Palestinian doctors hope ceasefire will revive Gaza’s healthcare sector

Khan Younis, Gaza Strip, Palestine – In the dimly lit corridors of al-Amal Hospital in western Khan Younis, one of the 17 partially operational healthcare facilities in Gaza, a rare sense of hope grips the staff and patients.

Mediators have announced a ceasefire between Hamas and Israel to end the 15-month war on Gaza, and although the Israeli cabinet has yet to approve the deal, optimism is contagious.

For the first time in months, orthopaedic consultant Dr Khaled Ayyad speaks with confidence as he reassures patients of soon receiving the medication and procedures they urgently need and hospitals have been unable to provide due to Israeli restrictions on aid deliveries to Gaza.

“We’ve done the impossible. We’ve had to improvise ways to handle cases so grave in scope and so large in number and for the longest stretch of time to get this far,” Ayyad explains.

Along with other medical staff and patients, he was forced by the Israeli army to leave his post at the Palestinian Red Crescent-run al-Quds Hospital in Gaza City a month after the war began on October 7, 2023. The 53-year-old surgeon had since been operating out of al-Amal, relying on what he describes as “minimal capabilities”.

Throughout Israel’s war on Gaza, “each medical centre or humanitarian delivery system has been or is being destroyed,” according to a January 7 report by the medical aid group Doctors Without Borders, known by its French acronym, MSF.

Ayyad had to endure two Israeli raids on al-Amal Hospital in February and March and had to navigate displacement in the arid area of al-Mawasi in southwestern Gaza along with his family, including his six children. He says he is lucky to have survived: More than 1,000 healthcare workers have been killed, and many have been detained by Israeli forces.

“The number of cases I examined shot up to 70 patients and injured people a day in addition to the hospitalised cases in the departments, which are no less than eight cases,” Ayyad tells Al Jazeera. As he speaks, countless patients and visitors crowd the hospital’s wards as external clinics and corridors overflow with those seeking care.

Patience

Ayyad explains how he often resorted to temporary measures to treat fractures until the fixation plates required for operations became available. “Soon they will be,” he says with a big smile, reassuring Hani al-Shaqra, a patient whose collarbone was fractured on Monday in an Israeli attack near the Deir el-Balah home he had sought refuge in.

Unable to return Ayyad’s enthusiasm because of his pain, al-Shaqra says he cannot wait for a ceasefire to come into effect so he can undergo the surgery he needs.

“Amid this genocide, the care I received is to be expected, especially since everyone faces great difficulties in obtaining treatment or even reaching hospitals. I am optimistic … that treatment is possible after the ceasefire,” he says, speaking cautiously, careful not to move his arm or the sling that is helping lift the weight off his shoulder.

“I just hope it happens soon before my condition deteriorates,” he adds.

Talks to reach a ceasefire and end a war that has killed more than 46,700 Palestinians had faltered repeatedly over the past year until mediators announced on Wednesday that a deal had been reached.

The inauguration of Donald Trump as United States president on Monday served as a de facto deadline, and the ceasefire is due to come into effect the day before. With it, larger supplies of much-needed humanitarian aid are to be allowed to enter the enclave after a massive dearth in aid deliveries, which were exacerbated by the May closure of the Rafah crossing with Egypt, through which most of the supplies came in.

‘A lot more work to be done’

While Ayyad hopes that the influx of humanitarian supplies will lead to some respite for Palestinians in Gaza, he knows he and other medical staff will have a lot of work to do.

“Many of the wounded who we sent away with temporary treatment will need to be reoperated on, properly, once supplies are available,” he says.

Dr Adnan al-Zatma, a general surgeon working alongside Ayyad, emphasises the enormity of the challenges.

Putting aside the obvious shortages of medication and supplies, he lists the devastation seen across the hospital: from the X-ray machines and electricity generators destroyed during the Israeli invasion to the burned-down wards, bullet-ridden walls and the bulldozed entrances and roads leading to the hospital.

“A ceasefire would be a respite, but it won’t be magical,” al-Zatma says.

According to Dr Haidar al-Qudra, executive director of the Palestine Red Crescent Society in Gaza, the healthcare sector is operating at less than 10 percent of its pre-war capacity. The condition of the pre-war healthcare system was already below what was needed, according to MSF, because of Israel’s 17-year blockade on Gaza. It is now in shambles.

“Tens of thousands of patients have suffered because of the healthcare collapse,” al-Qudra says.

“This includes fatalities, disabilities and severe complications for those unable to access proper care during the war,” he adds, highlighting that facilities like al-Amal Hospital and al-Wafaa Hospital were nonoperational for most of the war.

“For many patients, rehabilitation was their only path to regaining mobility or basic functions. The loss of these services has been catastrophic,” he says.

Major hospitals like al-Quds and al-Shifa were heavily damaged, and facilities like al-Amal Hospital suffered significant infrastructural damage.

Despite these challenges, Red Crescent hospitals treated more than 500,000 cases and received an additional 900,000 patients at their primary care centres during the conflict. Al-Amal Hospital alone has been handling 1,500 cases daily alongside two field hospitals and 10 primary care centres in northern Gaza.

‘Gradual recovery’

“A ceasefire would bring a gradual recovery of the healthcare system, supported by international aid,” al-Qudra says. “The Red Crescent plans to establish five field hospitals across Gaza and 30 primary care centres, including one main centre in each of the five governorates” once supplies are made available.

Coordination with international organisations like the Red Cross and World Health Organization aims to facilitate the entry of medical supplies from the occupied West Bank, where Red Crescent warehouses hold critical stock, he says.

“These supplies, along with the arrival of Arab and international medical teams, will breathe life into Gaza’s healthcare system,” al-Qudra adds. “Reopening hospitals, even gradually, and improving mobility across Gaza will restore some sense of normalcy. The ability to work without fear of targeting will also improve conditions for medical teams.”

“The ceasefire offers a glimmer of hope for everyone. Like everyone, the medical staff is depleted. The healthcare system, battered by relentless war, needs a chance to recover, and it’s braced for the long road to recovery,” he concludes.

This piece was published in collaboration with Egab.