As Gaza Hospitals Collapse, Medical Workers Face the Hardest Choices

In some hospitals, patients arriving in cardiac arrest are not resuscitated, because medical staff choose to work on patients with a greater chance of survival instead. Few of the critically wounded get a hospital bed. Fewer still, a ventilator or anesthesia when operated on, including for brain surgeries, the doctors said. Anesthesia has been in short supply for about two weeks, doctors say.

On top of all those challenges, the hospitals have become temporary orphanages, too, according to the medical workers.

In some cases, children have arrived at the hospitals after their entire families were killed in the war or watched as their parents died on hospital gurneys or tile floors. The medical staff have cared for some of the children until a relative can come to take them.

Dr. Najjar said that each day in his hospital starts with a fight to preserve dwindling fuel supplies. That struggle is shared by the 19 other hospitals that are still functioning, to varying degrees, in Gaza.

And the pressure on those hospitals is mounting as they compensate for 16 hospitals that are now out of service, according to a health ministry statement on Thursday.

On Friday, an explosion near the entrance of Al Shifa Hospital in Gaza City struck a convoy of ambulances carrying wounded people preparing to evacuate to Egypt, according to a Hamas spokesman and the head of the hospital, Dr. Mohammad Abu Salmiya. Thirteen people were killed and many others injured, Dr. Abu Salmiya said, adding that paramedics and patients being evacuated were among the injured while the hospital sustained damage from the explosion.

Two other hospitals came under attack on Friday, according to the World Health Organization.

The Israeli military said it had carried out an airstrike on an ambulance “being used by a Hamas terrorist cell.” An Israeli military spokesman, Maj. Nir Dinar, confirmed it was the same strike that had caused the explosion outside the hospital.

Doctors in two hospitals in Gaza said that, with nothing to power air-conditioners, the heat has gotten bad enough that it is making patients’ wounds fester. Medical staff need their diminishing fuel stocks to light up operating rooms instead.

In the Kamal Adwan Hospital in northern Gaza, surgeries are being done by cellphone flashlight, according to one doctor there. Vinegar is sometimes used to disinfect wounds, with no iodine left.

The Gaza Strip has been plunged into darkness and cut off from the world after the territory’s only electricity plant ran out of fuel and as Israel’s military has cut telecommunications. Ambulance drivers say they often have to chase the sounds of airstrikes in order to know where they are needed.