24 hours in a Gaza hospital

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Medics reduced to eating animal feed to get through their gruelling shifts. Mothers unable to breastfeed because they are so weak and hungry. Pregnant women in intensive care – and even losing their babies – because they are so malnourished. Tiny bundles of newborns, crammed two to an incubator because space is running out.

This is the grim picture painted by doctors and nurses in the war-ravaged north of Gaza where a catastrophic famine is unfolding in real time.

Israel vehemently denies there are any limits on aid going into Gaza and maintains it is supporting air, land and sea deliveries of supplies. But the United Nation’s most senior officials say this humanitarian crisis is the result of Israel’s crippling restrictions and bombardment of the strip in retaliation for Hamas’s attack on 7 October.

“The situation at the hospital is catastrophic, we face severe shortages of everything from electricity, to staff, to food, to medicines to clean water, “ says Ahmed al-Kahlout, a senior nurse at Kamal Adwan hospital in Gaza City, which is one of the only facilities in the war-ravaged north treating newborns and children.

“Around 70 per cent of the women giving birth in our hospitals end up in intensive care units due to low immunity and malnutrition,” he added.

“Breastfeeding mothers cannot feed their babies because they cannot find enough food to eat. It is catastrophic because a child may suffer from a simple pneumonia, but due to their weak immunity, that is now fatal.”

Kamal Adwan’s intensive care unit (ICU), which is run on solar power, now only has six beds and five incubators, as electricity is largely cut.

“In the vast majority of cases we have to put two children in one incubator – and with the ICU beds we put two to three children to one bed to make space,” he adds.

Videos from the hospital show tiny bundles of babies, often several to a bed, with worried parents clutched around them. In photos sent from inside the hospital, two young boys are hooked up to drips.

Wisam al-Sakani, who works for the hospital as media coordinator, stands in front of one bed with babies being treated for malnutrition, while on the bed behind him lie babies suffering from hunger-related illnesses.

“We lack milk, food, medical supplies, incubators – some machines are not working as they need spare parts which are not allowed in by Israel,” he says.

Iman, a female medic who works in the ICU ward, begs for help in another video – as she stands in front of a baby dwarfed by the machines treating him.

“The hospital lacks enough milk for these children. Today we lost a new baby girl in the intensive care unit. Every day we lose children. How long will we continue to let them die?”

For months civilians in Gaza have endured Israel’s most ferocious bombardment of the strip, launched in retaliation for an unprecedented rampage by Hamas inside southern Israel. On 7 October, they slaughtered 1,200 people and took another 250 hostage, including the elderly and toddlers. An unknown number of the captives are believed to be dead.

Pressure is mounting on Israel to pull back as its gruelling offensive has killed more than 31, 000 Palestinians, the vast majority women and children according to Palestinian health officials. The siege has led to hunger and thirst while sickness and the constant bombardment threaten the lives of families.

On Monday, a report by a global hunger monitor – whose assessments UN agencies rely upon – said that famine is imminent in north Gaza, the most devastated part of the strip, where only a trickle of aid is getting through. The Integrated Food Security Phase Classification (IPC) said an estimated 70 per cent of the population in this area faces catastrophic hunger. It warned of “major acceleration of death” if an immediate ceasefire is not agreed and an increase in aid deliveries is not implemented.

The most vulnerable are the youngest.

The UN’s children’s agency, Unicef, had already warned that nearly 1 in 3 children under two years old in northern Gaza suffer from acute malnutrition, twice as many as in their last report in January. They said they had registered children with severe wasting, the most life-threatening form of malnutrition in shelters and health centres their staff and partners visited.

In total, the health ministry in Hamas-run Gaza says that 27 children have died from malnutrition and dehydration in recent weeks.

At least 20 of the total deaths from hunger and hunger related diseases have been registered in Kamal Adwan, where medics say without supplies they have to make tough decisions every day.

“In the ICU we have to prioritise cases we think might survive. Many patients are discharged before they they have fully recovered, even though they should ideally stay in intensive care for at least two weeks,” Mr Kahlout says, sounding exhausted. He adds that the unit lacks even the most basic medical supplies to tackle the hunger crisis, like paediatric antibiotics, intravenous fluids for rehydration and infant formula.

“We have babies orphaned by the bombing staying here as they have no family left, we lack even enough milk to provide for them,” he adds.

UN officials have blamed Israel for the growing crisis telling The Independent that famine in Gaza is “manmade” and due to Israel’s restrictions on delivery of supplies. On Tuesday the UN’s human rights chief Volker Turk went a step further saying Israel’s actions may amount to using starvation as a weapon of war, which is a war crime. Israel has repeatedly denied strangling supplies to Gaza. Cogat, the Israeli defence ministry body tasked with coordinating with the Palestinians, told The Independent there are no limits on aid going to Gaza that it is helping facilitate aid through land, sea and air. In response to Turk’s statement, the Israeli diplomatic mission in Geneva issued a similar statement: “Israel is doing everything it can to flood Gaza with aid, including by land air and sea. The UN must also step up.”

However, multiple UN agencies, international, Palestinian and Israeli aid workers have told The Independent it is hard to get supplies in. Right now only two land crossings to Gaza are functioning in the south - and none in the north where Kamal Adwan is located. A small percentage of the trucks needed to supply Gaza are entering Gaza every day, and according to UN officials several items – form anathestic medicines to water filters – are either temporarily or permanently banned as they are on “dual list” of barred items which Israel does not allow into Gaza amid concern they could be used by militants in fighting. Meanwhile multiple UN agencies told The Independent convoys going north have repeatedly been denied or turned around.

In Al-Awda hospital, also in north Gaza, resident Dr Mohamed Salha said that it means people are resorting to eating animal fodder, including wheat, barley ann corn.

“Even we, as medical and administrative staff in the hospital, have had to resort to consuming this so-called animal feed. It has meant that diseases have spread due to malnutrition, such as hepatitis A, as well as the spread of gastrointestinal diseases and dehydration, especially among children and women.

Pressure is mounting on Israel to agree to a ceasefire to allow the unfettered delivery of aid, as talks begin again in Doha with the help of Qatari negotiators.

The United States has also made a fresh push on Tuesday for a ceasefire, with President Joe Biden pressing Israel’s prime minister, Benjamin Netanyahu, to back away from plans for a ground assault on the southern city of Rafah, the last refuge in Gaza for more than a million displaced people.

The humanitarian suffering in the besieged territory, and the prospect of an assault on Rafah, have opened a clear rift between the two allies.

Mr Biden and Mr Netanyahu spoke by phone on Monday, after which White House national security adviser Jake Sullivan said Washington had made it clear a ground operation into the town “would be a mistake”.

“It would lead to more innocent civilian deaths, worsen the already dire humanitarian crisis, deepen the anarchy in Gaza and further isolate Israel internationally,” Mr Sullivan said.

Israel, which pounded Rafah overnight, killing at least 14 people, agreed to send a team of Israeli officials to Washington to discuss the plan for the town. But Mr Netanyahu insisted on Tuesday that he had told Mr Biden there was “no way” to eliminate Hamas ”except by going in on the ground”.

Meanwhile, the US secretary of state, Antony Blinken, announced a trip to the Middle East, where he would meet senior leaders of Egypt and Saudi Arabia to “discuss the right architecture for a lasting peace”. Unusually, Mr Blinken made no mention of a stop in Israel itself.

Back on the wards of Kamal Adwan hospital, doctors tell The Independent they are desperate. They are suffered from electricity blackouts, medicine and food shortages and a lack of clean water.

“Imagine performing surgeries without proper hand washing before the procedure, [as] we don’t have the water?” Mr Kahlout asks in desperation.

“As for treatments, it cannot be described as catastrophic because there are no treatments available to begin with,” he adds “People are living under the mercy of war.”