Guaranteed that we'll hear from Geno condemning this strike. He repeatedly tells us we must listen to what the UN says. He supports law and order and condemns terrorism. He even did so today while praising the ruling of the ICJ and agreeing with the HRW's latest ruling that on Oct.7 Hamas was guilty of war crimes, crimes against humanity and acts of atrocity which most likely included rape and mutilation.White House, EU and UN chief condemn Houthi drone strike on Tel Aviv
White House, EU and UN chief condemn deadly Houthi drone strike on Tel Aviv
Netanyahu remains mum on attack from Yemen; IDF says it failed to intercept or sound alarm because of 'human error'www.timesofisrael.com
Israel at war
- Thread starter Butler1000
- Start date
Israel is a pariah state officially now.
Until they leave Palestine they are in breach of the law.
Until they pay restitution for 57 years of illegal occupation they are in breach of the law.
Yemen did everything that makes it totally ok.
They dropped leaflets warning Israelis to leave Palestine.
You should condemn the IDF for putting their military headquarters in the middle of Tel Aviv, Palestine.
This article is devestating.
Every zionist should read it and understand what they've become.
GAZA — In the United States we would never dream of operating on anyone without consent, let alone a malnourished and barely conscious 9-year-old girl in septic shock. Nevertheless, when we saw Juri, that’s exactly what we did.
We have no idea how Juri ended up in the Gaza European Hospital preoperative area. All we could see was that she had an external fixator — a scaffold of metal pins and rods — on her left leg and necrotic skin on her face and arms from the explosion that tore her little body to shreds. Just touching her blankets elicited shrieks of pain and terror. She was slowly dying, so we decided to take the risk of anesthetizing her without knowing exactly what we would find.
In the operating room, we examined Juri from head to toe. This beautiful, meek little girl was missing two inches of her left femur along with most of the muscle and skin on the back of her thigh. Both of her buttocks were flayed open, cutting so deeply through flesh that the lowest bones in her pelvis were exposed. As we swept our hands through this topography of cruelty, maggots fell in clumps onto the operating room table.
“Jesus Christ,” Feroze muttered as we washed the larvae into a bucket, “she’s just a fucking kid.”
Right: Dr. Mark Pearlmutter playing with some of the girls in the displaced persons camp around Gaza European Hospital. Left: Feroze Sidhwa, left, operates on a man who was shot. | Feroze Sidhwa, left; Mark Pearlmutter, right
The two of us are humanitarian surgeons. Together, in our combined 57 years of volunteering, we’ve worked on more than 40 surgical missions in developing countries on four continents. We’re used to working in disaster and war zones, of being on intimate terms with death and carnage and despair.
None of that prepared us for what we saw in Gaza this spring.
The constant begging for money, the malnourished population, the open sewage — all of that was familiar to us as veteran war zone doctors. But add in the incredible population density, the overwhelming numbers of badly maimed children and amputees, the constant hum of drones, the smell of explosives and gunpowder — not to mention the constant earth-shaking explosions — and it’s no wonder UNICEF has declared the Gaza Strip as “the world’s most dangerous place to be a child.”
We have always gone where we were most needed. In March, it was obvious that the place was the Gaza Strip.
The team of healthcare workers, including Feroze (left) and Perlmutter (second from left), that volunteered to work with the World Health Organization through the Palestinian American Medical Association. | Courtesy of Feroze Sidhwa
The two of us had never met before this trip. But we both felt called to serve, so we packed our bags, leaving our lives behind in California and North Carolina.
We landed in Cairo around midnight and met up with the rest of our group of 12: an emergency nurse, a physical therapist, an anesthesiologist, another trauma surgeon, a general surgeon, a neurosurgeon, two cardiac surgeons and two pulmonary and critical care intensivists. All of us had volunteered to work with the World Health Organization through the Palestinian American Medical Association.
We were the only two surgeons in the group with experience in disaster zones. We were also the only two on the trip who didn’t speak Arabic, were not of Arab origin and were not Muslim. Mark is an orthopedic surgeon who grew up in a Jewish family in Penns Grove, New Jersey. Feroze is a trauma surgeon who grew up in a Parsi household in Flint, Michigan and worked with a Palestinian-Jewish cooperative in Haifa after graduation from college. Neither one of us is religious. Neither one of us has any political interest in the outcome of the Israeli-Palestinian conflict — other than wanting it to end.
At 3:30 a.m., we loaded into vans with the hundreds of bags of supplies our group had brought and joined a humanitarian convoy comprised of people from UNICEF, World Food Programme, Save the Children, Doctors Without Borders, Oxfam and International Medical Corps, among others, heading to Rafah, the (now closed) crossing point between Egypt and Gaza.
The sight of thousands and thousands of semi-trucks parked alongside the highway for nearly 30 miles was truly something to behold — convoys of lifesaving aid turned into static walls of a tunnel directing us toward Gaza. Travel through the Sinai is slowed by the half dozen Egyptian military checkpoints in the peninsula; after 12 hours we finally arrived in the middle of the afternoon.
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The Egyptian side of the Rafah Crossing on March 25, 2024, where most goods are transported to Gaza. | Courtesy of Feroze Sidhwa
The Rafah Crossing functions like a rural American airport: one baggage scanner, odd procedures and minimal facilities. Scanning the medical and humanitarian supplies from the dozens of aid teams one bag at a time was inefficiency defined. But it was the only reliable way to bring anything into Gaza.
As Democratic Sen. Jeff Merkley of Oregon noted on the Senate floor, the process for clearing aid with the Israeli authorities is opaque and inconsistent. “Items that are allowed in one day can be rejected the next….” For this reason, everyone simply brought whatever they could as personal luggage — even surgical equipment — paying exorbitant airline baggage fees instead of bulk shipping rates. Now that Rafah is closed, even this route for resupplying Gaza’s hospitals has been cut off. (Israeli Prime Minister Benjamin Netanyahu, who has shown no signs of backing off, is scheduled to address the U.S. Congress on Monday. He will also meet with Vice President Kamala Harris.)
Finally, after 10 p.m., we were off to face Salah al-Din Road, Gaza’s famous “road of death.”
Salah al-Din Road is the main north-south highway of the Gaza Strip. To cross it requires relying on a remarkably ineffective process called “deconfliction.”The fact that “deconfliction” is so unreliable explains why “Gaza is the most dangerous place in the world to be an aid worker,” according to the International Rescue Committee. It works something like this: COGAT — the office of Israel’s Defense Ministry that coordinates between the Israeli armed forces and humanitarian organizations — agrees it will not attack traffic on a specific route for a specified period.
This coordination is done through — what else? — a smartphone app. When the road turns green on the app you have 15 minutes to get on and off the specified route, and you can only request deconfliction of a particular route every three hours. After a 40-minute wait, we got the go-ahead and our drivers floored it, dodging foot and donkey traffic all along the road.
The sleeping quarters for the volunteer healthcare team. Half the team slept in one room in the adjacent Palestine College of Nursing, while the other half slept in one of the hospital’s outlying patient-care areas. | Courtesy of Feroze Sidhwa
Just before midnight, we finally arrived at our destination — Gaza European Hospital — where we were greeted by a sea of children, all shorter and thinnerthan they ought to have been. Even over their screams of joy at meeting new foreigners, we could hear Israeli drones humming overhead. We headed to our living quarters — half of our team slept in one room in the adjacent Palestine College of Nursing, while the other half slept in one of the hospital’s outlying patient-care areas — and spent our first night sleeping under continuous, room-shaking bombardment.
For our entire time there, we lived in constant fear that Israel would invade the hospital. Thankfully we never saw a single combatant, Israeli or Palestinian.
By the time we arrived, 59 percent of all the hospital beds in Gaza had been destroyed, while the remaining partially functioning hospitals operated at 359 percent of their actual bed capacity. The World Health Organization describes them as “partially operational.”
European Hospital is located at the southeastern edge of Khan Younis; it’s normally one of three hospitals providing elective general, orthopedic, neurosurgical and cardiac surgical services to a city of 419,000 people in southern Gaza. Now it functions as the only trauma center for well over 1.5 million people, an impossible task even under the best of circumstances. It is likely the safest and best-resourced city block in the entire Gaza Strip — and yet its horrors defy description.
Clockwise from top left: Raw sewage runs out of the displaced persons camp on the grounds of Gaza European Hospital; A child sits on the floor near the exit to the main ICU; People line the floor of the hall at the entrance to the main ICU. | Courtesy of Feroze Sidhwa
We first noticed the overcrowding: 1,500 people were admitted to a 220-bed hospital. Rooms meant to hold four patients typically had 10 to 12, and patients were housed in every possible space: the radiology department, the common areas, everywhere. Next, we noticed the 15,000 people sheltering on the hospital grounds and inside the hospital — lining and even blocking the hallways, throughout the wards, in the bathrooms and closets, on the stairs, even in the sterile processing and food preparation facilities and the operating rooms themselves. The hospital itself was a displaced persons camp.
Then there were the odors: The intensive care units smelled like rot and death; the corridors stank like a kitchen filled with filth; the hospital grounds smelled of sewage and spent explosives. Only the operating rooms were relatively clean.
It’s what we imagine the first weeks of a zombie apocalypse would look — and smell — like.
While touring the hospital we walked through one of the ICUs and found multiple preteens admitted with gunshot wounds to the head. One might argue that a child could have been injured unintentionally in an explosion, or perhaps even forgotten when Israel invaded a children’s hospital and reportedly left infants to die in a pediatric intensive care unit.
Gunshot wounds to the head are an entirely different matter.
A picture of a 10-year-old boy who had been shot in the head one month prior and underwent a craniectomy. Dr. Sidhwa removed his sutures from his scalp. | Courtesy of Feroze Sidhwa
We started seeing a series of children, preteens mostly, who’d been shot in the head. They’d go on to slowly die, only to be replaced by new victims who’d also been shot in the head, and who would also go on to slowly die. Their families told us one of two stories: the children were playing inside when they were shot by Israeli forces, or they were playing in the street when they were shot by Israeli forces.
(The Israel Defense Forces did not respond to specific questions for this story, but in an emailed statement, it said, “The IDF is committed to mitigating civilian harm during operational activity. In that spirit, the IDF makes great efforts to estimate and consider potential civilian collateral damage in its strikes.”)
As we met Palestinian physicians and nurses working at the hospital, it was clear that they, like their patients, were physically and mentally unwell. Giving anyone a pat on the back dropped your hand between two unpadded shoulder blades and onto an exposed spine. In any given room one found staff members with jaundiced eyes, a sure sign of acute hepatitis A infection in such overcrowded conditions.
Many staff had no sense of urgency and often no empathy, even for children. We were initially taken aback by this, But we quickly learned that our Palestinian health care colleagues were among the most traumatized people in the Strip. Like all Palestinians in Gaza, they had lost family members and their homes. Indeed, almost all of them now lived in and around the hospital with their surviving family. Although they all continued working a full schedule, they had not been paid since October 7; health sector salaries are paid by the Ramallah-based Palestinian Authority and are always cut off during Israeli attacks.
Graffiti in the pediatric wing of Gaza European Hospital. Pearlmutter and Sidhwa quickly learned that their Palestinian health care colleagues were among the most traumatized people in the Strip. | Courtesy of Feroze Sidhwa
Many of the staff were working at the Shifa and Indonesian Hospitals when they were destroyed. They were the lucky ones — they survived the attacks. Since October 7, at least 500 healthcare workers and 278 aid workers have been killed in Gaza. Among them was Dr. Hammam Alloh, a 36-year-old nephrologist at Shifa Hospital who refused to evacuate when Israel besieged the hospital in October.
On October 31, in an interview with Amy Goodman for Democracy Now!, the doctor talked about why he chose to stay: “If I go, who treats my patients? We are not animals. We have the right to receive proper health care. So we can’t just leave.” Eleven days later, Dr. Alloh was killed by an Israeli air strike on his home, along with three of his family members.
Among the medical staff who survived the assaults on the Shifa and Indonesian Hospitals, many were taken from those hospitals by the Israeli military. They all told us a slightly different version of the same horror story: In captivity, they were barely fed, continuously abused and ultimately dumped naked on the side of a road. Many said they were subjected to mock executions and other forms of mistreatment and torture.
After his home was destroyed and his family threatened, European Hospital’s director fled to Egypt, leaving an already overburdened hospital without its longtime leader. This sense of helplessness and disorientation was made worse still by the constant spread of hearsay about kidnappings, troop movements, food shipments, water availability and everything else of importance to survival and safety in a land under siege.
Cut off from the outside world and unable to access reliable information about the forces controlling whether they live or die, eat or starve, stay or run, rumors spread and amplified.
Several staff members told us they were simply waiting to die, and that they hoped Israel would get it over with sooner rather than later.
On April 2 we met Tamer. His Facebook posts show a proud young man and father who became a nurse to provide for his two small children — no small feat in a land with one of the highest unemployment rates in the world. When Israel raided Indonesian Hospital last November, he was assisting the orthopedics team in the operating room. He refused to leave his anesthetized patient. He said Israeli soldiers shot him in the leg, breaking his femur. His own orthopedic team cared for him, placing an external fixator to stabilize his shattered leg.
Images of Tamer from his Facebook feed that show him after he was shot and operated on (left), after he was released from Israeli custody (center) and after he was treated at Gaza European Hospital (right).
Next, Tamer told us, the Israelis came to his hospital room and took him, where exactly he doesn’t know. He told us he was strapped to a table for 45 days, given a juice box every day — sometimes every other day — and denied medical care for his broken femur. During that time, he told us, he was beaten so badly that his right eye was destroyed. As malnutrition set in, he developed osteomyelitis — infection of the bone itself — in his broken femur. Later, he said, he was unceremoniously dumped naked on the side of a road. With metal sticking out of his infected and broken leg and his right eye hanging out of his skull he crawled for two miles until someone found him and brought him to European Hospital.
(The IDF did not address specific questions about Tamer’s case, but instead emailed a press release responding to another outlet’s report of detainee abuse and torture at Sde Teiman. In it, the IDF denied mistreating detainees.)
When we met Tamer at the hospital for treatment, all that was left of him was the disfigured outline of a human being, his body crippled by violence, his eye surgically removed and his mind haunted by torture. A man who once healed others was reduced to constantly begging for pain medications, reliant on others for everything — and wondering if his wife and children were even alive.
Con't
Nearly all our patients arrived during mass casualty events. Khan Younis, a city in southern Gaza, had been under siege and bombardment since December. By the time we arrived on March 25 the town was inhabited by a combination of displaced persons from the north and locals who had not fled south to Rafah despite Israel’s threats against them. (Israeli forces frequently drop flyers or send texts demanding that Palestinians in Gaza leave their homes or shelters.) Extended families often concentrate themselves in as few buildings as possible. They told us they hoped that gathering in numbers would keep them safe — or at the very least, that dying together was preferable to dying separately.
A view of some of the displaced persons camp as seen from the second floor of Gaza European Hospital. The town was inhabited by a combination of displaced persons from the north and locals who had not fled south to Rafah. | Courtesy of Feroze Sidhwa
We noticed that bombing seemed to peak at iftar when families were gathered together to break the fast during Ramadan with whatever food they had available.
Most of the bombardment was directed at empty buildings, but when an inhabited one was hit we’d see a flood of casualties. Those who made it to us alive met very specific criteria: They were trapped in part of the collapsed building that was accessible to people digging with their hands — and their injuries weren’t severe enough to kill them over the hours it took to free them.
Israa, a 26-year-old woman with a fair complexion and a quiet voice, arrived with our first mass casualty event around 4 a.m., on our second day in Gaza. In the chaos nobody could translate for us, so we were forced to improvise as she sobbed uncontrollably on a stretcher. All the ligaments in her right knee were torn; she had three open fractures in her two legs; and a massive chunk of her left thigh had been torn off. Both of her hands had second degree burns, and her face, arms and chest were stippled with shrapnel and debris. In the same incident a teenage girl came in with a lethal traumatic brain injury (she died the next morning) and a 7-year-old boy came in with a ruptured spleen (he recovered after several days).
Left: Israa, a 26-year-old woman during her operation. The mother of four said her home was bombed without warning. Right: The list of ICU patients in the main ICU. | Courtesy of Feroze Sidhwa
We took Israa to the operating room. In the United States or Israel this would have been a 5-minute transition, but in the most functional hospital in Gaza it took more than one hour to get her there — working in such a severely compromised space, there was simply no way to get a trauma patient into surgery quickly. During her surgery, we realigned her broken femur, tibia and ankle in external fixators, explored an injured artery, cut chunks of dead tissue out of the massive wound in her thigh and her burned hands (a procedure known as debridement) and stopped her bleeding. It took three experienced surgeons almost four hours to do all of this. For the next 24 hours we were at her bedside almost continuously, knowing the traumatized and exhausted local staff couldn’t be expected to care for her properly.
After three days in the hospital, Israa, a mother of four, told us how she was injured: Her home was bombed without warning. She saw all her children die in front of her when the ceiling collapsed on top of them. Her relatives confirmed that her entire immediate family was buried under the rubble of their home. We didn’t have the heart to tell Israa that some of her children were probably still alive at that moment, dying unimaginably cruel deaths from dehydration and sepsis while trapped alone in a pitch-black tomb that alternates as an oven during the day and a freezer at night.
One shudders to think how many children have died this way in Gaza.
Two days later, while we waited in the preoperative area, one of the nurses pointed to a slight and clearly sick little girl. “Can you operate on her?” she asked.
“Who is she? We’ve never met her before.”
“Debridement,” the nurse said, shrugging and walking away.
Left: Juri, left, age 9, who underwent multiple operations. To have even a chance at a full recovery, Juri will need dozens more hours in surgery and days in a specialized pediatric ICU, which no longer exists in Gaza. Right: Sidhwa holding Juri’s hand. | Courtesy of Feroze Sidhwa
That’s how we met Juri, the 9-year-old girl with the horrific injuries.
After washing away the maggots, we positioned her on her right side and got to work. We cut away four pounds of dead flesh, washing her wounds as aggressively as we could. Then we bandaged her up and booked her for another debridement the next day.
“Wain baba?” (where’s daddy?) she asked upon waking, her voice barely audible.
He’ll come soon, we assured her.
“You’re lying,” she told us, calmly. “He must be dead.”
As it turns out, Juri’s father wasn’t dead. We found him waiting for her in the pediatric ward of the hospital. He was a loving and gentle man who spent all day every day scouring a land in famine for anything his precious daughter would agree to eat. He told us how Juri was maimed: The family evacuated from Khan Younis to Rafah, as Israel demanded. He and his wife left their seven children with their grandparents while they desperately searched for food and water. They came back to the house bombed and destroyed, their children all severely injured or killed. Juri’s surviving siblings were at another hospital with their mother.
Over the next 10 days, in a series of operations, four surgeons put Juri back together as best we could by debriding her wounds, bringing the two ends of her femur together to close the gap in the muscles of her leg and giving her a colostomy so that feces no longer soiled her wounds. To have even a chance at a full recovery, Juri will need dozens more hours under the knife and days in a specialized pediatric ICU, which no longer exists in Gaza.
And for Juri, “full recovery” means a lifetime of severe and permanent disability.
Still, amid all this horror, there were moments of light. We took great joy seeing Juri’s personality resurface once her sepsis resolved. Instead of meekly calling for “baba” and screaming in pain when touched, she now acted like a sharp 9-year-old girl who knew she had her dad in her pocket. From then on, she refused to be sedated unless he promised her honey melon and phone calls with her siblings afterwards, famine and disrupted cellular services be damned!
On April 4 two young siblings, Rafif and Rafiq, arrived in the emergency room. An airstrike in Gaza City earlier in the war killed their mother along with 10 other members of their family and ripped through their immature and malnourished bodies. Both were being treated at Shifa Hospital in Gaza City when Israel raided the hospital for the second time in March. Medical Aid for Palestinians, a British charity, repeatedly requested that Israel allow MAP to evacuate these two critically ill children from Shifa. Israel repeatedly refused, according to MAP. Perhaps sensing what was to come, the children’s family members somehow got them out of the hospital, onto a donkey cart, and walked south for two days until they came to European Hospital. The siblings arrived with their IVs still in place.
Rafiq Doughnosh, who has severe malnutrition, after being transferred on a donkey cart by his family from Shifa Hospital before it was destroyed. | Courtesy of Feroze Sidhwa
Rafif, a keen and bright-eyed 13-year-old girl, had a chronic ulcer on her amputated right lower leg, an external fixator on what remained of her right leg and malnutrition that was obvious from her sunken face and recessed eyes. Still, she was without major complications. With access to food, proper wound care and future surgical treatment — none of which is guaranteed, but possible — she could survive. But her brother, 15-year-old Rafiq, was so severely malnourished that he could barely speak. The explosion that ripped his sister’s foot off and killed his mother had also sent shrapnel through his abdomen, tearing his intestines apart. He had open wounds on his buttocks that made it impossible for him to lie on his back or sit upright, and a broken left shoulder that had never healed, leaving it frozen. He screamed in pain with any attempt at examination and was constantly terrified.
We asked the hospital to admit Rafiq for tube feeding — pumping nutrients into his stomach until he grows strong enough to eat on his own — but the hospital lacked the equipment needed for this simple intervention, and the hospitals that had these basic capabilities have been destroyed. We told Rafiq’s family to look for foods that he would eat and to feed him slowly throughout the day, but we knew we were giving them false hope. If he is not evacuated from Gaza he will certainly die, for want of an $11 piece of plastic and a protein shake.
There were 3,412 acute care hospital beds in Gaza at the beginning of the war, 1.5 beds per 1,000 people, compared to 7.3 per 1,000 people in Ukraine. After the widespread destruction of hospitals in Gaza there are now approximately 1,400 acute care hospital beds for 2.2 million people, more than 88,000 of whom have been seriously injured by military weaponry in the past eight months.
With the medical resources left in Gaza, treating the 88,000 Rafifs and Rafiqs and Juris and Israas would take decades.
A girl walks past bombed out buildings in Rafah. After the widespread destruction of hospitals in Gaza there are now approximately 1,400 acute care hospital beds for 2.2 million people. | Courtesy of Feroze Sidhwa
As Gregory Stanton, founder of Genocide Watch, a nonprofit whose mission is to eliminate mass murder worldwide, noted in his 2017 testimony on Myanmar: “Courts always come after a genocide is over, too late to prevent it.”
We had no illusions that two American physicians could prevent it, either.
We both believe — passionately —that Americans as a nation can stop what is happening. As a Jewish American, Mark has taken to telling everyone he can that support for what Israel is doing in Gaza has nothing to do with supporting Judaism or Israeli society.
The moment the United States cuts off military aid to Israel the bombs will stop falling and the troops will withdraw. We must decide, once and for all: are we for or against murdering children, doctors and emergency medical personnel? Are we for or against demolishing an entire society? Are we for or against starvation?
Are we for or against peace?
After two weeks, our time in Gaza ended.
But leaving Gaza is impossible to do gracefully.
As we handed Israa’s care off to a team of Canadian orthopedic surgeons, she begged her “American doctors” not to abandon her. We sedated her with ketamine to perform one last dressing change, and then snuck away before she fully regained consciousness, knowing we had no explanation for why she must suffer alone — while we were free to return to our lives and families.
We left on a Monday, just after sunrise. We were both consumed with guilt; we felt like we had no right to exit Gaza, that by leaving — and not staying permanently — we were deeply complicit in this mass murder.
Pearlmutter and Sidhwa walk towards the Rafah Crossing while leaving Gaza, a decision that consumed them with guilt. | Courtesy of Feroze Sidhwa
To this day both of our consciences refuse to let us forget that we chose to leave.
At the Rafah border we encountered — once again — a gaggle of children. With no school to attend they gathered around us, some of them practicing their English. One of them was a 9-year-old boy, Ahmed. He grew up in this desperately poor and besieged territory his entire life, and had almost certainly never met anyone who had ever been outside of the Gaza Strip. He has no past and no present, and if nothing changes, he will have no future.
We both wondered: If nothing changes, where will Ahmed be on October 7, 2033?
Nearly all our patients arrived during mass casualty events. Khan Younis, a city in southern Gaza, had been under siege and bombardment since December. By the time we arrived on March 25 the town was inhabited by a combination of displaced persons from the north and locals who had not fled south to Rafah despite Israel’s threats against them. (Israeli forces frequently drop flyers or send texts demanding that Palestinians in Gaza leave their homes or shelters.) Extended families often concentrate themselves in as few buildings as possible. They told us they hoped that gathering in numbers would keep them safe — or at the very least, that dying together was preferable to dying separately.
A view of some of the displaced persons camp as seen from the second floor of Gaza European Hospital. The town was inhabited by a combination of displaced persons from the north and locals who had not fled south to Rafah. | Courtesy of Feroze Sidhwa
We noticed that bombing seemed to peak at iftar when families were gathered together to break the fast during Ramadan with whatever food they had available.
Most of the bombardment was directed at empty buildings, but when an inhabited one was hit we’d see a flood of casualties. Those who made it to us alive met very specific criteria: They were trapped in part of the collapsed building that was accessible to people digging with their hands — and their injuries weren’t severe enough to kill them over the hours it took to free them.
Israa, a 26-year-old woman with a fair complexion and a quiet voice, arrived with our first mass casualty event around 4 a.m., on our second day in Gaza. In the chaos nobody could translate for us, so we were forced to improvise as she sobbed uncontrollably on a stretcher. All the ligaments in her right knee were torn; she had three open fractures in her two legs; and a massive chunk of her left thigh had been torn off. Both of her hands had second degree burns, and her face, arms and chest were stippled with shrapnel and debris. In the same incident a teenage girl came in with a lethal traumatic brain injury (she died the next morning) and a 7-year-old boy came in with a ruptured spleen (he recovered after several days).
Left: Israa, a 26-year-old woman during her operation. The mother of four said her home was bombed without warning. Right: The list of ICU patients in the main ICU. | Courtesy of Feroze Sidhwa
We took Israa to the operating room. In the United States or Israel this would have been a 5-minute transition, but in the most functional hospital in Gaza it took more than one hour to get her there — working in such a severely compromised space, there was simply no way to get a trauma patient into surgery quickly. During her surgery, we realigned her broken femur, tibia and ankle in external fixators, explored an injured artery, cut chunks of dead tissue out of the massive wound in her thigh and her burned hands (a procedure known as debridement) and stopped her bleeding. It took three experienced surgeons almost four hours to do all of this. For the next 24 hours we were at her bedside almost continuously, knowing the traumatized and exhausted local staff couldn’t be expected to care for her properly.
After three days in the hospital, Israa, a mother of four, told us how she was injured: Her home was bombed without warning. She saw all her children die in front of her when the ceiling collapsed on top of them. Her relatives confirmed that her entire immediate family was buried under the rubble of their home. We didn’t have the heart to tell Israa that some of her children were probably still alive at that moment, dying unimaginably cruel deaths from dehydration and sepsis while trapped alone in a pitch-black tomb that alternates as an oven during the day and a freezer at night.
One shudders to think how many children have died this way in Gaza.
Two days later, while we waited in the preoperative area, one of the nurses pointed to a slight and clearly sick little girl. “Can you operate on her?” she asked.
“Who is she? We’ve never met her before.”
“Debridement,” the nurse said, shrugging and walking away.
Left: Juri, left, age 9, who underwent multiple operations. To have even a chance at a full recovery, Juri will need dozens more hours in surgery and days in a specialized pediatric ICU, which no longer exists in Gaza. Right: Sidhwa holding Juri’s hand. | Courtesy of Feroze Sidhwa
That’s how we met Juri, the 9-year-old girl with the horrific injuries.
After washing away the maggots, we positioned her on her right side and got to work. We cut away four pounds of dead flesh, washing her wounds as aggressively as we could. Then we bandaged her up and booked her for another debridement the next day.
“Wain baba?” (where’s daddy?) she asked upon waking, her voice barely audible.
He’ll come soon, we assured her.
“You’re lying,” she told us, calmly. “He must be dead.”
As it turns out, Juri’s father wasn’t dead. We found him waiting for her in the pediatric ward of the hospital. He was a loving and gentle man who spent all day every day scouring a land in famine for anything his precious daughter would agree to eat. He told us how Juri was maimed: The family evacuated from Khan Younis to Rafah, as Israel demanded. He and his wife left their seven children with their grandparents while they desperately searched for food and water. They came back to the house bombed and destroyed, their children all severely injured or killed. Juri’s surviving siblings were at another hospital with their mother.
Over the next 10 days, in a series of operations, four surgeons put Juri back together as best we could by debriding her wounds, bringing the two ends of her femur together to close the gap in the muscles of her leg and giving her a colostomy so that feces no longer soiled her wounds. To have even a chance at a full recovery, Juri will need dozens more hours under the knife and days in a specialized pediatric ICU, which no longer exists in Gaza.
And for Juri, “full recovery” means a lifetime of severe and permanent disability.
Still, amid all this horror, there were moments of light. We took great joy seeing Juri’s personality resurface once her sepsis resolved. Instead of meekly calling for “baba” and screaming in pain when touched, she now acted like a sharp 9-year-old girl who knew she had her dad in her pocket. From then on, she refused to be sedated unless he promised her honey melon and phone calls with her siblings afterwards, famine and disrupted cellular services be damned!
On April 4 two young siblings, Rafif and Rafiq, arrived in the emergency room. An airstrike in Gaza City earlier in the war killed their mother along with 10 other members of their family and ripped through their immature and malnourished bodies. Both were being treated at Shifa Hospital in Gaza City when Israel raided the hospital for the second time in March. Medical Aid for Palestinians, a British charity, repeatedly requested that Israel allow MAP to evacuate these two critically ill children from Shifa. Israel repeatedly refused, according to MAP. Perhaps sensing what was to come, the children’s family members somehow got them out of the hospital, onto a donkey cart, and walked south for two days until they came to European Hospital. The siblings arrived with their IVs still in place.
Rafiq Doughnosh, who has severe malnutrition, after being transferred on a donkey cart by his family from Shifa Hospital before it was destroyed. | Courtesy of Feroze Sidhwa
Rafif, a keen and bright-eyed 13-year-old girl, had a chronic ulcer on her amputated right lower leg, an external fixator on what remained of her right leg and malnutrition that was obvious from her sunken face and recessed eyes. Still, she was without major complications. With access to food, proper wound care and future surgical treatment — none of which is guaranteed, but possible — she could survive. But her brother, 15-year-old Rafiq, was so severely malnourished that he could barely speak. The explosion that ripped his sister’s foot off and killed his mother had also sent shrapnel through his abdomen, tearing his intestines apart. He had open wounds on his buttocks that made it impossible for him to lie on his back or sit upright, and a broken left shoulder that had never healed, leaving it frozen. He screamed in pain with any attempt at examination and was constantly terrified.
We asked the hospital to admit Rafiq for tube feeding — pumping nutrients into his stomach until he grows strong enough to eat on his own — but the hospital lacked the equipment needed for this simple intervention, and the hospitals that had these basic capabilities have been destroyed. We told Rafiq’s family to look for foods that he would eat and to feed him slowly throughout the day, but we knew we were giving them false hope. If he is not evacuated from Gaza he will certainly die, for want of an $11 piece of plastic and a protein shake.
There were 3,412 acute care hospital beds in Gaza at the beginning of the war, 1.5 beds per 1,000 people, compared to 7.3 per 1,000 people in Ukraine. After the widespread destruction of hospitals in Gaza there are now approximately 1,400 acute care hospital beds for 2.2 million people, more than 88,000 of whom have been seriously injured by military weaponry in the past eight months.
With the medical resources left in Gaza, treating the 88,000 Rafifs and Rafiqs and Juris and Israas would take decades.
A girl walks past bombed out buildings in Rafah. After the widespread destruction of hospitals in Gaza there are now approximately 1,400 acute care hospital beds for 2.2 million people. | Courtesy of Feroze Sidhwa
As Gregory Stanton, founder of Genocide Watch, a nonprofit whose mission is to eliminate mass murder worldwide, noted in his 2017 testimony on Myanmar: “Courts always come after a genocide is over, too late to prevent it.”
We had no illusions that two American physicians could prevent it, either.
We both believe — passionately —that Americans as a nation can stop what is happening. As a Jewish American, Mark has taken to telling everyone he can that support for what Israel is doing in Gaza has nothing to do with supporting Judaism or Israeli society.
The moment the United States cuts off military aid to Israel the bombs will stop falling and the troops will withdraw. We must decide, once and for all: are we for or against murdering children, doctors and emergency medical personnel? Are we for or against demolishing an entire society? Are we for or against starvation?
Are we for or against peace?
After two weeks, our time in Gaza ended.
But leaving Gaza is impossible to do gracefully.
As we handed Israa’s care off to a team of Canadian orthopedic surgeons, she begged her “American doctors” not to abandon her. We sedated her with ketamine to perform one last dressing change, and then snuck away before she fully regained consciousness, knowing we had no explanation for why she must suffer alone — while we were free to return to our lives and families.
We left on a Monday, just after sunrise. We were both consumed with guilt; we felt like we had no right to exit Gaza, that by leaving — and not staying permanently — we were deeply complicit in this mass murder.
Pearlmutter and Sidhwa walk towards the Rafah Crossing while leaving Gaza, a decision that consumed them with guilt. | Courtesy of Feroze Sidhwa
To this day both of our consciences refuse to let us forget that we chose to leave.
At the Rafah border we encountered — once again — a gaggle of children. With no school to attend they gathered around us, some of them practicing their English. One of them was a 9-year-old boy, Ahmed. He grew up in this desperately poor and besieged territory his entire life, and had almost certainly never met anyone who had ever been outside of the Gaza Strip. He has no past and no present, and if nothing changes, he will have no future.
We both wondered: If nothing changes, where will Ahmed be on October 7, 2033?
This illustrates why Ziontologists are the grubbiest individuals around. Whether here, abroad or in POS Nation
Grubby Ziontologists attack and beat a Palestinian family. Occupation thug soldiers do nothing to stop it but have no problem pointing guns at the victims.
Grubby Ziontologists attack and beat a Palestinian family. Occupation thug soldiers do nothing to stop it but have no problem pointing guns at the victims.
Every accusation by a grubby Ziontologist is a confession.
The HRW calls for investigations into Hamas for acts on Oct 7.
I fully support that report, hold both sides to the equally.
Just as we should back this HRW call, as you obviously must support if you think HRW's work is trustworthy.
Houthis Launch Deadly Drone Strike on Tel Aviv, Evading Israel’s Defenses
At least one person was killed and eight others injured in a predawn attack on Friday. The Israeli military said it was investigating why it “did not identify it, attack it and intercept it.”
Every post by you is ignorant hate speech.
What is a Ziontologist? What does Shazi mean, microbe?
The racial supremacist again calls a critic 'subhuman'.
Well done, Shazi.
Turf Israel from the olympics.
Boycott them until they respect international law and leave Palestine.
Every one of these occupation thugs needs to be held accountable. These need to be de-radicalized
Keep bullshitting Geno.
They already released the results of that investigation 3 days ago.
Hamas and other groups committed war crimes on 7 October - HRW (bbc.com)
You say they are trustworthy, then you agree when they say:
Hamas and at least four other Palestinian armed groups committed numerous war crimes and crimes against humanity against civilians during the 7 October attack on southern Israel, the campaign group Human Rights Watch says.
A new report accuses the hundreds of gunmen who breached the Gaza border fence of violations including deliberate and indiscriminate attacks on civilians, wilful killing of persons in custody, sexual and gender-based violence, hostage-taking, mutilation of bodies and looting.
It also found the killing of civilians and hostage-taking were “central aims of the planned attack” and not an “afterthought”.
Says the guy who calls Gazans and Palestinians "lesser humans." You make yourself look more and more ridiculous everyday. From January of this year:
Idiotic. As if that will save even one Gazan life? BTW, are you talking about Olympics where the PLO kidnapped innocent Israeli athletes and savagely killed them in cold blood? For that reason alone, Israel will never be banned from the Olympics.
If you actually gave an iota of care for the Gazans, you'd call for a Hamas surrender. It's inevitable they'll be destroyed because not a single country is providing any troops to help Hamas and their shrinking army while more Gazans die as you wait 10 years for your boycotts. And the UN will not send in the military either while the ICJ rulings are not binding.
You continue to cheer for Hamas' incestuous genocide of their own people. This is the worst crime in history. Hamas have a hand in every single death that's occured in Gaza. Seeing as the authors of that opinion letter to the editor of Lancet did not attribute blame to Israel, it must be Hamas.
A MESSAGE FROM THE NEW PRESIDENT OF IRAN
As Bibi's visit to US Congress approaches, I expect the cacophony blaming Iran's malign intent to get shriller by the day. As a contrast, read President Pezeshkian's message and judge for yourself.
By Iranian President-elect Masoud Pezeshkian
My message to the new world
July 12, 2024 - 20:59
TEHRAN – On May 19, 2024, the untimely passing of President Ebrahim Raisi- a deeply respected and dedicated public servant- in a tragic helicopter crash precipitated early elections in Iran, marking a pivotal moment in our nation's history.
Amidst war and turbulence in our region, Iran’s political system demonstrated remarkable stability by conducting elections in a competitive, peaceful, and orderly manner, dispelling insinuations made by some “Iran experts” in certain governments. This stability, and the dignified manner in which the elections were conducted, underscore the discernment of our Supreme Leader, Ayatollah Khamenei, and the dedication of our people to democratic transition of power even in the face of adversity.
I ran for office on a platform of reform, fostering national unity, and constructive engagement with the world, ultimately earning the trust of my compatriots at the ballot box, including those young women and men dissatisfied with the overall state of affairs. I deeply value their trust and am fully committed to cultivating consensus, both domestically and internationally, to uphold the promises I made during my campaign.
I wish to emphasize that my administration will be guided by the commitment to preserving Iran's national dignity and international stature under all circumstances. Iran’s foreign policy is founded on the principles of "dignity, wisdom, and prudence", with the formulation and execution of this state-policy being the responsibility of the president and the government. I intend to leverage all authority granted to my office to pursue this overarching objective.
With this in mind, my administration will pursue an opportunity-driven policy by creating balance in relations with all countries, consistent with our national interests, economic development, and requirements of regional and global peace and security. Accordingly, we will welcome sincere efforts to alleviate tensions and will reciprocate good-faith with good-faith.
Under my administration, we will prioritize strengthening relations with our neighbors. We will champion the establishment of a "strong region" rather than one where a single country pursues hegemony and dominance over the others. I firmly believe that neighboring and brotherly nations should not waste their valuable resources on erosive competitions, arms races, or the unwarranted containment of each other. Instead, we will aim to create an environment where our resources can be devoted to the progress and development of the region for the benefit of all.
We look forward to cooperating with Turkiye, Saudi Arabia, Oman, Iraq, Bahrain, Qatar, Kuwait, the United Arab Emirates, and regional organizations to deepen our economic ties, bolster trade relations, promote joint-venture investment, tackle common challenges, and move towards establishing a regional framework for dialogue, confidence building and development. Our region has been plagued for too long by war, sectarian conflicts, terrorism and extremism, drug trafficking, water scarcity, refugee crises, environmental degradation, and foreign interference. It is time to tackle these common challenges for the benefit of future generations. Cooperation for regional development and prosperity will be the guiding principle of our foreign policy.
As nations endowed with abundant resources and shared traditions rooted in peaceful Islamic teachings, we must unite and rely on the power of logic rather than the logic of power. By leveraging our normative influence, we can play a crucial role in the emerging post-polar global order by promoting peace, creating a calm environment conducive to sustainable development, fostering dialogue, and dispelling Islamophobia. Iran is prepared to play its fair share in this regard.
In 1979, following the Revolution, the newly established Islamic Republic of Iran, motivated by respect for international law and fundamental human rights, severed ties with two apartheid regimes, Israel and South Africa. Israel remains an apartheid regime to this day, now adding "genocide" to a record already marred by occupation, war crimes, ethnic cleansing, settlement-building, nuclear weapons possession, illegal annexation, and aggression against its neighbors.
As a first measure, my administration will urge our neighboring Arab countries to collaborate and utilize all political and diplomatic leverages to prioritize achieving a permanent ceasefire in Gaza aiming to stop the massacre and prevent the broadening of the conflict. We must then diligently work to end the prolonged occupation that has devastated the lives of four generations of Palestinians. In this context, I want to emphasize that all states have a binding duty under the 1948 Genocide Convention to take measures to prevent genocide; not to reward it through normalization of relations with the perpetrators.
Today, it seems that many young people in Western countries have recognized the validity of our decades-long stance on the Israeli regime. I would like to take this opportunity to tell this brave generation that we regard the allegations of antisemitism against Iran for its principled stance on the Palestinian issue as not only patently false but also as an insult to our culture, beliefs, and core values. Rest assured that these accusations are as absurd as the unjust claims of antisemitism directed at you while you protest on university campuses to defend the Palestinians' right to life.
China and Russia have consistently stood by us during challenging times. We deeply value this friendship. Our 25-year roadmap with China represents a significant milestone towards establishing a mutually beneficial "comprehensive strategic partnership," and we look forward to collaborating more extensively with Beijing as we advance towards a new global order. In 2023, China played a pivotal role in facilitating the normalization of our relations with Saudi Arabia, showcasing its constructive vision and forward-thinking approach to international affairs.
Russia is a valued strategic ally and neighbor to Iran and my administration will remain committed to expanding and enhancing our cooperation. We strive for peace for the people of Russia and Ukraine, and my government will stand prepared to actively support initiatives aimed at achieving this objective. I will continue to prioritize bilateral and multilateral cooperation with Russia, particularly within frameworks such as BRICS, the Shanghai Cooperation Organization and Eurasia Economic Union.
Recognizing that the global landscape has evolved beyond traditional dynamics, my administration is committed to fostering mutually beneficial relations with emerging international players in the Global South, especially with African nations. We will strive to enhance our collaborative efforts and strengthen our partnerships for the mutual benefit of all involved.
Iran's relations with Latin America are well-established and will be closely maintained and deepened to foster development, dialogue and cooperation in all fields. There is significantly more potential for cooperation between Iran and the countries of Latin America than what is currently being realized, and we look forward to further strengthening our ties.
Iran’s relations with Europe have known its ups and downs. After the United States’ withdrawal from the JCPOA (Joint Comprehensive Plan of Action) in May 2018, European countries made eleven commitments to Iran to try to salvage the agreement and mitigate the impact of the United States’ unlawful and unilateral sanctions on our economy. These commitments involved ensuring effective banking transactions, effective protection of companies from U.S. sanctions, and the promotion of investments in Iran. European countries have reneged on all these commitments, yet unreasonably expect Iran to unilaterally fulfill all its obligations under the JCPOA.
Despite these missteps, I look forward to engaging in constructive dialogue with European countries to set our relations on the right path, based on principles of mutual respect and equal footing. European countries should realize that Iranians are a proud people whose rights and dignity can no longer be overlooked. There are numerous areas of cooperation that Iran and Europe can explore once European powers come to terms with this reality and set aside self-arrogated moral supremacy coupled with manufactured crises that have plagued our relations for so long. Opportunities for collaboration include economic and technological cooperation, energy security, transit routes, environment, as well as combating terrorism and drug trafficking, refugee crises, and other fields, all of which could be pursued to the benefit of our nations.
The United States also needs to recognize the reality and understand, once and for all, that Iran does not—and will not—respond to pressure. We entered the JCPOA in 2015 in good faith and fully met our obligations. But the United States unlawfully withdrew from the agreement motivated by purely domestic quarrels and vengeance, inflicting hundreds of billions of dollars in damage to our economy, and causing untold suffering, death and destruction on the Iranian people—particularly during the Covid pandemic—through the imposition of extraterritorial unilateral sanctions. The U.S. deliberately chose to escalate hostilities by waging not only an economic war against Iran but also engaging in state terrorism by assassinating General Qassem Soleimani, a global anti-terrorism hero known for his success in saving the people of our region from the scourge of ISIS and other ferocious terrorist groups. Today, the world is witnessing the harmful consequences of that choice.
The U.S. and its Western allies, not only missed a historic opportunity to reduce and manage tensions in the region and the world, but also seriously undermined the Non-Proliferation Treaty (NPT) by showing that the costs of adhering to the tenets of the non-proliferation regime could outweigh the benefits it may offer. Indeed, the U.S. and its Western allies have abused the non-proliferation regime to fabricate a crisis regarding Iran's peaceful nuclear program - openly contradicting their own intelligence assessment - and use it to maintain sustained pressure on our people, while they have actively contributed to and continue to support the nuclear weapons of Israel, an apartheid regime, a compulsive aggressor and a non-NPT member and a known possessor of illegal nuclear arsenal.
I wish to emphasize that Iran’s defense doctrine does not include nuclear weapons and urge the United States to learn from past miscalculations and adjust its policy accordingly. Decision-makers in Washington need to recognize that a policy that consists of pitting regional countries against each other has not succeeded and will not succeed in the future. They need to come to terms with this reality and avoid exacerbating current tensions.
The Iranian people have entrusted me with a strong mandate to vigorously pursue constructive engagement on the international stage while insisting on our rights, our dignity and our deserved role in the region and the world. I extend an open invitation to those willing to join us in this historic endeavor.
