What it’s like working in a hospital in Gaza

Roberta Staley sits down with Canadian physician Dr. Fozia Alvi to talk about what she witnessed working on the frontlines in Gaza.

There was little that Dr. Fozia Alvi could do to help the mother, Riham, lying in a hospital bed in Rafah, southern Gaza. “Her house had been bombed. She lost one eye. Her right arm was amputated. Her two legs were amputated above the knee,” Alvi says via Zoom from a Rafah medical clinic. Worse — if anything could be worse — was the loss of all her children. How many were killed? “Three or four? I don’t know,” says Alvi. “I didn’t have the courage to ask.” 

Alvi travelled almost halfway around the world from her home in Calgary, Canada, on February 12th to provide care to Palestinians in Gaza. She was part of a volunteer medical team organised by the World Health Organisation (WHO),and was accompanied by her 20-year-old son Waleed, who speaks Arabic and acted as translator, as well as by another Canadian physician, Dr. Yipeng Ge of Ottawa. On the day of their arrival, Israel Defence Forces (IDF) had carried out a wave of attacks on Rafah, a city once home to 150,000 that now sheltered 1.7 million displaced Gazans. “I’m scared, of course, but I get my strength from Gazans,” says Alvi, dressed in a set of purple scrubs and a light grey hijab.

Image: Supplied by Dr Alvi.

Alvi has spent much of her career helping out in humanitarian disasters. Trained as a physician in the United States as well as her home country of Pakistan, Alvi moved to Canada in 2007. The mother of three was soon undertaking missions to wherever people had suffered violence, starvation and displacement, leading to a Nobel Peace Prize nomination in 2019. Across her career, Alvi has opened a medical clinic to treat Rohingya refugees in Bangladesh, personally financed and opened a 60-bed hospital in the Punjab of Pakistan, and helped raise money for an orphanage for young female Syrians. 

Nothing, however, could have prepared her for Gaza, where 30,000 people are now dead, including 10,000 children and 300 healthcare workers. More than 69,000 people are injured while untold thousands lie buried under the rubble of bombed out buildings. In Rafah, people are sleeping on the streets or huddling in makeshift tents. “It’s a genocide. It’s a war against children, babies and women,” says Alvi. “I can’t wrap my head around it.” 

The so far five-month assault on Gaza is in response to a terrorist attack on Israel on October 7th by the Palestinian militant group Hamas. Their objective in doing so was to demonstrate a blatant rejection of Israel’s right to exist. The Hamas assault killed 1,200 people while another 240 people were taken hostage. At the time of writing, about 100 of those people were still being held by Hamas. Israel has threatened to begin a ground assault on Rafah by March 10 unless the rest of the hostages are freed. It’s the only place refugees from elsewhere in the war, have to go.

Alvi and her team assisted local physicians in Rafah’s hospitals and also ran a daily clinic ministering to the injured and ill. By 7 AM, when the clinic opened, there was already a line up, says Alvi, who returned a few days ago to Canada due to the bombing. Alvi was hamstrung by the lack of supplies, especially antibiotics. Babies with pneumonia were being treated with either paracetamol or Tylenol and an intravenous drip of saline or sugar (dextrose) water, says Alvi. “Lots are dying. Lots of babies, lots of small children.” 

Gaza’s drinking water is contaminated, sparking an epidemic of highly infectious Hepatitis A, potentially fatal to children and babies, caused in part by the severe overcrowding and lack of sanitation. “Everybody’s sick with gastrointestinal bugs. Everybody has diarrhoea. Mothers are using plastic as diapers, so the babies have a bad rash.” Malnutrition makes the diseases more deadly. “The children are starving, they are skin and bone,” says Alvi, who survived mainly on protein bars brought from Canada.

Alvi also brought medicines, PPE, sanitation wipes and gel, but it wasn’t enough. A land and sea blockade by Israel is preventing food and medical supplies from entering Gaza. Many of Alvi’s patients who had undergone surgery in a northern Gaza hospital were in Rafah after being forced to flee. They had received no post-operative care for their amputations and other wounds, now oozing pus due to the dearth of antibiotics. The most gut-wrenching, says Alvi, is the “countless” children who somehow survived sniper wounds to the head. “It went into their brain and they have complete paralysis of their body. They cannot talk. They are on ventilators.” 

Alvi, who plans to return to Gaza if a ceasefire takes effect, wonders what the future holds for the deeply traumatised people of Gaza. She will never forget Riham, or her unimaginable suffering and loss. “As a physician, as a woman, as a mother, and as a human being, it’s hard to see these atrocities, these crimes against humanity,” says Alvi. “It’s a moral injury.” 

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