Gazan doctors forced to choose which children to save

“It is difficult for us to choose a child and give them priority over another child so that they can live”: Doctors forced to make heartbreaking decisions over babies’ lives in Gaza amid soaring demand and equipment shortage.

As World Health Day is marked globally today, doctors in Gaza are having to make impossible choices about which sick babies to save amid a severe shortage of equipment and a sharp increase in patients.

Aaliyah, a 32-year-old doctor who works in the nursery department of Al Hilal Emirates Hospital in Rafah, which specialises in maternity and infant healthcare, told ActionAid that there were not enough incubators for the number of newborns in need, forcing staff to decide which babies to prioritise.

In a video message, she said:

“There are many cases that require artificial respiration, but there are [not enough] devices for them…We have reached the point where we are choosing between cases; Who has a [health] priority to put [them] on a ventilator? It is difficult for us to choose a child and give [them] priority over another child so that [they] can live.

“Each incubator is supposed to [support] one child. But due to the war and the accumulation of cases, we must have three or four [babies] in [each] incubator…we are forced to do this because there are not enough incubators available.

“The total number [of babies being treated] in the nurseries [ward has reached] 70, and this is a disaster. There are 20 cases that came from Al-Shifa Hospital. After Al-Shifa Hospital was besieged, we received [their] incubator cases. The number of displaced people in Rafah [became] very large. This meant the hospital [has had to] accommodate a larger number because the number of births [in the area] has increased.”

Living conditions in Rafah, which is now hosting a population more than four times its usual capacity, are so dangerously overcrowded and unsanitary, while food and other essentials are in such short supply, that patients are arriving at the hospital severely weakened and with complex health needs. Aaliyah said:

“Cases [that have come] from tents… [arrive here] in a very bad situation. With every shift, two or three infants die, due to infection and because of the health situation in Gaza… There are cases [which are in] a very difficult situation. A woman gives birth here and is already suffering from stress and anxiety, and this affects her infant. The infant is born tired, and [they have] difficulty breathing, and therefore [they] need more care. We cannot provide [them] with this complete care… There are babies that [have been born in] tents and have suffered from extreme cold, and therefore we lose these children. In addition, the mother herself cannot breastfeed due to the lack of food, drink and nutrition, this increases the burden on us.”

Six months of bombardment and limited access to aid have driven Gaza’s health system to the brink of collapse, with only 10 hospitals left partially functioning in the territory. Following a two-week siege, Al-Shifa Hospital – the largest in Gaza – has been reduced to ruins and is unable to function, putting further pressure on other health facilities. Since October 7, the World Health Organisation (WHO) has recorded at least 100 health facilities – including 30 hospitals – affected by attacks. This is unacceptable: hospitals and health facilities have protected status under international humanitarian law and must never be a target.  

Without enough food and safe water, people’s health is deteriorating daily. At least 27 children have died as a result of malnutrition and dehydration so far, according to health officials in Gaza. Meanwhile, doctors at Al-Awda Hospital in northern Gaza, run by ActionAid’s partner Al-Awda, tell us of having to operate on women who have lost their babies late in their pregnancies because they are so malnourished.  

Riham Jafari, Advocacy and Communications Coordinator at ActionAid Palestine said:

“Gaza’s health system is in total crisis, with the few hospitals that are functioning desperately struggling to address the needs of an ever-growing number of patients while experiencing a major shortage of staff, equipment, medical supplies, fuel, safe water and food. It is devastating to hear of the heartbreaking decisions that exhausted and overwhelmed medical staff are having to make about which patients they can treat and which they are unable to help.  

“Hospitals simply cannot function without more aid supplies. While we welcome the long overdue announcement that two additional entry points for aid will be opened at the Erez crossing and the port of Ashdod, this will still not be enough to ensure aid on the scale required can enter Gaza, especially if these new crossings are plagued by the same delays and red tape as the existing ones. And we are deeply concerned by the Israeli government stipulating that these openings will only be temporary.  

“The only way to ensure aid on the vast scale required can enter Gaza and reach those in need, as well as put a stop to the killing and injuring of Palestinians, is a permanent and immediate ceasefire. As this crisis reaches the devastating six-month milestone, and as the UN Security Council resolution for a ceasefire passed almost two weeks ago remains unenforced, states must use every diplomatic lever available to them to pressure Israel into ending its military operation in Gaza – including ceasing arms sales and imposing sanctions.” 

Quotes attributable to ActionAid Australia Executive Director Michelle Higelin:

“The situation facing children in Gaza and the absolute breakdown of health systems is unacceptable, and the only solution is for the international community to push for a permanent ceasefire,” said Ms Higelin.

“We know pregnant women and those with newborns are especially suffering at the moment due to the lack of safe water, food and appalling living conditions, on top of that women often eat last or not at all so they are the ones going the most hungry,” said Ms Higelin.