As Israeli bombs fell, wounded children overwhelmed this Gaza hospital. Dozens died

CAIRO (AP) — When the archetypal explosions successful Gaza this week started astir 1:30 a.m., a visiting British doc went to the balcony of a infirmary successful Khan Younis and watched the streaks of missiles airy up the nighttime earlier pounding the city. A Palestinian surgeon adjacent to him gasped, “Oh no. Oh no.”

After 2 months of ceasefire, the fearfulness of Israeli bombardment was back. The seasoned surgeon told the visiting doctor, Sakib Rokafiya, they’d amended caput to the exigency ward.

Torn bodies soon streamed in, carried by ambulances, donkey carts oregon successful the arms of terrified relatives. What stunned doctors was the fig of children.

“Just kid aft child, young diligent aft young patient,” Rokafiya said. “The vast, immense bulk were women, children, the elderly.”

This was the commencement of a chaotic 24 hours astatine Nasser Hospital, the largest infirmary successful confederate Gaza. Israel shattered the ceasefire successful spot since mid-January with a astonishment barrage that began aboriginal Tuesday and was meant to unit Hamas into releasing much hostages and accepting changes successful the truce’s terms. It turned into 1 of the deadliest days successful the 17-month war.

The aerial attacks killed 409 radical crossed Gaza, including 173 children and 88 women, and hundreds much were wounded, according to the territory’s Health Ministry, whose number does not differentiate betwixt militants and civilians.

More than 300 casualties flooded into Nasser Hospital. Like different aesculapian facilities astir Gaza, it had been damaged by Israeli raids and strikes passim the war, leaving it without cardinal equipment. It was besides moving abbreviated connected antibiotics and different essentials. On March 2, erstwhile the first, six-week signifier of the ceasefire technically expired, Israel blocked introduction of medicine, nutrient and different supplies to Gaza.

Triage

Nasser Hospital's exigency ward filled with wounded, successful a country described to The Associated Press by Rokafiya and Tanya Haj-Hassan, an American pediatrician — some volunteers with the foundation Medical Aid for Palestinians. Wounded came from a structure campy sheltering displaced that missiles acceptable ablaze and from homes struck successful Khan Younis and Rafah, further south.

One caregiver was trying to resuscitate a lad sprawled connected the level with shrapnel successful his heart. A young antheral with astir of his limb gone sat nearby, shivering. A barefoot lad carried successful his younger brother, astir 4 years old, whose ft had been blown off. Blood was everyplace connected the floor, with bits of bony and tissue.

“I was overwhelmed, moving from country to corner, trying to find retired who to prioritize, who to nonstop to the operating room, who to state a lawsuit that’s not salvageable,” said Haj-Hassan.

“It’s a precise hard decision, and we had to marque it aggregate times,” she said successful a dependable message.

Wounds could beryllium casual to miss. One small miss seemed OK – it conscionable wounded a spot erstwhile she breathed, she told Haj-Hassan -- but erstwhile they undressed her they determined she was bleeding into her lungs. Looking done the curly hairsbreadth of different girl, Haj-Hassan discovered she had shrapnel successful her brain.

Two oregon 3 wounded astatine a clip were squeezed onto gurneys and sped disconnected to surgery, Rokafiya said.

He scrawled notes connected slips of insubstantial oregon straight connected the patient’s tegument – this 1 to surgery, this 1 for a scan. He wrote names erstwhile helium could, but galore kids were brought successful by strangers, their parents dead, wounded oregon mislaid successful the mayhem. So helium often wrote, “UNKNOWN.”

In the operating room

Dr. Feroze Sidhwa, an American trauma surgeon from California with the aesculapian foundation MedGlobal, rushed instantly to the country wherever the infirmary enactment the worst-off patients inactive deemed imaginable to save.

But the precise archetypal small miss helium saw -- 3 oregon 4 years aged -- was excessively acold gone. Her look was mangled by shrapnel. “She was technically inactive alive,” Sidhwa said, but with truthful galore different casualties “there was thing we could do.”

He told the girl’s begetter she was going to die. Sidhwa went connected to bash immoderate 15 operations, 1 aft another.

Khaled Alserr, a Palestinian surgeon, and an Irish unpaid surgeon were doing the same. There was a 29-year-old pistillate whose pelvis was smashed, the webbing of veins astir the bones was bleeding heavily. They did what they could successful surgery, but she died 10 hours aboriginal successful the intensive attraction unit.

There was a 6-year-old lad with 2 holes successful his heart, 2 successful his colon and 3 much successful his stomach, Sidhwa said. They repaired the holes and restarted his bosom aft helium went into cardiac arrest.

He, too, died hours later.

“They died due to the fact that the ICU simply does not person the capableness to attraction for them,” Sidhwa said.

Ahmed al-Farra, caput of the pediatric and obstetrics department, said that was successful portion due to the fact that the ICU lacks beardown antibiotics.

Sidhwa recalled however helium was astatine Boston Medical Center erstwhile the 2013 Boston Marathon bombing happened, sidesplitting 3 radical and sending immoderate 260 wounded to country hospitals.

Boston Medical “couldn’t grip this influx of cases” seen astatine Nasser Hospital, helium said.

The staff

Rokafiya marveled astatine however the infirmary unit took attraction of each different nether duress. Workers circulated with h2o to springiness sips to doctors and nurses. Cleaners whisked distant the bloody clothes, blankets, tissues and aesculapian debris accumulating connected the floors.

At the aforesaid time, immoderate unit had their ain household members killed successful the strikes.

Alserr, the Palestinian surgeon, had to spell to the morgue to place the bodies of his wife’s begetter and brother.

“The lone happening I saw was similar a packet of nutrient and bones, melted and fractured,” helium said successful a dependable message, without giving details connected the circumstances their deaths.

Another staffer mislaid his woman and kids. An anesthesiologist -- whose parent and 21 different relatives were killed earlier successful the warfare -- aboriginal learned his father, his member and a relative were killed, Haj-Hassan said.

Aftermath

Around 85 radical died astatine Nasser Hospital connected Tuesday, including astir 40 children from ages 1 to 17, al-Farra said.

Strikes continued passim the week, sidesplitting respective twelve much people. At slightest six salient Hamas figures were among those killed Tuesday.

Israel says it volition support targeting Hamas, demanding it merchandise much hostages, adjacent though Israel has ignored ceasefire requirements for it to archetypal negociate a semipermanent extremity to the war. Israel says it does not people civilians and blames Hamas for their deaths due to the fact that it operates among the population.

With Tuesday’s bombardment, Prime Minister Benjamin Netanyahu besides secured the instrumentality to his authorities of a right-wing enactment that had demanded a resumption of the war, solidifying his conjugation up of a important fund ballot that could person brought him down.

Haj-Hassan keeps checking successful connected children successful Nasser's ICU. The miss with shrapnel successful her encephalon inactive can’t determination her close side. Her parent came to spot her, limping from her ain wounds, and told Haj-Hassan that the small girl’s sisters had been killed.

“I cannot process oregon comprehend the standard of wide sidesplitting and massacre of families successful their slumber that we are seeing here,” Haj-Hassan said. “This can’t beryllium the satellite we’re surviving in.”

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AP correspondents Julia Frankel successful Jerusalem, Fatma Khaled successful Cairo, and Sarah El Deeb successful Beirut contributed to this report.