Jason Staines writes:
A high-profile British surgeon who volunteered in Gaza has described horrific scenes, including of Israeli drone attacks that targeted injured children, and operating rooms devoid of basic medical supplies.
Professor Nizam Mamode, a retired NHS surgeon, told the UK Parliament’s International Development Committee this week of children targeted by drones in what he characterised as deliberate acts of violence.
“I was operating on children who said, ‘I was lying on the ground after a bomb had dropped, and a quadcopter hovered over me and shot me’,” he said.
The injuries he treated revealed the calculated nature of the attacks: small cuboid pellets fired by drones that ricocheted inside the body, causing extensive internal damage. “The youngest I operated on was three-years-old,” Mamode said.
“The supposedly safe zones were neither safe nor humane,” he said, likening the devastation to the Rwandan genocide.
Beyond the physical trauma inflicted on civilians, Mamode – formerly a senior transplant surgeon at Guy’s and St Thomas’ NHS Foundation Trust and honorary consultant at Great Ormond Street Hospital – described the catastrophic state of Gaza’s healthcare system.
Doctors were forced to perform surgeries without basic medical supplies, including swabs and sterile gloves. Hospitals that were once well-equipped and staffed with skilled professionals had been systematically targeted, leaving the healthcare infrastructure in ruins.
A BBC report of his testimony said Mamode was overcome by emotion as he described drones picking off children and civilians.
“What I found particularly disturbing was that a bomb would drop, maybe on a crowded, tented area and then the drones would come down,” he told MPs.
Dismantling UNRWA would be ‘catastrophic’
Meanwhile, UNRWA Commissioner-General Philippe Lazzarini has painted a grim picture of Gaza’s spiralling health and humanitarian crisis.
In an address to the United Nations General Assembly on 13 November, Lazzarini said “UNRWA is a casualty of the war in Gaza”.
The potential dismantling of UNRWA would be catastrophic, not only for Gaza but for Palestine refugees across the region, he warned.
“If the agency cannot operate in the occupied Palestinian territory, the responsibility for providing services to Palestinians — and bearing the cost — will lie with Israel as the occupying power,” he warned.
Yet, with 17,000 UNRWA staff in Gaza fearing for their jobs and lives, the agency’s ability to continue its mission is under severe threat.
Lazzarini’s appeal to Member States included three urgent requests: preventing the implementation of Israeli legislation targeting UNRWA, ensuring continued funding, and establishing a clear role for the agency in any political transition.
Without immediate action, the humanitarian collapse in Gaza could deepen further, with Lazzarini warning of catastrophic consequences if UNRWA is forced to cease operations. He said dismantling the agency would not terminate Palestinian refugee status, but would deepen their suffering, leaving over 660,000 children without education and hundreds of thousands without primary healthcare.
Lazzarini’s warning came amidst an escalating famine, crumbling healthcare infrastructure, and growing concerns over antimicrobial resistance (AMR) in conflict settings.
Gaza’s healthcare system in freefall
As the conflict continues, Gaza’s healthcare infrastructure is barely coping.
Over half of its primary health centres are non-functional, and hospitals are operating at diminished capacity. The United Nations Population Fund (UNFPA) reports soaring maternal deaths and a surge in premature births, driven by severe hunger and trauma among 155,000 expectant and new mothers.
Meanwhile, humanitarian access remains severely restricted and the World Food Programme (WFP) has described Gaza’s food markets as “in decay”, with fresh foods scarce and prices soaring.
Attempts by the UN to deliver critical aid have been systematically blocked, particularly in northern Gaza, where famine thresholds may have already been crossed.
In its latest update on conditions in Gaza, the UN Office for the Coordination of Humanitarian Affairs (OCHA) said: “Access to medical care has been severely affected by Israeli military actions in North Gaza. As Kamal Adwan hospital came under intensified threat from fighting and critical medical supplies dwindled, requests to transfer severely ill patients to Al Shifa hospital were denied on 8 and 9 October, only to be permitted on 10 October.
“On 12 October, during the transfer of critically ill patients an ambulance driver was stripped, blindfolded, and restrained at a checkpoint by the Israeli soldiers, despite being part of the approved convoy. Israeli soldiers also instructed a UN staff to position their vehicle so to shield military personnel during this incident.”
A silent epidemic
Amidst the visible devastation, a silent but deadly threat looms – antimicrobial resistance (AMR).
Médecins Sans Frontières (MSF) says Gaza is a stark example of how conflict accelerates AMR.
Years of blockade and war have left its health system fragmented, with limited access to diagnostics and effective antibiotics. Hospitals are overwhelmed by infections resistant to first-line treatments, particularly in trauma patients and newborns.
MSF data reveals that multidrug-resistant organisms are prevalent in Gaza, with 60 percent of isolates from osteomyelitis patients resistant to standard antibiotics. These infections, compounded by inadequate infection control and water, sanitation, and hygiene infrastructure, have exacerbated already dire health outcomes.
Crisis in Lebanon
Meanwhile, Israeli airstrikes have killed over 3,300 people, including 203 children, and displaced nearly a million more in Lebanon as the conflict widens.
Humanitarian agencies are struggling to provide aid, with attacks on residential buildings and healthcare facilities compounding the suffering.
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