At Gaza’s Al-Shifa Hospital, the War Isn’t Over

Gauze saves lives, but Al-Shifa Hospital successful Gaza City indispensable ration what small it has, months into a expected ceasefire.

Both gauze and its English sanction are wide thought to deduce from Gaza and the Arabic connection for blended silk, khazz. While possibly apocryphal, the presumed transportation testifies to the bounty that the tiny portion of onshore astatine the eastbound borderline of the Mediterranean, affluent successful weaving traditions, has provided humanity. As a coiled dressing, gauze is an mundane miracle. Its escaped weave ironically strengthens its durability, making it capable to sorb blood, discharge, pus, and drainage without becoming oversaturated and thereby returning specified worldly to a coiled site.

Gauze’s worth becomes evident during its absence. Bacteria similar to beryllium successful pools of bodily fluid. An undressed coiled beset by bacteria volition go infected. Then “the occupation explodes,” says Nahreen Ahmed, a pulmonary specializer from Philadelphia who lived and worked astatine Al-Shifa, the largest infirmary analyzable successful the Gaza Strip, from November 25 to December 11, 2025.

The near-absence of gauze successful the onshore of its evident commencement means that wellness attraction providers person nary prime but to nonstop patients location without it. Those patients bash not typically instrumentality to a sterile home. More than 2 years aft Israel responded to Hamas’ October 7, 2023, massacre with a subject ferocity that the International Association of Genocide Scholars recovered to “meet the ineligible explanation of genocide,” the patients’ homes are tents. The wintertime flooded galore tents with filthy water. Infections that statesman astatine the coiled tract volition dispersed to the bony and necessitate a preventable amputation. A akin shortage of antibiotics compounds the problem. “It started with gauze,” Ahmed reflects.

Although hospitals are expected to beryllium protected nether planetary law, the Israel Defense Forces (IDF) included them successful a run of devastation that familiarized the satellite with the neologism “domicide,” oregon the demolition of residences. According to the World Health Organization, lone 14 of the strip’s 36 hospitals are functioning. By past summer, the Israeli subject had killed much than 1,700 wellness attraction workers; it inactive holds 220 successful detention. When the Israeli authorities announced successful October that its forces would abide by a US-brokered ceasefire, Palestinians successful Gaza who had survived 2 years of unrelenting devastation hoped for a instrumentality to normalcy. So did a web of overseas wellness workers, galore of whom had antecedently entered Gaza astatine utmost carnal risk.

Those overseas doctors knew their Palestinian colleagues faced an tremendous task. A genuine ceasefire would beryllium challenging capable for Gaza’s decimated wellness attraction infrastructure. For 2 years, it lone had abstraction to code emergencies caused by subject attacks. An existent extremity to the slaughter would overwhelm the remaining doctors with patients seeking attraction for everything not instantly life-threatening, from chronic conditions to mundane illness, each of which the devastation of Gaza exacerbates.

Gauze was expected to beryllium abundant. But 7 overseas doctors and assistance workers who volunteered successful Gaza, including 4 who were determination aft the ceasefire was meant to person taken effect, described a perverse concern successful which Israel permits doctors into Gaza but not aesculapian equipment, prompting respective to smuggle captious implements of attraction into their idiosyncratic belongings. And the world since October is that Gaza’s remaining doctors indispensable woody with some an influx of patients needing regular attraction and a continuing, if reduced, gait of casualties from the IDF, and bash it each without important supplies. Doctors told WIRED the public-health situation they witnessed looked to them much similar a caller signifier of the genocide than its aftermath. During this phase, the Israelis nary longer request to unfastened occurrence to termination Palestinians, though they inactive bash that, too. (In a connection to WIRED, the Israeli concern authority, known arsenic the Coordination of Government Activities successful the Territories, oregon COGAT, said it “continues to facilitate the introduction of aesculapian instrumentality and medicines successful enactment with requests from planetary organizations.”)

“The warfare is not over,” says an planetary doc who spoke to WIRED from Al-Shifa and who requested anonymity for fearfulness of Israeli reprisal. “The casualties are not the mode they were before. They’re isolated incidents, but they’re inactive happening.” It happens with strength erstwhile Israeli soldiers comprehend Palestinians to transverse the poorly demarcated “yellow line” into Gazan territory occupied by the IDF. “All the radical that are being injured, the radical that are dying—it’s each wrong this arbitrary yellowish line.”

Between the ceasefire declaration and mid-February, Israel killed much than 600 people, pushing the authoritative decease toll from the Palestinian Ministry of Health supra 72,000, which is apt an undercount. While Israel partially reopened the Rafah crossing earlier that month, successful 2 weeks Israel permitted the departure of lone 260 radical retired of much than 18,500 successful hopeless request of aesculapian attraction nary longer disposable successful Gaza, according to the United Nations. As ominously, during that period, Al Jazeera reported that Israel allowed lone 269 radical backmost into Gaza, raising fears that those who permission volition ne'er beryllium permitted to instrumentality home.

Palestine famously provides Israel and its allies with a laboratory for its weaponry of the future, from artificial-intelligence targeting to quadcopter drones unchangeable capable to occurrence guns. Meanwhile, Gaza’s remaining hospitals are reduced to “Civil War [era] medicine,” Ahmed said. To help, overseas doctors smuggle successful 9-volt batteries, cochlear implants, and Tylenol, putting themselves astatine hazard of being banned from Gaza. Perhaps astir importantly, they smuggle gauze.

International aesculapian workers began traveling to Gaza soon aft Israel besieged it. To participate Gaza, doctors, nurses, and different assistance workers flew to Cairo and caravanned up done the Sinai Peninsula to the Rafah Crossing. The Egyptians permitted Israeli inspections of the trucks, ostensibly to forestall weapons smuggling, a process that slowed the beforehand of assistance to a crawl. Mark Perlmutter, a North Carolina–based manus surgeon who archetypal visited Gaza successful the outpouring of 2024, recalled seeing lines of 18-wheelers “30 miles long, bumper to bumper,” filled with food—“dead chickens, rotting vegetables”—that were idling, successful enactment with erstwhile Israeli defence curate Yoav Gallant’s pledge that “no electricity, nary food, nary fuel” would beryllium allowed into Gaza.

Yet the Egyptians permitted the doctors entry, on with their aesculapian instruments. Thaer Ahmad, a Chicago emergency-medicine specializer who traveled to Gaza successful January 2024, filled six oversize valises with thorax tubes, antibiotics, and more. Perlmutter bought $30,000 worthy of supplies connected eBay—including drills, surgical instruments, and 700 pounds of screws and plates for delicate microfracture surgeries to reattach and stabilize severed fingers. He says helium utilized up his supplies successful his archetypal week successful Gaza.

Then, successful May 2024, the IDF pushed into Rafah, the confederate Gaza metropolis connected the Palestinian broadside of the crossing, and took control. No longer was Egypt a viable entranceway for the aesculapian workers. Now they had to alert to Jordan, walk implicit the Allenby Bridge into the Israeli-occupied West Bank, past question done Israel to the Kerem Shalom checkpoint, besides astatine the confederate borderline of Gaza.

Nahreen Ahmed, the Philadelphia lung doctor, had entered Gaza from Egypt doubly since October 7. October 2024 was her archetypal clip accessing it from Kerem Shalom. Through the WHO, she was informed she could instrumentality lone a ample container and a backpack, which archetypal had to walk done 2 layers of information astatine Allenby. In her bags she stuffed gauze, reagents, immoderate she heard would beryllium useful. “I’m not definite we were needfully allowed to beryllium doing that, but they surely didn’t halt us,” Ahmed recalls. She did not spot the Israelis confiscate thing from her oregon anyone else.

Feroze Sidhwa, a California surgeon, returned to Gaza successful March 2025. On his archetypal trip, a twelvemonth earlier, helium came done Rafah, wherever helium had nary problems taking successful utile supplies. But astatine Kerem Shalom, helium says, “we were not allowed to bring thing in, conscionable idiosyncratic effects.” Cognizant of Gaza’s terrible deficiency of aesculapian equipment, Sidhwa “decided to accidental it.” He dispersed medications passim his luggage that helium prepared to walk disconnected arsenic his own—along with handheld ultrasounds helium couldn’t, but which the Israelis didn’t find.

That aforesaid month, Perlmutter took much than $10,000 worthy of microsurgical instruments to Amman, on with antibiotics similar doxycycline to forestall infection. He did truthful adjacent aft proceeding that nary would beryllium allowed—and that 1 discovered smuggler could disqualify an full squad from entry. At Kerem Shalom, the Israelis recovered and confiscated his instruments and “counted my pills,” permitting Perlmutter lone what helium could plausibly assertion were his own. He hid antibiotics “in my butt cheeks,” helium says. “I felt similar I was bringing contraband into a prison.”

Ahmed returned to Gaza successful precocious November 2025, the period aft the ceasefire declaration. Her web of planetary doctors informed her that the Israelis had go “a batch stricter,” she says. And what they fto successful seemed arbitrary: Stories circulated connected radical chats of doctors getting spinal rods and adjacent a CPR mannequin through, but besides of medicines being confiscated and groups barred. When she got to Allenby, a doc who was carrying trial tubes and laboratory reagents that had been permitted connected earlier trips “was kicked retired completely,” Ahmed says.

Ahmed “was truly stressed out” but had travel prepared. On her erstwhile trip, she heard Palestinians petition circumstantial things that she would request to contiguous arsenic her own. To sneak successful an other iPhone and iPad, she logged successful arsenic herself and created a passcode, telling the authorities who aboriginal thumbed done for pictures that they were her enactment devices. Nine-volt batteries and tiny magnets, indispensable for powering aesculapian equipment, were wrong her luggage arsenic the Israelis rummaged done it. Cochlear implants looked similar wired earphones. She had autoimmune medications, which request refrigeration, wrong a toiletry container with crystal packs. All of it got into Gaza undetected. “Those are usually the moments erstwhile galore of america are kicking ourselves,” she says. “Like, ‘Oh man, they lone fixated connected the tablet this time, I could person brought 10 much packets of the crab medication.’”

The proviso restrictions and unpredictable enforcement are acquainted to generations of Palestinians surviving nether Israeli occupation. Now doctors from crossed the satellite person experienced them. “This is highly orchestrated to interfere with the transportation of wellness care,” says Perlmutter. “Why would you [confiscate] antibiotics if it was not your extremity to beforehand an corruption that you knew existed?”

I enactment Perlmutter’s question to COGAT. “We firmly cull claims of immoderate deliberate effort to harm aesculapian services,” the concern authorization told maine successful a statement. “The request for anterior coordination stems from information and bid considerations and is intended to supervise the benignant and quantity of instrumentality entering the Gaza Strip and to guarantee that it is not utilized for non-humanitarian purposes.” Asked astir Perlmutter’s microsurgery instruments, COGAT replied: “As the instrumentality had not been pre-coordinated and approved successful accordance with the procedures known to organizations, it was confiscated by Israeli customs.”

I cannot see Gaza for myself. Israel has kept overseas reporters retired since October 7. Gaza’s journalists told its communicative amended than outsiders similar maine ever could. Israel killed astatine slightest 260 of them for it. “Three of these killings, including 1 murder, occurred aft the October 2025 ceasefire,” the Committee to Protect Journalists noted successful a February study that recovered Israel “has present killed much journalists than immoderate different government” since CPJ began keeping records 34 years ago.

No substance however often an algorithm showed you the ruins of Gaza, “nothing tin hole you for entering into a scenery similar that,” says Elise Thorburn, a Canadian ER doc who arrived 2 weeks into the expected ceasefire. What she saw arsenic she took the coastal al-Rashid Road northbound did not “resemble a quality situation successful immoderate way.” Silence from the collapsed buildings and shattered roads gave mode to masses of displaced radical surviving successful integrative tents oregon the remains of structurally unsound buildings. “Not 1 building,” Thorburn says, “is unaffected.” Concrete dust, suspended successful the aerial from the estimated 68 cardinal tons of debris, makes it consciousness “hazy each the time,” she adds.

Ahmed paid attraction with alarm to what Gazans respire in. Her acquisition treating patients with COPD from the World Trade Center leads her to forecast that the effects of the genocide volition stay successful the lungs of its survivors for decades.

As Ahmed began her 4th sojourn to Gaza, crossing astatine Kerem Shalom successful November 2025, much urgent concerns instantly made themselves known. She rapidly heard “a mates large weaponry blasts” adjacent to Rafah. “I conjecture we’re backmost successful the mediate of this,” she thought. Ahmed has treated patients successful war-ravaged Sudan, Syria, Yemen, Ukraine, and the Rohingya exile camps successful Bangladesh, from wherever her parents immigrated to the United States. Unlike there, she says, each of Gaza is simply a target. “In Dnipro, I could locomotion crossed the thoroughfare and not interest astir a sniper,” she says. She started calming the newcomers successful her enactment erstwhile she saw the fearfulness successful their eyes arsenic they beheld Gaza.

Ahmed had not seen the ravaged field of Al-Shifa successful a year. The main surgical gathering inactive looked “torched,” she says, the bequest of 2 punishing IDF assaults successful November 2023 and March 2024. The March 2024 raid lasted 2 weeks and resulted successful the deaths of hundreds of people, whether staff, patients, oregon radical seeking shelter. Israel claimed, without providing evidence, that Hamas had turned Gaza’s hospitals into bases for staging attacks and were accordingly morganatic targets. Ahmed says she would person seen Hamas infrastructure had it been present, either astatine Al-Shifa oregon astatine Nasser Hospital successful Khan Younis, wherever she worked during a harrowing January 2024 assault. She lived successful Nasser’s basement, adjacent wherever the expected tunnels would person been. “I person ne'er once, successful my 4 visits there, ever seen a militant wrong immoderate of the hospitals,” she says.

The slower gait of bombardment during the expected ceasefire permitted Al-Shifa, a pillar of wellness attraction successful Gaza, to marque immoderate cosmetic repairs. Functionality had improved since Ahmed was determination successful 2024, to see the reopening of a pediatric intensive-care unit, but the infirmary remained a “shell of what it was.” Ahmed’s location for 2 weeks, on with the different planetary volunteers, was connected the 2nd level of the New Obstetrics Building. “Layers of dust” proceed to overgarment the wards, destined for Palestinian lungs. Without gowns, gloves, and masks that beryllium crossed the border, it’s hard to make a sterile environment. Staff firearm done structurally unsound buildings to hunt immoderate supplies that survived the IDF sieges. “If there’s a container of gauze, and the gauze is usable, that’s a win,” Ahmed says.

The discrepancy betwixt diligent request and infirmary resources prevented the Palestinian unit from having clip to make plans for what the foreigners would do. International volunteers similar Ahmed floated betwixt the ER and the ICU arsenic necessary. Ahmed, an ICU doc and teacher, treated patients, performed bedside teaching, and advised infirmary unit connected however to execute ultrasounds, an important method considering that Al-Shifa has nary CT scanner. Sometimes little experienced volunteers would explicit alarm implicit the lack of captious supplies. Ahmed would instrumentality them speech and archer them they risked embarrassing the Palestinian doctors, who person experienced unimaginable trauma to dainty their patients. Many of them are inferior residents who indispensable marque agonizing choices successful rationing care. “In Gaza, a batch of the elder doctors are gone,” Ahmed says. “Either they evacuated, oregon they were imprisoned, oregon they were killed.”

Those doctors haunt the hallways of Al-Shifa.

The chaos levels of the infirmary are little than erstwhile the bombs fell nonstop. Ahmed had clip for tea, coffee, and conversation. She learned that spare clip was unsafe successful its ain way. “That’s erstwhile the affectional chaos happens,” Ahmed explains. “That’s erstwhile you person clip to deliberation astir what you’ve experienced.”

An ICU doctor, unprompted, beckoned Ahmed to a presumption of the Al-Shifa courtyard. He told her that during 1 of the sieges, the IDF detained 1 of his colleagues. After asking what the antheral knew astir Hamas, they told him helium was escaped to go. “He said helium watched his colleague, his friend, transverse done that courtyard and past get changeable by a sniper,” Ahmed recalls. A caregiver returned to Al-Shifa from a twelvemonth successful Israeli detention. As helium reentered the ICU, helium looked for absent colleagues and learned they were dead. “People are seeing him, and it’s astir similar they’re seeing a shade successful him, and past connected the flip side, he’s seeing ghosts,” Ahmed says.

“Everyone has a story, the astir devastating trauma that they volition benignant of casually bring up to you,” says Thorburn, the Canadian ER doctor, who worked astatine Al-Ahli infirmary successful Gaza City, not acold from the overmuch larger Al-Shifa. Many of the doctors she worked with astatine Al-Ahli divided clip astatine Al-Shifa arsenic well. She recounted treating a young antheral “who had gotten excessively adjacent to the yellowish line” and had “half his caput blown off” by a drone. Thorburn asked a Palestinian doc moving with her astatine the patient’s bedside if the concern made him angry. He replied that helium can’t consciousness thing anymore. The announcement of the ceasefire gave him momentary happiness, but that went away.

“It’s shocking and hard to emulate the level of resiliency and sumud that the Palestinian nurses and doctors show,” Thorburn says, utilizing an Arabic word for perseverance that has go synonymous with Palestinians. “That being said, erstwhile you make relationships with radical and beryllium down and speech with them, the cracks commencement to show.”

It is hardly conscionable the doctors. As patients question much than exigency care, they person a hard clip accepting the chronic shortages of supplies. There is “an choler that wasn’t needfully determination before” astatine Al-Shifa, Ahmed says. Even arsenic Gazans process the trauma of having survived, they watch, arsenic impotently arsenic their doctors, portion radical dice “due to things that are wholly reversible and treatable,” similar infections oregon a deficiency of blood-pressure medication. Although doctors study specified deaths arsenic war-related connected authoritative forms, they mightiness ne'er amusement up successful the casualty tolls published by the Ministry of Health.

There is nary specified ambiguity with different patients that Thorburn and Ahmed saw.

On Thorburn’s archetypal nighttime astatine Al-Ahli, she treated a 17-year-old lad whose femoral artery had been severed by either a slug oregon a portion of shrapnel. “He died that night,” she recalls. Despite a slower complaint of occurrence than earlier October, trauma wounds, similar those from gunshots oregon artillery, remained “an highly communal occurrence.”

In aboriginal December, Ahmed recalls, “we heard tanks advancing from the borderline of the yellowish line.” Soon, a 14-year-old miss was rushed into the ICU with a shrapnel coiled to the abdomen. The miss needed 250 milliliters of blood, “a precious resource” astatine Al-Shifa, and a splenectomy. Even with minimal supplies, adjacent amid an onslaught that was not expected to happen, the doctors astatine Al-Shifa saved her life.

By the clip Ahmed left, the miss was discharged, “smiling.” Her wounds were truthful terrible that the doctors utilized immoderate of their gauze allotment connected her. But the miss had nary prime but to instrumentality to her family’s tent, hardly a unchangeable situation for recovery. Even earlier she was admitted to Al-Shifa, she was “so malnourished.” The instrumentality of immoderate amounts of nutrient to the shelves has been small assistance to her family, who cannot spend to wage inflationary prices. Ahmed, afloat of interest for the girl, remains successful touch.

On December 11, Ahmed recorded a four-minute dependable enactment to memorialize her thoughts connected her past time successful Gaza. In the background, she points out, are bulldozers. Rescue teams took vantage of the comparative calm to exhume the courtyard, which has go a sedate of necessity for untold numbers of radical astatine Al-Shifa. “The odor of decease is literal, successful this case,” she says connected the dependable memo. An Al Jazeera communicative from 3 days earlier reported that the Palestinian Red Crescent had recovered 150 bodies.

“This infirmary is haunted by each these stories of radical that were killed, and past each of the stories that are present being told, due to the fact that we person a small spot of abstraction and clip to perceive them, astir what happened to people,” Ahmed says. “It’s not conscionable the field successful Al-Shifa. It’s everyplace successful Gaza.”

Along with the assaults connected Palestinian life, health, and question comes an battle connected what remains of their sovereignty. The Israeli authorities successful caller months has opened the floodgates to some authorities and settler seizures of West Bank land. President Trump has established a “Board of Peace” to regularisation Gaza, opening with the operation of a 350-acre subject basal to presumption 5,000 troops.

The declaration of a ceasefire, nevertheless one-sided, has prompted many, peculiarly successful the United States, to determination on. Sidhwa, the California trauma surgeon, says this “ is simply a full disaster—it means the Palestinians are going to beryllium destroyed successful Gaza.” As Israel’s accomplice, supplying it arms and diplomatic screen during the genocide, the United States is besides the lone imaginable cheque connected its behavior. “It’s precise dispiriting that we don’t person a governmental civilization oregon a media culture, oregon adjacent the motivation culture, to admit that we should attraction astir our ain crimes,” Sidhwa says.

But Gaza is much than a transgression scene. “Obviously, overmuch of it is destroyed, but Gaza City is beautiful, the radical are beautiful,” Thorburn says. At Al-Ahli, she lived with 10 young women successful their twenties. They were nurses, radiology technicians, aesculapian students, laboratory techs. They took Thorburn to the formation to ticker radical fish—a unsafe enactment with the Israeli navy offshore—enjoy a picnic with what nutrient they had, and different bash “their precise champion to unrecorded a mean life.” Resisting the attempts to rip them apart, they weaved themselves together, each reinforcing the others, similar gauze.