Medical Aid Worker Describes the Bloody Aftermath of Israel’s Hostage Rescue

An Israeli military operation in Gaza this week aimed at rescuing four hostages from Hamas killed over 270 Palestinians and wounded hundreds more. The Nuseirat refugee camp, where the attacks occurred, became a scene of horror as the injured sought care from Gaza’s few remaining hospitals. Karin Huster, a Doctors Without Borders medical coordinator, witnessed the aftermath. She joins host Murtaza Hussain on Intercepted to discuss what she saw following the Israel Defense Forces attack alleged to involve grave war crimes, and the ongoing impact of the war on Gaza’s civilian population.

Transcript

[Intercepted theme music.]

Murtaza Hussain: Welcome to Intercepted. I’m Murtaza Hussain.

The last few days have seen a tremendous escalation in violence in the Gaza Strip, with hundreds of Palestinians reportedly killed and wounded in the course of an Israeli military operation aimed at rescuing four hostages being held by Hamas. Authorities in the Strip announced that 274 people were killed in Israeli strikes on the Nuseirat refugee camp, along with over 400 wounded. Among the dead in those attacks included 64 children, according to local health authorities.

Very few hospitals continue to operate in the Gaza Strip amid a brutal Israeli military campaign that has now stretched into its eighth month. The staggering increase in civilian dead and wounded in the attacks this week has stretched the remaining healthcare infrastructure in the territory to the brink, and there’s little prospect of an end to the carnage in sight.

Joining me now to discuss the situation, as well as what she herself has witnessed in recent days, is Karin Huster, a medical coordinator with Doctors Without Borders, currently working at Al-Aqsa Hospital in Gaza. Due to the conditions in Gaza, the connection and audio quality are not optimal, but we’re very grateful to have her joining us today.

Karin, welcome to Intercepted.

Karin Huster: Thank you for having me.

MH: Karin, just before we were about to begin recording, you had to suddenly leave and transport from a different location to another for security concerns. Can you tell us a bit about what’s going on on the ground in Gaza, where you are presently?

KH: We are in the town of Deir al Balah, which is in the center of Gaza, and it has been receiving some pretty intense attacks from the Israeli forces for the past, I would say, 10 days. At the same time as the town of Rafah, which is south of it, also has been under attack.

There are activities every day. And so, sometimes we have to adjust times that we leave the office to go home. It’s just the way of life in Gaza.

MH: Karin, you’ve been working in the Strip on a medical mission for Doctors Without Borders. Can you tell us a bit about the context of the mission that brought you there, how long you’ve been there, and what the overarching support role is for the medical system in Gaza?

KH: Yeah. I am in charge of medical activities for Doctors Without Borders. We’ve been in Gaza for many, many, many years, and we were doing quite high-level reconstructive plastic surgery for victims of war before October 7. And then, when October 7 happened we, of course, had to pivot activities and focus 100 percent on supporting the health system to respond to the needs [of] wounded patients, the collapse of the healthcare system. So, strengthening the primary healthcare system, looking at malnutrition, supporting vaccination. We are one of the actors trying to make sure that the health system doesn’t completely collapse.

We have activities in Rafah, and we were there at first because, as you all know, the internally displaced people had moved to the south. Everybody had moved from the north to the south at the orders of the Israeli forces. And so, this was obviously the most critical place for us to be.

We started primary health care activities. We did maternities, maternity support, antenatal care, postnatal care, deliveries. We are doing trauma care — so, support to hospitals — but [also] doing surgeries and plastic surgeries, orthopedic surgeries.

And then, as the war started to come closer to Rafah and then into Rafah, we moved our activities so that we put them where the people now are, with Deir al Balah. We were already in Deir al Balah at Al-Aqsa Hospital, where we had some surgery activities related to victims of war wounds, and we had escort to the emergency department of Al-Aqsa hospital. And what we did when the people were displaced north towards Deir al Balah, we started this primary health care programming again, because people didn’t have access to care. So, that’s where we’re at.

Something else we did in Rafah before we left was, we had a trauma stabilization point, which was right behind the front lines when Israel was attacking. We were fearing that Israel was going to invade Rafah; this was on the news for many weeks. So, we had prepared a trauma stabilization point which would stabilize patients that were received from the front lines. And then referred to field hospitals or other hospitals within Gaza.

So, we did that for two weeks. And then, when it became too dangerous, we closed that. And now we’re exclusively in Deir al Balah, but also looking at the north to see if there are some activities we can start there.

MH: Karin, the past week has seen a huge uptick in Israeli military operations, particularly one operation aimed at rescuing a number of hostages held by Hamas. Can you describe the aftermath of this attack, which took place in or around Deir al Balah, and reportedly resulted in tremendous civilian casualties, including at the hospital that you were working at?

KH: Yeah. So, it wasn’t one attack. As a matter of fact, it started with an attack in Deir al Balah itself, not far away from our office. And that attack was the first event that happened that day. It was a huge explosion, and it generated a lot of victims; wounded and dead. And all of those casualties were brought to Al-Aqsa Hospital.

Maybe half an hour after this initial attack in Nuseirat, which is a little bit north of Deir al Balah. Nuseirat was attacked by the Israeli forces — a very intense attack, as we now are learning — and that also resulted in a tremendous caseload of patients and many fatalities that were initially brought to Al-Aqsa Hospital, which is right next to Nuseirat. But it’s a very small hospital with not a lot of capacity.

And so, everybody was brought to Al-Aqsa Hospital. Al-Aqsa Hospital is the only Ministry of Health hospital that is still standing in the middle area. And, as a matter of fact, in the south, period, there are no more hospitals in Rafah, aside from two NGO field hospitals. And so, all victims are brought to Al-Aqsa Hospital, pretty much de facto. There is no incident command center, and the communications, as you know, are very poor, so everybody is brought to Al-Aqsa Hospital, regardless of Al-Aqsa Hospital’s capacity.

To start with, on June 8 — that infamous day — was already extremely poor. The past week had seen two huge mass casualty events. With that, an overpopulation of patients and internally displaced patients in the hospital. So, the hospital normally has a bed capacity of 250. Before June 8, [it] had 600 patients in that hospital, plus several hundred internally displaced people who believed that it is safer to be on the ground sleeping in a hospital than being in a plastic tent. I think they’re right.

That’s sort of the situation to set you up. These events happen. The hospital is completely overloaded. It felt like a 747 had crashed, and all the victims, the wounded, and the fatalities were brought to Al-Aqsa Hospital. Completely unable to manage, obviously, such a caseload, when we arrived, pretty much the entire floor of the emergency department, which is relatively big, was full of patients on the grounds. No mattresses for them. Critical patients, patients who were expectant — so on their way to dying. Kids, moms, young women, adults, elderly people. Everything.

They attacked in the middle of the day, people were going to the market. There was no warning to those attacks. So, obviously, the impact was massive. The scene was really difficult. It’s very difficult for us to see three-year-olds, to see young adolescents being there with enormous wounds that will affect them for the rest of their lives if they survive. It’s really difficult to see scenes like that. So, a very, very intense situation. It was super-hot inside. It smells, you know? The smell of warm blood that just impregnates you, because so many people are bleeding.

And so, we just spent our time. We went there, two nurses and one physician, and then we had our wound care clinic staff that we also moved to the emergency department. And, basically, you work in the chaos, you know? There is no time for fancy anything. You have survival kits, you cut people’s clothes so that you can reach the wounds. You pack wounds, you stop the bleeding. You try as best as you can to stabilize patients, so that they can wait for when there is a time for them to go to the operating room, or for them being transferred to another facility, if that is an option.

MH: And Karin, as you mentioned, there are very few medical facilities still operating in Gaza in general, but also in the region you’re operating in. Also, Gaza is also subject to an effective blockade, with the result in decrease in access to medical materials, and so forth.

How is this strangling of the health care system impacting the ability to deal with these very catastrophic and large numbers of wounded and dead coming into hospitals?

KH: Well, I mean, the math just doesn’t work, right? You have less and less structures and more and more patients, more and more victims. So, I’m not a math expert, but when you reduce the bed capacity but you increase the wounded, you increase your attacks, your strikes on the civilians, you won’t have enough space for people to have a bed. You won’t have enough healthcare workers to attend to all of these victims. You won’t have enough operating rooms to operate in. You don’t even have enough fuel to go and get the patients with your ambulances, and you won’t have enough supplies or medical equipment to take care of everyone. That’s absolutely a nightmare.

For us, it’s been since May 7th that the Rafah crossing between Rafah and Egypt has been closed. There have been very, very few things, very, very few trucks that have been able to come across. Certainly, for Doctors Without Borders, we’ve had no medical equipment, no medicines that have been able to enter. So it’s a situation that, if the status quo remains, it would worsen everything, and it will definitely worsen the outcome for the poor patients who have been able to survive these massacres.

MH: Karin, you’re obviously attending to a population which is undergoing incredible trauma, and it’s been about eight months now this military defensive has gone on, and all the human and social impacts of it on the people of Gaza.

What have you observed, in terms of how people are coping or not coping with these attacks? It seems almost unthinkable, but you’re seeing it firsthand, the impact on this population. How is this affecting Gazan society? How is it transforming people in ways people may not be expecting?

KH: It’s shocking to me every time I look at some — I don’t speak Arabic. So, really, my way of speaking is through my eyes and looking at people. And every time when somebody comes with me in the emergency department with their child who is very severely wounded, or they are calling me to show me their grandmother, begging me to do something about it. And they just raise their hands in helplessness.

Part of them is just empty. They’re just in automatic survival mode. They have no choice, right? If they live, they live. But they really ask all the time: What kind of life is that? Some of my colleagues have told me that I’d rather be dead than going through this day in and day out with no hope that this is going to be finished.

But, really, for me, still— For example, the healthcare workers, I find that they are incredibly resilient. I think if this were to happen in the United States, we would absolutely not have the capacity and the resilience, the wherewithal to withstand such a repeated assault on our population. We’re just not used to that. Gazans are used to this. It’s been happening for decades and decades, and I think it helps them cope, in a way, with this, right?

But their eyes are tired, they’re empty. It’s difficult. They show me their kid, and what is it that we can do? Yet they are not angry. They’ve never been angry toward me or towards my other colleagues. It’s just helplessness.

I think they know that they were not counted before, that they were not thought of as Palestinians. But they do know now that the world is watching. It’s not doing enough, but the world is watching. And they are very thankful about this, and It brings them hope. Many people have told me that.

MH: Karin, during the time you’ve been in Gaza, are there particular cases emblematic of the human impact of the war that have stuck in your mind? Either patients at the hospital or scenes you’ve witnessed in the territory. Are there particular stories or individuals that you think people should know about?

KH: Yeah. The most recent one happened on June 8th, when we responded to this Nuseirat incident.

When we entered the emergency department, it was complete chaos. We all figured out how to dance in this chaos, and I started to know my area and all the, I don’t know, maybe 80, a hundred patients that were lying there. Two struck me pretty hard, even though I’m usually pretty good at blocking it, especially in the heat of the moment.

But one was this little kid. She was three to four years old, I don’t know. And she was lying in the fetal position on the ground. Nothing, no mattress, no nothing. She was alone. Usually, in Palestine, everybody, if you can, you always have somebody that accompanies you. And, if you’re young like this, it will always be your parents.

But she was alone, and behind her was an elderly woman, completely confused. And people were bleeding everywhere. This was an intolerable scene for us, let alone for a little kid. And my eyes were just focused on this kid who was in this fetal position. Cold, completely wet from her blood. She had a big head wound.

And so, I asked, left and right. I said, is this your kid? You know, with gestures. And, “no.” My first reaction was, I’m just going to carry her. I can’t leave her on the ground like this, this baby. I have children. And so, I asked the person next door, can you at least check in on her?

And I would do my rounds, and then come back, and see this kid. Then, eventually we took all her clothes off, and wrapped her in a survival blanket, still completely on the floor, and gave her some pain medicine. She fell asleep. And, eventually, her uncle came.

I couldn’t even imagine what was going on in her little brain. The woman who was right behind her was actually the aunt of one of our pharmacists, whose house in Nuseirat was the victim of all the shooting that happened, and the missiles. And our pharmacist lost two family members; one who was three years old and another adult cousin.

And this aunt was severely wounded, completely confused. It was clear that maybe she had dementia on top of it, but she was absolutely confused. She would be falling on the ground. Normally, if you were in the United States, somebody like this is given, first of all, all the medicines to calm them down, but is given, also, all the right care immediately, and the attention from one nurse because that patient is so confused.

But there, she was just left to her own devices. And it really pained me to see that this is what was the result of these strikes, these repeated strikes that have been happening on Gaza. It’s these stories that just hurt you.

Back in January, I was in Gaza in January/February. And, on our way, our driver said, “You know, Karin, they killed a fisherman this morning.” So, the Navy is out there, and they bomb if fishermen are beyond a particular distance from the beach. And so, he was just killed, you know? He was fishing. Just fishing.

And then, the last one, that’s not really a story about anybody; it’s maybe the story about everybody. But when I was there in January, we were there while they were destroying Khan Yunis. It was intense every night of the five weeks that I was there. And every time I heard the plane go around, I would know when the bomb would drop, because you get used to the patterns and the time that you wait. During the days when that happened, you’d see the smoke. But every night I would hear the bomb and then [explosion sound]. And I would think, that’s it. That’s one family that’s gone.

That haunts me all the time. This big explosion, for me, is the soul of one Palestinian family going to heaven. Being blown to smithereens and going to heaven. It’s not one person’s story, but it’s, for me, the people of Gaza’s story. And that hasn’t left me.

A little bit less now, but definitely in January/February, every time I heard this noise, it was poof, one family, gone. Poof. One family, gone.

MH: Karin, thank you so much for sharing that.

A number of Doctors Without Borders’ family members have been killed or wounded in the war since it began. Can you talk a bit about the risks that the medical workers and their families have faced since the start of the conflict?

KH: Well, our staff are — and I will talk about my Palestinian colleagues, not the international medical staff — but Palestinian colleagues not only are healthcare workers, but they’re also Palestinians. So they live with the same dangers [as] the other Gazans. They also live in areas that are unsafe. Nowhere in Gaza is safe.

So, they can also be the victims of strikes. And then, at the same time, they have to care for others, they have to care for their Palestinian co-patriots, they have to care for the wounded in the hospital. So, they have this double duty and this double weight on them, which is really, really difficult.

Some of them have left to Egypt, but many are choosing to stay. And, for many, it is, in any case, a super-painful choice to make. Sometimes they do it because they have very young children and they want to save them, you know? Exactly what we would do if we had the opportunity to leave.

But some stay. One of my colleagues, Dr. Sohaib, he’s staying here, and he sent his wife and his young daughter to Egypt. He had to pay about $10,000 for the two of them, and he’s chosen to stay with us, and to work to help the Palestinian people.

MH: You’ve worked with Doctors Without Borders missions before in other countries, including wartime situations, such as in Iraq during the war against ISIS. What can you say is different about the situation in Gaza?

KH: I think, first of all, we have a population that’s prisoner, right? We have a population that’s stuck in an enclave with no choice to get out. It’s a population that’s been abused through decades of Israeli, either occupation or Israeli oversight and control. And now it’s been the victim of relentless attacks by a military that’s one of the most sophisticated militaries in the world, with no moral compass whatsoever.

And so, it’s a military that has no hesitation to kill, to have huge collateral damage, to strike one particular target that they might have. And so, that I think is very unique, to have a country that calls itself a democracy but that behaves in a way that has completely lost any sense of humanity. It’s unique to me. I’ve never seen something like that.

MH: Karin, given that the Israeli military is carrying out these attacks in one hand with grave disregard for civilian casualties at best, at the same time, it’s controlling the access to this population, which is cut off from most international press. Its access to medical aid and food aid is very restricted.

How are these two dual pressures making this humanitarian situation worse? And I could ask how, if you had access to a free flow of medical supplies, how would that change the situation? And how is the current situation exacerbating the amount of death and chaos taking place in Gaza at the moment?

KH: Well, I think there is no question that, if we were able to scale up — which is something that we’ve been asking for eight months, besides asking for a ceasefire and a permanent ceasefire — but also, if we were able to open the Rafah crossing, Kerem Shalom, or any other crossing to let the aid go in, to let food go in, to let humanitarians go in, humanitarian aid, so that we could scale up to the needs, it would most certainly help patients to have better outcomes. It would help them survive things that people may not have survived. It would be able to save limbs that maybe today are amputated.

We can’t send anybody. There is a list right now of patients that the U.N. has, and it’s a list of 25,000 patients that should be referred outside of Gaza for further tertiary care. That’s not just victims of trauma; it’s also oncology patients, right? So, cancer, a variety of conditions. It could be congenital diseases, kids with malformations that could be completely resolved with surgery, if we had access to surgery here.

And so all, all of these folks, 25,000 of them are waiting, hopelessly waiting, because there is not one border that is open for them to cross, to get that so-desperately-needed care.

MH: Karin, tens of thousands of people are reported to have been killed since the start of the war, and the true figure may not be known given the number of people buried under rubble in airstrikes and so forth since it began last October. Of course, many, many of those are believed to be innocent civilians, including men and women.

But, particularly in Gaza, given the young age of the population generally, it seems that a disproportionate number are also children. Can you talk a bit about the impact specifically on children that you’ve seen as a medical worker in Gaza, of the war, and of these IDF attacks?

KH: Right now, when I look at kids, I look at kids who have nothing to do. There is no school, obviously. There is not even a system, because humanitarian aid is so scarce, we can’t scale up. You don’t have the usual actors in the Gaza Strip that are able to provide some activities or some education to all the children of Gaza, or at least even to some. It’s very, very restricted.

So, you have kids who are just doing absolutely nothing, who are losing, right now, eight months of schoolwork. This is huge. I mean, there are students who were going to be doctors, who were going to be lawyers. It’s an economy, it’s a society that’s going to be wounded and maimed for the long term. These things will have repercussions for decades. The future is just bleak for them.

On top of it, I think you are going to see — and this is just an observation — but when I see the number of children with amputations, we are going to have to deal with the biggest cohort of amputated children in the world. And we don’t even have access to prosthetics, we don’t even have access to good follow-up for these children as they grow. To change the prosthetic, to do some limb adaptation, all the things that come with having an amputation. That’s fancy magical thinking. We hardly can save lives, so forget about doing what we need to do for kids with amputations.

It’s really sad, when you think about that.

MH: Karin, you’re there on the ground right now and dealing with the full force of the implications of this military campaign and the impact on the civilian population. In the United States, there’s still debates and the discussion of pushing for a ceasefire in Gaza.

Is there a message you’d like to send from Gaza at the moment to the rest of the world about what should happen and what needs to happen there going forward, for the sake of the humanitarian situation?

KH: People in the United States, people around the world have to stop thinking of Palestinians as this — I don’t know what people think about Palestinians — but they have to believe, they have to think of Palestinians as being just like them. They are people who love to go to the beach during the weekend, to hang with their families, to do a barbecue, to go and smoke shisha together. Women [like] to get together and talk, they like to do sports. Just like us, there is no difference. They should have access to that same freedom.

Macklemore, I think, had a line in his song that said, “what if you were in Gaza? What if those were your kids?” And that’s what we need to do.

Macklemore [Singing “Hind’s Hall”]: What if you were in Gaza? What if those were your kids? If the West was pretending that you didn’t exist, you’d want the world to stand up, and the students finally did. Let’s get it.

KH: We need to think about, what if this was us? What if this were us in Gaza? These were my kids, that was my son who was amputated, my daughter who died. Maybe then, when we internalize things a little bit more, would we really pick up the phone, call our congresspeople, call our representatives, and put relentless pressure on them and on our government, and on governments around the world. To not just keep talking, but to actually do something.

I am heartened by the number of people here. There’s a small cohort of people in Gaza that are taking the risk to come here, and to tell the people of Gaza that we are thinking about them, that they are worth being saved, that they are worth fighting for. And I know there is the same happening in many places around the world. I’ve seen the young people really stand up for Palestinians, but I want to see the older people like me, the forties, the fifties, the sixties. I want them to stop being silent.

People are being silent, and they seem to be ashamed of voicing their disagreement of these inhuman strikes, repeated inhuman strikes on the people of Gaza. Like, what is wrong with people, that you don’t feel comfortable to criticize a government that has been completely ignoring the international humanitarian laws for eight months, now? Since when is this wrong, to tell somebody that what they’re doing is unacceptable and that they need to stop?

And, for the United States, it has the power to stop them. So, what is it doing? What is it waiting for?

MH: Karin Huster, thank you for joining us on Intercepted.

KH: You’re very welcome. Thank you for giving me the time to come to your show.

MH: That was Karin Huster, a medical coordinator with Doctors Without Borders, currently working at Al-Aqsa Hospital in Gaza.

And that does it for this episode of Intercepted.

Intercepted is a production of The Intercept. Laura Flynn produced this episode. Rick Kwan mixed our show. Legal Review by David Bralow, Shawn Musgrave, and Elizabeth Sanchez. This episode was transcribed by Leonardo Faierman. And our theme music, as always, was composed by DJ Spooky. And special thanks to Ali Gharib.

Thank you so much to our supporters and listeners. If you haven’t already, please subscribe to Intercepted and our other podcast, Deconstructed. Also, do leave us a rating and review whenever you find our podcasts. It helps other listeners to find us as well.

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Thank you so much for joining us. I’m Murtaza Hussain.