Article
Comment
Gaza
Middle East
5 min read

The human cost of the Israel-Gaza war

A veteran volunteer surgeon laments a well lived life.

Tim Goodacre is a reconstructive plastic surgeon, and volunteer at a hospital in Gaza.

A young doctor wearing scrubs smiles.
AbdulRahman at work.
Tim Goodacre.

The Israel-Gaza war rages on. Every few days a new tragedy hits our dulled senses. The West Bank and now Lebanon are getting dragged into the conflict. Palestinians and hostages continue to die, and hunger and disease threaten Gaza's displaced people as autumn and winter approach. 

Yet what is often lost is the human face of this conflict. This is the story of one such life. 

AbdulRahman was an intelligent, gentle and diligent young third year medical student in his early twenties, with judgement well beyond his peers. Towards the end of 2023, as the war spread more viciously towards southern Gaza, he was one a group of around 10 students who volunteered to join the team of health care workers at the European Gaza Hospital (EGH). I was volunteering there as a reconstructive plastic surgeon and and met him in the hospital.

Both medical schools in Gaza before the war began were in the north alongside their parent universities. They had been destroyed during the onslaught in the early months of fighting. In the southern town of Khan Younis, the EGH was the sole surviving operational facility to which the wounded could be transferred. It was overwhelmed by the vast numbers of families also taking refuge in what was deemed a safer space than most of the surrounding war zone.  

Many of the senior medical staff and surgeons had retreated to scattered parts of the strip, displaced frequently by the ever-moving conflict and driven by the need to support their families and stay together. ‘Live together-die together’ is an understandable feature in the horror show of war. Students, frequently left with no money or resources, started to volunteer to serve in hospitals in exchange for a little food and a sense of worth in the work they could offer. Any functioning hospital, if briefly ‘deconflicted’ so they could provide relatively safe care, found itself staffed by a disparate crew of local staff, displaced students, and an indeterminate number of more senior surgeons from both Gaza and humanitarian agencies. 

His desire to learn all that could be learnt, and to try to become the best surgeon possible, was palpable.

It was into this chaotic mix that young AbdulRahman walked having fled his family home in the east of Khan Younis in November 2023. A bright young man, with great aspirations to qualify as a surgeon and serve his community, he had spent the first six weeks of the war at home, unable to attend his medical school in Gaza City to the north, but working hard at his studies regardless, using every online and library resource available to him.  

At some point in late November, the battle zone moved south, and his family home was shelled along with many dwellings in the vicinity. Caught in crossfire, he sheltered in his neighbouring relative’s house after his parents and other close family had escaped to Rafah. 

Abdulrahman told me the dramatic story of his escape into the house in which he survived for a week alongside his relative’s family when I spoke to him in late January 2024. This young man not only survived an ordeal of indescribable fear and potential slaughter, but he was then arrested and interrogated in brutal fashion by IDF forces.  

On his release after a harrowing week, he made his way barefoot to the nearest hospital, which happened to be the EGH. In that place of safety, he was given food and water and after recuperation, volunteered to work alongside a reconstructive plastic and burns surgeon who had recently returned to Gaza after training in the UK. 

Although his family were still all alive in Rafah in displaced makeshift shelters, he opted to stay and throw his weight into whatever he could do to support the hospital whilst continuing to learn his profession as a doctor. Travelling occasionally at great personal risk to see and support his family, he devoted all his waking hours to surgical work in EGH operating theatres and wards. His excellent command of English made him immensely valuable to any visiting surgeons who managed to access Gaza during the war months. He was always cheerful, always willing to respond to requests for his time, however stressful the surrounding clamour from desperate patients and relatives might become.  

When his working day was done, in the middle of the night he would arrange for his fellow students to have informal teaching seminars from whoever he could cajole to deliver them, and would absorb knowledge and ideas about best practice like a sponge. His desire to learn all that could be learnt, and to try to become the best surgeon possible, was palpable.  

I had every intention of supporting this fine young man in achieving his professional aspirations by whatever means I could once a ceasefire arose and he could be brought safely to Europe to continue his training. 

In the last week of August, AbdulRahman was sheltering in a relative’s house in Khan Younis. In the small hours of the morning an Israeli attack was launched on the neighbourhood and the house took a direct hit. AbdulRahman was killed instantly. 

He knew, as does every Gazan in these troubled times, that nowhere was safe, and all lives in that tragic zone are at risk. His is a story of a life tragically cut short, of the randomness and destructiveness of war. His death strikes right at the heart of my hopes for the remnant of the fine young population of such a desperately sad nation state. He, and those like him, could have been at the heart of the re-building of Gaza, able to live in what now feels a far-off peace. I cannot translate this into anger, as AbdulRahman himself had a passionate concern for peace and reconciliation, and never once spoke to me in many conversations of support for Hamas, or of hatred for those who had destroyed his country.  

What can be done however, is to honour his life and commitment with similar tenacity in supporting the pursuit of peace, justice for his people, learning and education for the remnant of the nation, and reconstruction of a Palestine that can proudly and honourably reflect the finest values it possesses. AbdulRahman was a great Palestinian, and his all too short life was one which I want to celebrate as one of the finest I have seen in many students of the next generation of doctors. May he rest in peace, and may a lasting peace come quickly to Gaza, to all of Palestine and the whole of the Middle East.

Snippet
Comment
Trauma
War & peace
2 min read

Hospitals are home to the truth of war

Remembering what war really is.
A black and white photo shows solider patients and nurses in a hospital.
Christmas in a German military hospital, Word War One.
Aussie~mobs, public domain, via Wikimedia.

I’ve been re-reading Erich Maria Remarque’s All Quiet on the Western Front in the run-up to Remembrance Day. Remarque, born in Westphalia in 1898, uses his own experiences of the horrors of the Western Front to paint a gut-wrenching portrait of its futility and suffering, seen through the eyes of 20-year-old Paul Baum. 

It had been towards the end of this First World War that Hiram Johnson, Republican Senator of California, observed that ‘the first casualty when war comes is truth.’ This is precisely Paul’s experience. 

The newspapers delivered to the soldiers at the Front are hopelessly, naively, offensively optimistic. They present a painfully, laughably discordant tissue of lies that deny the most basic truths of daily experience. When Paul goes home on leave, truth is even harder to find. His remote father only wants to hear tales of glory and courage and well-fed soldiers. His blabbering former teachers - the very ones who had cajoled his whole class to sign up - are patronising, ignorant and opinionated on the best route to victory. They literally have no idea, and worse, they don’t want to know.  

It’s only when he’s taken to a Catholic Hospital after an injury that Paul stumbles on an agonising truth -  

‘A hospital alone shows what war is.’ 

Paul’s vivid description of life on the wards backs this up. He witnesses the unceasing production line of shattered bodies tumbling into every available space. He’s warned against ‘The Dying Room’ which is conveniently, practically, located next to the mortuary. He catalogues the surrounding wards - ‘abdominal and spinal cases, head wounds, double amputations, jaw wounds, gas cases, nose, ear and neck wounds … the blind … lung wounds, pelvis wounds, wounds in the testicles …’ He’s grateful for the gentle, joyful kindness of Sister Libertine, ‘who spreads good cheer through the whole wing.’ 

This hospital is more eloquent on the theme of the futility of the fighting than any newspaper article or speech, censored or otherwise. 

For much of my adult life grainy videos of precision-guided bombs and leaders pounding their fist in defiant rhetoric have been the go-to guides to tell us the truth about modern warfare. I trust these sources less than ever, as I recall my instinctive respect for the ambulance drivers, nurses and doctors on the front-line - wherever it may be - marvelling at their courage and truth-telling and even-handed humanity. 

Their voices are shamefully drowned out in the world’s conflict zones, dwarfed by propaganda as insulting and truth-lite as the newspapers that doubled as toilet paper for both sides on the Western Front. And I cringe at the thought of what Paul and his young comrades would’ve made of hospitals - those oases of truth - becoming the targets of today’s bombs, missiles and drone strikes. 

We, rightly, remember the First World War as the very epitome of futility - Paul and his generation saw this truth far more clearly than we do. But let’s not congratulate ourselves, as we prepare for Acts of Remembrance in 2024, on having made any real progress in the last 100 years - hospitals across the globe’s conflict zones still tell us what war really is, if only we could hear, if only we would listen.