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Lose a limb or risk death? Many people in Gaza face a heartbreaking choice

DEIR AL-BALAH, Gaza Strip — Doctors gave Shaimaa Nabahin an impossible choice: lose her left leg or risk death.

The 22-year-old had been hospitalized in Gaza for about a week, after her ankle was partially severed in an Israeli airstrike, when doctors told her she was suffering from blood poisoning. Nabahin chose to maximize his chances of survival and agreed to have his leg amputated 15 centimeters (6 inches) below the knee.

The decision turned the life of this ambitious university student upside down, as it did that of countless others among the more than 54,500 war wounded who faced similar, heartbreaking choices.

“My whole life has changed,” Nabahin said, speaking from his bed at Al-Aqsa Martyrs Hospital in the central city of Deir al-Balah. “If I want to take a step or go somewhere, I need help. »

The World Health Organization and the Health Ministry in Hamas-run Gaza say amputations have become commonplace during the war between Israel and Hamas, now in its 12th week, but do not were unable to provide precise figures. At Deir al-Balah hospital, dozens of recent amputees are in various stages of treatment and recovery.

In many cases, the severity of the injuries means some limbs are not salvageable and must be removed as soon as possible, a senior World Health Organization official said.Hatem Moussa/AP file

Experts believe that in some cases, limbs could have been saved with proper treatment. But after weeks of Israel’s intense air and ground offensive, only nine of Gaza’s 36 hospitals are still operational. They are severely overcrowded, provide limited care, and lack basic equipment to perform surgical procedures. Many wounded cannot reach remaining hospitals, blocked by Israeli bombing and ground fighting.

Sean Casey, a WHO official who recently visited several hospitals in Gaza, said the dire shortage of vascular surgeons – the first responders to trauma and best placed to save limbs – increases the risk of amputations .

But in many cases, he added, the severity of the injuries means some limbs are not salvageable and must be removed as quickly as possible.

“People can die from infections that they have because their limbs are infected,” Casey said at a news conference last week. “We saw septic patients. »

Israel declared war after Hamas militants crossed the border on October 7, killing some 1,200 people, mostly civilians, and taking more than 240 hostages. Israel has vowed to continue fighting until Hamas is destroyed and removed from power in Gaza and all hostages are released. More than 20,900 Palestinians have been killed in the fighting, about 70 percent of them women and children, according to Gaza’s health ministry, which does not distinguish between civilians and fighters among the dead.

Before the war, Gaza’s health system was overwhelmed after years of conflict and a border blockade imposed by Israel and Egypt in response to Hamas’ takeover of the territory in 2007. In 2018 and 2019, thousands of people were injured by Israeli army fire during weekly protests against the blockade led by Hamas, and more than 120 of them had limbs amputated.

Even then, amputees in Gaza struggled to obtain prosthetic limbs that would help them return to active lives.

Those who join the ranks of amputees now face almost impossible conditions. Around 85% of the 2.3 million inhabitants have been displaced, crammed into tents, schools transformed into shelters or with relatives. Water, food and other basic necessities are scarce.

On November 13, when an Israeli airstrike hit Nabahin’s neighbor’s house in Bureij, an urban refugee camp in central Gaza, her ankle and arteries in her leg were partially severed by a piece of cement. which blew into his house in the next explosion. door. She was the only one in her family to be injured, while a number of her neighbors were killed, she said.

She was quickly taken to the nearby Al-Aqsa Martyrs Hospital, where doctors managed to stitch her leg up and stop the bleeding.

But after that, Nabahin said she received little care or attention from doctors, who were caring for a growing number of seriously injured people as medical supplies dwindled. A few days later, her leg turned dark, she said.

“They found out there was… shrapnel that was poisoning my blood,” she said.

Crowds flee Bureij, in the Gaza Strip.
Crowds flee Bureij, in the Gaza Strip.Fatima Chbair / AP file

The amputation went well, but Nabahin said she still suffered from severe pain and could not sleep without sedatives.

Jourdel François, an orthopedic surgeon with Doctors Without Borders, says the risk of post-operative infections in the war-stricken Gaza Strip is high. François, who worked at Nasser Hospital in the southern city of Khan Younis in November, said hygiene was poor, mainly due to lack of water and general chaos in a hospital overwhelmed with patients as he hosts thousands of displaced civilians.

He remembers a young girl whose legs had been crushed and urgently required a double amputation, but she could not have surgery that day due to the high number of other serious injuries. She died later that night, François said, probably from sepsis or blood poisoning from bacteria.

“There are 50 (wounded) people arriving every day, you have to make a choice,” he told The Associated Press by telephone after leaving Gaza.

At Al-Aqsa Martyrs Hospital, many new amputees struggle to understand how life-changing the loss of a limb has been. Nawal Jaber, 54, had both legs amputated after being injured on November 22, when Israeli shelling hit her neighbor’s empty house and damaged her house in Bureij. Her grandson was killed and her husband and son were injured, she said.

“I wish I could provide for my children, (but) I can’t,” the mother of eight said, tears streaming down her face.

Before the conflict, Nabahin had begun his studies in international relations in Gaza and planned to travel to Germany to continue his studies.

She said her goal now was to leave Gaza, “save what’s left of me, get a prosthesis fitted and live my life normally.”

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