Tent cities
Gaza’s crisis of overrun hospitals amid Israel’s relentless attacks on the Gaza Strip is worse than anything Adam Fahs had ever seen in his career as a doctor.
Bullet wounds, blast injuries from explosions and treating patients with missing limbs were the norm at Gaza’s European Hospital as the Detroit orthopedic surgeon spent a week in December on a medical mission with Rahma Worldwide, a humanitarian nonprofit based in Michigan.
Palestinians were transported into the hospital without arms and legs, the majority due to severe crush injuries amid Israel’s bombardment on Gaza following Hamas’ attack on Oct. 7. Some came in with what appeared to be minor wounds to be treated with antibiotic ointment but later required an amputation.
“Someone will have their leg still attached but it’s mangled, it’s broken in multiple spots,” Fahs said. “We saw everything from little kids to elderly people. When Israel bombs, they don’t discriminate. … Even if you try to take care of individual patients, what you’re dealing with is a health care system that’s overrun and undersupplied, which makes it absolutely impossible to provide appropriate health care for mass casualty situations.”
More than 30,000 Palestinians have been killed by Israel, according to the Gaza Health Ministry, and U.S. Defense Secretary Lloyd Austin, at the end of February, said more than 25,000 had been killed.
Dr. Adam Fahs sits at his home in Bloomfield Hills, Mich. Fahs recently spent six days in southern Gaza through Rahma Worldwide, a humanitarian aid organization, where he, along with other doctors, operated on injured people at the European and Nasser hospitals.
not being restocked for 100 days, let alone Gaza, which is already on limited supply. Even if I wanted to do complex surgeries there, I couldn’t because I was handcuffed by the limitations and implants that we had,” Fahs said.
“It got to a point in Gaza where you’re doing surgery where you put external fixators, which are pins that go into the bone and they stick out of the body, and then you connect them with clamps and rods to hold the leg straight.”
External fixators essentially act as a massive splint, he added, and many patients required internal hardware, such as plates, screws and rods.
“It got to the point where you would take the pins out of one patient after they were done being used, you would sterilize them and be prepared to put them into the next patient. That is totally against our standards here for health care in the states,” Fahs said.
Many of his team’s surgeries could have been performed to higher standards with the right tools. Limb salvage, for example, requires specialized implants and ample coordination. Luckily for Fahs, the hospital had “an amazing”
plastic surgeon who helped with soft tissue coverage. As a result of blast injuries, patients can lose muscle, skin and tissue, which requires the plastic surgeon to reconstruct by sourcing it from other parts of the body, he said.
Fahs was able to bring in orthopedic implants, though he said his supply wasn’t enough, nor will medical missions traveling in every few weeks solve the health care crisis. He pointed to the responsibility of the Egyptian and Israeli governments to open their borders to allow aid to pour in.
“You have this massive substandard level of care to a population of traumatized people. We’re not talking about some small village in the Sahara Desert that nobody has access to. This is right off the Mediterranean,” Fahs said. “This is something where medical aid and humanitarian aid is easily reachable.”
Families living with makeshift tents, typically of fastened sheets providing some coverage, became a part of survival for those who managed to escape their homes during an airstrike. Fahs recalls overlooking the hospital grounds and seeing tents of families who left with the clothes on their backs and, if lucky, a suitcase with extra items.
“Everyone has been degraded to tent cities. Everyone had been displaced from their homes, they were trying to find whatever shelter they can,” Fahs said. “We’re not talking about nice camping tents, this is basically like a sheet of plastic that you throw over a tree, or you pin to a tree or try to hang from the side of a wall.”
Unsanitary conditions worsened, and the population is without regular waste management services. Those living in tents outside of the hospital would pile waste in an area away from the tents with no certainty of when it might be removed.
“That pile of garbage gets bigger and bigger and bigger. There’s no waste management company driving around with garbage trucks to pick this up and take it somewhere else and keep the area clean,” Fahs said. “Gaza wasn’t a playground before all of this reignited on Oct. 7. They were already dealing with terrible living situations. And everything got dramatically worse after that.”
ERIC SEALS/DETROIT FREE PRESS FILE