Palestinian doctors hope ceasefire revives Gaza’s devastated hospitals

In the dimly lit corridors of Al-Amal Hospital in western Khan Younis, Gaza, one of the 17 partially functioning medical facilities in the Gaza Strip, medical staff and patients felt a rare sense of hope. Mediators had announced a ceasefire agreement between Hamas and Israel to end the 15-month war in Gaza. Although the Israeli cabinet has yet to approve the agreement, optimism is spreading.

Orthopedic consultant Dr. Khaled Ayad spoke to his patients with confidence for the first time in months, assuring them that they would soon receive much-needed medication and treatment, which the hospital had been unable to provide due to Israeli restrictions on aid supplies to Gaza. Ayad explained, "We have accomplished the impossible. We had to improvise ways to deal with such severe, numerous, and prolonged cases to get to where we are today."

Like other medical staff and patients, Ayad was forced to leave his post at the Al-Quds Hospital, run by the Palestinian Red Crescent in Gaza City, a month after the war began on October 7, 2023. The 53-year-old surgeon has since been working at Al-Amal Hospital, which he described as having "very limited capacity." According to a January 7 report by the medical aid organization Doctors Without Borders (MSF), in Israel's war on Gaza, "every medical center or system for delivering humanitarian aid has been or is being destroyed."

Ayad experienced two Israeli attacks on Al-Amal Hospital in February and March and had to displace with his family, including his six children, to the arid Mawasi area in southwestern Gaza. He said he was lucky to have survived: more than 1,000 medical personnel have been killed, and many have been detained by Israeli forces. Ayad told Al Jazeera, "The number of cases I check daily has surged to 70 patients and injured, in addition to no less than 8 cases hospitalized in the departments." As he spoke, countless patients and visitors crowded the hospital's wards, with external clinics and corridors also packed with people seeking care.

Ayad explained that he often takes temporary measures to treat fractures until the plates needed for surgery are available. "It will be soon," he said with a smile, reassuring Hani Shakla, who suffered a fractured collarbone on Monday in an Israeli attack near his home where he sought refuge in Deir al-Balah. Shakla, unable to respond to Ayad's enthusiasm due to the pain, said he couldn't wait for the ceasefire to take effect so he could receive the surgery he needed. "The care I am getting in this genocide is taken for granted, especially considering the great difficulty everyone faces in getting treatment and even reaching the hospital. I am optimistic… treatment is possible after the ceasefire," he said cautiously, careful not to move his arm or the sling that was helping to support his shoulder.

Shakla added, "I just hope it happens soon so my condition doesn't worsen." Negotiations to reach a ceasefire agreement and end the war that has killed more than 46,700 Palestinians have repeatedly failed over the past year, until mediators announced an agreement on Wednesday. Donald Trump's inauguration as US president on Monday was the de facto deadline, with the ceasefire agreement set to take effect the day before. At that point, more much-needed humanitarian aid will be allowed into Gaza after severe shortages, exacerbated by the closure of the Rafah crossing with Egypt in May, through which most aid was delivered.

While Ayad hopes the influx of humanitarian supplies will bring some respite to Palestinians in Gaza, he knows that he and other medical staff have a lot of work ahead of them. "Many of the injured we sent away with temporary treatment will need to undergo surgery again for proper treatment once supplies are available," he said. Dr. Adnan Zatmah, a general surgeon who works with Ayad, emphasized the magnitude of the challenge. In addition to the obvious shortages of medicine and supplies, he listed the damage throughout the hospital: from X-ray machines and generators destroyed during the Israeli invasion to burnt-out wards, walls riddled with bullet holes, and entrances and roads leading to the hospital bulldozed.

“The ceasefire will be a respite, but it won’t be magic,” Zatmah said. Dr. Haidar Kudra, executive director of the Palestinian Red Crescent in Gaza, said the medical sector is operating at less than 10% of its pre-war capacity. According to Doctors Without Borders, the pre-war state of the healthcare system was already below what was needed due to Israel’s 17-year blockade of Gaza. Now it is in shambles. "Tens of thousands of patients are suffering because of the collapse of medical care," Kudra said. "This includes deaths, disabilities, and serious complications for people who have not been able to receive proper care during the war," he added, highlighting that facilities like Al-Amal and Wafa hospitals were unable to operate for much of the war.

"For many patients, rehabilitation is the only way for them to regain their mobility or basic function. The loss of these services is catastrophic," he said. Large hospitals like Al-Quds and Al-Shifa have been severely damaged, while facilities like Al-Amal have suffered significant infrastructure damage. Despite these challenges, Red Crescent hospitals have treated more than 500,000 cases during the conflict and have received another 900,000 patients at their primary care centers. Al-Amal alone handles 1,500 cases daily, in addition to two field hospitals and 10 primary care centers in northern Gaza.

"With the support of international aid, the ceasefire will allow the health system to gradually recover," Kudra said. "The Red Crescent plans to establish five field hospitals and 30 primary care centers across Gaza, including a main center in each of the five governorates," once supplies are available. Coordination with international organizations such as the Red Cross and the World Health Organization aims to facilitate the entry of medical supplies from the occupied West Bank, where the Red Crescent has warehouses storing critical supplies, he said. "These supplies, along with the arrival of Arab and international medical teams, will revitalize Gaza's health system," Kudra added. "Reopening hospitals, even gradually, and improving mobility in Gaza will restore some sense of normalcy. Working without fear of being attacked will also improve conditions for medical teams."

"The ceasefire brings a glimmer of hope for everyone. Like everyone else, medical staff are exhausted. The healthcare system, ravaged by relentless war, needs a chance to recover, and it is ready for the long road to recovery," he concluded.