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“Unconscionable”: American Pediatrician Who Worked in Gaza Hospital Recalls Horrors of Israel’s War

StoryFebruary 06, 2024
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Image Credit: Sami Thabet for MAP

Democracy Now! speaks with Dr. Seema Jilani, a pediatrician who spent two weeks in Central Gaza volunteering in the Al-Aqsa Hospital emergency room. “I saw the fall of a hospital before my very own eyes,” says Jilani, who shares recorded voice notes from her time in the besieged territory while trying to save children in a health system collapsing under Israeli pressure and bombing. “I have never treated this many war-wounded children in my career.” Finally, Jilani shares why she continues to serve as a doctor in war zones with the International Rescue Committee. “It is the absolute honor of my life to serve the people of Gaza,” she says. “It is all of our responsibility to consider those orphans, consider those families who are completely bereft of any and all human dignity that has been taken from them. … Their fate will sit with us.”

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This is a rush transcript. Copy may not be in its final form.

NERMEEN SHAIKH: We spend the rest of the hour with an American doctor who just spent two weeks in central Gaza. Dr. Seema Jilani is a pediatrician who volunteered in the Al-Aqsa Hospital emergency room as part of a team of doctors with the International Rescue Committee, where she’s senior technical adviser and leads their emergency health responses globally. The team included doctors from both IRC and Medical Aid for Palestinians.

Before she joins us, we’ll play some of Dr. Jilani’s voice notes that she recorded in Al-Aqsa Hospital’s emergency room and also at night in the compound housing the emergency medical team.

DR. SEEMA JILANI: We’re in the resuscitation room in Al-Aqsa Hospital. It’s a mass casualty, where the site of the mass casualty was a school. Of the five casualties, four are children. So, he was injured in the first day of the war.

UNIDENTIED: Yeah.

DR. SEEMA JILANI: And now we’re day 82.

UNIDENTIED: Yeah.

DR. SEEMA JILANI: And he’s waiting.

UNIDENTIED: Yeah.

DR. SEEMA JILANI: I’m so sorry.

I can hear the — I can hear the airstrikes coming in now. It’s about 2 a.m. And this is the sound of drones right outside my window, and also overhead flying more airplanes, I believe. I can’t sleep, so I decided to do this voice note. It’s a very specific hellscape that exists here in Gaza when you’re cursed enough to hear the words from a doctor that say, “Whose body part is that? Don’t carry it through the halls. I don’t want children seeing that.” And that is a quote from one of my colleagues in the emergency room, where we saw a leg being carried, a lower leg with the boot still on, sock still on. And it was being carried through the emergency room.

We have arrived here at Al-Aqsa Hospital emergency room. And what I’m seeing here is children lying on the ground, a double amputation on one child. And there are no beds available, so people are literally just on the ground seeking treatment. We’ve already had three parents come up to us and ask — they see the stethoscope, and they ask me, “Can you come see my child? Can you come see my child?” And I’m waiting for the local doctors to come in to be able to guide us through what we need to do and do a handover. There is one child that I’m looking at, approximately 8 years old, at the — lying on the ground. Next to him is a woman in a wheelchair who’s waiting to be seen. The one on the ground has bandages on bilateral lower extremities going all the way up, and looks like he’s been brought in overnight.

And we’re hearing right now that it was a terrible, terrible night because of the bombing in al-Maghazi, where people had been told to evacuate and then, subsequently, were bombed. There are definitely more people here than yesterday, and yesterday was very full. So, no beds available. As I said, people — there’s not really room or space for us to breathe or think. There’s a gentleman here that’s sobbing in front of me and being comforted by maybe his son, maybe a stranger. I don’t know. But he’s an older gentleman with a bandage on his head, and he’s just sitting and holding his head in his hands, crying and head hung low. And then there’s one, two, three, four, six children in my line of sight right now in the corner that need medical attention urgently, one of whom is crying, a little boy around 6 or 7 years old, wiping his tears. I can’t see the injuries clearly, but we’ll get started to work today to see how we can support and help them through this — through their tragedy.

UNIDENTIFIED: Rockets. They’re rockets. And they’re nearer than they were before.

DR. SEEMA JILANI: That feels very close.

UNIDENTIFIED: Because you don’t get to hear — you don’t get to hear much whistle before it comes.

DR. SEEMA JILANI: One morning, we arrived to a nurse who was quietly sobbing in the corner. His colleague had been killed the night before, and he had tried to resuscitate him in the emergency room. He is dignified in his grief. I asked, “Should we leave?” But instead, he just thanks us for our presence and asks us to see a few patients on his behalf. He just could not face the grueling work and the patients outside the room right now. I felt rewarded if I could be helpful to this one person in this one moment. As I was rounding about two hours later, I raised my head from a patient to see him, again, right back at work, as if nothing had happened.

The next day, we see a 23-year-old patient with his lower leg blown off so badly, it’s disconnected from its upper leg, floppy. I look down to plant my stethoscope on his chest, only to find him still wearing his UNRWA, or U-N-R-W-A, vest as a staff member. The only comfort I can provide him is to wipe the dried blood off his face, to moisten his dry lips as he yearns for some water, quietly lifting his neck for a little more. I quieten his fear with a wet washcloth to his forehead and some whispers of sweetness, of calm. None of these interventions are morphine. He died on the floor of a Gaza emergency room with little more than my hand in his hand and a washcloth to his forehead.

NERMEEN SHAIKH: Those were voice notes recorded by Dr. Seema Jilani, a senior emergency health technical adviser and pediatrician who traveled to Gaza to volunteer in the Al-Aqsa Hospital emergency room as part of a team of doctors from the IRC and Medical Aid for Palestinians. Dr. Jilani previously worked in Gaza and the West Bank in 2005 and 2015. She’s also a freelance journalist who was nominated for a Peabody Award for her 2006 radio documentary, Israel and Palestine: The Human Cost of the Occupation. She joins us now from Brussels.

Dr. Seema Jilani, welcome back to Democracy Now! Those were immensely haunting notes, voice notes, that you made. If you could talk about your journey to Gaza in December, where you went from, how long you stayed, and what you witnessed?

DR. SEEMA JILANI: We departed Cairo on December 25th as part of an emergency medical team with the IRC and Medical Aid for Palestinians in partnership. From Cairo, we arrived through the Sinai, which itself is a militarized zone, and then El-Arish, and then — overnighted there, and then, following that, completed the two-day journey to Rafah and crossed over into the Gaza Strip as a team and later went to our guesthouse. And the drive from the Rafah border all the way up to the guesthouse, which should only have been a few kilometers, maybe 10 at most, maybe seven, took several hours, two to three hours, if I recall, because everyone was leaving and evacuating from the north.

There were people piled into cars, vans, if they were lucky, because fuel is such a precious commodity. There were babies falling asleep. There were pets and cats and dogs and families and blankets and mattresses, any food items you can imagine piled into donkey carts, and people hanging off, trying to evacuate. It was a sea of human tragedy coming straight to the border, straight into southern Rafah. And it was quite a harrowing scene, people that were barefoot, looking for shelter, looking for garbage bags to put up tents, looking for lumber. Quite, quite something. And I’ve worked in several areas of conflict, and it was quite staggering.

AMY GOODMAN: Dr. Jilani, it must be just incredible for you to listen back to what you were saying, so immediate, as you whispered into your microphone, whether you were holding the hand of a dying man or with a baby or in the barracks where you were staying. The place where the doctors slept, does that even exist anymore?

DR. SEEMA JILANI: Our guesthouse was bombed shortly after I left. And I am not sure of — it’s certainly not functional or able to be resided in. I don’t know of how it looks anymore. But certainly, it has been bombed, yes.

AMY GOODMAN: And one of the people you describe helping on the floor of the hospital — and I was wondering if you can talk about the significance of Al-Aqsa, and what does it mean for so many hospitals not to be functioning — was wearing an UNRWA vest. It is the center of controversy right now. Netanyahu talks about getting rid of UNRWA the way he talks about getting rid of Hamas. Talk about the central role UNRWA plays, whether we’re talking about education, whether we’re talking about hospitals.

DR. SEEMA JILANI: I worked at Al-Aqsa Hospital, which was one of the last remaining hospitals in the middle part of Gaza, or central Gaza. It was a lifeline hospital providing critical, critical services. And from the time that I arrived to the two weeks, I saw its decline. I saw the fall of a hospital before my very own eyes. And, you know, in war, we’re used to talking about the fall of cities, the fall of Mosul or Saigon. And suddenly, we’ve normalized, somehow, the fall of Al-Shifa Hospital and the fall of Al-Aqsa Hospital. We’ve normalized the fall and complete dismantling of healthcare infrastructure, totally paramount to saving lives not only in a war zone, but in an otherwise high-functioning, high-capacity society. And it’s unconscionable that we continue to watch this unfold.

In terms of UNRWA, it provides services throughout the region. I have worked in the West Bank and in Gaza. I’ve worked in Lebanon, in Shatila refugee camp, in Burj al-Barajneh. They provide schooling services. I’ve been to their schools. They provide health services, education. And so, the thought of defunding such an organization that provides jobs, education, healthcare, other services that are not otherwise available, really is deeply disturbing, as we’re now producing a generation of orphans, a generation of children with new disabilities, who will then have no access to healthcare, education or other services that would be able to, in some way, help relieve some of their pain and get them back to a functioning society.

NERMEEN SHAIKH: And, Dr. Jilani, you have spoken about the fact that many patients may not have survived, but their pain would certainly have been eased, if the proper medical supplies were made available, if, minimally, medication — you spoke specifically of morphine — could be administered to ease their pain. I mean, if you could explain, you know, how you work under conditions where you don’t have access to even minimal medical supplies, and what it is that you’re calling for?

DR. SEEMA JILANI: Well, it’s the doctors and nurses and healthcare staff of Gaza who have displayed just absolute colossal bravery in how their see their patients, many of whom haven’t been paid, many of whom are themselves displaced, four or five times over, scavenging for food, water, shelter, and then showing up to work, as I mentioned in one of those notes, strenuously to serve their communities, and then coming to a workplace that doesn’t have what they need to be able to treat their patients with dignity. There is no death with dignity in Gaza on the floor of an emergency room.

At the beginning of my time in Gaza, we did have access to morphine. But by the end, there was no access. And at that point, it becomes a very cruel and inhumane situation to have someone actively dying without any pain — or, comfort to offer them. There was, I recall vividly, a young boy that had come in, not for a life-threatening injury, but for stitches because of some deep lacerations. And we would usually use ketamine in a situation like that, because it’s safe, and in children it provides both pain relief and amnesia, so they’re not retraumatized from the procedure. Of course, we didn’t have ketamine. And so I tried any distraction measures I could with this young boy. I have sort of flashing lights in my arsenal as a pediatrician. I have some toys. And he just was screaming through the pain.

And then, when I tried to ask him questions and engage him to distract him, because that’s a mechanism, a coping mechanism, we can use, you know, every question is a landmine. What I would typically say in the U.S. is, “Who’s your best friend?” Well, his best friend probably or might be dead. “What’s your favorite food?” I don’t know the last time this young child ate, and would probably retraumatize him further. You know, “Are you closer to your mom or dad?” She came in as an orphan with only extended family members. There is no part or no prism or facet of their life that has been left untouched. It is completely devastated and in a cataclysmic situation.

AMY GOODMAN: Can you talk more about being a pediatrician in a war zone, and also people seeing you as a foreigner coming in? And you — parts we didn’t play — talk about people just coming up to you and saying, “Ceasefire.”

DR. SEEMA JILANI: Yeah, absolutely. People, as the days went on, more and more crowded into the hospital seeking safe shelter. And so you would see entire families perched on blankets. And so, you would — they would recognize us as foreigners. And their little blankets served as their bedroom, their coffee room, their breakfast room, their kitchen. Just in the hopes that the hospital would keep them safe, and they would see us and turn to us and see us as foreigners and say, “Ceasefire?” or, even more heartbreakingly so, “Take me with you.” Well, where can we go? Where is safe?

In terms of being a pediatrician, I’ve worked in war zones. I’ve worked in refugee rescue boats off the coast of Libya. I’ve worked in Iraq, Afghanistan, Pakistan, Lebanon and Egypt. I have never treated this many war-wounded children in my career. No system is built to withstand what these people are going through.

On one day, as you saw, four out of five of the children whom we were actively resuscitating, which means trying to bring back from the brink of death, four of five of my patients were under the age of 15, so children. And the extent of the injuries, the scale and magnitude and severity, especially in terms of burns, is also something that I’ve not witnessed, borne witness to before. We had an approximately 11-year-old girl whose face was completely charred black, and her arms were flexed and contractured and sort of waxy because the burns had penetrated all the way down to the very flesh of her. And the smell of burnt flesh permeated the entire emergency room and will stay with me for a very long time.

NERMEEN SHAIKH: Dr. Seema Jilani, we only have a minute, but if you could say — it’s already so unbearable to just hear accounts of what you’re saying — why do you do this work? And what has it been like for you, from one war zone to the next, and now in a place like Gaza, as you say, where you’ve never seen so many children in an emergency room of the hospital?

DR. SEEMA JILANI: It is the absolute honor and privilege of my life to be able to be let into people’s moments, whether they are tragic moments of death and pain or whether they are a new baby being born and counseling a new mother on breast-feeding. It is the absolute honor of my life to serve the people of Gaza. And I am so lucky to have served alongside these towering heroes that are nurses and doctors and people that are serving their communities. And that’s why I will keep going back and keep doing this work.

And on the flip side of that, I would say it is all of our responsibility to consider those orphans, consider those families, who are completely bereft of any and all human dignity, that has been taken from them. And it sits with us. Their fate will sit with us.

NERMEEN SHAIKH: Dr. Seema Jilani, thank you so much for joining us. Dr. Jilani, senior technical adviser at the International Rescue Committee, where she leads their emergency health responses globally. She’s recently joined an emergency team of doctors from IRC and Medical Aid for Palestinians who went to central Gaza to volunteer in the Al-Aqsa Hospital.

And that does it for today’s show. I’m Nermeen Shaikh, with Amy Goodman. Thanks so much for joining us.

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