Endless shifts with no food, water, working environment; having to choose between patients, do surgeries without anaesthesia, letting them die for want of medicines, with infection; constantly losing their own health, house, colleagues and family members — these are some of the realities being faced by the doctors and healthcare staff in war-torn Gaza for over a month now.

The Gaza Strip, home to 2.3 million people, is under siege by the Israeli military in response to Hamas’ terror attack on October 7 that left 1,200 dead and 240 — from babies to octogenarians — taken hostage by Hamas.

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While accidents, calamities, wars and deaths are not something unknown to doctors and other healthcare workers, the situation in Gaza is reportedly way beyond imagination. Yet amid a collapsing health system, limited painkillers, huge numbers of burns victims, amputations, the doctors are putting on a brave front.

“We are humbled by the heroic work of health workers in #Gaza,” Tedros Adhanom Ghebreyesus, WHO Director-General, posted on X.

Since October 7, the WHO has verified more than 250 attacks on healthcare in Gaza — at hospitals, clinics, ambulances and patients — and the West Bank.

“Half of Gaza Strip’s 36 hospitals and two-third of its primary healthcare centres are not functioning at all. Those that are functioning are operating way beyond their capacities,” the WHO chief said.

Many doctors and healthcare workers have lost their lives by choosing to stay back for their patients.

“We are being overwhelmed. There is nowhere to evacuate to… There is no escape route. We are probably one of the last lines of defence,” Paul Ley, a doctor at the European Hospital in Khan Yunis, Gaza, was quoted as saying by The Guardian.

“We never leave the hospital. We work round the clock. We do operations with minimal anaesthesia. If we run out, we can’t operate, but there is no clear line. There are a lot of people crying, screaming with pain, but we don’t have enough analgesics. We keep them for the kids or very severe cases.

“Normally we would change dressings on patients with 40 per cent burns with them under sedation and minimise the time by using more attendants… Now it has to be done with a lot of pain. We try to keep our heads cool and steady, but for local staff this is their families, friends, their people,” Ley said.

Speaking to IANS, Dr Ishwar Singh Gilada, Health Expert and Secretary General, People’s Health Organisation-India, said that in a normal scenario, a patient is surrounded by a team of expert doctors. But it is difficult in warzones.

“A general surgeon may have to do even cardiovascular surgery, plastic surgery or neurological surgery and sometimes even MBBS doctors will have to do some kind of minor surgery. So in that situation, it is not kind of more of a standard care. It is not optimal care.”

Doctors cannot “get any emergency care; blood supply, or any kind of surgery done immediately to plug the holes”, and are likely to make “judgmental errors, and not make the proper decision; feel fatigued, overwhelmed and ultimately burnout”.

Even as there is no safe water, air and food, doctors in Gaza are also facing patients with waterborne and respiratory diseases, in addition to war victims.

“This brutal annihilation of an entire population’s health system stretches beyond what humanitarian aid can fix. Doctors can’t stop bombs,” said Joe Belliveau, Executive Director for Doctors Without Borders, while calling for a sustained ceasefire in Gaza.