar from the stick. May God protect him from any more harm and make his family (may God have mercy on them) proud one day.
• Listen to Dr. Ahmad Yousaf’s interview on Morning Ireland, the flagship current affairs show on RTÉ Radio 1, Ireland’s national broadcaster.
This 20-year-old young man is blind. He used to be an Imam for one of the mosques, but it was razed to the ground and praying out loud in groups in any substantial group has resulted in targeting. He is unable to lead prayer in this manner. His voice carries the meaning of the verses he chose to recite for us. Translation noted below:
16. And indeed, We have created man, and We know what his self-whispers to him. And We are nearer to him than his jugular vein.
17. (Remember) that the two receivers (recording angels) receive (each human being), one sitting on the right and one on the left.
18. Not a word does he (or she) utter but there is a watcher by him ready (to record it).
19. And the stupor of death will come in truth: “This is what you have been avoiding!”
20. And the Trumpet will be blown — that will be the Day of the threat.
21. And every person will come forth along with a Sa’iq and a Shahid.
22. (It will be said to the sinners): “Indeed you were heedless of this. Now We have removed from you, your covering, and sharp is your sight this Day!”}
23. And his companion (angel) will say: “Here is (his record) ready with me!”
24. (Allah will say to the angels) “Both of you throw into Hell every stubborn disbeliever”
25. “Hinderer of good, transgressor, doubter,”
Life will go on. It will continue. Time will pass. Gaza will persist. Gazans will move forward, inshAllah. These things all feel certain, despite the uncertainty. We walked as a group with our team through the streets of Gaza towards the organization’s main office. Despite the absence of light and electricity, despite the streets being lit with some poor solar cells, despite the rubble and dust spilling over into permanent tent homes, despite the overwhelming sense of dread of another large-scale displacement south… children still play. Men still sit around and drink tea (almost exclusively without sugar because it is too expensive), and postulate about what happens next. Women can still be heard doting over or disciplining their kids as they prepare for bed. There are some murmurs that with the terrible news about Israeli forces coming back for a full-scale invasion, that there might be a delivery of chicken into the markets over the next 72 hours. Maybe some cigarettes and coffee will be available too.
If Israel opts to follow through with a full-scale military invasion again, thousands will die within days. Many Gazans are permanently disabled, weak, elderly, and fragile. They will never make the displacement to the south because they simply cannot. “This feels like a bad dream we cannot wake up from.” My friend Alaa tells me, “My mother just learned to walk again after her femur fracture, she can barely walk two steps.” What will it take for meaningful action to be taken to stop this madness?
Our last evening in the north with our new family. They got us tea. There was no food to eat here. We sat together and quickly enjoyed this moment. For a few seconds, we forgot where we were. We laughed, as a couple of guys hid their quick hits of the vape from Dr. Shadman who gave us the big brotherly stare of concern. It felt normal for a second or two. Until you look at the background carefully or hear the bombs dropping in the distance in the red zone. Life will go on.
This is the remains of a press truck. All journalists here have been targeted, or worse, many had been killed when they returned to their families. Many have asked me: “Why have our colleagues in the media not said more on our behalf?” What kind of precedent has been set that media is not considered a neutral body and protected in a war zone? Demand they let the media in to observe what the doctors have observed.
16-year-old Jenan, the daughter of one of the heads of the ministry of health, made this bracelet. Her father is a trained pharmacist who has tried to help keep public health alive in Gaza with some level of healthcare delivery, despite everything against the Gazan people. There is barely any medicine, no supplies… barely functioning hospitals (the ones that have not been completely destroyed at least) and a large part of the healthcare community now dead or incapacitated as they were targeted specifically for their titles as healthcare providers. You read that correctly - healthcare providers have been systematically destroyed. Early on, they were murdered in cold blood, detained, tortured and under constant threats to themselves or their families.
Jenan’s dad was no different. He finally returned home after some time away from his family (for their own safety, as his own life was constantly threatened by the IDF for speaking out about the destruction of the hospitals). His two daughters, Jenan and her sister, would adorably argue about who was going to sleep next to their beloved dad as they had missed him and he looked exhausted. Jenan finally won the argument. Shortly afterwords, a rocket struck his bedroom that night, breaking his back and killing Jenan right next to him.
Jenan’s parents shared this story with Dr. Farhan, and they gave him her precious bracelet so people could know her story. She had just finished memorizing the ENTIRE Quran by heart and was the apple of their eye. The guilt they feel… the guilt her sister feels… will always amplify the pain they feel in how much they miss her and miss the woman she could have become.
As we are preparing to move south this morning, a group of new doctors arrived. One from Jordan, one from Yemen, and a few from Indonesia. We’ve learned at least 4-5 docs were blocked at the border. This group of doctors’ experience was the same as ours upon entry - the IDF rules applied strictly about which supplies were absolutely not allowed in: baby formula, vitamins, medications, medical supplies… only one cell phone… one suitcase… and about $100 (300 shekels). One cell phone is nothing for anyone on the inside.
The doctors have chosen the cots they’ll sleep in for the next few weeks. It is a strange feeling… you meet people here in the overlap for an evening… share a cup of coffee or tea… some broken conversations between various languages. They see our hearts heavy leaving, and we see their hearts ready to work. May Allah make them of service to the people of Gaza. So much of the world is represented in this room…
Jamal is a neurosurgical resident and an absolute brain himself. I met him a year ago, and we reunited last night for a few moments. He has lost a tremendous amount of weight and the brightness in his eyes appeared a little dimmer than how I remembered him. Despite that, his baseline is a big smile…
He has written a book, and I am hoping to help him get it published in America when I return. It has already been translated in several languages. The Survivor… documenting medical cases and his own life through this savage invasion and occupation. The Gazan people’s voices will be heard. Military force, infrastructure destruction and brutal occupation will not prevent people like Jamal from shining through to the world.
This is the director of the only functional NICU in Gaza city. After Shifa was destroyed and babies were left in their incubators to die, they moved the salvageable incubators here, underground in a building that was primarily designated for some outpatients before the invasion. There are 11 NICU beds… only 2 available ventilators, 2 CPAP machines, no TPN for nutrition, no XRAY, no Ultrasound, or blood gas. These are the most basic needs for a neonatal ICU to deal with the most difficult and expected pathologies for which premature babies are susceptible. The three Neonatal ICU docs here look exhausted… the nurses have not eaten since yesterday and the director told me he just needs a cigarette. A majority of these kids won’t survive… and if they do, they will likely suffer the significant consequences of inadequate nutrition and oxygen during the most crucial parts of their early life.
We made our way south to the central area in anticipation of a final exit date on the 12th. We said goodbye to Al-Shifa Hospital, Al-Ahli Hospital, and the people of the north. I cannot help but document the level of destruction and tell you…videos and pictures do not do it justice. This has not been some back-and-forth battle; it has been the systematic destruction of everything standing across a large part of the Strip. It goes on like this for miles.
To see this today and then catch news clips of my governor shaking hands with the man who has perpetrated these war crimes is disheartening. But I am reminded that my true job here is to witness and share what I am seeing, so that our leaders can course-correct and our tax dollars are no longer sent to those responsible for this level of devastation upon the Gazan people.
You cannot come to Gaza and ignore the politics. You cannot see this level of inhumanity and not question, and condemn, its source. Israel, the IDF, and Netanyahu will have to account for all of this one day.
Also, an update on food access: As per multiple people on the ground here, more aid has been let in again today, including medications from the UN that had been blocked for months. I walked around the north with our group and there were signs that there was a little more food available. Sugar was definitely found as people were selling small sweets they could not possibly make just a week ago when sugar was extremely rare.
The ones selling and buying make up the most well off in this context, and the vast majority of people still are only subsisting on the bare minimum. This is what famine looks like… and, God willing, if we have a month or two of consistent aid access daily, we’ll see the turnaround we all wish to see. To share the absolute absurd level of hospitality these amazing people show us… this is the kind of thing we hear: “Doctor! I found out we may have chicken in the market on Monday for the first time in 8 months!! If it’s true, I will cook you something!”
We do not deserve the Gazans.
- Leaving the north knowing what Israel has said it will do in the coming weeks feels like betrayal. There is finally some food… but another round of displacement, death and misery has been promised by the Knesset and the IDF. If anyone here knows any way to reach out to anyone in any position to do something, please connect with me. I’ll sit in front of anyone and everyone — likely with a vast majority of the doctors who have been here.
- I hugged some people so hard I squeezed the air out of them. When you hug someone in Gaza, you never know if you’ll see them again. They’ll never know. I may be denied entry like so many other doctors who have tried to come back. There may be a rocket launched towards their homes, they may be at risk or targeted because they are aid/healthcare workers, as has been the case here during the entire invasion. Or maybe worse than all of those things, they may not find food when they need it most.
- The thought of these things makes me literally want to crumble into a ball of sadness, but I am reminded by the very people I am sad for: head up, no sadness, no tears. Remember, Allah is in control and then I’m reminded by this verse:
- وَمَا كَانَ لِنَفۡسٍ أَن تَمُوتَ إِلَّا بِإِذۡنِ ٱللَّهِ كِتَـٰبࣰا مُّؤَجَّلࣰاۗ وَمَن یُرِدۡ ثَوَابَ ٱلدُّنۡیَا نُؤۡتِهِۦ مِنۡهَا وَمَن یُرِدۡ ثَوَابَ ٱلۡـَٔاخِرَةِ نُؤۡتِهِۦ مِنۡهَاۚ وَسَنَجۡزِی ٱلشَّـٰكِرِینَ﴿ ١٤٥ ﴾
• “And it is not [possible] for one to die except by permission of Allāh at a decree determined. And whoever desires the reward of this world - We will give him thereof; and whoever desires the reward of the Hereafter - We will give him thereof. And We will reward the grateful.”
• After getting back to Aqsa and settling in, I had a chance to reunite with some of my ICU nurse friends. One of them I asked: “How are you doing, my sister?” With the biggest smile on her face: “Alhamdulilah, still breathing… Alhamdulilah.”
• I reconnected with Amro today too, my nurse buddy from last year. He sat down to talk about what had been going on. He sighed deeply after we finished greeting each other. He looked broken this evening. He did this thing I’ve seen a lot here do on this trip… he stared ahead at the wall and froze there… almost holding his breath thinking about something heavy. In his trance, he rocked a bit back and forth. I touched his arm, and he snapped out of it and looked at me and smiled… “I missed you,” he said, “It’s just been so much harder.” We talked about his family, his living situation, his lack of consistent salary, his lost weight. He then asked me: “Can I ask you a small favor?” I replied: “I would do anything for you.” He continued: “Can you try to get me out of here when the war is over? Help me get into an academic nursing program, a place I can work… anything?” A lump began to grow in my chest. I would do anything to get him out of here. He is smart, kind and loves nursing more than anyone else I know. He cares about patients and teaching, and he knows when to be tough and when to soften up. He should not have a chance just because I know him. He should have a chance because he deserves it on his own accord. I felt the lump climb in my throat… All I could say was: “InshaAllah, when the war is over, I’ll try everything I can.” Amro was too smart not to sense the worry I had about what was actually possible. He replied: “Don’t worry, I know you will try, and I will always love you for that no matter what happens.”
- I do not have any pics for this post because I could not get myself to take a picture with Amro. Seeing him so depressed, knowing I was powerless to change his situation, knowing I’d be leaving in three days and just go back to living while he’s here alone. I don’t have words for that feeling.
I’ve drifted away from telling many patient stories for a few reasons. Every person in each of these stories is a victim. The patient that has been traumatized by shrapnel, explosives or bullets. The mothers left crying for their children, their fathers left feeling the guilt and shame of not being able to protect them. Their siblings who forever lose someone that shaped their identity, and their children who will be forced to live a life without them. The medical staff suffers as they are tasked with often shepherding them through the last stages of death and dying. The larger community that watches these patients go from the rubble or the dirt in front of the food stations, to the hospital and then finally to the morgue.
Neighborhoods are left caring for mourning widows and helpless orphans, adopting them into larger broken families with similar stories. I feel like if I take another picture of a broken bodied child, it does nothing less than diminish their dignity. I’ve shared them here occasionally because I battle that reality with the alternative: Masses of people hear the numbers of dead but forget that these are real human beings.
Taqwa is 20 years old and was 17 weeks pregnant when a rocket targeted her house. The attack killed her young husband, caused an intracranial hemorrhage, destroyed her right arm and killed multiple family members. She is in her second trimester, and the baby still has a heartbeat, though they have been very concerned about injury to the baby because of poor growth. Taqwa is awake but nonverbal. She called me over with her hand when she saw me and had a smile on her face. I tried for a minute to understand what she was trying to tell me as she kept making a sign where she rubbed her lower lip. I thought perhaps she was thirsty. The nurse came from behind me and said… “No, she is trying to tell you that you have some toothpaste in your beard and should clean it.” We all laughed, including Taqwa who got a kick out of the whole interaction. Hey, I’ll take a laugh at my expense here any day.
I saw Amro today in the ICU and he was in a better state of mind. He wanted to take a pic with me. :)
This is Mutasim. Despite the deep sadness he feels for his brother, he smiles like this every time he sees me, and he usually makes jokes about how Real Madrid is better than Liverpool because he knows I’m a fan.
I sat with Mutasim last night for a few minutes. He is 16 years old and is one of those kids who is smart and has a quick quip for everything. He tries to practice his English with me which he says he learned from video games and while watching soccer with English broadcasters. I ask him how his family is doing since his brother was killed a month ago. “My mother, she keeps going, but I know she is sad every day. And me…” The smirk goes away, and the little boy who loves his older brother appears on his face. “I miss him too much.” He takes a minute to regain composure. The ability to do so amongst people here— to go from complete darkness to restoration of the light in their face, to restoring composure… it is an unfortunate skill required by the Gazan, no matter the age. He continues: “My brother used to be the one who would check on me since our father was gone. He’d give me money and make sure we were all okay and would take care of our mother. Now our mother takes care of his surviving kids, as both my brother and his wife were murdered in a rocket strike in their home.”
- It is worth mentioning from a clinical and public health perspective — there has been a significant rise in clinical presentations of Guillain-Barré syndrome (GBS)-like illness. It’s unclear exactly what the cause is, but there are three new cases in the ICU at Aqsa today. Normally, these cases involve ascending paralysis after a viral infection (classically the flu), but these cases present very atypically. Unfortunately, patients inevitably become ventilator dependent. There are some floating theories: Is this the consequence of Poliomyelitis in a population that’s been deprived of vaccinations? Is this a consequence of chemical/biowarfare? Or is this just a sign of the global immune state of starved people? It is impossible to confirm in this context without any tests available to verify.
Dr. Ahmad Yousaf’s interview with Al Jazeera English:
Inside the ICU, there are no moments of calm. The trauma specialist works nonstop, shifting between patients with massive internal injuries, crushed limbs, third-degree burns, and shrapnel wounds from airstrikes.
Dr. Ahmad Yousaf, alongside other physicians, healthcare workers, and aid teams, is bearing witness to a man-made humanitarian crisis in Gaza — where deliberate starvation is being used as a weapon against an already suffering population.
I just learned moments ago they just killed Anas Al-Sharif and many of his colleagues. They were journalists I have met here who risked their lives every day to be the voices of Gaza when nobody would listen. A war on journalism and the truth. This bombing was directly outside the hospital I was at the last two weeks (Al Shifa hospital) and I am now in Aqsa. If you had any doubt to this point, today is the day you have no excuse. We are talking about evil in its truest form.
Mai is a 35-year-old clinical pharmacist in the ICU. There are times when you sit with someone and realize you may be sitting with someone so special; you can only pray that your short meeting with them allows for an association with them in a place far better. I learned so much about life, religion, humanity, perspective, being a parent, being a spouse and every quality I wish I had, from one person in a two hour conversation. It is impossible to convey in writing, but I will try my best to at least tell you her story (paraphrased) so that you may know, turning the world upside down to protect her (and her remaining family) would be worth it.
As many nephrologists have been killed or escaped early in the war, Mai essentially functions as the nephrologist APN in the dialysis center. She also works overnight as the lead pharmacist (based in the ER) and dispenses medications AND materials for the whole hospital, when materials are scattered and medication rooms are half empty disasters. As she literally served me and Dr. Shadman tea, she told us the story of her sister Maisoon (not exactly her twin, but she called her one), while being interrupted about once a minute for dispensing of a med or supply. She would bounce between conversation, her desire to host us in her tiny new closet/pharmacy, and the needs of the doctors/nurses like she was walking a tightrope… and she never lost her balance. “Maisoon was my life. The day she died, with her husband Ahmed and their 3 children, I realized I would never be truly happy again. She was my light; my best friend and she loved my kids more than she loved herself.” She showed us pictures of her late beautiful sister, her kind-faced husband and her little children. Despite the obvious sadness, her eyes were alive with the love she still had for them.
She shared: “Two days before she died, I had a dream that she was buying a white dress. I became very worried about her husband because I thought this would mean something was going to happen to him. When I found out they all died together, I was devastated but at least they are together in heaven now. We ask for this, the people of Gaza… that ‘Oh Allah, if you take us, take us altogether so we don’t have to suffer alone in this world.’” She described learning that Maisoon bled out in the ER, and that the bodies of her nephews and niece were incinerated and unrecoverable. She learned that her beloved brother-in-law, Ahmed was under the rubble… and she said in this moment, “I felt a sharp fire in my chest like my heart broke into millions of pieces and I could not put it back together until now.” Mai would stop after these moments of heavy conversation and say Alhamdulilah. In this pause, she would write something on her hand and then rub it away. I never asked her what she was writing but I suspect it was a prayer.
I would see her, in these brief moments of pause, contemplating, and her eyes would soften, and she would smile as if she remembered something that made her happy. She said, “I feel like the dream I had was God telling me Maisoon took my place, that I was supposed to go and Maisoon asked God to take her and her family instead and protect mine here. Months after her shaheed, I was living in the Nusserat camps where the IDF rained bombs down like raindrops. There was fire everywhere and I could not find my four children. When I left the tent, there was a huge fire, and my feet were burning like I was in Hell itself. I was clutching on to my 2-month-old, Sara… and I found my 6-year-old screaming out to me (disoriented) that she could not find her shoes, and her face covered in blood and soot. I grabbed her too and ran as fast as I could towards the street. One of my brother-in-law’s friends found us in the chaos and carried Abdullah (my 4-year-old son who had suffered a head injury), but I could not find my oldest until we found her in the ambulance unconscious. All four kids survived, some with more serious injuries than others.
Wallahi, I felt like Allah protected me because my sister Maisoon asked Him to. I know this, I feel her in these moments having prayed for us.” I asked her… how does she remain strong in these moments. “I am not strong; I am always scared. Not for myself, but for my kids, for my family. I don’t have anything. They have destroyed my house, taken my sister and my other family members from me. I just need to know that my kids can be safe.” She deserves safety. She deserves everything.
“God gave me an amana (trust) with my work to help patients and their families. I think now, the only reason I am here is to serve these people. This is what gives me the small moments of meaning and happiness. When the patients feel relieved or say thank you, or say a prayer for me, I know this protects us all too.”
Dr. Shadman and I were left speechless by everything this woman told us. Between dispensing medicines, she would make jokes about the fact that being a pharmacist has made her a very good cook, and she wanted to make us Maklouba (the Palestinian national dish if there ever was one) when the war is over but there was no meat so it would have to be vegetarian. Unless they finally let some in. By the end of our sit down, I was completely spent. I wish I could tell you that this story ends happily, but that ending does not feel close. I know that Mai, may God grant her safety and security, has already won on a timeline longer than we can perceive (this from her own perspective as well), but what these people have gone through is so unimaginable, that my very poor vision of reality leaves me unable to appreciate how they maintain this level of faith in the face of this ongoing genocide.
Mai says something, with a wry smile multiple times during our conversation with a hint of dark humor the almost didn’t wish it was the case: “Alhamdulilah, we are still alive.” We told her, “Listen Mai, you can’t die for a while because this hospital and these patients need you, and we need you safe so that we can visit you with our families for the Maklouba you promised us.” She laughed and seemed to love the idea of that. She continued to dispense some pain meds through the window to the nurse and said, “Inshallah, I cannot wait for this.”
I sat here, with Dr Shadman, and we both cried about this woman, her husband, her kids and her sister Maisoon (may Allah have mercy on her) and her lost family members.
The people of Gaza, Mai and her kids deserve safety, and the fact that we cannot convince the world or provide it ourselves is the most shameful feeling I have ever felt in my life.
Anas Al-Sharif: Anas Sharif knew he had a target on his back. Israel had sent him messages that if he kept reporting the truth on the news in Gaza, he would be targeted. He wrote his last will and testament, knowing it was coming but kept going. He is the essence of the Gazan struggle. His post below:
“This is my will and my final message. If these words reach you, know that Israel has succeeded in killing me and silencing my voice. First, peace be upon you and Allah’s mercy and blessings.
Allah knows I gave every effort and all my strength to be a support and a voice for my people, ever since I opened my eyes to life in the alleys and streets of the Jabalia refugee camp. My hope was that Allah would extend my life so I could return with my family and loved ones to our original town of occupied Asqalan (Al-Majdal). But Allah’s will came first, and His decree is final.
I have lived through pain in all its details, tasted suffering and loss many times, yet I never once hesitated to convey the truth as it is, without distortion or falsification—so that Allah may bear witness against those who stayed silent, those who accepted our killing, those who choked our breath, and whose hearts were unmoved by the scattered remains of our children and women, doing nothing to stop the massacre that our people have faced for more than a year and a half.
I entrust you with Palestine—the jewel in the crown of the Muslim world, the heartbeat of every free person in this world. I entrust you with its people, with its wronged and innocent children who never had the time to dream or live in safety and peace. Their pure bodies were crushed under thousands of tons of Israeli bombs and missiles, torn apart and scattered across the walls.
I urge you not to let chains silence you, nor borders restrain you. Be bridges toward the liberation of the land and its people, until the sun of dignity and freedom rises over our stolen homeland. I entrust you to take care of my family. I entrust you with my beloved daughter Sham, the light of my eyes, whom I never got the chance to watch grow up as I had dreamed.
I entrust you with my dear son Salah, whom I had wished to support and accompany through life until he grew strong enough to carry my burden and continue the mission.
I entrust you with my beloved mother, whose blessed prayers brought me to where I am, whose supplications were my fortress and whose light guided my path. I pray that Allah grants her strength and rewards her on my behalf with the best of rewards.
I also entrust you with my lifelong companion, my beloved wife, Umm Salah (Bayan), from whom the war separated me for many long days and months. Yet she remained faithful to our bond, steadfast as the trunk of an olive tree that does not bend—patient, trusting in Allah, and carrying the responsibility in my absence with all her strength and faith.
I urge you to stand by them, to be their support after Allah Almighty. If I die, I die steadfast upon my principles. I testify before Allah that I am content with His decree, certain of meeting Him, and assured that what is with Allah is better and everlasting.
O Allah, accept me among the martyrs, forgive my past and future sins, and make my blood a light that illuminates the path of freedom for my people and my family. Forgive me if I have fallen short, and pray for me with mercy, for I kept my promise and never changed or betrayed it.
Do not forget Gaza… And do not forget me in your sincere prayers for forgiveness and acceptance.
Anas Jamal Al-Sharif
06.04.2025”
A post from Journalist Anas Al-Sharif minutes before he was murdered on X:
To Whom It May Concern,
The occupation is now openly threatening a full-scale invasion of Gaza.
For 22 months, the city has been bleeding under relentless bombardment from land, sea, and air.
Tens of thousands have been killed, and hundreds of thousands wounded.
If this madness does not end, Gaza will be reduced to ruins, its people’s voices silenced, their faces erased — and history will remember you as silent witnesses to a genocide you chose not to stop.
Please share this message and tag everyone who has the power to help end this massacre. Silence is complicity.
On the topic of journalist being targeted, I visited Nasr hospital this morning and was told the story of Hassan Aslih, a journalist who was targeted at the entrance of this hospital. Initially they did not get the job done, but Hassan had lost multiple fingers of both of his hands and was admitted to the hospital for a planned surgery. The night before his surgery, a precision rocket struck his room, another exacted assassination against the journalists. The men and women that were/are the voice of the Gazan people. The IDF immediately paints these people as terrorists. I did not know Hassan, but if he was anything like Anas, his show of resistance revealed the truth. He knew his life was at risk, but he put the preservation of the truth over the value of his own life.
This was the window through which the IDF assassinated him… another child patient was in that room, and the director of pediatrics tells me: That child was going to be discharged that day, but he was murdered with Hassan.
Dr. Ahmed at Nasr Hospital is the director of the pediatric department. He told us how the IDF evacuated and destroyed large portions of Nasr hospital. “We never imagined how we could rebuild. Everything was destroyed. The IDF drew things in the walls, vulgar things sometimes. When we came back in, we rebuilt portions of the hospital and covered up these ugly things on the wall… and just kept going. God made a way for us.” He says this with bullet holes behind him in the window, and with a hospital infrastructure which just hangs on by a thread. The most vulnerable patient populations here have b been neglected the most by the world.
My last night in Gaza
- Israel has stepped up its bombing in Deir Balah. In this last evening, they’ve been striking the green zone multiple times. One of the strikes killed multiple small children who were playing soccer in the street. Dr. Aslam showed me video from the ER, and it is as gruesome and terrible as you can imagine. I’ve contemplated sharing it here but will hold off for now as not to dishonor the dead with something you’ve been able to see for two years simply by paying attention to the internet. Many of the people here say: They are doing this because people are not going to GHF and the IDF needs to meet its quota for eliminating an amount of the population daily. Because aid has been getting in, people have not been willing to risk their lives as they can find enough sustenance in the market and from distributed aid. It is a sick cycle of violence that I would not believe if I did not literally see it happen with my own eyes.
- If you still do not believe what I’m saying about children coming into the ER this evening in pieces, I’ll send you the video evidence of the war crimes committed by the IDF if MORE evidence is still required to believe what all this is.
- I said goodbye to some of the people I literally love most in this world today. I may have said this already, but it weighs heavily on me. I squeezed these people harder than I ever have anyone else because they may die tomorrow, or in a week or a month or before I ever get to see them again. We’ve heard bombs drop on civilian infrastructure the entire day today. Close enough to us to shake the building…enough percussion to make us startle and duck our heads reflexively. And to drive the point home, that’s only the foreigners. The Gazans are so used to it; they barely pause as they are speaking or simply add a “hasbunaAllah.” Nermeen, my translator at Nasr today told me: “Don’t worry, if you hear it, it means you are still alive.”
- The people of Gaza live between life and death like they are the rope in a game of tug of war. Some days they are closer to death than life, and it is this reality that has shaped them into who they are.
- I sat with my “life teacher,” Dr. Jihad Juwaidi. If I could learn at his feet for the rest of my life I know I would still not have time to gather all of the knowledge and wisdom of this man. He is a rather odd man who wears a baseball cap all the time on top of his long gray stringy hair which he ties into a small ponytail. He speaks like the words need to be filtered through a myriad of trials before being allowed to escape his mouth and be worthy of sound. Simultaneously, he has Gazan charm and hospitality. And if he likes you (and he’s quite picky), he treats you like a son who needs to be respected and honored and fed and caffeinated (or nicotinated if that’s your jam). I asked him about how the weeks/months were during the starvation phase of the IDF strategy before some food was available and he said, with a sarcastic smile, “Listen, if you are Muslim and Gazan, you look for the good in every situation. When we could not find food, I realized I did not have the caloric reserves to get frustrated or angry. I never raised my voice once. Which is something I do when my belly is full…” Later… speaking about how the Gazan people have adapted, he continued: “Drones are part of our lives now. The hum is such a staple of existence for us that if they suddenly stopped using them, we would not be able to sleep. It is ESSENTIAL SOUND POLLUTION FOR US.”
I asked Dr. Jihad: “What do you think is going on with the ceasefire talks?” He replied: “The people of Gaza are stuck. No one listened to us before October 7th, and they sure as hell have not listened to us since. What is interesting to me is that I believe that Israel is even more stuck. They are so scared about their reputation, that they’ve permanently destroyed their reputation. And if they proceed now with our annihilation, they will lose everything. And if they back off now, their people will think they lost as well. It’s like they climbed a tree… got too high, and now they have no idea how to safely jump down.”
Leaving Aqsa now. To OCHA guesthouse for UN transport to Kareem Abu Salem crossing. May get some reception while driving through occupied West Bank iA.
At the guesthouse now and getting messages from so many of the beautiful Gazans.
Here is one from a man that will carry a portion of my heart until I see him again:
It was only a few days that brought us together amid the busyness of work and the circumstances we both faced, but I swear by Allah that they were among the most beautiful moments for me. It was a lovely opportunity to gain a respectful and kind friend like you.
I truly wished the circumstances were better so I could host you properly — please forgive me. I ask Allah Almighty to reunite us again in better times, so I can take back a piece of my heart that you took with you. Wishing you a calm, comfortable, and safe journey. And send my regards to your honorable family, especially Musa and Ibrahim.
While I wait in this unnecessarily long exit process, I thought I’d share some of the people who have accompanied me on this trip. Dr. Farhan, our ameer, and the person who invited me to come while at hajj. I owe him significant gratitude, and he will not like it, but inshAllah he is likely to busy making Dhikr or praying to read this anyway. This was his 6th entry into Gaza. The people of Gaza know him and love him and he loves them. His Arabic (not his first language) is impeccable and to pray behind him is an honor. He also turns into a child if he sees a stray cat and has a cute squeaky voice that immediately makes them aware he’s one of the good guys.
He found ways of helping patients and their families in amazing ways and I will always look up to him (despite us being the same age) because he is the kind of role model the average American Muslim needs… an unabashed believer who speaks the truth, acts accordingly and balances that with a career in medicine and a family. May Allah keep him sincere and in His service.
Dr. Shadman, a vascular surgeon in Dallas, has been my true older brother this entire trip. He has scolded me for taking risks, he constantly makes sure I have my things and ensures that I’m hydrated and praying on time. He has also refused to eat the vast majority of time while here. He’ll joke that this is because his son’s wedding is next week and he needs to fit in his clothes. The truth is, his heart did not let him. He was aggressive about not eating lol. The idea of taking one bite away from any of the Gazans was so abhorrent to him, he did not have an appetite. I’ve been his sidekick during deep conversations with many of our Gazan colleagues and he tells me every time: “Thank God you were there because I would be on the floor in the fetal position crying if I had to say anything in response to the immense hardship of these people.” He performed many life saving and life modifying surgeries MashAllah, and often when I woke up, his bed was already empty, and he was off to get to the next case.
He also hates pictures, so I’ll share two so that he gets really upset 😉. He is among the top ten most introverted guys I’ve ever met so taking these pics with the team members was a big deal 😂 May Allah protect him and continue to use his hands to heal the people of Gaza and beyond.
Dr. Masood, ER physician. He did not come with our group, but we adopted him quickly into the team because of who he is. He was the workhorse. Day shift/night shift… it didn’t matter. If he heard an MCI had occurred, he got dressed and ran down to the ER every time MashAllah. His kindness and insistence on helping is what defines my understanding of him. He was also simultaneously studying for a high-level certification for religious studies between patients and would walk around the tents around the hospital so he could find and provide food to people. May God preserve these qualities in him and protect him.
At Kareem Abu Salem (Kerem shalom crossing now). Waiting for security process for them to look at our bags. I have a bunch of small trinkets and gifts from friends in Gaza and I’m praying they don’t confiscate these things.
Done! On our way through occupied Palestine towards Amman Jordan. We will pass south of Jerusalem. Some of the Gazans told us - when we are finally free, we will go to Jerusalem and cook the largest Maklouba dish ever made. If you don’t know what Maklouba is, you don’t know enough Palestinians :) (in Gaza it’s pronounce MAGLOOBA) :)
They questioned Dr. Farhan because he had a bunch of the gifts that were given to him. They said: “You are not allowed to take gifts.” He said, “People gave me gifts.” She said: “It’s a lot of gifts.” The truth is, Dr. Farhan has a lot of friends, and they all love him enough to get him stuff. He shrugged. It’s not his fault he’s popular. 🤣
She waved him through and said: “Don’t do this next time.” May Allah grant us all a next time in a situation that sees a free Gaza, the cessation of death and destruction and the era of rebuilding.
Dr. Uzer is a trauma surgeon from Dallas. He was stationed at Nasr hospital. He was immediately “one of us.” He quickly recognized that his role was going to be crucial but different than his normal job. He was going to just be relief and a shoulder to lean on for his fellow surgeons. He often stayed in the OR ten hours at a time doing back-to-back cases: “I saw enough penetrating trauma for a lifetime in two weeks.” He also had this smile on his face almost all the time you see him. May God reward him for his compassion and his surgical skills he studied decades to perfect.
Dr. Masood has been intermittently studying for an online religious certification and continues to be studious even on the exit bus. 🙃 Gaza brings together some truly extraordinary people.
Two short stories (ETA to Amman is about an hour).
- Dr. Farhan visited a tent mosque that had been constructed and used for prayer and Quran recitation during this trip. He was invited because of his own credentials in the field of recitation to listen to some of the amazing students. He told me there was a 14-year-old girl who had memorized the entire Quran and recited with perfection during the event. He then asked the teenagers (mostly girls): “What motivates you to come to the mosque when you know all of the other ones have been destroyed?” This same 14-year-old girl raised her hand and said: “In Gaza, death is always around the corner. We may as well be reading the Quran and praying when it meets us.”
- I sat in my last night with some of my ICU friends from last year and had food with them. They had some cheese and a few vegetables with their rice and bread, and they were super excited to make something for me as a farewell, as they didn’t have ingredients before the last couple of days. One nurse, the cook said: “Listen, the only vegetable we’ve eaten for the last 6 months consistently is eggplant. During this time, we have relied on eggplant like an old friend. We’ve mashed it, we’ve fried it, we’ve baked it. We’ve made it taste like other foods and mixed it in our rice and even made eggplant sandwiches. Eggplant has been more reliable to us than the entire world during this war… and at times, our only ally!” He said this and everyone burst into laughter at his vegetable ode. He then looked at me seriously, “When you come back and we have ingredients, you will honor us by allowing us the normalcy of cooking you the real food we all wish to eat together… spices and chicken and meat… things we have not seen for a while.” He then made me promise I would let him do so and I took his hand and said God willing I would find him when this was over.
Arrived in Amman after a 13-hour ordeal of mostly just waiting. But Alhamdulilah I am here now. Jumped on the first of hopefully many interviews to try and communicate what’s happening on the ground in Gaza. Please share as you see fit:
My plan for this chat and all its content: will consolidate to a website for easy access to entries, pictures and videos inshAllah. Will share website in the next day or two.
I stayed in Amman last night. Connected with a few friends I would not otherwise have, except that our hearts are tied together by a love of Gaza and its people.
We passed by streets full of fruits and vegetables… shawarma. There was electricity in every home. No rubble… no tents full of the displaced… no buzzing drones circling above… no explosions in the distance… no gun shots in the distances… no dead children, no mourning mothers wailing at the site of the funeral prayers… no bleeding out on cold hospital floors… no tears falling from the faces of fathers left powerless to protect their own.
There is nothing “normal” about Gaza. It is not a war zone, it is a cage for killing. It is imposed hunger… blood and injustice.
Gaza is the issue of our time. It is the defining “furqan” (litmus test) of our generation. We will all be asked, in this life and the next… what we did when we saw this televised massacre live on our phones. If we were afraid of standing up for them because we worried for our representation, feared for our livelihood… when we were scared of discomfort… as their children died in their arms and the bodies were covered in dirt by bulldozers.
It is a living hell… full of the people of paradise.
The people of Gaza honored me simply with their presence. They soothed me when I cried for them (“La tahzan lana… gul Alhamdulilah ala kulli hal “don’t be sad for us, say Alhamdulilah in every situation). They humored me by allowing me to be associated with them in this brief moment. They permitted me access to their kindness, generosity and compassion. They fed me with their hands from food that was their right. They dignified me by mentioning me as their family (“hua ghazawi… khaalis” - He’s Gazan, through and through). They gifted me from the rubble from which they have climbed out of… they have broken me into pieces and glued me back together with their love. I write about them because I cannot speak easily about them without losing myself. They forgive me for my neglect and heedlessness of their states. They show gratitude for the simplest things. they taught me about dignity and 3iza… they schooled me on manners and reliance on God… They made me laugh when they had no business doing so. They have provided me purpose… from now until I die.
They are chosen… not because of what they are made of… but because of what they represent in their action… in their resilience… in their resistance.
Breathing another day… is resistance.
Surviving another dawn… is resistance.
Saying Alhamdulilah Da’imun is resistance.
Finding footing on broken earth is resistance.
Replanting the olive trees torn from their roots… knowing it will be a decade before they
produce fruit again… is resistance.
Walking through the smoke of the weapons meant to kill them… is resistance.
To be Gazan is resistance.