"During the first 43 days of the war in Gaza, Ghassan Abu-Sittah volunteered as a reconstructive surgeon. By the second week, he said, there were 6,500 wounded in Gaza, with only 2,500 hospital beds available. Patients with burns and crushed limbs and dirty blast injuries with complicated constellations of shrapnel shared mattresses and crowded into the hospital halls. At the end of October, Abu-Sittah decided to swab eight consecutive patients that came to him from other hospitals. Seven of the eight were infected with multi-drug-resistant bacteria. Later in the fall of 2023, he said, less than half of those who needed antibiotics in Gaza could get them; many were taking only partial treatments.
By November 2023, the sort of testing Abu-Sittah did in October was inconceivable. Gaza had run out of lab supplies, not to mention more basic items like disinfectant. There were too many critically injured patients to afford the time for data-gathering and research. Precise diagnosis of infections was a luxury, requiring resources that were unavailable. Even if doctors in Gaza wished to outsource lab testing, Israel wouldn’t let samples out of the region.
Israel also wasn’t letting many critical medical supplies in, on the grounds that they might be repurposed for military use. Israel’s list of restricted items is known as the “dual use” list and includes anesthesia machines, crutches, generators, X-ray machines, oxygen concentrators, water-test kits and detergent.
“If we want to achieve our war goals, we give the minimal aid,” Prime Minister Benjamin Netanyahu of Israel said in a news conference in January.
Abu-Sittah began going to the supermarket across the street from Al-Shifa hospital several times a week, in order to concoct his own disinfectant with vinegar, saline and dishwashing soap, a wartime trick he learned from another physician he met in Beirut. One of Abu-Sittah’s patients was a 9-year-old girl whose body was studded with gravel and dirt and shards of metal. He and other surgeons took her to the operating room every 24 to 36 hours to debride her wounds. After the second surgery, the hospital ran out of anesthetic. At one point, terrified of the pain, she skipped a debridement. By morning, her dressings were soaked with pus and green discharge, and her temperature had spiked.
Abu-Sittah told her father that unless her wounds were cleaned, she would succumb to sepsis and be dead by the end of that week. Abu-Sittah took her to the operating room and scrubbed her with his vinegar disinfectant. She screamed continuously as tears rolled down her father’s face. It was one of the darkest moments of Abu-Sittah’s life.
By November, patients with dirty wounds and dead tissue were waiting up to two or three weeks for their first debridement — something that typically should happen within 24 hours of injury. By Dec. 7, 20 out of 22 hospitals in northern Gaza identified by CNN had been damaged or destroyed, and 14 had been directly hit, including Al-Shifa. By Dec. 21, a W.H.O. official said that no hospitals were functioning in northern Gaza and described one recently disabled facility as a “place where people are waiting to die.”
“You have 100,000 wounded, most of whom haven’t received proper treatment,” Abu-Sittah told me this summer. “Many are malnourished and combating infection. Their open wounds act like petri dishes.” Even before the war, 34 percent of Gazan hospitals had resistant bacteria in their water. Now, water-treatment and sewage-treatment plants have been destroyed, with supply reduced by 94 percent. Oxfam concluded that “Israel has systematically weaponized water” in Gaza; Israel has also cut off electricity for more than a year. Biological waste isn’t incinerated; it’s buried or flushed, pouring back into the community. Thousands of bodies are decaying under more than 40 million tons of urban rubble, with asbestos and heavy metals that cause bacterial mutation. Every time it rains, carcasses and debris leach into the ground and infiltrate the groundwater. Mysterious skin infections are raging through the population. Polio has re-emerged for the first time in 25 years and left a 10-month-old baby partially paralyzed.
“Water currents in the East Mediterranean travel up from Alexandria past Gaza,” Abu-Sittah said, up “to Syria, to Greece, Italy.” His point was that the infections of war can’t be contained to war zones: “Everything that reaches the sea is going to reach the Earth.”” [1]
1. Modern Warfare Is Breeding Deadly Superbugs. Why? Mari, Francesca. New York Times (Online) New York Times Company. Nov 26, 2024.
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