The Denver Post

Growing numbers of war wounded face hard decisions

- By Wafaa Shurafa and Jack Jeffery

DEIR AL-BALAH, GAZA STRIP>> The doctors gave Shaimaa Nabahin an impossible choice: lose your left leg or risk death.

The 22-year-old had been hospitaliz­ed in Gaza for around a week, after her ankle was partially severed in an Israeli airstrike, when doctors told her she was suffering from blood poisoning. Nabahin chose to maximize her chances of survival, and agreed to have her leg amputated 6 inches below the knee.

The decision upended life for the ambitious university student, as it has for untold others among the more than 54,500 warwounded who faced similar gut-wrenching choices.

“My whole life has changed,” said Nabahin, speaking from her bed at the Al-aqsa Martyrs Hospital in the central town of Deir al-balah. “If I want to take a step or go anywhere, I need help.”

The World Health Organizati­on and the Health Ministry in Hamas- run Gaza say amputation­s have become commonplac­e during the Israel-hamas war, now in its 12th week, but could not offer precise figures. At the hospital in Deir al-balah, dozens of recent amputees are in various stages of treatment and recovery.

Experts believe that in some cases, limbs could have been saved with proper treatment. But after weeks of Israel’s blistering air and ground offensive, only nine out of Gaza’s 36 hospitals are still operationa­l. They are greatly overcrowde­d, offer limited treatment and lack basic equipment to perform surgeries. Many wounded are unable to reach the remaining hospitals, pinned down by Israeli bombardmen­t and ground combat.

Sean Casey, a WHO official who recently visited several hospitals in Gaza, said the acute lack of vascular surgeons — the first responders to trauma injuries and best positioned to save limbs — is increasing the likelihood of amputation­s.

In many cases, he said, the severe nature of the injuries means some limbs are not salvageabl­e, and need to be removed as soon as possible.

“People may die of the infections that they have because their limbs are infected,” Casey told a news conference last week.

Israel declared war after Hamas stormed across the border on Oct. 7, killing some 1,200 people, mostly civilians, and taking more than 240 hostages.

Before the war, Gaza’s health system was overwhelme­d after years of conflict and a border blockade enforced by Israel and Egypt in response to the 2007 Hamas takeover of the territory. In 2018 and 2019, thousands were wounded by Israeli army fire in weekly Hamas-led anti- blockade protests, and more than 120 of the wounded had limbs amputated.

Even then, Gaza amputees had a hard time getting prostheses that would help them return to an active life.

On Nov. 13, when an Israeli airstrike hit the home of Nabahin’s neighbor in Bureij, an urban refugee camp in central Gaza, her ankle and arteries in her leg were partially severed by a clump of cement that blew into her home from the explosion next door. She was the only one of her family who was injured, while a number of her neighbors were killed, she said.

She was quickly taken to nearby Al-aqsa Martyrs Hospital, where doctors managed to sew up her leg and stop the bleeding.

But after that, Nabahin said she received minimal treatment or attention from doctors, who were dealing with a growing number of critically wounded people amid dwindled medical supplies. Days later, her leg turned a dark color, she said.

“They discovered that there was … shrapnel that was poisoning my blood,” she said.

Jourdel Francois, an orthopedic surgeon with Doctors Without Borders, says the risk of post- op infections in war-stricken Gaza is high. Francois said hygiene was poor, mainly because of scarce water and the general chaos in a hospital that’s overwhelme­d with patients while hosting thousands of displaced civilians.

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