At 8AM on the morning of July 22, a Doctors Without Borders/Médecins Sans Frontières (MSF) surgical team returned to an MSF office in Gaza after an overnight shift at Al-Shifa Hospital, in the center of Gaza City. Weary from a night of treating one wounded patient after another in the emergency department, they took a moment to describe what they’d just seen. “It’s going to be a busy night,” Alaa, an MSF driver, had said the prior evening, as Israeli tank fire and shelling reverberated in the distance and the team prepared to leave for Al-Shifa. He had been correct.
“I monitored two new patients hospitalized in intensive care in the major burn unit,” says Adriana Dumitru, an anesthesiologist. “One was a young mother, 24, and the other was a 10-year-old boy. The young woman had been buried under the rubble of her house for 12 hours. She lost her daughter and 10 other family members there. We did everything we could, but she died this morning.”
Dumitru had just arrived in Gaza to help the emergency team, having completed a previous assignment with MSF in Gaza earlier in the year. It had been relatively calm then. This was different.
“The little boy lost his father,” she continued. “His mother was with him. A missile struck their house, which collapsed. He suffered burns and crush syndrome, trauma, and had 100 wounds over his entire body from exploding shells.”
After surgery, he was admitted to intensive care at Al-Shifa Hospital’s burn unit. A small wound worried Kelly Dilworth, the other anesthesiologist on the MSF emergency team. “It was a small cut in the belly that wouldn’t stop bleeding,” Dilworth says. “I requested a scan of his abdomen and we saw that he had an internal hemorrhage. The bomb fragments had made seven perforations in his small intestine."
By noticing the wound, “she saved his life,” Dumitru adds.
The wounded arrived in waves of three, four, or five. The first came from the Shuja’iyeh neighborhood, which was still being shelled. Others were transferred from the al-Aqsa Hospital in Gaza, which was bombed earlier in the day. The last group seen by the MSF team came from the area around the al-Aqsa Hospital.
Cosimo Lequaglie, an MSF surgeon, managed to extract a bullet from the superior vena cava, a vein that carries blood into the heart, of a 20-year-old woman. “The other two patients I operated on last night had thoracic wounds from explosions that occurred near them,” he says.
“A 20-year-old man was hospitalized at at-Aqsa when the hospital was hit,” Dilworth recalls. “He came to the Al-Shifa emergency room. We had to amputate both legs below the knee. His operation took nearly three hours.”
Most of the cases in the operating room are very serious and require several surgeons. “Yesterday we had at least two neurosurgery cases,” Dilworth adds. The emergency department refers dire cases to the operating room as quickly as it can, but sometimes it’s too late.
“A little eight-year-old girl was transported to the operating room,” Dumitru explains. “She had lost both legs in an explosion and suffered multiple traumas, including head trauma. Other than ease her pain, there was nothing else to do.”
According to Lequaglie, 30 percent of the patients in the hospitalization unit are children.
The emergency room was crowded with children with minor wounds as well. But last night, the only patients in intensive care were adults. At least five of them died in the hospital.
An aerial strike fell near Al-Shifa as well. “The entire building of the burn unit shook like during an earthquake,” reported the team that was still there.
Back at the office, the overnight team described their night, each member holding a cup of coffee, lowering their eyes as they listened to the latest media reports. According to the United Nations, 10 people were killed and 130 wounded last night. That number sounds low to the members of the team, given what they’d witnessed at Al-Shifa.
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