Gaza: Caring for survivors after deadly escalation of conflict

Sakhar was asleep when a bomb hit his family home in Gaza City, in the Palestinian Territories, on August 5, 2022—three days before a ceasefire was announced. He was knocked unconsciousness and woke up in the hospital. 

His neighbors sent him images of the destruction several days later. Some showed Sakhar and his brothers lying on the ground—their faces covered in blood and dust. He said he can’t believe they survived. 

This is the second bombing 30-year-old Sakhar has survived. The first was during the Gaza War in 2014. Then, he needed skin grafts to recover from his injuries. This time, his back is covered in open wounds.  Sakhar came to the clinic with his two younger brothers to have their dressings changed. His brothers sustained severe fractures and wounds in the bombing. “We saw bad and horrible sights, but not like this one,” said Mahmoud, Sakhar’s 22-year-old brother. 

According to the United Nations, 49 people were killed during the recent escalation of violence, including 17 children. Approximately 350 people were severely injured. Thousands of people have been injured during the wars that have taken place in the last 15 years. Many of the injuries lead to permanent disability.  

Sakhar’s younger brothers told MSF how their lives have been impacted by the constant trauma of war, despite repeatedly moving neighborhoods to escape the destruction. “During the 2008 war, I was in 4th grade, [and] I remember as children we used to hear the explosions and see the [dead bodies],” said Mahmoud. “In 2012, again we saw many injured and [dead people], and I lost many of my friends at the time. Then in [the 2014 war] our house was damaged.”

For many Gazans, the cycle of repeated war has led to compounding physical and mental health trauma. It impacts health care workers too.

Dr. Osama Tawfiq Hamad, an MSF anesthesiologist, was working on the Friday night that the bombing started. He’s worked with MSF since 2019, caring for patients through two wars. He described how the emergency room at Al-Awda hospital received more than 15 patients, including six children, within minutes.

“In Gaza . . . every time there’s an airstrike, we have a huge amount of [injured people] that all come to the hospital at one time,”  said Dr. Hamad. “You could have 50 or more patients at a time. In these moments, we have very bad emotions: anger and mixed emotions. But you must be strong to deal with the cases.” Dr. Hamad treated one young child who was hit in the head with shrapnel, and another with trauma to the chest—both required urgent surgery.

For many patients, follow-up visits to the hospital for surgeries, physiotherapy, and mental health support become a part of their daily lives. “I am still seeing patients from the May escalation in 2021 getting rehabilitation and physiotherapy,” said Shadi Al-Najjar, who manages the physiotherapy department at Al-Awda Hospital. “In our department we have a high load of patients as well from the Great March of Return [protests]. We are now preparing the department, both [inpatient] and outpatient, to receive the injured from this escalation.”

Al-Najjar’s home was partially destroyed on the second day of the war when his neighbor’s house was bombed. His family was still in the house when his 9-month-old son’s bedroom was hit. Al’Najjar found his son in his crib surrounded by glass and shrapnel—fortunately uninjured. He says his youngest daughter is traumatized. “She is not able to sleep, crying all the time. I am trying to be as supportive as I can for them,” said Al’Najjar. 

Sakher has four children. He said that one of the worst parts of coping with the aftermath of a bombing is trying to support his children emotionally. “My eldest is now 5-years-old,” said Sakher. “And after this escalation my son has been asking me to stop the war. And he always screams at night—he has not slept for three nights, and when he is asleep he wakes up from nightmares and starts running. I don’t know what to do or how to help him.”

The trauma of repeated violence in Gaza has severely affected the mental health of children and their parents. According to the World Health Organization, in 2021, 82 percent of adolescents in Gaza reported overall poor to very poor levels of mental wellbeing. The United Nations’ 2022 Humanitarian Needs Overview states that more than half of all children in Gaza need child protection and mental health services. Additionally, 137,000 caregivers in Gaza need mental health services.

“I hope that there will be no wars in the future and the calm [in Gaza] stays without any bombings,” said Wael, Sakhar’s 13-year-old brother, after his dressings were changed.