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Doctor details struggles and horrors of working in a Gaza hospital

ARI SHAPIRO, HOST:

Very few people are allowed to enter Gaza right now. Dr. Seema Jilani, an American, is one of them. She spent two weeks working at a hospital there, and she saw horrors. We want to warn you that the descriptions you'll hear over the next 10 minutes or so include graphic scenes of violence and suffering.

(SOUNDBITE OF ARCHIVED RECORDING)

SEEMA JILANI: It's just massively crowded. I'm stepping in blood.

SHAPIRO: Dr. Jilani recorded voice memos while she was treating patients in Gaza.

(SOUNDBITE OF ARCHIVED RECORDING)

JILANI: I guess I can't bring the mom in right now. And she's so emotional right now.

SHAPIRO: It's been nearly a hundred days since the deadly Hamas attack on Israel, which prompted Israel's ongoing bombardment of Gaza. Israel says it aims to destroy Hamas. By Palestinian officials' tally, more than 23,000 Palestinians have been killed in Gaza and about one in every 40 people there have been wounded in just three months. Israel's military is now pushing deeper into central Gaza and says Hamas uses hospitals as command centers. The World Health Organization says the most important hospital in central Gaza is Al-Aqsa.

(SOUNDBITE OF ARCHIVED RECORDING)

JILANI: I've seen a lot. And I never compare conflicts, but that's got to be the most nightmarish thing I've ever seen and the most - one of the most inhumane and cruel things I'll ever see.

SHAPIRO: Dr. Jilani is talking there about one young patient in the emergency room at Al-Aqsa, an 11-year-old girl who was severely burned in an explosive blast.

(SOUNDBITE OF ARCHIVED RECORDING)

JILANI: To look at her was an infinite waterfall of pain coming out from her. It's the stuff of nightmares.

SHAPIRO: Dr. Jilani worked in the ER for two weeks with the International Rescue Committee in partnership with medical aid for Palestinians, bearing witness to agony again and again.

(SOUNDBITE OF ARCHIVED RECORDING)

JILANI: Children lying on the ground, double amputation on one child. And there are no beds available, so people are literally just on the ground, seeking treatment. There's not really room or space for us to breathe or think. And then there's one, two, three, four, six children in my line of sight right now from the corner that need medical attention urgently, one of whom is crying, a little boy around 6 or 7 years old wiping his tears.

SHAPIRO: She describes a hospital on the brink of collapse, 500 patients arriving in just one night. And those patients were showing up at a facility desperate for supplies. She had no morphine or portable oxygen to give people.

(SOUNDBITE OF ARCHIVED RECORDING)

JILANI: I've always told myself, there's not much we can do in medicine, but we can treat pain. And it's no longer true anymore. So we cannot even offer any comfort here. There is no death with dignity when you're lying on the ground of an emergency room in Gaza.

SHAPIRO: All this while surrounded by bombing and gunfire.

(SOUNDBITE OF ARCHIVED RECORDING, MISSILE EXPLODING)

UNIDENTIFIED PERSON: Rockets. They're rockets, and they're nearer than they were before.

JILANI: That feels very close.

UNIDENTIFIED PERSON: Because you didn't get to hear much whistle before it comes.

SHAPIRO: Now Doctors Without Borders and the International Rescue Committee have evacuated medical personnel from Al-Aqsa hospital because of increasing Israeli attacks in the area and evacuation notices to neighborhoods there. The U.N. reports that just three doctors remain to treat hundreds of patients. And Dr. Seema Jilani joins us now from Cairo. Thank you so much for being with us.

JILANI: Thank you for having me.

SHAPIRO: I imagine that when you recorded those voice memos, you were very focused on the tasks right in front of you. And so what's it like to hear them now in a place where you have a little more room to think and breathe?

JILANI: It feels that my mind, my heart and my spirit is still in Gaza and my body is somehow in Cairo and then will continue onwards to where I call home. And it feels inherently wrong that I'm allowed that privilege and others are not because of the luck of where I was born.

SHAPIRO: You've worked in many conflict areas, Afghanistan, Lebanon, Gaza in 2015, right after the Israeli ground invasion. And we heard you describe this experience as the most nightmarish. How is it different from other wars where you have worked as a pediatrician, as a doctor?

JILANI: You know, as a pediatrician, I didn't think I would be very useful because this is war. And in war, I would imagine and think that the victims or this - or the war-wounded or the killed would be predominantly young men. I can say that on one day in our code room - in our code resuscitation room - out of our five patients, four were children. And I'm very sad and deeply disturbed to say that I was very useful as a pediatrician in a war zone, and that should never be the case.

The second way in which I find it extremely different is that in war we often talk of the fall of cities - the fall of Mosul, the fall of Saigon. And somehow I wonder when it was normalized that we are now speaking of the fall of hospitals - the fall of Al-Shifa, and now the fall of Al-Aqsa hospital, crescendoing all the way south to Rafah. And we expect it. And we are now estimating timings of - we're giving deadlines to when we anticipate the next fall of the next hospital as it rams its way through Nasser and perhaps European Gaza Hospital. And we're continuing to watch the landslide as voyeuristic onlookers to grief.

SHAPIRO: Can I ask you about one patient who you told us about in a voice memo? You explained he was a man in his early 20s who worked for the U.N. He was brought in still wearing his vest with the logo of the United Nations Relief and Works Agency, and both of his legs were severed. You couldn't offer him morphine, and it was clear that he was dying. So you took a little piece of gauze and wiped the blood from his eyes, gave him some water. Here's what you told us in the voice memo.

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JILANI: The way he just calmed down when I was just putting water to his lips told me everything I needed to know. His ask was so little, was so tiny, and that's all he needed. He just needed some comfort, someone to bear witness, someone to say, yes, you're in pain, someone to say this is not OK, someone to help clean him up and make him feel like a human being.

SHAPIRO: You said the best you could offer him was a quiet place to die, but in Al-Aqsa hospital, you couldn't even provide that. What does that experience with that one man say about the situation across Gaza right now?

JILANI: All he had when he died was my hand in his hand, and the only comfort I could provide him was wetting his lips with some makeshift gauze and some salty water. It was actually saline, which we usually put into IVs. I think it's a testament to the - to how we have failed the people of Gaza. And I only wish I could do more. But the way that he reached up and shifted his neck as I stroked his hair just to - the human connection there I'll never forget. And it will be one of the most rewarding memories I will take with me that, no, I wasn't able to give him what he deserved - I was able to stroke his forehead with a wet washcloth, whisper some words of calm, maybe a little sweetness, get some wetness of water on his tongue as he lifted his head to meet my fingers. And none of those interventions are morphine. And at the end of the day, he died on the floor of a Gaza emergency room with little more than my hand in his.

SHAPIRO: You know, there was one detail from the voice memos you sent us that stuck with me. And I'd like to play this for you.

(SOUNDBITE OF ARCHIVED RECORDING)

JILANI: I'm questioning, you know, how much of a difference am I really making? It's such a proverbial drop in the ocean of blood. Yesterday I noticed that there was a fly - there's a lot of flies here. And there was a fly that had drowned in the blood of a patient. And I just thought, wow, it's just literally a river of blood here, it's that - so much that, like, insects are drowning in the blood of my patients.

SHAPIRO: Can you speak to what medical professionals are actually able to do in a hospital in that horrific situation? I mean, is a doctor in an overcrowded hospital with no morphine, no gauze, an ongoing bombardment actually able to make a difference to patients?

JILANI: I believe so. I believe it means something when they're - when I'm holding a gentleman's hand and he's dying and he's looking at me in the eyes. And I think that's worth something, otherwise I wouldn't be doing this. And I think it means something to the doctors there to see us in solidarity with them. Gaza is a space that is hyperaware of the political situation outside and the forces that exist outside of it, and they feel forgotten. And the moment they see someone standing with them and offering support to them, not even in a material way, in a symbolic way - to say, we are here to see your patients while you mourn the death of your friend or your family member, it means something. And it certainly means something to me.

And I think it's worth holding space for that, however little that feels. Some of those things are intangible, but they're not intangible to the ones that are feeling it, that are soaking blood through their clothes. They're not intangible to the mothers that are having to bury their children, and they're not intangible to the orphans whose, you know, heads I've held in my hand.

SHAPIRO: If you're able to go back, will you?

JILANI: Absolutely.

SHAPIRO: You say that so unequivocally.

JILANI: Unquestionably.

SHAPIRO: Tell me more.

JILANI: I've been anchored in this conflict for over 18 to 19 years. The people of Gaza occupy a little Gaza space - place in my heart. Their resilience, their incredible ability and tenderness, that they're in vulnerability that they are able to tap into - every time I go there, I feel that I learn more than I give. I am completely blessed and grateful to know the people that I have gotten to know there as part of the staff and my patients and the nurses. And I will take lessons from each of those people and hope to bring them to my profession, to my family, and show them this is how a life well-lived, this is what it looks like.

SHAPIRO: Dr. Seema Jilani is a pediatrician and humanitarian aid worker. Thank you so much for talking with us about your experience.

JILANI: Thank you so much.

(SOUNDBITE OF SAM SAPPHIRE'S "HONEYSUCKLE") Transcript provided by NPR, Copyright NPR.

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Erika Ryan
Erika Ryan is a producer for All Things Considered. She joined NPR after spending 4 years at CNN, where she worked for various shows and CNN.com in Atlanta and Washington, D.C. Ryan began her career in journalism as a print reporter covering arts and culture. She's a graduate of the University of South Carolina, and currently lives in Washington, D.C., with her dog, Millie.
Courtney Dorning has been a Senior Editor for NPR's All Things Considered since November 2018. In that role, she's the lead editor for the daily show. Dorning is responsible for newsmaker interviews, lead news segments and the small, quirky features that are a hallmark of the network's flagship afternoon magazine program.
Ari Shapiro has been one of the hosts of All Things Considered, NPR's award-winning afternoon newsmagazine, since 2015. During his first two years on the program, listenership to All Things Considered grew at an unprecedented rate, with more people tuning in during a typical quarter-hour than any other program on the radio.