“The moment you cross the border, you can see thousands of people standi𒅌ng in endless queues for food. People live in the most dehumanised conditions. The air is filled with the smell of hydrogen sulphide, methane and sulphur dioxide,” says Saꦫnthosh Kumar, a doctor working with Médecins Sans Frontières (MSF). Santhosh, the former South Asia Vice President of MSF, reached Gaza in November 2023 and worked there until April 2024. He recollects his experiences in Rafah and Deir Al Balah.
“About 1.8 million people live in such conditions. There is no food, water, electricity or cooking gas. All buildings and houses have collapsed. People live in tiny plastic tents―10-15 people squeezed in each one. There ☂is an endless queue before make-shift toilets. Can you imagine 250 people queuing up before you when you come to use a toilet?” asks Santhosh, who has worked in seveജral conflict zones across the world since his association with MSF in 2005. He believes that what is happening in Gaza is nothing but genocide.
“This is genocide, not even war. This is a one-sided onslaught on unarmed and helpless civilians. We have witnessed genocides before―in places like Armenia, Burundi and Rwanda―but they had options to flee or migrate to other places. Gaza is different. It is a confined, narrow strip. On one side is Egypt, and on the other is Israel and the Mediterranean Sea. They have no place to go. When Israel started bombing from the north, people fled to the city of Khan Younis; when Khan Younisꦜ𝔍 was bombed, people ran to Rafah; and when Rafah was bombed, they ran to Deir Al-Balah―there are no other places to escape beyond that,” says Santhosh. This is the first time in history when people have been trapped within a closed space, adds Santhosh.
“Genocide ends when there is external intervention. When the Russian Army entered Armenia and the French Army entered Rwanda, the genocides were averted. If genocide is not 🌜prevented by a force from outside, then it will go on and on,” says Santhosh. “Around 35 per cent of the remaining population is hit by diarrhoea. People die more of epidemics than by shelling, bombing and gunfire. Each toilet is being used by 1,500 to 2,000 people. The water is severely contaminated. There are frequent disease outbreaks. People used to bel📖ieve that hospitals wouldn’t be bombed, but they have been attacked. Doctors would run away as they are served an advance warning. But where do the injured civilians go?” asks Santhosh.
Santhosh explains what he has witnessed in Rafah and Deir Al-Balah. “Even humanitarian aid is blocked by the armed forces. As there is no electricity or gas, the humanitarian organisations can only provide cooked food. What you see is kilometre-long queues at the food distribution centres. Women and children get preference, then 🌳there are men who have not eaten for 2-3 days. They go mad seeing children eating and wasting food. They attack women and children. H💮unger makes people less of a human being,” says Santhosh.
“If you are given three options—either to be killed, to be detained or to be evacuated—which one will you go for? These are the options given to the medical professionals in Gaza,” says Ahmed Moghrabi, a plastic surgeon who was the head of the reconstructive surgery and burns department at the Nasser Hospital in Khan Younis. He now lives in Belgium. Moghrabi is one of the survivors who was evacuated from the hospital moments before a heavy bombing. “The impact of bombs dropped over Gaza is worse than what we have seen in Hiroshima and Nagasaki,” he says.
Moghrabi illustrates the true scale of the war taking place in Palestine. “Gaza may have come under sudden global attention since October 7, but we have been under siege for 20 long years since Hamas won the parliament election in 2006. Gaza is the world’s largest and oldest open prison where people have no option but to die. Where do we go? It is not even like Syria. The people of Syria can go to Iran or Turkey, but Gaza is a prison surrounded by Israel, Egypt and the Mediterranean Sea,” he says. M꧋oghrabi becomes emotional while recollecting the horrifying experiences he underwent in his land.
In a video relཧeased on December 6, 2023, the world witnessed a helpless Moghrabi bursting into tears, asking: “How many of us have to die?” In other videos, later released on social media, he explained the miserable conditions in hospitals.
Like other health professionals who have spoken to Outlook, he too asserts that what has been happening in Gaza is nothing less than genocide. “So far, two lakh people have been either killed or badly injured, including thousands of medical professionals. This is 20 per cent of the population. Humanitarian aid has been blocked and hospitals are being targeted. What else is this if not genocide?” asks Moghrabඣi.
The hospitals are flooded not only with people injured in the war, but with people running away from bombs and missiles and taking refuge in hospitals. “When hospitals are giꦛven a notice to evacuate, the severely injured people are left behind. What can the doctors do? They also are either killed or arrested🐽,” says Moghrabi.
“The immediate impact of war is the complete destruction of the healthcare system. The system becomes helpless with the number of injured people rushing into the hospitals,” says Paul Ransom, a UK-based trauma care specialist and the medical lead for Hazardous Area Life-support Organization (HALO), which is a humanitarian body working to clear landmines and other explosive material in conflict zones. Ransom, who has extensive experience in most of the war-stricken countries all across the world, vouches that the ongoing war in Gaza is the mother of all wars. “This year, I was working in Nasser Medical Complex, probably the largest hospital in Gaza. This was the toughest of all my overseas experie🦩nces so far,” he says. Ransom expl♍ains the multiple and complex nature of wounds and related health issues that doctors have to deal with in Gaza.
“Huge buildings have been shelled and collapsed. Civilians, including children, come with crush injuries due to this. There are fragmentation injuries too caused by bombs. Bombs having a metal case containing countless tiny metal things called ‘fleshers’—little arrows—make small but multiple injuries in a human body. So, in areas where such bombs are used, there are a lot of people who have fragmentation💯 injuries in many parts of their bodies. Sometimes it may kill them if it goes into a placꦫe in the neck or the heart,” Ransom recollects. He asserts that the wounds in Gaza are the most terrible thing he has ever witnessed in his career.
Psychological trauma of war victims either gets the last priority or often goes unattended. Says Ransom: “We often deal with the immediate and primary impact as injuries, burns, and epidemics. The psychological trauma caused by war, both on adults and children, often gets the last priority. Besides, to address the psychological impact of war, we need experts from that region because language becomes a barrier,ღ” says Ransom. Often, the countries injured by war do not have sufficient resources to provide mental health support.
This also leads people to become alcoholics, abuse drugs, get involved in domestic violence and all other sorts of crimes. “The PTSD (Post-Traumatic Stress Disorder) caused by war has a terrible impact on the entire family. The൩ untold effects of war continue even in what we call peace time,” says Ransom.
