I couldn’t have predicted that my career as a transplant surgery professor in a sprawling London teaching hospital would lead me to an entirely different world. Yet, last August, I stepped into that world when I operated on an eight-year-old girl in Gaza. As she bled profusely on the operating table, the scrub nurse informed me we were out of gauze swabs. Desperately, I used my hands to scoop out the blood, battling nausea and fear for her survival. Miraculously, she lived, though many others weren’t as fortunate.
After retiring from the NHS, I felt the urgent call to assist in Gaza, knowing my surgical skills were critically needed. My life in London as a transplant surgeon was demanding but immensely fulfilling, granting me a certain esteem within that community. Gaza, however, presented an entirely different challenge. Nothing could have prepared me for what awaited when I crossed the border.
From the outset, the surreal experience of extremes enveloped us. Sven, a towering Swede sporting an oddly cheerful floral shirt, led our convoy of UN-armored vehicles, jokingly advising us to stay alive. Just two weeks later, those same vehicles came under fire from the Israeli army. The danger in Gaza was, undeniably, palpable. It stands as the most perilous place for aid workers, having already claimed the lives of over 300 aid personnel and 1,000 healthcare workers since the war began.
As we traversed southern Gaza toward our base, the desolation reminded me of old Hiroshima photographs. Buildings were laid to waste across vast stretches, populated only occasionally by armed looters. Arriving at Nasser hospital in Khan Younis revealed a scene of unimaginable chaos reminiscent of medieval times.
Hospital wards overflowed. Beds jammed together in every nook and cranny—corridors, rooms, even outdoor balconies—served as sleeping quarters for relatives who helped the staff care for patients. Hygiene standards were abysmal. Basic necessities like soap, shampoo, and cleansing gel were frequently barred from entry into Gaza, as were critical medical supplies. Repeatedly, I would check wounds only to find maggots within. In intensive care, my colleague had the grim task of removing maggots from a child’s throat as they obstructed a ventilator. Supplies like sterile gloves, gowns, and drapes often ran out.
The constant threat of bombing rocked the hospital, a target itself in an attack from February of the previous year that resulted in numerous casualties among staff and patients. We routinely confronted mass casualty events in which chaos descended upon the emergency department—blood, bodies, shouts of pain. It was a scene from Dante’s Inferno. Typically, these incidents left about 10 to 15 dead and another 20 to 40 seriously injured.
Waves of the wounded arrived at any hour, forcing us into gruelling 24-hour operations. The constant nearby explosions held the ever-present threat of a direct hit, making sleep difficult. Yet we watched the local staff persist with tireless dedication, balancing their hospital duties with life in makeshift “tents” fabricated from carpets and wood, deprived of water and sanitation. Throughout my time there, I saw no sign of Hamas—no restrictions impeded our movements inside or outside the hospital.
The memories that linger most vividly are those of injured children. Amer, a seven-year-old, came to us one evening, a victim of drone fire intended to pick off civilians fleeing the chaos. With his liver, spleen, and bowel damaged and stomach protruding from his chest, his survival was a relief. Yet each day, similar cases confronted us, many ending tragically.
Many of the injured were women and children. Particularly harrowing were the instances where children bore a single, targeted gunshot wound to the head—clear marks of deliberate sniper fire. This prompted 30 UK doctors and nurses, myself among them, to write to Keir Starmer, insisting such acts were deliberate. Similarly, 99 US healthcare workers addressed a letter to President Joe Biden. Palestinians in Gaza, feeling the weight of genocide, find support in assessments by UN human rights experts and organizations like Amnesty International, who also see potential acts of genocide. It’s hard to dispute their conclusions.
In my experience across conflict zones, the civilian toll in Gaza stands unparalleled, characterized by an overwhelming and different scale of devastation.
Despite hopes for a lasting ceasefire, fueled by the unpredictability of Trump’s policies, the road to Gaza’s recovery, both physical and societal, is long. I fervently wish for a future where children like Amer can see a world of humanity and dignity.
When our convoy departed last September, I felt a profound guilt in leaving my secure life while countless others faced continuous peril and hunger. That guilt soon evolved into disappointment and shame towards the UK government, particularly the Labour party I have long supported, for refusing to strongly denounce Israeli war crimes, even while continuing arms deals.
Political power may require compromises, but there are moral boundaries that must not be crossed, irrespective of the political fallout. In my view, what is happening in Gaza tests the moral fortitude of today’s leaders. Up to now, they have fallen short. Though bombing has paused, accountability for those guilty of these crimes is an urgent priority.
Nizam Mamode, a humanitarian surgeon and retired transplant surgery professor, volunteered with Medical Aid for Palestinians in Gaza in August and September of 2024.
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