Areej
Hijazi
I
am Dr. Areej Hijazi, an obstetrician and gynecologist. Before the October 2023
war, I worked at al-Shifa Medical Complex in Gaza, and now I work at the
Emirati Hospital in Rafah. In this article, I will discuss my experience as an
obstetrician and gynecologist during the Gaza genocide.
Relatives of the Palestinian baby Bassam El-Maquse who was killed in
Israeli attacks, mourn as they receive the his body from the morgue of
Al-Aqsa Hospital for burial in Deir El-Balah, Gaza on March 22, 2024.
(Photo: Ali Hamad/APA Images)
The
war began while I was on duty in the obstetrics department at the al-Shifa
Medical Complex. I remember the fear on the faces of most of the patients as
they suffered from labor pains amid the sound of the missiles.
Pregnant
women are the hidden victims in this war. I worked at al-Shifa for a month
during the war, and then my work was transferred to Al-Helou International
Hospital due to the large number of injured people. Al-Shifa’s maternity
building was converted into a building for the wounded and injured of the war.
On
November 1, when I was working at Al-Helou, I was taking a break in the
emergency room after an exhausting shift. Soon, the thunderous sound of
relentless shelling startled me awake. Israeli tanks were bombarding the
hospital and its surroundings, targeting the fifth floor which is where all the
cases from al-Shifa’s obstetrics department had been transferred to.
Fear
gripped me. Everyone was in a state of panic, rushing outside. Pregnant women
and patients still attached to IV fluids and urinary catheters were fleeing
barefoot in sheer terror.
In
that instant, I comprehended the extent of devastation Israel planned to
inflict upon us. It was then that I resolved to move south to safeguard my life
and the lives of my family.
I
was displaced to Khan Younis and worked at Nasser Medical Hospital. Then, in
January, I moved to Rafah to work at the Emirati Hospital where I have stayed
until now.
My
patients’ stories
There
are many patients that I remember along the way.
One
patient I will never forget is Shahd Al-Qatati, 20 years old, even though it
has been an entire year since I treated her. She had been transferred from the
trauma department to check on her fetus due to its lack of movement. I will
never forget her face on that day—a young, beautiful, calm girl in a state of
total shock. She had fallen from the third floor of her house after a missile
hit it. This had led to the martyrdom of her husband. They had only been
married for a few months. One of her legs was amputated, and her other three
limbs were broken. Now she needed a cesarean section due to the loss of her
fetus in her sixth month. Shahd was forced to suffer the pain of loss and the
pain of the cesarean section together.
I
also remember the patient M.A., 19 years old, who I cared for when she was in
her second month of pregnancy. She came to the maternity reception accompanied
by her father and sister, suffering from a high fever and vaginal bleeding. Due
to the dangerous situation in northern Gaza, she could not come earlier. She
came to the maternity reception at the al-Shifa Complex on the day our
department was being transferred to another hospital. Her condition required
intensive care as she was diagnosed with an aseptic abortion. There were no
intensive care beds available, as they were filled with war injuries. She was
transferred to a hospital without intensive care, and she died within 24 hours.
I remember her as if I was with her yesterday. It was her first pregnancy.
As
you can imagine the genocide is complicating access to essential healthcare,
which exacerbates the conditions faced by mothers and pregnant women. I am
reminded of one of my recent patients,
Salma, who came to the maternity reception last month. She has only one
child and was hoping to give him a sibling. Salma told me she had missed three
months of follow-up appointments because she had been repeatedly displaced
during the ongoing genocidal war. She came to the hospital after not feeling
any fetal movement in the last 24 hours. Tragically, the ultrasound scan
revealed no fetal heartbeat, indicating that she had experienced a miscarriage.
It
is not just the war that is killing the innocent; the effects of rockets,
bombs, and toxic smoke in the air, inhaled by pregnant women, lead to many
complications, the most significant of which is miscarriage.
Just
last week, during my conversation with one of the patients, M.R., 27 years old,
she told me that she had her first baby after five years of infertility, but
her baby was martyred in this war at the age of four months. M.R. went through
deep psychological trauma but soon became pregnant again. She came to the
hospital because she was experiencing lower abdominal pain and wanted to check
on the fetus. I didn’t know how to tell her that she had also lost her second
baby before he was born.
Current
conditions
Many
doctors have refused to evacuate from the north to the south and insisted on
staying in the north to serve the patients there. The situation in the north is
worse than in the south, especially in the Jabalia area, which suffers from
daily massacres, artillery shelling, and sniper attacks on citizens up until
today.
Pregnant
women in northern Gaza have been attempting to access Kamal Adwan Hospital and
Al Awda Hospital, but with the intensified bombardment prenatal care is almost
nonexistent, and reaching health facilities is extremely difficult. In many
cases, pregnant women who need to undergo a cesarean section are refusing to
stay in the hospital even overnight because hospitals and their surroundings
have been repeatedly targeted by Israeli aggression. Many chose to attempt to
recover in overcrowded schools that lack basic living necessities out of fear
for their lives.
With
the continuation of the Israeli aggression and the closure of the Rafah
crossing, hospitals, and health clinics are suffering from a shortage of
medicines and a scarcity of sanitary pads. Currently, despite their necessity
for all women, their price has doubled or even more.
The
significant increase in the use of contraceptive pills, which are no longer
available in UNRWA centers or pharmacies, coupled with the closure of the Rafah
border crossing, is exacerbating the humanitarian disaster.
The
situation in Gaza is indeed appalling. The collapse of medical institutions and
the increase in pregnancy complications due to the ongoing conflict is
alarming. The rise in cases of gestational diabetes, pregnancy hypertension,
early miscarriage, fetal deformities, premature placental separation, uterine
rupture, postpartum hemorrhage, and even postpartum depression are clear
indicators of the severe impact on maternal health.
The
absence of a health education system to teach women further complicates
matters.
Although
these factors are not communicated in the numbers and statistics shared about
the war, these are all realities that communicate the horrific truth of the
Gaza genocide.
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