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Today in Gaza, scalpel blades are reused in surgery, but this results in them becoming too blunt to do what they are supposed to do.
Today in Gaza, physicians often perform surgical procedures without pain control.
Almost all patients in Gaza today suffer from malnutrition, so their wounds do not heal.
Dr Riad Almsharkah, 54, told Al Jazeera that the infection rate among patients is “beyond imagination”.
Plastic and reconstructive surgeons said instruments are rarely disinfected, and patients usually remain in overcrowded wards.
All of this is a result of the siege imposed by Israel, which has severely limited food and life-saving medical supplies from entering Gaza.
nothing works
Medical professionals – hungry, exhausted and fearing for the safety of everyone around them – are struggling to help people in the handful of medical facilities left in the besieged Gaza Strip.
They receive rare assistance from abroad in the form of medical missions that manage to obtain Israeli approval to enter Gaza, such as the Palamed mission in which Almasharka spent two weeks working in a European hospital, located in the southern Gaza Strip. and was the only hospital functioning in central Gaza.
“It's a frustrating situation to describe completely. I mean, everything was difficult,” Almsharqa told Al Jazeera while working at the struggling Khan Younis hospital.
Following Hamas-led attacks on southern Israel on October 7, six months after Israel's deadly assault on Gaza, shortages of equipment, medicine and supplies have pushed the medical sector close to total collapse.
The situation has worsened due to famine-like conditions, affecting more than 90 percent of Gaza's 2.3 million people – the majority of whom are now internally displaced.
The combination of the two means that simple reconstructive procedures, such as skin grafts, become very difficult to perform properly and, likely, the malnourished state of the patient often means that they will not heal properly.
In every scenario, essential items were lacking.
Add to this the doctors' fears about Israeli attacks and the unimaginable number of patients in Almsharqah.
“Only in the orthopedic (department)… at one time, there were 250 patients. In plastic surgery, there were 70 patients,” he said.
Necessary procedures range from basic wound care to emergency surgeries and even major surgeries that require reconstruction.
But “simple processes in that environment become so…complicated because the equipment is not working”, Almsharka said.
'Emotionally exhausting'
Palestinian families forced to flee their homes since the beginning of Israel's offensive on Gaza have sought shelter in and around hospitals.
However, most hospitals have come under attack and raided by Israeli forces, forcing thousands of injured and displaced Palestinians to flee and putting the facilities out of service.
Israeli attacks have partially or completely destroyed more than 200 medical facilities. At least 32 hospitals have been taken out of service.
Hundreds of displaced Palestinians, medical workers and patients have been killed.
But due to a lack of places to seek shelter, families still seek shelter in and around medical facilities, leading to even more overcrowding in hospital courtyards, hallways and wards.
Almsharakah said the situation makes it difficult to find a patient after an operation and that follow-up is necessary.
“All the wards are full, so they send them to a field hospital attached to the (main) hospital,” Almsharka said.
“It was a challenge to trace where the patients had gone and whether they had received proper treatment after the operation,” he said. He said, this is also because there is a shortage of nurses and paramedics.
Often, patients cannot get the antibiotics or fluids they need after surgery.
“It is an inhumane situation in every way,” Almsharakah said.
“Conveniently, more than 80 percent (of the patients) were children and women, and they were badly injured. I…can't describe their injuries and burns,” he said.
Almasharakah, a father of six, lost three children to burns within 48 hours, despite repeated requests that they be taken out of Gaza for treatment.
“No… action was taken,” he said. “Many donors contacted me and promised to do something, but I kept losing them one by one.”
The primary baby was a bit woman who suffered about “50 % burns,” he mentioned. “We misplaced her as a result of she was so chilly and we had been attempting to maintain her heat.”
Israel has killed greater than 33,137 individuals and injured about 75,815 others in Gaza since October 7, in keeping with the well being ministry in Gaza.
The ministry mentioned a couple of quarter of the injured had been kids.
Almasharakah mentioned there are “numerous recollections” that can stick with him endlessly – from the sound of the bombing to the sight of triage facilities full of sufferers and our bodies.
He mentioned, “There have been many faces I cannot overlook, particularly the faces of harmless kids torn by warfare.”
But probably the most memorable moments for Almasharakah had been the youngsters who “confirmed unbelievable resilience regardless of accidents”.
“Their bravery within the face of adversity was heartbreaking and galvanizing,” he mentioned.
“I spotted that these persons are very robust and they’ll by no means lose.”
Regardless of the acute ranges of human struggling, Almsharka mentioned that “there have been moments of hope and positivity – whether or not it was saving a life or offering consolation to a affected person in ache”.
“Individuals had been very grateful,” he mentioned. “They simply need aid from ache.
“I’d positively return,” he mentioned. “These individuals deserve higher. They deserve full assist, full care.”