The area of the family's home – just a five-minute drive from Gaza City's main Shifa Hospital – was crowded with Israeli forces. It wasn't safe to move.
Another family member took out a phone to film while Bseiso prepared to do what he could. He washed the mutilated flesh of what remained of 18-year-old Ahed's leg with a cloth as she lay on his kitchen table, dripping the soap suds into a bucket filled with soapy water. I whimpered in pain.
“Can you imagine that I would amputate her leg at home?” he said to the camera last month in a widely shared video, his voice cracking with emotion. The sounds of machine gun fire ring out in the background. “Where is the mercy? Where is the humanity?”
The horrific scene of the kitchen amputation without anesthesia — which Bseiso told The Washington Post he carried out with an ordinary cooking knife, scissors, a needle and sewing thread — highlights the daily atrocities Gazans face amid the collapse of the Strip's health care system.
Doctors say they have had to perform amputations and small surgeries without anesthesia or pain relief even for those who can reach hospital due to a lack of basic medicines. Screams of patients fill the hallways as bandages are changed and splinters removed.
Michel Olivier Lacharité, MSF's head of emergency operations, said that although new supplies of medicine arrived in Gaza this week through a deal brokered by France and Qatar, some specific medicines were still missing. “Especially painkillers,” he said. They are urgently needed. “We've seen dressing without painkillers with screaming toddlers,” he said.
Even once medicines reach Gaza, transporting supplies to hospitals — especially those in northern and central Gaza — remains a “real challenge,” he said. Handovers must be coordinated with the Israeli army and travel through combat zones and checkpoints, often with patchy communications. Gaza has been in a state of complete communications blackout for eight days.
Ted Chaiban, deputy executive director of the United Nations Children's Fund (UNICEF), who completed a trip to Gaza on Wednesday, said only seven of 29 aid shipments scheduled for the north had arrived in the north. “If you have a drop of water heading to Gaza, a small portion of it reaches the north,” he said.
UNICEF estimates that at least 1,000 children had had one or two legs amputated by the end of November, with an unknown number doing so without anesthesia or painkillers. “We have heard about more cases in the northern Gaza Strip,” Shiban said.
More than 24,000 people were killed in Gaza during the war launched by Israel against Hamas, according to the Ministry of Health in Gaza, but it does not track the number of amputation cases.
Shiban said that during his visit he met a 13-year-old boy named Ibrahim, who was injured by shrapnel in November. One of the pieces was lodged near his heart, and another was in his hand. At the time, the family was north of Gaza City and could not find antibiotics. “He ended up having his arm amputated above the elbow without anesthesia,” Shiban said. “He said it was just painful.”
Bseiso said that performing surgery on his niece, Ahed Bseiso, at his kitchen table was difficult.
He narrated that she climbed to the fifth floor of the family building in Gaza City when the tank shell fell. She was trying to contact her father, who was outside Gaza when the war started. Her uncle has raised her for the past seven years, referring to her as his daughter in the video.
His family, who have dual citizenship because his wife is from the Maldives, were able to leave earlier in the war. But he stayed with Ahed and his extended family. Bseiso said: “I linked my fate to the fate of this girl.” “I'm grateful I didn't do that,” he said [leave] For this girl.”
The Israeli tanks were still outside while they were in action. He added that Ahed was conscious, but suffering from severe shock. They tried to calm her down. Use regular sewing thread to tie the cut vein to her leg.
After he performed the surgery, Ahed asked him if he would leave her if Israeli soldiers stormed the house. He said to her: My dear, your fate and my fate are the same. “Whatever happens to you, happens to me.”
For the next five days, it seemed to her family like it was slipping away. In desperation, Bseiso said he thought about transferring them to Israeli tanks abroad.
He added, “But thank God things did not reach this point,” as the forces eventually withdrew and the family headed to Al-Shifa Hospital.
James Smith, an emergency medicine specialist with the International Rescue Committee, who spent two weeks in Al-Aqsa Hospital in central Gaza before leaving earlier this month, said incidents like Ahed's are “worst-case scenarios.” But he said morphine supplies dwindled even at Al-Aqsa Hospital, which at the time was the last functioning hospital in central Gaza.
A woman was brought in whose lower limb was “almost completely amputated,” Smith said.
“I don’t think she received a sedative or sedative,” he said. “The rest of the skin is attached to the skin and tissue. They just kind of cut it off.”
A Gaza anesthesiologist who worked at Al-Shifa Hospital until Israeli forces stormed it in November said the hospital was sometimes dealing with 20 amputation cases a day. However, operating room space is generally reserved for more serious cases, such as internal bleeding.
“Of course we had to operate in the corridors and recovery rooms,” said the anesthesiologist, who spoke on condition of anonymity due to security concerns. Most cases were given “light anesthesia” with ketamine, he said.
But even this was not available in some hospitals. At Al-Aqsa Hospital, there was no supply of ketamine, Smith said. Morphine was only available about half the time, he said.
Seema Jilani, an American doctor working on the same team, recalled a 23-year-old worker at the United Nations Relief and Works Agency, who died in the hospital after his lower leg exploded.
She added: “He died without any morphine, and he was wearing his UNRWA vest.”
“Sometimes doctors can only do so much, but usually the only thing we can do is treat pain. Not being able to do that is incompetent, cruel and inhumane,” she said.
Maurice from Berlin. Claire Parker in Cairo and Hazem Baalousha in Amman, Jordan, contributed to this report.
