NORA BARROWS-FRIEDMAN: Welcome back to The Electronic Intifada Podcast. I’m Nora Barrows-Friedman. I wanted to bring Dr. Majed Jaber back onto the program today, while he can grab a little bit of internet, to talk about the current medical and health situation across Gaza. Dr. Majed, welcome back to The Electronic Intifada Podcast.

DR. MAJED JABER: Thank you. It’s been a while since we last talked. A lot of things happen, you know, day by day here in Gaza, and it feels like a day feels like months, for how many events, how much change happens. And it’s unpredictable, moment by moment, to make choices and to find solutions.

NORA BARROWS-FRIEDMAN: Well, that’s why I wanted to have you back on. I mean, so much… you know, decades happen in minutes in Gaza, there’s so much, like you said, that happens day to day. Tell us a little bit about what you’ve been doing lately, and where you’re speaking to us from. Last time we talked, it was over the summer; you were working to provide medical care to people in various field hospitals, in the tent areas, in al-Mawasi. But you and your colleagues have been very busy reopening various medical centers that have been bombed or destroyed or disabled by Israeli attacks over the last 11 months. As we reported last week, al-Shifa Hospital’s emergency department has been reopened against all odds, and that’s in the north! Tell us where you’re working these days, and from where you’re coming to us now.

DR. MAJED JABER: I am in the European Gaza Hospital. We have spent a few weeks, if not months, after the evacuation of the hospital — it was a highly inaccessible place, very dangerous to get close to — so, we had a lot of destroyed equipment, missing equipment, we tried to reach out to everyone, we don’t have the medication, we don’t have the equipment, we’re trying to figure out a way to make this hospital at least half functioning. At least the most important department — the emergency department — in this war. It took us a while. We are slowly gathering staff back again. We reopened the ER department, thankfully, we gathered the basic equipment to get it running, and we slowly reopened the surgical department. We had some assistance from some Norwegian doctors, some Norwegian surgeons, who provided us with some equipment, I’m really grateful for that. So the operating theater is working again, and then we have the medical department, and then, well, somehow, with the UN, we reopened the pediatric department. So we have some resemblance of how the European hospital was working back again, minus the huge load of patients or displaced people.

You know, during the evacuation, everyone was scared, everyone left the area. The European Gaza Hospital is still in the red danger zone. There is no safe place here in Gaza. So people are reluctant to come here; people are hesitant. Even people who are living around here don’t like to move a lot. But sadly, some people stayed here, because al-Mawasi is very crowded, there’s no place even to install a tent anymore, and they decided to stay because they had some houses that are partially destroyed, but at least it’s more dignified to live in these places. But sadly, airstrikes, bombardments, do not stop. Any person who moves around is a threat. I personally, and other staff, do not move during the night or evening that much, plus we’re also scared. The drones are very low, quadcopters – they just watch everything. It’s very risky.

The last few weeks have been working tirelessly. We don’t have many staff, so people like me and my other co-workers work on 24-hour shifts at a time, because what is happening right now is that we’re trying to alleviate the pressure from the previously only functioning hospital in the south, Nasser Hospital. Nasser Hospital is highly loaded, especially now that a lot of people are coming back to Khan Younis from other areas. We’re trying to absorb much pressure from these highly crowded areas. We are receiving more emergency cases, either from surrounding areas or from Khan Younis; we’re absorbing a lot of ICU patients, terminally ill patients. We have too many cancer patients here, patients who require organ transplants, kidney, heart transplant, who are just not able to leave Gaza to receive their treatment. And this is, well, a theme of misery here in Gaza: those people, well, they’re not a danger to anybody, they’re just slowly dying, and we as healthcare workers can’t do anything about it. They can’t do anything about it. Those who can do something about it are silent, or maybe don’t care enough about it. Yes, we’re back to the same theme, we’re having a lot of old patients dying of chronic illnesses, those who should receive treatment abroad. And there’s nothing we can do here. We are trying to just to… like, some analgesics that we’ve got left are not going to do much for them; we’re just trying to prolong their inevitable demise, sadly, so long as the borders are closed.

NORA BARROWS-FRIEDMAN: Yeah, Majed, the amount of humanitarian aid over the last two months has drastically dropped, and that includes medical equipment, medicines, basic essentials such as gauze and antibiotics and, as you said, analgesics. I mean, what is it like, as a physician—and I know I’ve asked you this before, but maybe just talk about what’s changed for you in the last few months since we talked, about trying to provide basic, correct medical care, of like, basic injuries, let alone after a massive bombing attack, or, you know, these rampant skin infections, the epidemic of hepatitis A… with these limited supplies. What is a typical day like for you and your colleagues, especially in the emergency rooms, in the triage centers?

DR. MAJED JABER: Absolutely. Let me give you the simplest cases. Let’s say we’re trying to care for or tend to the wounds of people who were previously injured, children with burn wounds, people with broken bones who have this external fixations (you know, the metals). These people, these children, with burn wounds or any other wounds, get infected easily, because they’re living in dismissed areas, they lack any hygiene equipment to keep them clean. And they come here more often. The wound gets bad because it cannot heal itself. These children get into infections; this bacteria will not stay local, it spreads through the bloodstream, they get into sepsis, and some of them die—because of a simple skin infection. Okay, like, what can I do about it? As you said, I need to take care of it, I need to put a lot of dressings on a daily basis, I need to administer antibiotics.

And yeah, the last few months, we, as Gazans, especially healthcare workers, we’re bullied, we’re humiliated by the Israelis to just let these simple items go through. There’s no justification for that. I’m not going to make a nuclear weapon out of some gauze and some antibiotics; it just doesn’t make any sense. These children are just dying… and for what? For what reason? And this is the same practice they’re using, let’s say, in the West Bank: they shot someone, and they prevent ambulances from reaching them, they just bleed to death, and then they let us do something about it, which is to bury him, because we just can’t do anything, it’s just too late.

So, just imagine there’s a mass casualty going on, where, of course, we’re trying to triage. Let me give you a hint: the kind of weapons they’re using lately are way worse than they were using previously. Back then, we had a lot of injured people that we were able to do something about, at least save their lives, and now—they’re just.. they’re dead. It’s abysmal. You’re hearing the news about these weapons that evaporate civilians; we just register them as missing, the families go hectic, they keep looking and digging everywhere but they can’t find anything. It’s been really frustrating. You know, as a doctor, I want to help, I want to save lives, but the scale of massacres they are using, the weapons themselves, are just too lethal. We have some cases of people getting poisoned by something we don’t know about. It’s really frustrating. I’m just trying to give you a picture that we can’t do something about the simplest of cases. So the worst cases, like injured people, people are bleeding to death, people with missing limbs, people who are heavily wounded, are usually not salvageable anymore, even though we were able to, back in the day. So that is really so troubling.

Now, after the evacuation of the European Gaza Hospital, me and many co-workers decided to go to dismissed areas in al-Mawasi. My family is in al-Mawasi, most families are in al-Mawasi, it’s supposed to be the safe area. Again: there’s nowhere safe here in Gaza, and these places are really, really dismissed. The organizations love to claim that there are many healthcare facilities, many field hospitals, many medical points, but it’s not enough. The population is too dense, too crowded, and we need as many doctors in that place. We need as many healthcare centers and medical points, as much as we could, because there are areas that are just out of touch with the rest of al-Mawasi. Some areas are provided with better access to healthcare than the rest, and this is not the case for the most part; this is just an exception.

So, volunteering; I go visit the camps that are near me. People who know there’s a doctor here, you try to provide, you try to get as many dressings, get as many drugs to provide for these people who just can’t afford to transfer to these healthcare centers. Transport is really bad. Second of all, you have the issues of a lot of these wounded people aren’t able to move around. Either the whole family is killed, either the parents are too sick to move around, or it’s just depression. Just the mental… The Palestinian people, especially here in Gaza, they’re traumatized, they’re crushed mentally, they don’t bother looking after themselves anymore. And you can’t blame them.

I used to check on a lot of pregnant women… And I hear these stories that became a norm, of their husbands getting killed, of them losing their children. And now they have their hope in this child, I mean, her and her husband used to have it and now her husband is killed trying to get some groceries, trying to get some food, and now she’s alone, mentally crushed, trying to take care of herself, about to have this baby, and she doesn’t know what to do about the baby. And that’s not a case; that’s just a theme at this point. There are a lot of these women like this nowadays. And they’re anemic, they’re ill, they’re sick, they lack in many important nutrients and vitamins and they don’t eat well. This is going to affect the baby, even will lead to miscarriage at some point, because, well, there are some interesting papers that correlate mental health alone as a factor for miscarriage, other than, well, the malnutrition that is going on already.

And then you have children with amputated limbs. These children, they’re young and innocent, and they can’t really process that they can’t go abroad and receive treatment. They keep asking me, or asking other workers, like: Can we get out? Why don’t you get us out? What can we do about it?

NORA BARROWS-FRIEDMAN: And these are kids who will need multiple surgeries throughout their lives, especially as they continue to grow. I mean, is there any of that ability to do these necessary surgeries at the European Gaza Hospital, for example? Or where do these kids go to receive these treatments after their limbs have been amputated?

DR. MAJED JABER: Well, they are supposed to receive treatment from a multidisciplinary team, surgeons, orthopedic surgeons, peripheral nerve surgeons, plastic surgeons. These surgeons need to communicate with some kind of medical organization, that needs to provide, let’s say, prosthetic items that need to be well adjusted. This is not going on here anymore, sadly. For me, from what I’m seeing as Gazans go through this, these surgeries are the least of our concern. These children, they don’t want to live anymore. These children are just done; they lack any facial expression when you try to interact with them, they’ve went from being innocent, playful, children to just nothing — just shock.

And these children are the youngest, they’re going to outlive most of us. This opens the issue of generational trauma: these children survived, at the end of the day, and have families, and these families are going to be also dysfunctional due to the traumas that these future parents are having. It’s just that… We don’t know what to do about it. We, as adults, are tired, we’re exhausted, we’re burned out, we’re crushed under many circumstances, and these circumstances just keep getting worse. But we, at least, are trying to push forward and get going with things. These kids don’t have anything to do. They don’t have work to numb the brain a little bit, they don’t have any responsibilities. They just wanted to play football, they wanted to, you know, get some bread for their families, and now – they’re damaged for good.

it’s just depressing — I mean, “depressing” is an understatement.

NORA BARROWS-FRIEDMAN: Yeah, it’s unbearable. And half the population of Gaza are children. Yeah.

Let’s talk a little bit more about al-Mawasi, which is close to where you work at the European Gaza Hospital, and where you said your family is sheltering. The Gaza government media office announced on Saturday that it was launching “an urgent humanitarian distress call to save 2 million displaced people in the Gaza Strip before it is too late, coinciding with the onset of winter and the deterioration of the displaced people’s tents.” Talk to us about the conditions of people in these tents, especially in places like al-Mawasi, which, just, of course, last weekend, Israel bombed, incinerating more than 20 people, like you said, completely evaporating them, causing craters in the sand up of to 30 feet deep. These are US-made weapons. What are these tents made out of? You know, as the seasons shift — we’re almost a year into this genocide — as the seasons shift from the blistering heat now into fall and eventually into rainy, cold winter, what are the conditions for people? And what’s the significance of the Gaza government media office issuing this distress call? Do you think it’ll be heeded by anybody?

DR. MAJED JABER: No, of course not. No one cares. We are treated as sub-humans by most of the governments worldwide. But, these conditions: the tents are not usually made of, well, let’s say, water-resistant materials, or anything sophisticated, really. Most of these tents are made of flour bags, some covers, some rugs. You know, something primitive, sewed together. You place some wooden parts, some metal rods, anything you find, and then you have this “tent.” So it’s not water-resistant, it’s not clean, and it’s not stable. If the winter happens, the rains are going to demolish most of these tents, these camps are going to be swamped in mud. These rods and these wooden parts they’re using are just going to fall down from the effect of the water, the effect of the mud. It’s going to be a disaster.

And most of these people rely on bread as the main source of food, and they use these muddy ovens. And these muddy ovens are also going to fall apart, and now we don’t have a reliable source for food. And almost no one has winter clothes. I personally don’t have winter clothes. My house was destroyed, I wasn’t even able to evacuate properly, to take my clothes with me. So everyone — it’s just a hot topic nowadays, like, what are we going to do in winter? We don’t have gas, we don’t have shelter, we don’t have food, we don’t have clean water, and we don’t have anything. We have a huge number of people that need urgent help.

And then, you go back to the things we discussed previously. There are a lot of sick patients that are bedridden, people who can’t move, people who don’t have any caretakers. And then you have the issue of, well, there will be increased rates of infections, chest infections, skin infections that don’t have any dressing and get infected again. Then you’re going to have this crisis exacerbating in many aspects, and honestly, I don’t think that there’s something… that no one is going to do about it much. If someone didn’t do anything about it for 11 months, do you expect them to change their minds? They’re going to just say some weird-ass slogans, yeah “we’re going to save the people. We’re working to save Gaza, we’re trying to make peace ” — but seriously?

NORA BARROWS-FRIEDMAN: yeah, “Working around the clock for a ceasefire,” right.

DR. MAJED JABER: Oh yeah, I believe in you.

NORA BARROWS-FRIEDMAN: Majed, can you talk about the attacks over the last few days, especially in the central areas of Deir al-Balah and Nuseirat, which is not far from where you are, where more than half of the entire Gaza Strip is concentrated? What kinds of injuries have your colleagues and you been seeing? You mentioned that the injuries are different from previous attacks, that maybe they’re using different weapons. You know, from your medical assessment, what can you say about the kinds of injuries you’re seeing, and if there’s been a difference in any way?

DR. MAJED JABER: I think the impact of these weapons was different from the ones we were used to seeing at the beginning of the war. Let’s say there’s an explosion and you were, well, close, but not close enough to die instantly. Usually you would have decent shrapnel the would cut through your wounds, but you’re still going to have your hand; you know, it is like, you’re going to have some bones, some muscles, to repair, that will make it viable by any chance. But nowadays we’re just seeing this hand just disappearing; the impact is just too strong. I don’t know what they’re using, honestly, probably no one does, but it’s really bad.

Before we talk about Dir el Balah, I want to tell you that I was there for the Sand Massacre, you know, the one that created a huge crater. It was close to my place of residence. And days before it, there was another airstrike that was carried out by a helicopter, an Apache or something like this. And I was lucky to survive it, honestly. I was seconds away from it. It’s a very crowded camp, one of the camps I work at. Yeah, suddenly… There were a lot of kids, a lot of people, going around, it was supposed to be a safe area. And suddenly you just see this Apache lighting up, sending these missiles, and suddenly this camp that had tents doesn’t exist anymore. And we were in shock. And I was shocked. Like, I was just seconds away from just dying, you know, getting killed. And then I have to just absorb this, to process, and remember: okay, I’ve worked in emergencies, and there are a lot of people screaming, and you get into this dilemma, because usually they hit an area multiple times. So if I go right now, I’m just risking myself, but if I don’t go now, I’m also risking the people who could have been saved. And you have to make that decision. Luckily, that time they didn’t hit it another time, because… I don’t know.

I’m just, I’m trying to process that kid who got killed instantly. This kid, you know, I don’t know him personally, but I used to see him playing around, he was just trying to get some cellular connection, calling some relatives or something, and he died – for no reason. He was killed because he was just there. And it seems that for the last 11 months they have no regard for any child or woman, or anyone, really.

And the same thing in the huge massacre that happened, where they dropped massive bombs, the MK-84, I suppose. I was like 100 meters away from it, you know. You just question yourself sometimes, like: isn’t this a violation of international law, of the Geneva Convention? You designate a humanitarian zone and then you try to target it, over and over again. And we don’t have a place to go, mind you. We’re not Ukraine, we’re not a huge country, we can’t just go back to safe areas. We’re just cornered. No one’s cooperating with us, no one’s trying to help us; we’re just in a corridor, and then there’s nothing to do about it, really. You’re a bystander that just keeps getting beaten up for no reason.

So that massacre, also, I had friends who were calling me, like, “Is that this camp?” and I was like, “Yeah,” and they just talk to me and they scream: “I have relatives there, I have friends there,” and then the journey of trying to figure out if they are alive or not starts. We had many people buried under ground by the effect of these bombs, we had people that are still missing. Ah. The effect of this explosion had blood and flesh falling out of the sky. This is something I can’t really explain to you; you have to be there to… to be… to just realize the scale of, well, horror that we’re going through. We had children with amputated limbs, we had pregnant women injured, we had all the people. You know, we had this guy with an open fracture, his bone was just out of his body, protruding out of his body, just screaming, “My kids, my kids, where are my children.” What are we supposed to do with this kind of case? What are we supposed to do?

Yeah, the same thing in Deir el- Balah, same think in Nuseirat. We’re just seeing increased levels of misery; we’re not seeing any kind of improvement at all. Don’t let the media fool you otherwise. The genocide, this ethnic cleansing, is still ongoing, and they have no regards for children, for women, or anyone else. Nothing. And one day, you try to make peace with yourself that this may be the last day you’re living, because there’s nowhere safe.

Yeah, and we don’t have any equipment, really. You know, like, back in that massacre, I didn’t have any equipment. We had to tear down clothes to create these primitive tourniquets, to stop the bleeding as much as we could; we tried to use metal rods and anything around to stabilize these fractures. But there’s only so much you can do to prevent that, if these are the weapons they’re using.

NORA BARROWS-FRIEDMAN: Majed, I know you’re very busy — you said you’re working a 24-hour shift at this hospital. What do you want your colleagues in the West, especially in the US and in Europe, to know about the conditions that you are working in, as a physician, as an emergency doctor, as… sometimes you put on your field medic hat, your paramedic hat. What do you want them to know? And, kind of, what are you thinking most about these days, in terms of the profession that you’ve chosen, and your duty, your honorable duty to be a doctor right now?

DR. MAJED JABER: Well, many people here in Gaza decided to become doctors because at some point of their lives they lost people and felt helpless, and now they just decided to, you know, get into medicine to help people and try to prevent the deaths in the future they’re facing, and trying to reduce the misery as much as they could, because no one has to fear the pain of losing someone, let alone losing someone during a genocide, from an airstrike, someone who gets shot in the head in front of you. So, I lost many relatives and many people, and this is why I decided to become a doctor. Nowadays, I feel an obligation to work. But we as healthcare workers here in Gaza are not even allowed to perform that duty anymore.

In the States, you have a multidisciplinary team. You have the whole government, the whole place just working and cooperating to just save one life. But here we don’t have anything. We don’t have the equipment, we don’t have the staff, we don’t have the facilities, we don’t have the medication, we don’t have anyone to back us up. A doctor in the States, say, in their resuscitation room during a mass casualty, they have one duty, okay, they have one thing to do at that point, because they have a team. But here you have to do many things, and this, well, this is very stressful. If you do this a thousand times, you eventually get really strained mentally.

And what I want to say to my colleagues in the States is that: Imagine yourself here in Gaza, in my place. You’ve got nothing to do and you want to help, and you feel completely paralyzed, even though you want to do something. And this is the feeling that many foreign doctors and healthcare workers felt when they came here. They had different expectations. They thought that they are going, you know, to have really some easier time. They didn’t expect it to be easy, but really easier, like, in the resuscitation room, they kept looking for monitors, for equipment, and half of them are just not functioning that well, it’s just not accurate, and it takes time to perform something that would take 5 seconds in the States, and you keep losing patience, and you try to improve it, but it doesn’t work at all.

What I expect from my coworkers is to speak up, to raise their voices, to send messages to their House representatives, to those who can make some kind of a tangible change. Getting these medications, getting these drugs, getting this medical equipment should be a priority during this genocide. I mean, during this humanitarian crisis — this is a no-brainer. But nowadays, when it’s taken to an extreme, we’re not allowed to do anything about it. Yeah, please, speak up, help us make a change here, and if you can, come over; we need some help.

NORA BARROWS-FRIEDMAN: Well, thank you so much, Dr. Majed Jaber. You are a physician currently working in the south of Gaza, and we’ll just keep checking back with you periodically and as often as possible. I’m really, really appreciative that you took some time out of your very, very busy schedule to talk with us today. And yeah, keep me posted, keep us posted, and our audience is incredibly grateful as well. Thank you so much, Dr. Majed.

DR. MAJED JABER: Thank you, Nora. I mean, it’s really important to provide a platform for Palestinians to speak up about the issues and struggles, and I’m also thankful for that. Thank you so much.

NORA BARROWS-FRIEDMAN: Thank you for all you do.