Gaza: Chaotic scenes at Al-Aqsa, Nasser hospitals after bombings

Chris Hook, MSF medical referent, sent a voice note from Gaza today:

"We heard earlier in the day of the attacks occurring further north in Deir al-Balah and Nuseirat, so the hospital had a little bit of pre-warning that we should expect some patients, but not entirely sure how many.

I think in the last hour or so, we've received, coming close now to about 50 badly injured patients. There are people with multiple major open fractures of their limbs. We've got several unconscious children who are trying to be escorted through CT scans and on to intensive care.

A few very bad burns have come through, and already four or five people who've required chest tube insertions, and things like this, for major injuries to the chest.  

The [operating] theaters are already running flat out. We have very limited resources. The emergency department was able to clear out as many people as possible that were already here, but there's a shortage of ability to perform CT scans. Patients have to go to another hospital.  

We have very little painkillers available. In terms of things like morphine and ketamine, we're still having to ration those a little bit. The intensive care unit is now full already, and more patients are arriving. It's a serious mass casualty incident occurring right now.”

Another MSF medical referent, Karin Huster, also sent an update on the situation: 

"Today is Saturday and I just came back from Al-Aqsa Hospital. Things started happening around 11:30 a.m., when there was a huge blast right next to our office ... And we started to hear really, really intense IDF activity, lots of bombardments, lots of shooting, helicopters ... As soon as we were able to, we three clinicians decided to prepare a bunch of supplies and medicines and go and support colleagues at Al-Aqsa Hospital. We had also heard by then the plea of the Al-Aqsa Hospital director to come and help. It just took some time to clear everything from a security standpoint.  

Finally in the early afternoon, we entered Al-Aqsa Hospital’s emergency department. I have no idea how many dead there were. We had no time to take a look at the morgue ... It was, as usual, mayhem. But it was compounded mayhem from the last four days: total chaos inside; the entire emergency room, the red zone, the yellow zone, the green zone were completely packed with patients on the floor coming from the bombings in Nuseirat. There were hundreds of patients, and we did whatever we could to stabilize them, give them some IV fluids, put on a splint, bandage, try to refer for surgery for those who would benefit from that. And, thank God we were able to refer a bunch of patients to Nasser Hospital as well as IMC Field Hospital which is not far away from here.

Despite the fact that the place was completely overwhelmed, it did an amazing job. The nurses of the hospital, the Doctors Without Borders nurses and physicians that lent a hand, did an amazing job and continue to do an amazing job as we speak.  

It is not difficult to imagine the horror that we saw. There were children everywhere, there were women, there were men. We had the gamut of war wounds, trauma wounds, from amputations to eviscerations to trauma, to TBIs (traumatic brain injuries), fractures, and obviously, big burns. And so, it was just survival for all of us rolling up our sleeves and putting fluids in people, giving them pain medicine and [sending] them to a place where they could get care.

Unfortunately, the system is so overwhelmed that a lot of patients are staying much longer than they should in this emergency department. Kids completely grey or white from the shock, burnt, screaming for their parents. Many of them are not screaming because they are in shock. Expectant patients mixed in the yellow area. It's just one of those moments when you don't think about the chaos that is happening: there is no system, there is no triage. You roll up your sleeves, you put a ton of stuff in your pockets, and you do the best you can.

But there is nothing, nothing at all that justifies what I saw today. Nothing. These children: the 3-month-old, the 7 year old, the 12 year old who died, the 25 year old man, the 78 year old woman who all have horrendous injuries. Why did they deserve this? And why is the world looking on in silence? To what level of horror do we need to go before we finally do something, before we finally tell Israel that this is not acceptable?"