GAZA: The little girl was weeping in pain and screaming “Mummy, Mummy” while the nurse stitched up her head wound without using any anaesthetic, because none was available at the time at Al Shifa Hospital in Gaza City.
That was one of the worst moments nurse Abu Emad Hassanein could recall as he described the struggle to deal with an unprecedented influx of wounded people and a dearth of pain relief medication since the war in Gaza started a month ago.
“Sometimes we give some of them sterile gauze (to bite on) to reduce the pain,” said Hassanein.
“We know that the pain they feel is more than someone would imagine, beyond what someone their age would stand,” he said, referring to children like the girl with the head wound.
Arriving at Al Shifa to have the dressing changed and disinfectant applied to a wound on his back caused by an air strike, Nemer Abu Thair, a middle-aged man, said that he was given no pain relief when the wound was originally stitched up.
“I kept reciting the Qur’an until they finished,” he said.
The war started on Oct. 7 when Hamas gunmen burst through the Gaza Strip’s border fence with southern Israel. Israel says Hamas killed 1,400 people and abducted 240, in the worst day of carnage in Israel’s history.
Israel responded with an air, sea and ground assault on the densely populated, Hamas-controlled enclave, which health officials in Gaza say has killed more than 10,800 Palestinians.
Mohammad Abu Selmeyah, the director of Al Shifa Hospital, said that when very large numbers of injured people have been brought in at the same time, there has been no choice but to deal with them on the floor, without adequate pain relief.
He gave as an example the immediate aftermath of an explosion at the Al Ahli Arab Hospital on Oct. 17, when he said some 250 injured people arrived at Al Shifa, which has only 12 operating theaters.
“If we had waited to operate on them one by one, we would have lost many of the wounded,” said Abu Selmeyah.
“We were forced to operate on the ground and without anaesthesia, or using simple anaesthesia or weak pain killers to save lives,” he said.
Procedures that have been performed by staff at Al Shifa under such circumstances have included amputating limbs and fingers, stitching up serious wounds, and treating serious burns, said Abu Selmeyah, without elaborating.
PAIN OR DEATH
“It is painful for the medical team. It is not simple. It is either the patient suffers pain or loses his life,” he said.
Israel said the blast at the Al Ahli Arab Hospital was caused by a failed rocket launch by the Palestinian Islamic Jihad militant group. Palestinian Islamic Jihad and Hamas blamed an Israeli air strike.
Israel’s ally the United States said its own intelligence assessment supported Israel’s explanation.
At Nasser Hospital in Khan Younis, in the south of the Gaza Strip, director Dr. Mohammad Zaqout said there had been a period early on in the war when anaesthetic supplies ran out completely until aid trucks were allowed in.
“Some procedures were carried out without anaesthesia, including Caesarian sections on women, and we were also forced to operate on some burns that way too,” said Zaqout.
He said that staff did their best to alleviate patients’ pain with other, weaker medications, but this was inadequate.
“This is not the ideal solution for a patient inside an operating theater, who we want to operate on with full anaesthesia,” he said.
For the first 12 days of the war, no aid was allowed into Gaza. On Oct. 21, a first convoy of aid trucks came in through the Rafah Crossing on the strip’s border with Egypt. Since then, several convoys have entered, but the United Nations and international aid groups say the aid provided is nowhere near the scale needed to mitigate a humanitarian catastrophe.
Zaqout added that while the shortage of anaesthesia had been eased at his own hospital thanks to aid deliveries, there were still severe shortages at Al Shifa and at the Indonesian Hospital, both of which are in the heavily bombarded north of the strip.
In Gaza, hospital procedures without anaesthetics prompted screams, prayers
https://arab.news/9h3n8
In Gaza, hospital procedures without anaesthetics prompted screams, prayers
- Very large numbers of injured people were brought in at the same time, there was no choice but to deal with them on the floor, and without adequate pain relief doctors said
- Procedures were carried out without anaesthesia, including Caesarian sections on women, and we were also forced to operate on some burns that way too
How Sudan’s volunteer medics are helping war survivors cope with mental trauma
- Millions displaced by Sudan’s war face acute psychological distress, often without access to professional mental health support
- Fighting has devastated hospitals and clinics, leaving only volunteer networks and community initiatives to fill critical healthcare gaps
DUBAI: After being displaced from the Sudanese capital, Khartoum, several times before finally reaching safety in Kassala to the east, Dr. Tayseer Ibrahim understood better than most the lasting scars Sudan’s war would leave on generations to come.
Before she could complete her final semester in medical school, the 27-year-old was forced to pack her belongings and leave when the sound of shelling drew closer and war raged through the streets of Khartoum, a city since recaptured by the army but still in ruins.
Boarding the first bus packed with displaced people bound for Wad Madani, capital of Al-Jazira state to the southeast of Khartoum, Ibrahim’s journey was perilous, marked by sudden clashes at checkpoints and sleepless nights spent under trees in search of safe passage.
After settling temporarily in a camp in the village of Al-Shakaba, she was forced to leave once again when the situation deteriorated. The journey to Kassala took more than a week, mostly on foot, before she finally arrived at the Omar Al-Haj Musa School camp.
“As a survivor, I understood better than anyone what my people truly needed,” Ibrahim told Arab News.
Driven by the pain and loss she endured and the suffering she witnessed, Ibrahim joined a group of displaced female doctors to establish the Youth Voluntary Mental Health Organization in Kassala.
Founded in partnership with the UN refugee agency, UNHCR, the center seeks to meet the growing need for psychological relief and protection, amid the collapse of Sudan’s healthcare system, for a young generation displaced by war and now facing lasting trauma.
Now in its third year, the war between the Sudanese Armed Forces and the paramilitary Rapid Support Forces has triggered one of the world’s worst humanitarian crises, displacing nearly 12 million people and making Sudan home to the world’s largest internally displaced population.
The war also fueled what the UN describes as the world’s most extensive hunger crisis, with famine already declared in at least five locations.
The situation has been exacerbated by a new wave of displacement, with nearly 90,000 people fleeing El-Fasher in the past two weeks, according to the UN, following the RSF’s capture of the North Darfuri capital on Oct. 26 after an 18-month siege.
With the economy on its knees and public services almost nonexistent, aid groups say the war is leaving an entire generation traumatized, out of school, and malnourished.
Exposure to violence, hunger, disease, and mass displacement, compounded by the collapse of healthcare infrastructure, has led to a surge in cases of depression, anxiety, and post-traumatic stress disorder, particularly among children and adolescents.
“Most of the displaced in the camps suffer from trauma and depression; some to the point of suicide,” Ibrahim told Arab News.
“Conditions for those diagnosed before the war worsened alongside the new cases brought on by violence and displacement.”
A 2024 survey by the UN children’s fund, UNICEF, found that 67 percent of Sudanese children in displacement camps showed signs of severe emotional distress, yet only five percent had access to any form of psychological support.
Experts said Sudan’s mental health system, weakened by years of economic turmoil and a 22-year civil war, was already limited and severely underfunded.
The latest conflict has further eroded access to medical care as most psychiatrists and mental health workers have fled or been displaced, while medical supplies remain scarce.
Local psychiatrists also report that social stigma toward mental health disorders remains widespread in Sudanese society.
“Many people are not aware of the importance of psychological treatment and support,” said Ibrahim.
She described the “inhumane conditions” facing displaced families in Kassala, many of whom live in schools turned into emergency shelters or in overcrowded tents with no privacy and limited access to clean water or sanitation — conditions ripe for disease, exacerbated by natural disasters such as floods and droughts.
“The majority of the displaced are women and children who live without income or a family provider,” said Ibrahim. “Many displaced families include members suffering from chronic, infectious, or mental illnesses, yet they have little or no access to medical services.”
Such conditions put women at risk of gender-based violence, experts warn.
Ibrahim recalled the case of a 17-year-old girl who attempted suicide in the camp, driven to desperation by a lack of privacy, an uncertain future, and domestic abuse by her mentally unstable father.
“Fortunately, intervention came in time. She survived and is now receiving treatment,” said Ibrahim.
With only a handful of psychiatrists and medical professionals left in Sudan, community-based initiatives like Ibrahim’s have become a lifeline.
Despite these efforts, she said the most urgent needs, including food, medicine, shelter, and psychological support, far exceed the humanitarian aid currently available.
Her organization, funded by UNHCR, focuses on mental health and psychosocial support, gender-based violence, child protection, and primary healthcare.
Ibrahim works alongside a small team comprising a psychologist, a neurologist, and social workers to offer free diagnostic and therapeutic services to displaced persons, along with regular follow-ups for chronic and mental health conditions.
Women and girls affected by gender-based violence receive counseling sessions, supported by a referral network to ensure their protection and safety.
The team provides counseling across several displacement sites, including Sittat Arab Camp in Halfa, Omar Al-Haj Musa School, Al-Saadiya School, Tajoug School, and a camp west of the city’s airport.
Ibrahim said the organization focuses on children and youth in the hope of contributing to Sudan’s long-term recovery.
She was among more than 80 medical students who received UNHCR funding to complete their final semester after the war disrupted their studies.
Without that support, she said, she could not have afforded the fees or earned her degree, which later enabled her to establish the organization as a way to pay it forward and help her community rebuild.
Not many students, particularly children, were so fortunate. The conflict has devastated the education system, leaving more than 10,400 schools closed and forcing 19 million children out of formal education, including 4 million who are displaced, according to UNICEF.
The UN agency says Sudan is now facing the world’s largest child displacement crisis.
Aid groups and humanitarian organizations have warned that school closures and economic instability are deepening long-term psychological distress among Sudanese youth, creating a lost generation that could deprive the country of a skilled workforce and prolong its economic instability for years to come.
Malnutrition is another deep and lasting scar of the war. A March 2024 UNICEF report found that nearly 3.8 million children in Sudan are acutely malnourished, including 730,000 suffering from severe acute malnutrition, as health experts warn of the long-term impact of hunger on children’s cognitive development, memory, and ability to learn during their formative years.
To encourage emotional expression and a sense of security, Ibrahim said her organization has established child-friendly spaces as safe environments equipped with educational games and creative activities.
Besides providing one-on-one counseling, the center organizes recreational events for children and mothers, and sports activities targeting young people and adolescents to promote their mental and physical well-being.
The center aims to expand its outreach by training volunteers and community members to provide immediate support to those suffering from trauma.
It also holds seminars on mental health and developmental workshops designed to build the capacities of women and youth, empowering them to create lasting change in their communities.
Healthcare professionals want to see mental health treated as a core component of global humanitarian efforts, emphasizing that psychological support is as vital as food, shelter, and medical care in helping conflict-affected communities recover and rebuild.
Calls for a ceasefire and global action have surged amid mounting evidence from UN human rights bodies and independent experts of war crimes in El-Fasher.
Both the army and the RSF have been accused of crimes against humanity. The RSF has also been implicated in atrocities in Darfur that the UN said may amount to genocide.
RSF leader Mohamed Hamdan Dagalo, also known as Hemedti, has promised to investigate the El-Fasher allegations, but both sides categorically reject accusations of war crimes and genocide.
Mindful of Khartoum’s long road to recovery, Ibrahim said she hopes to return to her hometown and contribute to its reconstruction now that she has established a lifeline for displaced communities in Kassala.
“Communities in Khartoum are in dire need of psychological and medical support, and I feel that my experience as a doctor, a displaced person, and a survivor can make a difference.”
