The account to Clarín of Andrés Carot, a surgeon, Argentinian and Cordovan, from Gaza is an indigestible succession of atrocities. Wounded who arrive at hospitals in exorbitant numbers. Children who are late. That is, dead. Nobody's boys, in a bed not knowing that their whole family is dead. Cures without anesthesia. Wounds with maggots. Buildings that tremble. Healthcare workers who don't give more. A civilian population dying in gross numbers...
Shortly before the truce expired on Friday in the Gaza Strip, Carot answered a series of questions to this newspaper by email. He has been working with Médecins Sans Frontières (MSF) for 14 years, most of them on missions as a surgeon in armed conflicts in Syria, Yemen, Iraq, Afghanistan, and yet, he says, "I have never seen so many dead and wounded arrive at a hospital in a few hours".
Andres Carot, surgeon with Médecins Sans Frontières, working in Cameroon. Photo: Médecins Sans Frontières
He arrived in Gaza after waiting almost a month in Egypt for an entry permit. The doors opened on November 14. About two weeks after entering, he spoke to Clarín.
"The situation I've encountered is one of such abhorrent destruction that I've never seen or felt before," he says.
"It was during the first week that I was working at Nasser Hospital in Khan Yunis, where 120 people arrived (mostly women and children) of whom 70 were already dead. A clear example of this terrible massacre," he adds.
How is Gaza today?
In the city of Khan Yunis and in the Middle Area, two regions in the south where we work, I see houses and buildings destroyed by shelling (including medical centers, hospitals, schools). And we are supposed to be in the southern part of the Gaza Strip where the inhabitants of the north were forced to move by the Israeli army, and despite that, the sounds of the drones do not stop and neither do the bombings.
Andrés says that from the time he arrived until the truce that ended on Friday began, "there was not a day that we did not hear frequent explosions."
Patients and refugees at Al Aqsa hospital. Photo: Mohammed Abed
"Several nights I was suddenly awakened by explosions quite close to home that shook the walls of the house where we live," he says.
Hospitals are a painful landscape. "They are overwhelmed by the number of patients," says Carot, giving an example: Al Aqsa Hospital, which had a capacity of 200 patients before this escalation of the conflict, now has 600 inmates.
"It's total chaos"
Every description the surgeon makes is a leap into a grim photograph.
The health system collapsed. Most of Gaza's hospitals are out of service, without electricity and water due to lack of fuel, it is impossible for them to function; others have stopped working because of the attacks," he describes. He adds: "The hospital staff is exhausted, can't cope and does what they can in these conditions. It's total chaos."
The weather is the enemy. "It's winter, people are cold, and many are sleeping on the streets."
Patients and refugees at Al Aqsa hospital. Photo: Mohammed Abed.
Have you seen Gaza in this state on other occasions of war with Israel?
I was in Gaza in 2018 on two occasions. During that time, we treated wounded people who came from Gaza's eastern border with Israel, victims of serious injuries, the vast majority of them comminuted fractures in the legs executed by snipers, and there was also some sporadic bombardment that brought down some buildings; but nothing to do with this new escalation of the conflict. At that time, I was able to travel the entire Gaza Strip from north to south and from east to west. Something totally unthinkable now when our movements are extremely limited by security and limited access to fuel.
-Could you list the injuries you suffer?
Almost all patients we perform have injuries caused by shelling, including extensive burns, amputations of upper and lower extremities, complicated open fractures, serious injuries to the abdominal cavity, thorax, head. Most are women, children and the elderly.
Yahia Sami Asqou had to flee shelling to the hospital with a broken leg. Photo: Mohammed Abed
"What's going on with them?"
-Many die because of the severity of their injuries, others because there are no operating rooms available despite having serious injuries; However, they would be saved if we could operate them immediately. A large number of others die from complications due to widespread infections. In this moment of truce, we are engaged in the reoperations of complicated patients and the number of infected is abysmal, several with maggots in their wounds.
"What do children die of?"
Just today I was analyzing the data from the first days of the surgeries on the patients I operated on and absolutely all of them were for violent trauma due to bombs as the primary cause. Several arrive dead after the attacks and many are buried under the houses or apartments where they were when they were bombed.
-How is it possible to operate or amputate without anesthesia?
Abdalla Salem, MSF psychologist at Al Aqsa Hospital, stands next to Razan, a girl who lost her entire family. Photo: Mohammed Abed.
-Fortunately I have not done any surgery in the operating room without anesthesia or sedation, but we are short of strong analgesics, so the postoperative period of the patients is traumatizing due to the physical pain, added to the psychological trauma to which they are exposed. The vast majority lost several family members.
There is an acronym that began to be used in hospitals in Gaza: WCNSF (Wounded child no surviving family), it is very distressing and painful to see a child in a hospital bed without any family to take care of him. Here in the hospital there are some.
Carot explains that several dressings that should ideally be done in the operating room or in a dressing room with sedation, are done in patients' beds with mild or even no painkillers and in poor hygienic conditions. "It is what it is, there is no alternative. We do what we can with what we have," he laments.
MSF's surgical team: nurse Katrien Claeys, Dr Sohaib Safi and Dr Andres Carot at Al Aqsa hospital. Photo: Mohammed Abed.
Is there any situation that you have experienced in these days that you have never experienced in another conflict of this type?
Yes, the first few days when I was working at Nasser Hospital in Khan Yunis, after noon, an explosion 1 km away terrified us; Everything shook. After a few minutes, ambulances began to arrive one after the other and also carts pulled by donkeys and horses that brought patients; The number of patients who arrived in such a short time was impressive. I went to the emergency room and it was total chaos: people screaming with dead babies in their arms, patients being treated on the floor for lack of space; They kept coming. And a lot of images that I'd rather not describe.
What I found frightening, disgusting and very painful in this situation in this hospital in Gaza was that so many dead had arrived within the total number (70 dead out of a total of 120 patients) and most of them women and children.
Andrés CarotSurgeon, MSF
Did the truce allow the entry of sufficient supplies and fuel?
-The amount of supplies and fuel was miserably increased. It's ridiculous. Prior to this escalation, between 400 and 500 trucks of humanitarian aid entered per day; During the days of war before the truce, no more than 120 a day ever entered; Since the ceasefire, a few more came in than even close to 400-500 who had reached normal situations before; far from what is needed for the survival of the population.
For Carot, the siege imposed by the Israeli government, which includes the withholding of food, water, fuel and electricity, is outrageous and inhumane. "It is collective punishment, prohibited by international humanitarian law, and may constitute a war crime," he warns.
"Attacks on hospitals and civilians must stop immediately. The medical mission, medical transport, medical personnel and humanitarian aid workers must be respected and protected," he stresses.
People search for fuel, food and gasoline near Al Aqsa hospital on Nov. 29. Photo: Mohammed Abed
"Are you afraid that at the end of the truce, the war will return with greater intensity?" asked Clarín when the ceasefire was still in effect. "I hope not, it's my greatest wish," he replied.
But the truce fell apart when Hamas, according to Israel, fired a rocket from Gaza in the final minutes of the ceasefire on Thursday.