The view near Al Shifa Hospital (featured image for the zoom meeting with Dr. Hassan Ghassan)
The view near Al Shifa Hospital. (X/@WarMonitors)

Dr. Hassan Ghassan From Al Shifa Hospital Comments on the Situation in Gaza

Yesterday Nov. 12, Dr. Hassan Ghassan, who operates Al Shifa Hospital, provided crucial updates on the situation with innocent victims of the indiscriminate Israeli bombings during a Zoom meeting that included allies from different entities and affiliations.

Please note that the meeting has been edited for length and clarity.

Q: How’s the situation now in Gaza?

DR. HASSAN GHASSAN: We managed to get to the Bronx floor and from the school Ward so that we ran an orthopedic and plastic surgery service. And we were taking patients from all of the things that Dr. Postel now is the only functioning hospital in the whole of Gaza City.

It is somewhere only us. And the Indonesian hospital in the whole of the northern part of the Gulf. We have over 500 wounded. There are only 330. This year two operating rooms with too many. We don’t have an expert technique. And we don’t have access to a blood bank, the blood bank has been foiled. And if a hospital, as you know, has fallen, completely surrounded by training iPads, we’re firing in the window. And so, all of the people that are remaining, and the staff are in the corridors of the field a couple of duty young doctors today, and they fired into a couple of the buildings. And completely out of the question that we can’t even take the people inside the intensive care unit people have all died because of a lack of oxygen, and they hate the oxygen fight. 

Can you speculate for us what might happen in the next upcoming days? And how can we help you at the moment?

Now, the reason why I was keen to the peak is we need you on the outside to start thinking about the day after. There has been a systematic and not uprooting of the health system and what is over, and every nightmare has come to an end. We rely on you to be able to bridge that gap until the health system, both in terms of people and in terms of institutions and resources are able to get back on their feet. And because we don’t know what’s going to happen, we need you to do two things. We need you to do multiple scenarios where you figure out how you will behave in the outcome. 

So the first scenario is that there is no clear-cut ceasefire, but a humanitarian corridor was a lot of the people will be moved into Egypt. And so a lot of you are independent of origin or have access to friends who have licensed to practice in Egypt. And so we need to start thinking about the potential of what would happen if that would be the case. And the media, we can be 3000 wounded so far need to be treated in Egypt. And so organizations like PCRF and other organizations need to think about maybe figuring out now reaching out to the Ministry of Health reaching out to some of the hospitals offering the potential for aid. 

The second scenario is that there is a ceasefire and there is the ability to bring in things, hopefully not through areas but also a drop-off. There needs to be more than a toxin, the number of patients is overwhelming. And it is not an issue of ending a few weeks and every couple of days or every couple of weeks or every couple of months. And so, yet again, we need to figure out the way in which maybe some of the existing hospitals are taken over and turned into permanent frequent printers for the wounded, particularly those who are going to need second or third grade who will need a refill. 

And so, but you need in order to do that, you will need to be aware of the following too: The human resource aspect of the health system has been what you will find when you come to us. They help you find colleagues from the nursing field who have not been exhausted, both emotionally and physically. 

And so you will need to come up with an idea that you will need to carry the system. And by that, I mean that the teams need to come fully equipped with more nurses with all our nurses with mental health, with people capable of running, re-sterilization routine, and with herdsman good that that aspect of it is, is complete enforcement, you will not find anybody who has any energy left at the end of the floor to be able to help. And so we need you to start thinking about a contingency plan, how you’re going to do the tower, you’re going to do crane, the patient. 

And then the next aspect of this is the non-war related medical care that has also been destroyed. So as you all know, the ophthalmology Hospital has been destroyed, and the hospital has been destroyed, and all of the core pediatric hospitals have been destroyed. 

And so, there also needs to be a parallel plan for the most urgent non-communicable disease care that is out there. So that those people are not left dying while they try to recuperate. And the situation is beyond dire. I mean, at the moment, we are in a hospital that was a hospital during the First World War for British soldiers. Can I tell you today, I felt that, you know, the conditions that we were working in were not that dissimilar to the words they were working in. I did major things betting on children with nothing to do with no means, with no ketamine, with no morphine, not even Tramadol.

And so, you know, now we’ve been reduced to this kind of brutalization. We have a full bottle in the compound where the nipple landed when they hit the hospital. And we’re just basically making do, we have no CT scan, we have no neurosurgeons there are three of us, myself, a plastic surgeon, one orthopedic surgeon, and one general surgeon. 

And today, we’re lucky that there is a trickle-down economy. Because there was a woman with temporary, pregnant woman with a penetrating abdominal wound that we believed had a kind of uterine injury. And luckily, we found him, and he was able to come and the general surgeon at hand, but that’s about it. We don’t have access to blood. Debate to me, today, you know, my perspective, I mean, over 15 years, because there was no way to do it. And so that’s the kind of that’s what we need from you is to think for week two scenarios, and figure out a way to systematically hit the ground running when this is over in whatever shape or form it’s over.

Regarding the second scenario, the scenario where teams can come in, from watching. What about the infrastructure? How can they work? Like, what do we need to bring in equipment with that, like, I’m talking like not just simple things, even the big stuff because I don’t know how equipped these teams are to be able to work anymore?

In terms of consumables, you’re gonna have to bring everything. Everything’s been almost, I mean, by the time you do come, there’ll be nothing. Terms of recruitment have probably been damaged from recruitment hasn’t been and I think all of these organizations will need to kind of almost advance in that kind of get in and quickly assess the situation. Come in, I mean, that I leave that to the emergency of each of the organizations, what you need to do now is within your complexity, and try to figure out who are the local contacts that you have. A lot of them now are just completely different. And so, you need to figure out where they are and to start to kind of, you know, trying to figure out how to, how to be ready to be in touch with them immediately when you have all of the information available to you. 

An eye-opening report is 7 percent of all of the industries and the deaths and the wounded are in the southern part of Gaza. In the southern part of Gaza is complex. North Korean and European hospitals have not been not being open and are not being deployed as they’ve approved in the south. But that does not mean that that will not happen. The European hospital is coming forth on everything. And I think, you know, the kind of the diffusion of resources of hospitals is equal in the north and the south. The neutralization of the system in the North has been completed.

In addition to our basic expertise in our respective specialties, you’re someone who’s very experienced in war care, what can we do to prepare and plan before we come to you if we’ve never been in a war zone in an area that is destroyed to that extent, so at least we would be ready by the time when we can be there.

So the idea is that you are coming to basically a portal where there’s nothing left. And that is everything from the field to everything that you can imagine has been consumed by over 23,000 wounded and over 37 days with no real resupply of the system I mean. You know, I’ve not done it they were just a drop in the ocean. My advice was to get up, get on the scene, and funnily rather than toward students to make a daily list of every insignificant stupid item that you take for granted so that you have that available to you when you get in what’s happened in organizations like when the tour started, use their financial resources to buy whatever was in the private sector investment and so not even the private sector in wrestling will have anything to give you everything has been consumed. Because everything into these and one of the buildings that will hit find these really today was the storage facility storage building in Boston and very little and there’s all the old people gone.

We hear that Jordanians are probably sending some medical supplies. So is that true? 

Very, very little because the hospital is between hospitals is now almost impossible. And so and more field hospital I mean, today, one of the poor girls that I had to do a major change of dressing on her uncle is the director of the Jordanian hospital, and he was on the phone trying to get some ketamine, for me, you on her sister, and we couldn’t, we couldn’t even find a way to get me ketamine for his only. So don’t go around and have access to that poll, hospitals have benefited from it. But it’s not large enough to be able to make a dent, and movement is really restricted now. You don’t know where these are, and I mean, don’t be fooled by Polycom. There are these quadcopters with our new drone that fire people. And so, you no longer need my Person B to suit the ambulances. They’re these quadcopters that are kind of going around in Gaza and will fire at the ambulances for fire as people trying to get off.

I just received the call this morning, that a group of people in London Ontario are working in trying to get the preterm children who are in the incubators outside of Gaza, to hospitals in Egypt. And I think they have the logistics actually to do that. So he said that there are emergency cards from some Kuwaiti organization who are ready to transfer these children, and there are a physician or there are hospitals actually in Egypt, that they will take care of these preterm children, I think, but he was asking about the logistics. So they have concerns about if these cars start to go out of Al Shifa Hospital, how much security they will have, and how much logistics they need to go out of the desert strip?

That’s not confirmed. At the moment, what I need you to concentrate on really is the day after. At the moment it has not been shown any kind of any kind of humanitarian inclination, any kind of humanitarian and, you know, there’s nothing there’s not. I mean, the kind of brutality of what is happening, it defies any kind of logic, the very human violence, the kind of, you know, beyond the need to think that somehow these babies are going to allow one thing to happen. Even though the first thing they did when they got the oxygen was make sure that none of that was realistic. What the husband needs from those outside is thinking about the day after, because the whole aim of what is happening now, the whole aim, and this is why the art of the 1940 war, is to make the uninhabitable so that those who have not left during the war, and as a result of the war will leave to NAFTA. That’s the aim that is the aim of this talk on brutalization to have it populating or a big part of its population and leave the rats destitute and fending for survival. And that’s what we need those on the outside to be thinking about the second phase of the floor, which is the war or ethnic cleansing by making it into an uninhabitable place.

We keep hearing about a lot of supplies coming through Egypt to other countries, is anything making it to the hospital that you’re at? And the second question is about the incubators. Today we heard news that 39 kids died in incubators, is that true or not? And lastly, sorry for so many questions. Are any international organizations specifically US organizations and Medical Association? Or other specific organizations? Have they all been involved? Or could we get them involved? 

So the news about this is more likely to be true. Now, with regard to, I mean, that’s the lobbying that you guys need to be doing about involving the medical association that comes to certain in Canada and the American Medical Association and their needs, need to kind of use this time, it’s fine to start mobilizing for that the actor we cannot, it’s obvious that there’s no intervening in this war in terms of what is happening now. But at least one is over, we need to be able to the worst possible thing after these wars, is that people are destitute for six months and a year, by the time someone sends a consultant to do a field, study, and write their report, and then someone else moves and then an assistant goes and then writes their report. We need you to focus on hitting the ground running the minute this is over because the second wave will be the destitution.

We are just trying to work out if there is any organization or direct communication with the Egyptian hospitals if we can help and support in any way there are a lot of people here groups and social workers who are willing to do that, but there isn’t any direct organization where we can approach either in Egypt or properly the cities around we know the situation and crisis is very critical. But what about the people who manage to pass actually the borders to different cities around because of what is happening to them, and what’s the situation in terms of the hospitals, the illiteracy, particularly for the Arab American Medical Association, my feeling is there must be colleagues and friends, supporters and members who are different and have linked with the different medical syndicates and have linked within the medical establishment who can start reaching out and preparing the ground for a possible scenario. I mean, I think that the critical thing is to figure out on top of that they’re not even the worst-case scenario where the government says only those with licenses to practice in any form. I think there’s enough in American, Canadian, and European doctors and surgeons to be able to kind of at least do the old will only to reach out to them. So that they are, they start doing a lot of the legwork with the institution besides to kind of, you know, be prepared to move in.

War in terms of what is happening now, but at least one is over, we need to be able to. The worst possible thing is, after these wars, is that people are destitute for six months and a year. By the time someone can impose a consultant to do a field, study, and write their report, and then someone else moves, and then an assistant goes and writes their report. We need you to focus on hitting the ground running the minute business is over because the second wave will be the destitution.

I have a small suggestion. If we can take the injured people to Kuwait for example, or to Egypt, why we don’t take injured people to the West Bank? Because we are the PCRF an American registered organization that has 501C3 we use that tax-free from our donations to the PCRF maybe we can have a staff in Ramallah, and we can ask, for example, the American Embassy to interfere. It is less than an hour’s drive. We can send maybe 1000 engineers from Shiva directly to the West Bank as long as it is easy they say they will have safe corridors or four hours. Something to open the doors. I think that could be practical. I don’t know. But I’m just trying, you know, to help.

I think that’s what need at the moment, we’re only getting how we think they’re gonna pan out. And so what organizations need to be doing is looking at the possible scenarios. And the mixture of these different scenarios, bank, Jordan, Egypt, further afield, and my feeling is that the Israelis will not be letting anybody out of holiday through Arizona anytime. But it’s critical that we, you know, you have a plan, the most important thing is for us not to be caught off guard once it is done. And then start thinking and then start preparing.

Is there any camp or any sort of a field hospital where telehealth can be helpful?

I mean, you know, that’s another way to kind of think about what is going to happen at the moment. I mean, I couldn’t even go in at the moment, no, but afterward, that’s a possibility. All of the tools available to us, all of the tools available to us, have to be used. This is a war on a field that has not happened since the Second World War. This is 37 days with over 13 hours, and I’ve wound the point 3000, of whom the kids are 7000 dead, and wounded are 11,000 children. This is a team that is beyond a single tool and a single mechanism to deal with. And therefore everything that every one of us, who is comfortable doing a way will be called on because no single way we’ll be able to kind of reach I mean, this girl that Steve has managed to historic house, he’s going to need three fibula neurovascular free flap. And then he’s going to need pending funds for a nerve graft at all I could do for her or put a finger on the defect that was then graspable in the hope of stabilizing her enough to get her out before an infection and osteomyelitis and whatever remanent that they had. 

And, you know, this is one of many, I mean, you know, anything that we managed to do, we managed a paper my paper, because the numbers were so overwhelming that you could not afford to spend that long on, we were just doing limb saving surgery. And so everything that you can imagine, you know, 1000s and 1000s of external features on a limb that will need internal fixation and bone graft. Or even worse, the 1000s of patients who have upper limb injuries will need complex reconstruction. All of this, and then a society that has been buoyed will need primary health care. And we’ll need good primary health care because of what has undergone. There are over a million houses that have been demolished. 

These people will now come to the winter out in the open because there’s no possibility that you’re going to be able to get 200,000 prefabricated homes and the Gaza. And so all of the problems and all of the catastrophes that you can imagine with all of these people living in school with regard to infectious diseases, dermatological infections. We have no need to fix it now as we have dehydration in pediatric services. So a lot of kids with chronic illnesses are better. Thinking about all of these things will need to be sorted out. What needs to happen is you need to think about what you are able to do. Make sure that you’re all in the matrix of one of the organizations for the services and the specialty that you can. So that when the plan is is is rolled out, you are able to be there in whatever shape or form

Can you describe the kinds of injuries you’re seeing and what you believe the long-term impacts of these injuries are? And also how are hospitals able to handle the rising death toll? Are people able to bury their loved ones?

So the first question is, are there all black injuries and some of them are kind of weird and wonderful new weapons that get tested on us? One of the new ones that I’ve seen is the new hellfire missile fire, like the old science flagship bomb, that fires Dark Fire. And I’ve been seeing movies that have no thoughts or burning on the edges but a serrated edge. And it seems that these are Dyslexics who use the fireguards, they fire and clean, and amputate is really just the kind of guillotine amputations that we’re seeing. And then the traditional blast injury, you know, the burn, the blast, the gravel in the room, the spirit of soft tissue, bone mass, and then people being taken out from underneath the rubble underneath the rubble. 

The long-term effect is devastating because these weapons are not only do are we going to face the problems with the initial injury, we are going to face the problem with the fact that a lot of these treatments have been delayed. And so the overwhelming majority of wound infections that I thought I did. I looked at Southern people’s demands to get microbiomes before they were all multi-drug resistant. 

So all of these wound infections are multidrug resistant. So the consequences of delay in treatment mean that more complex reconstructive more surgeries, and more residual disability at the end of this complex because these people are looking at years and Steve knows, decades, in, in the case of children, you know, children born maybe two or three until they have grown as adults. And then again, when they start aging, they start another cycle of the aging, wounded, wounded body. And so all these all of these injuries are going to have an out the whole generation has been permanently damaged and disabled and I don’t even speak about the mental health. These are kids in their families pulled in front of them, they have in their crib little stones in front of them. They have seen they’ve been buried under the rubble for days. You know, I did an amputation on a little yesterday, her on her leg. And then you know, it’s just going to be overwhelming. And then I discovered my colleagues were working in the other room on a kid with a tropical in his abdomen. And my colleagues told me that he has no surviving family. And so now the family in the bed next door like today are looking after him. I mean, all of these, you know, there were unbidden 20 weeks I have no idea what happened to them. I have no idea what’s happened to these. What is happening is happening on a scale I’ve not seen before not even 82. This is worse than 82. We always thought that 82 was the worst, nor that we pray that ever more of the dismal fourth, and my only worry is that like 80 to one. Coup de grâce will be another. 

I have two questions. One, could we get an update on the neonatal babies that are in the incubators? How are they doing? And my second question is, we’ve been seeing reports of triage systems being implemented across hospitals in Gaza due to staff shortages, is that something that’s happening at Al Shifa at the moment?

There are no survivors in either the intensive care unit or the incubator. We don’t have intensive care. Look at critically ill patients, they’re sent back to the ward, and we don’t have access to the blood bank, we take the blood bank, and when it is destroyed and surrounded, we have no access. And so we really are kind of providing a rudimentary service. But we’re the only show in town, and we have to do our best in whatever circumstances we have, but we are thought of now the thing about that immunity solidarity, of belonging that is, unlike my family’s come through here. And I know my colleagues will move, move their families, and join the nearest hospital available to them. And it’s that community, spirit that solidarity, that the bad things all of them from being people really are carrying everything. When you have lived in a kind of individual, capitalist society long enough, you forget what community living looks like. But literally, people stare maps and their food and airspace with each other, there’s almost a kind of total communal living as people are relying on each other to help, and it makes you in all other people that are able to rise up in their humanity at the time when they are being brutalized to give an exemplary life like the way they do.