When a nonprofit organization asked Dr. Mohammed Khaleel and his colleagues last fall if they would be willing to go on a medical mission to Gaza someday, they didn’t hesitate to sign up.
FAJR Scientific brings orthopedic surgeons like Khaleel to Gaza to provide medical care there alongside local doctors. A colleague had gone the year prior, before the war started.
Khaleel, a spine surgeon with a clinic in Frisco, had joined medical missions in the past — to Pakistan and the West Bank — but never during an active war.
“They can be risky ... in a war zone,” he said. “But medical personnel are usually in a protected position. So we had all signed up at that time to be available should the opportunity come up.
“Then when it did, I think all of us felt we couldn’t say no.”
It’s been a year since Hamas militants in Gaza attacked southern Israel, killing about 1,200 people and kidnapping more than 200 others — many of whom have since been killed. And about 100 hostages are still being held captive, according to Israeli officials.
In the months that followed, Israel’s war in Gaza in response to the attack has killed an estimated 41,000 Palestinians, according to the Gazan Health Ministry, and displaced hundreds of thousands more.
Khaleel doesn’t have ties to Gaza. But he knew he wanted to help.
Khaleel said doctors often get caught up in the bureaucracy that is an inevitable part of healthcare in the United States, such as wrestling with insurance authorization for patients.
“But the main crux of going into medicine is hopefully to help people,” he said. “And I think going on these medical missions, we gain more than we give.
“And nowhere was that more true than in Gaza.”
Entering a war zone
Khaleel and the other doctors arrived in Egypt in early April with “80 or 90” suitcases full of medical equipment and necessities — like feminine hygiene products and infant formula — to bring into Gaza via the Rafah border crossing. The UN human rights office has said Israel has imposed “unlawful” restrictions on humanitarian aid entering Gaza, an accusation Israeli officials deny.
“It’s very surreal driving from Cairo to Rafah. A lot of desert, many, many checkpoints,” Khaleel said. “But once you get closer ... you just drive past miles and miles of parked aid trucks.”
His group traveled with about a dozen other medical teams, some of them headed for different hospitals. He said there was a feeling of camaraderie as they headed for the border. But that changed as they entered Gaza.
“I think as medical professionals we are used to some level of high-stress environments. And so we all kind of bounce off of each other and find comfort in each other’s company,” Khaleel said. “Once we got in and then [saw] the destruction, then you kind of felt more of a lull in the conversation.”
The European Hospital where Khaleel and his team spent the next week was just north of Rafah, near Khan Younis.
“It was actually one of the nicer hospitals in Gaza,” Khaleel said. “And by the time when we were there it was just a trauma center and a refugee camp, basically.”
Every bit of available space had been turned into someone’s sleeping quarters, he said. Makeshift tents attached to the ceiling made the tiles sag. Ropes were strung from one end of the courtyard to the other for people to drape sheets over.
The hospital was “teeming,” Khaleel said, with about 35,000 people who were seeking care and safety there. Most of the hospitals in northern Gaza, he said, had been heavily damaged or destroyed in Israeli strikes.
“While we were there, it was a designated safe zone,” he said. “It was the only last standing, like, real trauma hospital left, so we were getting cases of patients transferred from other places, other locations, that had more complex injuries.”
He said he and the 13 doctors on site saw more than 100 patients a day. The main goal, Khaleel said, was to get people mobile in case the hospital came under attack.
The injuries he saw were “gruesome.”
“The amount of devastation I think was beyond what any of us had fathomed, even watching videos on social media. It was just complete and utter destruction,” he said. “A lot of children with devastating injuries, traumatic amputations, gunshot wounds.”
By the time Khalil and his team had arrived at the European Hospital, the infrastructure was already strained, and supplies were limited. Procedures were done without anesthesia; there were no antibiotics to ward off infections.
"The amount of devastation I think was beyond what any of us had fathomed."
There was never enough time to operate on everyone set for surgery. Less critical patients would be scheduled for the next day, Khaleel said, if doctors could find them.
“The next morning would roll around and a number of these patients would be MIA,” he said. “You couldn’t locate them because they probably got lost in that sea of 35,000 refugees, and we just never saw them again.”
He remembers one patient, a man with a spine injury from a blast. There was no question he needed surgery, but he had been waiting so long for help — months, by then — that by the time Khaleel and the other doctors could get to him, he had developed a severe bedsore that went all the way to the bone at the bottom of his spine.
Surgery would have put him at risk for sepsis and death. There was no way doctors could operate.
“They explained to him that it wouldn’t be safe to treat him,” Khaleel said. “He started crying that, you know, ‘I need to get out of here for treatment.’ It was such a difficult conversation because we were like, ‘We 100% agree with you, but there’s no way we can control that.’”
Khaleel said the team followed him for a couple of days to see what could be done. Then, like so many others at the hospital, he got lost in the crowd.
Danger close
As much as Khaleel worried about his patients, he had to worry about his own safety as well. The doctors had a safe house nearby, the coordinates of which were shared with the Israeli military, but the team spent each night at the hospital, sleeping on the floor of the CEO’s office. At times they could hear bombs going off nearby as they worked.
“The first time that you feel the windows shake and a bomb go off, it certainly shocks you,” he said. “But at that point, there’s not much you can do.”
Days before Khaleel arrived in Gaza, Israeli forces killed seven aid workers with World Central Kitchen in what Israeli officials said was an unintentional strike.
But Khaleel said he and the other American and European doctors felt a sense of security that the Palestinian doctors didn’t.
“You have to be very cognizant of that privilege...” he said. “...In the back of our heads, we’re all like, ‘They’re not going to attack American and European doctors.”
But Palestinian doctors worried that once the Western doctors left, the hospital would become a target.
In early July, Israel ordered the evacuation of the area around the hospital, which remained closed for several weeks before reopening last month. It’s still one of the last remaining hospitals operating in Gaza.
Returning home
There wasn’t time to process what he was witnessing while he was in Gaza, Khaleel said.
“I think we just got so engrossed in working through the night that there wasn’t much time to think about it,” he said. “When we came back, that’s when it hits you.”
He and the other American and European doctors had a sense of guilt leaving their Palestinian colleagues in Gaza. In a short time, they had become like family.
Khaleel plans on returning to Gaza; his wife, an anesthesiologist, also wants to go on a medical mission there. He tried to return in September but there were complications. He’s still considering going either back to Gaza or now to Lebanon.
“I think we all said we were coming back, and I think every one of us in our mission has every intention of going back,” Khaleel said. “But there’s no question that you have this in the back of your head that when I come back, these people may not be there.”
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