Inside Al-Shifa: Medicine at the Edge of Human Endurance
When I first stepped into Al-Shifa Hospital by the light of a failing generator, the air hit me like a memory — hot, metallic, and heavy with the tang of antiseptic that wasn’t quite antiseptic anymore. Dr. Nada Abu Alrub, an Australian physician who came with a volunteer medical team, walked me through corridors where time had been stretched thin by exhaustion and grief.
“You come expecting to treat cases,” she said, voice low, “but you find yourself triaging humanity.” Her hands, stained with the day’s work, gestured toward a room where a newborn’s cry fought through the din. “We are improvising surgeries without proper sterilisation. We are choosing who gets a chance with two gloves and one IV line.”
Dr. Abu Alrub’s account is not theatrics. It is a dispatch from a place where the normal architecture of life has collapsed: homes reduced to skeletal frames, water turned into a luxury, food disappearing behind barbed bureaucracies and dwindling cash. “People have lost everything,” she told me, “and they sleep in the hospital because it’s sometimes the only roof left standing.”
A catalogue of shortages
Across the hospital, the list of absences reads like a how-to on catastrophe: no mattresses, scarce gauze, few antibiotics, minimal anaesthesia. Staff are living on hospital cots and stolen hours of sleep — two hours at a stretch, they joke, but there is no real laughter.
An emergency nurse named Samir — early thirties, with a voice rough from sleeplessness — told me, “We have been here for two years straight in shifts that never stop. My sister called the other day and said our block was hit again. I don’t know if I should go home or stay because home is not safe, but without me here someone else will die.”
These are not isolated anecdotes. The Israeli military has said that more than 550,000 people have fled Gaza City in recent weeks alone, a mass movement that comes on top of a population the UN estimated at roughly one million in late August for the same urban area. Staggering numbers, but behind each is a person, a family, an elder who remembers a different city.
The city under relentless assault
From high above, the skyline of Gaza City is an essay in gray: smoke plumes, toppled minarets, rows of gutted buildings. Residents speak of “constant bombing” — warplanes, tanks, and drones knitting a terrifying soundtrack. Saja Al-Kharoubi, 26, who grew up in Al-Daraj, told me, “There is nowhere to run. We try to leave, but transport is out of reach. We had ten shekels left when we left. We used it to buy bread.”
The military says its operations aim to eliminate armed groups within the city and to “secure the release of hostages.” The conflict’s origin — Hamas’s 7 October 2023 attack — left 1,219 people in Israel dead, according to official tallies compiled by news agencies, and 251 hostages taken, of whom numbers remain disputed but about 47 were reported still in Gaza. Those facts sit beside another set of tallies: Gaza’s health ministry, run by the territory’s authorities, places the death toll at tens of thousands — a figure the United Nations has said is the best available estimate for now.
Numbers, by themselves, are blunt instruments. But they provide a chilling context: when a hospital runs out of sterile gloves, the loss that follows is intimate and immediate — a mother with a fever, a child with a shrapnel wound, a man with a failing heart — each one a life that statistics can flatten if they are not accompanied by human stories.
When every decision is ethical triage
“There comes a moment when ethics and survival overlap,” said Dr. Miriam Hart, an international humanitarian surgeon who has worked in conflict zones for 20 years. “If you only have one dose of blood, you have to choose. That’s a choice no clinician should have to make. It breaks the profession.”
Back at Al-Shifa, nurses and medical students craft operating instruments from scavenged parts, rinse re-used equipment as best they can, and carry out amputations in rooms that smell of antiseptic and human sorrow. “We operate in survival mode,” another young doctor whispered. “You learn to let go of perfection because nobody has that luxury here.”
Cross-border echoes: Lebanon and the broader region
As Gaza burns, the conflict’s embers have lit skirmishes across borders. In southern Lebanon, a drone strike rocked the town of Bint Jbeil, killing five people — three of them children, according to Lebanese authorities. The strike underlined how the theatre of war has expanded and how civilians far from Gaza’s hospitals are paying a price in broken families and shattered futures.
Nabih Berri, Lebanon’s parliament speaker, described the attack as a message meant to intimidate people returning to their villages. “When children die, the wound runs deep,” Berri said, his voice carried on state media. The Israeli military said it struck a Hezbollah target, but also acknowledged that civilians were killed — a grim confirmation of the porous nature of modern combat where households can become collateral.
Is this how modern warfare should look? Assets and laws intended to protect civilians seem brittle in the face of urban combat married to aerial power. That brittleness raises questions about accountability, proportionality, and the international community’s capacity to intervene before a humanitarian situation becomes irreversible.
The world watches. Does it act?
International organisations and aid agencies keep sounding the alarm. A UN coordinator described Gaza as “teetering on the brink of humanitarian collapse” — a phrase repeated often enough to lose sting, but not meaning. Food, clean water, and medical supplies are chronically insufficient. Access is hindered by security concerns, damaged infrastructure, and bureaucratic restrictions.
What can be done? Humanitarian experts offer a three-point prescription:
- Immediate and unfettered corridors for medical supplies and fuel to power hospitals;
- A temporary cessation of hostilities in populated areas to allow civilian movement and aid distribution;
- International mechanisms to investigate alleged violations of civilian protection laws.
Small gestures multiply. An internationally coordinated airlift can mean hundreds of vaccines; a single convoy of baby formula can keep infants alive. But political will is the linchpin, and it is often the scarcest resource.
Faces behind the numbers
Walking past a makeshift tent camp, I met Huda, a grandmother of five. Her hands were bruised from carrying water. “We left with only the clothes on our backs,” she said. “My neighbour’s child asks every night if the sirens are our lullaby. How do you tell a child that the world is not supposed to sing that song?”
Her question lingers. It is easy to become numb to rolling casualty counts. It is harder — and essential — to see the torn fabric of daily life, the routines rent away by shock and displacement.
Dr. Abu Alrub told me she plans to stay beyond her scheduled rotation. “I came to help,” she said simply, “and I cannot leave while people have no clean water and no safe place to sleep. If medicine is what keeps someone alive, then I will sit with them and give it.”
Where do we go from here?
As readers around the world scroll past headlines, it is worth pausing: What responsibility does distance confer? Can we translate outrage into sustained pressure for safe passages, ceasefires, and unfettered humanitarian access? History will judge not just decisions made in the heat of conflict, but also the decisions not made.
Is there space for empathy to become policy? For counting to turn into care? The hospital corridors I walked were full of people asking these same questions — patients, doctors, children who only know the sound of military engines. Their answers are immediate: send supplies, insist on protection for civilians, keep telling their stories until the world acts.
When the next convoy arrives — if it arrives — someone will be there to open the crate of medical supplies. Someone will be there to welcome the sterile gloves. For now, the work continues in dimly lit operating rooms, in the back of ambulances, and under tents where life persists in defiance of everything designed to snuff it out.
