'A quarter were children': One surgeon's traumatic memories of operating on the victims of Gaza's war

On his first day back in Gaza, Saladin Sawan was quickly made aware of how bad things had become. Unlike his first surgical rotation a year ago, where there was “only” one major casualty event a week, there were two or three a day when he returned.

It was not just the casualties but the nature of the wounds the surgeon was seeing. He was forced to operate under the harshest conditions experienced during the Syrian-born doctor's long career. Instead of blast and fragmentation injuries, most were to an area of the body that surgeons dread – the pelvis.

It has been reported that of the 1,760 Palestinians killed since June seeking food, 994 died near the notorious Gaza Humanitarian Fund (GHF) sites, although the aid distributors claimed they had fired only “warning shots”.

A child is injured in an Israeli air strike on Rafah, Gaza. AFP

If that gunfire was indeed intended to be fired at people’s feet, many rounds certainly reached the midriff, causing scores of injuries.

“Pelvic injuries are notorious,” the British-trained doctor told The National. “You can injure several organs at once. They are devastating for the patient and they consume enormous hospital time.”

Young and old bore devastating entry points from rifle fire. “These weren’t fragmentation injuries,” he said. “These children were just standing around and they were directly shot.”

Saladin Sawan, a surgeon who operated in Gaza. Photo: Saladin Sawan

On its knees

Dr Sawan first operated in Gaza for five weeks in December last year but returned to a medical system pushed beyond breaking point, where every hour there was a decision over who might survive and who could not be saved.

When he speaks of his rotation at Nasser Hospital, he points out a quarter of casualties were children.

“It was far worse than before,” he said. “The aggressiveness of the fire from the Israeli military made people feel utterly hopeless.”

“One day we had no water to scrub. Another day we didn’t have enough fuel to keep electricity going Dr Saladin Sawan

Most of the wounded had been shot while trying to collect food at the GHF sites, run by US contractors and the Israeli military, that accounted for nearly a quarter of the hospital’s workload.

“People were desperate for food,” he said. “They were being shot while queueing for aid.”

When the surgeon arrived in August, the hospital’s operating theatres were “on their knees” and there were simply more wounded than the staff could cope with. “Patients died waiting to get into theatre.