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Gaza: How the cycle of violence has impacted MSF patients and staff

In early August, during a three-day escalation of violence between Israel and militants in Gaza, 49 Gazans were killed, including 17 children, compounding an already desperate humanitarian situation in the blockaded Strip.

MSF teams have responded by opening clinics, donating OT/ER drugs, and now treating patients with the overflow of patients impacted by the escalation of violence and will continue to adapt support as needed.

Following the ceasefire, MSF asked patients and Palestinian staff to share how this cycle of violence impacts them and their families in their own words. Here are their testimonies:

MSF, Lab Supervisor
Nesma El-Helou, 35, MSF Microbiology Lab Supervisor, Al-Awda Hospital shares her experience interacting with people in Gaza amid the war and violence they are exposed to.

This war was hard. We’ve had several wars in the Gaza Strip, but every war seems worse than the previous one. This war felt like it lasted a whole century, full of terrifying, painful, and scary emotions. This time, I had a rocket in my home. I can’t explain the terror I felt with the sound of the rocket, the debris falling in my home, shouting, “Where’s my mom, where’s my Dad, my brother, my nephew?”. Thank god they were all safe. We think one of the rockets passed 10 centimetres from my nephew’s window, thank God he is safe. It’s a bad situation we have here in Gaza, every time, people die for nothing. A lot of our relatives outside Gaza call us, telling us “Go outside if you don’t feel safe in your homes.” Our response is always that there is no safe place in Gaza. You never know where the rockets are going, so we prefer to sit in our homes so we can die with each other, so no one will be alone if the rest of us die. This is what we do in every war and every war we will have in the future.

I am still seeing about 300 patients from the May escalation in 2021, getting rehabilitation and physiotherapy. In our department, we have a high load of patients as well from the Great March of Return. We are now preparing the department, both in and out-patient, to receive the injured from this escalation. There are different types of injuries, including amputation, and many will need limb reconstruction surgeries over the coming weeks. Shadi Al-Najjar, 39, MSF Physiotherapy Manager, Al-Awda Hospital

I have three children. On the second day of the escalation, I was at home, and the building next to my room was targeted by shelling and rockets. My home was partially destroyed, and my baby who is nine months old was sleeping in his crib and his room was close to the targeted building. All the shrapnel and glass surrounded him. Thank god he is fine and OK. I carried my children out and we started to evacuate other families in the building. It was a horrible moment. After the escalation finished, I retruned to my home to clean up all the glass and the things that were destroyed. I covered the windows with plastic sheets, but unfortunately, my baby boy and my little daughter are traumatized. She is not able to sleep, crying all the time, I am trying to be as supportive as I can for them.

Dr. Rami Abu Jasser, MSF Operating Theatre Supervisor, Al-Awda Hospital
Dr. Rami Abu Jasser, MSF Operating Theatre Supervisor, Al-Awda Hospital shares his experience surviving the wars through the years.

I was working in the hospital this weekend over the escalation, we saw many patients with multiple, complex injuries. Most of those with explosion injuries or injuries from their houses collapsing. Some patients came by ambulance, some came by car. I took care of one child with a head injury and a fractured hand and a fractured leg. The hardest part is dealing with the patient’s family, who is in such shock.

The situation at home was really bad (this weekend), especially the children’s fear, mostly Waleed (Khaled’s eldest son). And I was overcome with a sense of fear and my memory went back to what happened during the previous wars. Khaled Awadallah, 35, MSF Nurse, Al-Awda Hospital

This escalation brought back the memory of what happened last year, 2021 and in the year 2014. In 2014 I was married, and I had Waleed, before the escalation by a couple of days it was his birthday and we kept all his unopened gifts in a room, he was 1 years old. I was working as an emergency nurse at Al-Awda Hospital, and the situation was very severe, as the escalation continues the situation became worse. On 30/7/2014 my house that I was renting at the time was bombed, it was completely destroyed and I lost all that I had. But thank God I got on my feet and rented a new house and started building myself all over again.

In 2019, I bought a house on monthly instalments and I started preparing it to be our shelter and stable place for us, the war in 2021 started in May, and unfortunately a week after the escalation started my house was bombed and I lost everything…This had a huge psychological impact on me, but the solidarity and empathy of my coworkers at Al-Awda Hospital in the IPD had an important role in supporting me and raising my morals.

The biggest impact was on the kids, especially Waleed, whenever something happens or if he hears a loud voice, he starts crying and this tears me from the inside as I am not able to do anything for him. I always try to support him and tell him not to be afraid and that I am there for him, but the stress and the psychological impact on the kids is still there and I am afraid that his nervousness will affect his other siblings. The last war that began last week reminded us of what happened before. I am now renting a house near my old house and I am rebuilding the house that I lost in 2021, we were afraid that the escalation will last for a long time.

Wael an MSF patient in Gaza
Wael, an MSF patient who is 13-years of age share his traumatic experienced during the escalation in Gaza.

My name is Wael, and I am 13 years old. On the day of the escalation, I had just showered and then the bombing started, the whole 6th floor was burned, the missile went through the 8th floor to the 6th floor and after that, the explosions were so strong, we thought the whole building has collapsed, we were all thrown to the floor.

I don’t remember much as I was dizzy at the time. I was afraid, I thought the whole building had collapsed and that we all died, but thank God we all went to the hospital. I was very tired. I hope that there will be no wars in the future, and it stays calm without any bombings.

My name is Sakhar and I am 30 years old…. I went through all five of the wars: 2008, 2012, 2014, 2021 and now 2022. During the 5 wars, I was injured also during 2014 with burns and they had to take skin grafts from my body, but I wasn’t as affected as this time. Sakhar, 30, MSF patient

I live with my father in the apartment. My father invited me to have lunch with him, I was sleeping with one of my brothers right in front of me and the other brother next to him. Suddenly, I felt something falling, stones, and concrete belts fell on my shoulders and I lost consciousness. The second

missile fell a little far so I stood up like a possessed person, I saw my brother in front of me, there was fire around and I could not see my other siblings. I started removing the rocks, as I wanted to get my brother out before something happens, then out of nowhere another missile hit, I was hit by a shard in my neck, and one of my brothers had his hands all torn. I saw my father in the area and I asked what is happening but he didn’t know, so I told him I saw my brother here and he started looking for him with me without knowing what is exactly happening.

The fourth missile fell and the whole concrete roof fell on us and we became under the rubbles. I stopped breathing for a while, people came to help and there were children in the next room but we didn’t know how they were doing and we started taking them out one by one. My mom was making tea in the kitchen before everything happened, after the first missile she came running out of the kitchen and then the second missile hit behind her and she fell on her hand and leg and was injured with shards in her back too, and when she saw us all on the floor injured and torn she was mentally affected and she still suffers psychologically from what she saw. We got out of the building and two more missiles hit the side of the apartment. Then I remember myself at the hospital, I don’t know how I reached there.

They started removing the shards from my back and body. I stayed in the ICU from Friday afternoon until Sunday all that time I was in a coma and between life and death until they removed the big metal piece from me yesterday and I had to get more than 16 stitches. My brother, there were metal rods in the missiles and they penetrated inside his bones; the doctors said that they couldn’t remove them because it would threaten his life. Thank God at Al-Shifa hospital did their best, but after I came here to MSF, honestly, I feel calmer and more mentally stable. They opened my back and removed more shards. And I thank them very much. As for the children, I am married and have 3 boys and a girl, my eldest is now 5 years old. And after this escalation my son has been asking me to stop the war, and he always screams at night, he has not slept for 3 nights and when he is asleep he wakes up from nightmares and starts running and I don’t know what to do or how to help him.

For me, I am holding up, but sometimes when I sit with myself and remember what happened I feel suffocated as if the whole world is against me, I can’t tolerate anything.

Mahmud an MSF patient in Gaza
Mahmoud a 22-year old, MSF Patient share his traumatic experience during the escalation.

My name is Mahmoud, 22 years old. I was living in a Palestine building during the escalation, the bombing was directed to the floor right below us, we woke up at the sound of the explosion, and we saw the house full of dirt, my dad was pushing us outside, another explosion hit and we all were thrown on the floor. It was indescribable, I tried to remember what happened but I couldn’t. I only came back to my senses while I was at Al-Shifa Hospital.

We live in fear all our lives. And this scene will never be erased from our memories. When we went down, we saw torn and dismembered bodies. It was very horrible.

I have third-degree burns on my hand, and there are shards and glass pieces in my body, I have stitches in my head and back. Thank God we are all fine. The feeling at the time was something that we have never gone through before this in our lives and we will never forget it. The house fell on us, the missile went through our apartment to the apartment below, we were sleeping on the floor. We didn’t feel it

when the missile hit, but we were seeing the situation around us. There was a missile that hit the room next to us and another one that thankfully didn’t explode.

During the 2008 war, I was in 4th grade, I remember as children we used to hear the explosions and see the dead people. We saw bad and horrible sights but not like this one.

2012, we saw many injured and (dead people), and I lost many of my friends at the time.

In 2014 we left the area as our house was damaged, and we moved to the Palestine building.

During the 2021 war, we were afraid that they will destroy the building completely, but thankfully that didn’t happen and we continued living here.

I can’t describe it (this last escalation) for you. I saw my sibling on the floor and my mom was calling for us and we couldn’t hear her. We were all covered in blood and injured when we left the apartment and there we saw torn bodies. We took the children and went down, we were 16 people at the apartment as my father has invited my brother’s family for lunch that day. We lost our house completely and because of the fear, we didn’t feel anything at the time; we just carried the children and went down.

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