"It's Madness"... American Nurse Documents the Collapse of the Healthcare System in Gaza City

SadaNews - As Israeli forces advance, the healthcare system in Gaza City is under fire and heading towards collapse, while an American nurse documents the moments of the healthcare system's breakdown amidst the war.

More than two weeks after the latest Israeli ground assault on Gaza's largest city, two clinics have been destroyed by airstrikes, and two hospitals have closed due to damage, while others are barely operating under a severe shortage of medicines, equipment, food, and fuel.

Many patients and staff have been forced to flee hospitals, leaving behind only a few doctors and nurses to care for children in incubators or other immobile patients. External bombardment shakes the walls of hospitals, Israeli drones hover nearby, often firing close by, making it dangerous to enter or exit, according to healthcare workers.

Al-Quds Hospital, located at the southern edge of Gaza City, hastily evacuated most of its patients last week as Israeli forces approached.

Paramedics placed one patient in a field of rubble, his body covered with gauze to treat severe burns on 40% of his body, and asked him to go to a clinic for treatment, according to Andy Vaughan, the American nurse who was among the rescuers. She told the Associated Press on the day of her evacuation: "It's madness. This is the state of the healthcare system," which she claims Israel is deliberately dismantling.

Al-Quds Hospital previously accommodated 120 patients. Now, only about 20 remain, including two infants in intensive care. The hospital houses around 60 doctors, nurses, and patients' families.

Volunteered in Gaza... and War Diaries

Vaughan volunteered from Seattle through the Palestinian-Australian-New Zealand Medical Association since July, and she has been keeping video diaries of her time at Al-Quds Hospital, sharing them periodically on social media. She shared dozens of videos with the Associated Press, which verified them. Volunteers in Gaza, like her, have become a vital source of information as Israel has banned foreign media.

Vaughan filmed with her mobile phone warplanes and projectiles landing in the city and around the hospital. In one scene, her room shakes, and thick columns of smoke obscure the view from her window.

In another scene from one of the hospital's lower floors, a child pauses while carrying a water jug as explosions shake the walls. On Saturday night, Vaughan said a convoy near the hospital was fired upon. She added that a teenager was hit with a superficial head wound, and this might have been the last patient admitted to Al-Quds Hospital.

Like other hospitals, Al-Quds Hospital is suffering from severe shortages of water, electricity, and oxygen, and the hospital's oxygen station was fired upon by Israeli forces.

"My Colleagues Are Afraid of Death"

Israel claims its campaign against Gaza City aims to destroy Hamas's infrastructure and free hostages taken during its attack on Israel on October 7, 2023, and has ordered all residents to leave and head south, citing their safety. Nabal Farsakh, a spokesperson for the Palestinian Red Crescent that manages Al-Quds Hospital, stated that Israeli vehicles have surrounded the hospital, "completely restricting the movement of remaining staff and patients," while drones fired on the hospital and nearby buildings.

Vaughan was evacuated on Tuesday with another doctor and headed south. Speaking from a guesthouse in Deir al-Balah after her evacuation, Vaughan said: "I get messages from my colleagues there asking me why I left. They tell me they will die."

Hospitals are being fired upon despite Israeli orders to leave, and hundreds of thousands of Palestinians remain in Gaza City, which had a population of nearly one million before the ongoing attack. International experts say the city is facing famine.

Israel has closed the border crossing into northern Gaza since September 12, preventing direct shipments of aid to the city. Relief organizations have rushed to supply resources from the south, navigating treacherous routes under increasing Israeli restrictions on their movement, according to the United Nations. In the past week, Israeli airstrikes destroyed at least two clinics at either end of Gaza City and forced two others to close, including a children's hospital and a specialized eye clinic, according to the United Nations. The Jordanian government announced the evacuation of a field hospital it was managing as Israeli forces approached.

"The Fear is Real"

The United Nations states that 27 medical centers and primary healthcare facilities in Gaza City, many of which are critical in treating malnutrition, were forced to suspend or close their services in September. Nearly 100 patients fled Shifa Hospital, the main hospital in Gaza City, on Wednesday and Thursday as Israeli tanks closed in. Fearing being caught in an airstrike, many staff ceased coming to work.

Hasan Al-Sha'er, the medical director at Shifa Hospital, said: "The fear is real."

According to human rights organizations, the number of medical personnel from Gaza detained by Israel is estimated at more than 160 as of February. Israel claims that arrests are carried out legally, asserting that some are involved in “terrorist activities.”

On Wednesday, the Israeli military claimed on social media that militants were operating inside Shifa Hospital. The military posted a blurry video it said shows militants firing. Shifa Hospital doctors denied this allegation, describing it as a pretext for raiding the hospital. Hospitals are being emptied as Israeli forces advance, with Israeli soldiers raiding Al-Quds Hospital for a week in November 2023, temporarily closing it. The Red Crescent stated at the time that parts of it were destroyed and at least one civilian was killed.

UN: Israeli Targeting is Systematic

The United Nations and some human rights organizations indicate that Israel has systematically targeted hospitals, using direct strikes, blockades, and raids.

Ezra Ziyada, a health systems analyst residing in the UK and closely working with medical teams in Gaza, stated that when a hospital becomes non-operational, neighboring residents usually flock to it.

Before the recent attack on Gaza City, the staff at Al-Quds Hospital began discharging patients not suffering from serious illnesses, fearing for their safety, Vaughan said. She added that they diverted traffic away from the hospital while Israeli drones fired at surrounding buildings.

Last week, hundreds of Palestinian families who had sought refuge at the hospital and its surroundings fled, many having previously escaped the advancing Israeli forces from the north.

Infant Under Bombardment

After a day, Vaughan accompanied nurses of the neonatal unit. One of the remaining infants – just 13 days old – was held to her body in an attempt to calm her. Vaughan reported that the baby's heart rate dropped dangerously low amid explosions close by. From the window of her room on the fifth floor, Vaughan recorded nearby strikes.

In a video, Vaughan said: "They bombed the hospital again." She filmed an airstrike from an Apache helicopter from a distance. On the fourth floor, there were glass shards on some beds from broken windows. Fresh blood stained an abandoned mattress. Vaughan filmed an empty hospital floor that had been cleaned.

She said in a video shot on Monday: "The floor was teeming with patients in the corridors, and now it is abandoned because everyone had to flee," and for her safety, Vaughan moved to the basement that day.

The following day, shortly after Vaughan left, her colleagues informed her that Israeli military vehicles had approached the southern gate of the hospital.