Palestinian British plastic surgeon Ghassan Abu Sitta knew he had to leave London, the city in which he lives and runs a clinic, and fly to Gaza as soon as Israel’s war on the Strip started on 7 October.
The award-winning plastic and reconstructive surgeon has published extensively on war injuries and worked in numerous conflict zones. His volunteer work in the Palestinian territories began during the second Intifada and has continued throughout Israel’s wars on Gaza, working at Al-Shifa Hospital, the enclave’s largest.
The tweets he started posting following his arrival on 9 October have earned him a large international following as his timeline effectively became a war blog. Starting on 8 October with a quote – “For the native, objectivity is always directed against him” – from Afro-Caribbean political philosopher Frantz Fanon’s The Wretched of the Earth, Abu Sitta’s account presents the unfolding war in its colonial context, one largely ignored in Western media coverage of the Palestinian-Israeli conflict.
“Part of our duty of care towards our patients is to advocate for them,” Abu Sitta, 54, told Al-Ahram Weekly on Monday, “and to bear witness to the horrific things that are being committed against them.”
“Unknown Child number six: ten or eleven years old,” he wrote on 10 October. “Brought out from the rubble of his family home in Sheikh Radwan neighbourhood. Half has face missing and fist sized defect in his left axilla. Total operative time three hours. That is someone’s baby boy.”
“And underneath the mud and gravel and caked blood you find the braids and the pink hair-band. A beautiful 6-year-old girl with horrific facial injuries. Mother dead,” he tweeted the following day.
On 15 October: “W.C.N.S.F. = Wounded Child No Surviving Family. It’s a thing in Gaza.”
It’s day 17 of Israel’s war on Gaza, the narrow strip of land that is home to 2.2 million people, on which Israel has rained bombs since 7 October in response to an incursion by the resistance movement Hamas which killed 1,400 Israelis. Israel has imposed a strict land, sea and air blockade on Gaza since 2006. With the death toll now more than 5,000 and over 15,000 injured Gaza’s health system, which had a capacity of just 2,500 hospital beds before the war, is in its death throes, he said.
In tandem with the carpet bombing of Gaza – Israel dropped 6,000 bombs in the first week of the war alone – Israel cut off water, electricity, fuel and all other supplies to the enclave which it controls despite claims it does not occupy the densely populated strip. Decried by international humanitarian agencies as collective punishment, Gaza’s 2.2 million population began to feel the brunt of the siege by the second week.
“The situation is more than catastrophic,” says Abu Sitta.
“We’re running out of everything. Yesterday we had lots of electricity cuts. Most consumables, everything you can imagine that is required for treating critically ill patients, those with massive wounds, is running out.”
Hospitals, including Al-Shifa where he works, have run out of dressings for burns and external fixators, the medical stabilising frame used to hold broken bones in position, and also out of space to absorb the tsunami of wounded patients. With room for only 550-700 beds, over 7,000 patients lie on mattresses and the floors of the emergency department corridors.
According to the UN Office for Humanitarian Affairs, five hospitals in Gaza have erected tents in their compounds to cope with overcrowding.
By cutting water, electricity and fuel Israel has deprived hospitals of the means to sterilise surgical equipment. Abu Sitta and other doctors have to treat and operate on patients without basic medical supplies. It has taken its toll on the mental health of Gaza’s health sector workers.
“Staff are emotionally and physically exhausted. Some of them have lost family members, some have lost their homes, almost all of them have had to relocate their families to safer places, or places they think are safe.”
Abu Sitta, who has worked as a war surgeon in Yemen, Iraq, Syria, South Lebanon and at least three previous wars on Gaza, says the current war “does not compare to anything I’ve seen in 30 years in this kind of work”.
“The sheer ferocity – I mean from midnight to morning a hundred civilians have been killed by the Israelis, and hundreds have been wounded.”
A video circulating on social media of the chaotic scene in Al-Shifa hospital on Monday morning showed hundreds of bleeding patients lying on the floor, moaning and screaming as dozens of doctors, nurses, reporters and other people walked around and over them.
The situation has become so dire that the head of Al-Awda hospital told Al-Jazeera TV network that doctors have had to conduct amputations without anesthesia. There have been medical reports of unusually deep muscle burns displayed by patients who did not suffer from visceral trauma, injuries different to those caused by white phosphorous, leading Palestinian rights groups to accuse Israel of using its wars on Gaza to experiment with new weapons.
As Israeli airstrikes intensify “the number of burns is exponentially increasing,” says Abu Sitta.
“I’ve attended Gaza’s previous wars, and the number of burns is astronomical. These bombs have incendiary components to them.”
Amnesty International and Human Rights Watch have confirmed Israel has used white phosphorous, the internationally prohibited chemical with an incendiary effect.
According to health authorities in Gaza, 57 health workers, including at least eight doctors, have been killed as Israel continues to target paramedics and hospitals. Twelve hospitals and 46 primary care clinics have been forced to shut down since 7 October due to damage or lack of electricity and supplies.
By targeting medical teams and hospitals, says Abu Sitta, Israel wants to “induce a humanitarian catastrophe”.
An Israeli airstrike on the Al-Ahli hospital on 17 October killed 500 Palestinians. Abu Sitta had just moved to the hospital where thousands of displaced Palestinians were seeking shelter when the attack happened. In a press conference given by the hospital’s doctors, Abu Sitta stood on a podium surrounded by dead bodies. Amid the scenes of piled bodies and amputated body parts he looked visibly shaken.
“Back operating today. They will not break us,” he tweeted the following day, before quoting American writer and civil rights activist James Baldwin on resilience.
Abu Sitta says his first impulse to rush to Gaza when the war started was driven by the feeling that this time the war will be more vicious. “But I had no idea it would be this vicious and that there would be a very narrow window to get in at the very beginning.”
His media profile has attracted the attention of the UK’s counter-terrorism force which showed up at his house in the UK and “harassed” his family. He later told BBC News night that the officers had questioned his wife on why he had travelled to the Palestinian territory, who paid for his ticket and which charity he was helping.“I think it’s a brutal attempt at harassment and silencing us,” he told the BBC.
Abu Sitta’s emotional attachment to Gaza goes back to when his family became refugees there after being forcibly displaced from their lands and property in the Negev by Zionist gangs in 1948. Their lands, less than 50 km away from Gaza and which carried his family name, Mu’een Abu Sitta, were seized and converted to Israeli settlements.
The displacement of over one million Palestinians in Gaza and Israeli calls to transfer the enclave’s population outside the Occupied Palestinian Territories struck a chord with Abu Sitta.
“It highlights the fact that the Nakba, the expulsion of Palestinians through massacres, was not an event in 1948 but a process that continues till this day,” he says.
“The logic of elimination that determines the relationship between colonial settler Israelis and the natives of the land still exists.”-
* A version of this article appears in print in the 26 October, 2023 edition of Al-Ahram Weekly