A doctor who spent 43 days in Gaza recounts the horrors he saw

December 15, 2023 at 9:00 a.m. EST

Ghassan Abu Sitta at his home in East London. (James Forde for The Washington Post)

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Ghassan Abu Sitta, a British Palestinian doctor, spent 43 days tending to the wounded in Gaza City before he left — exhausted and carrying a feeling of guilt that he could have done more. A reconstructive plastic surgeon in London, he arrived to volunteer with Doctors Without Borders in Gaza on Oct. 9, in the window after the Hamas assault on Israel and before the Israeli invasion.

Within days, Israeli airstrikes were hitting Gaza City and hundreds of wounded were being brought to al-Ahli and al-Shifa hospitals, where Abu Sitta worked round-the-clock. The bombing seemed to come closer and closer.

“Everything that I had done in my life had led me to this point, and this is where I was meant to be,” Abu Sitta said. “There were several evenings that I went to sleep thinking it was going to be the end of us.”

Those 43 days were among the most challenging and gruesome periods in the 54-year-old’s medical career, he said. But they were also marked by scenes of humanity and love and — in certain moments — unexpected levity.

The Washington Post interviewed Abu Sitta over several hours about his experiences. He described the events that stayed with him during his time at al-Shifa and at al-Ahli hospitals. His words have been lightly edited for clarity.

There were days of hopelessness

Do you know when you’re in the sea and a wave comes and covers you and for that split second, you’re trying to get your head above the water but you can’t because the wave is higher than you? It felt like that. You operate and you think you’ve done a good job, you’ve managed to get through 12 patients, but you know that in the last half-hour there was an air raid that brought in 70 or 80 [more] wounded and that you’ve done very little.

There was this little girl, I think she was 8 or 9 years old, the daughter of a doctor at al-Shifa Hospital. The doctor was killed and her two [other] kids were killed, and [the girl was] alone. Half of her face was missing. Half her nose, her eyelids had been ripped from the bone and had moved sideways. When you start out those cases, you have to clean them, because it’s all dirt and dust and gravel in the wound. And I’m cleaning the face and I’m cleaning the hair to make sure there aren’t any injuries underneath the hair. And then suddenly you see the braids. And you see the hairband, the little plastic hairband, in the shape of a flower. And it’s that, that kind of just, you just, you lose your breath. You’re completely disarmed by it. You’re completely devastated by it.

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This is a beautiful little girl.

There were horrors, but at the same time there were acts of love.

I was saying to somebody what happens when you live in the death world is that people start resisting the death world through acts of love. They become acts of resistance. There was a little boy, he was 3 years old, we didn’t know his name at al-Ahli. I amputated his leg and his arm. And the following day when I went to check up on him, the woman whose son was wounded in the bed next to him had him on her lap and was feeding him and her son, because he had no family. We didn’t even know his name because he was so young. These acts of love, these acts of kindness, people taking in people and even letting them stay in their houses for the whole war because they’d lost their homes.

There was kind of almost a dissolution of individualism, and a return to old communal life, that everything gets shared. Food gets shared. Medication gets shared. Houses get shared, and that kind of dissolution is amazing. It’s amazing.

When boys have to turn into men

We lost one of our colleagues, Dr. Medhat Saidam. He was a plastic surgeon. His sister came with her children to the hospital because she had to evacuate her own home. So he decided to take her to his house because his sisters and brothers were at his house, and he thought he was in a safer neighborhood. A few hours later, the house was bombed. We knew that he was killed, and [thought] everybody else had been killed. And then a day later they [rescued] his wife and his three children. And the wife was injured in her foot. Eventually, we managed to get them to stay in an office in our department in the burns unit. You see [his] 12-year-old turning into the man of the house, the adult of the house. And because he’s the eldest of his siblings, and his mom is injured, he’s doing the errands and keeping them and taking them to the bathroom and talking to us to help get stuff for them. And you can see the kid trying to become a man.

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Finding moments of levity

One day there was a barber around al-Ahli, lovely guy who ended up staying and helping out, just as a health-care assistant. He came to us and said he wanted to shave everyone, because we were all turning into cave men. We went to one of the rooms on the top floors of al-Ahli, which was partly destroyed. We all sat waiting for our turn in front of the mirror and he cut our hair and shaved our beards. He had brought his whole gear with him. And suddenly, everybody’s mood is picked up by this act of great generosity.

Suddenly, the conversation flowed. We started talking about normal things and cracking jokes and making fun of, you know, the cut or the hair or the ones who have gray hairs and those who don’t. All of this. Suddenly there’s this oasis of normalcy that you find yourself in, that kind of takes you back.

The injured are the families of doctors

I remember this kid whose face was just so covered with mud. I was looking after him because I was trying to stabilize and resuscitate, and this doctor, all he was trying to do was wash the mud off the face so that he could just see if it’s his nephew or not his nephew. Because the area that had been struck was their area.

[The boy] was about 4 or 5 years old. He had limb injuries, he had open fractures in both legs.

I’m on my knees, and doing all of this and I remember [the doctor] asked me what was happening, and I said I’m waiting for someone to come and do an ultrasound on his abdomen.

The doctor fell on his knees when he saw him and then started washing [the boy’s] face.

I remember [the doctor] said something about “they hit our house.” And then he left. He realized that if [his nephew’s] here, then there could be others from the family.

A life is born in the midst of death

There was a woman who had a penetrating shrapnel in her abdomen and she was pregnant. A general surgeon that we had found said, “I can do this but I’m afraid that if there was a complication I would have to take the uterus out, and it’s a 19-year-old woman.” So we managed to [find] an obstetrician from the areas surrounding us; someone knew him and we called him and he came in and he did a Caesarean section. Suddenly, after all that death, to hear a child! You kind of just feel the sound of life for the first time in 40 days of death. You feel the sound of life.

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Our sleeping quarters.
I think the sound of newborn babies from the ceasarian sections done in the OR filled the air with the optimism of a new tomorrow.
Laughter heard amongst the staff for the first time in a long while. pic.twitter.com/myAh9r6bNa

— Ghassan Abu Sitta (@GhassanAbuSitt1) November 14, 2023

One really distinctive night the bombing was so close and the building was shaking so violently, that was the night I kind of just sat down on my own and I just made peace with the idea that I wasn’t going to [survive]. It was extremely, it was extremely therapeutic. I was no longer anxious. I was at peace with myself and my choices in life. There was sadness, especially toward my youngest. I would send audio messages to [my] boys. Just to make sure that they heard my voice on the day that I die, as morbid as that [sounds]. But they weren’t morbid messages. They were just fun messages: I miss you! I love you!

We finished operations around 5 a.m. and the anesthesiologist told us there was no more anesthetic left. And there is nothing else we could do. And that’s when I made the decision, literally made the decision around 6 o’clock, 7 o’clock in the morning, and we were out at 9.

People, some carrying a wounded [person] in a wheelchair, to someone trying to drag a suitcase and then they give up on the suitcase and leave it. Families with kids carrying 40 nylon bags trying to carry their belongings in them. It really was a kind of horrific scene.

I left Gaza yesturday.
My heart and my soul are still there with my patients. I remember their names and their wounds. I will fight until they receive the treatment they need and the justice they deserve.
My heart is broken in ways I never knew was possible.

— Ghassan Abu Sitta (@GhassanAbuSitt1) November 19, 2023

I wake up around 3 a.m. Sleep is a problem now.

There are days when you think you should be there. And there are days when, depending on the story, when there’s a story about the European hospital and the fact that they’ve run out of medication and their operating rooms aren’t running. And then you kind of think, things haven’t gotten that much different from when you were there, in terms of your ability to have stayed, if it would’ve made a difference.

All the time you’re kind of second-guessing if I should have left.

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