In May 2024, Dr. Adam Hamawy began his first medical aid mission in Gaza, joining scores of humanitarians desperately trying to save as many Palestinian lives as possible amid an Israeli bombardment tantamount to an assault on the health care system.
The New Jersey plastic surgeon was no stranger to providing medical assistance in conflict zones. Hamawy delivered aid during the Bosnian genocide on behalf of the United Nations as a medical student, treated the initial casualties at a burn center on 9/11 as a resident in New York City and helped save Sen. Tammy Duckworth’s (D-Ill.) life more than a decade ago, while both were deployed by the Army during the Iraq War.
None of those missions prepared the doctor for what he would see in Gaza.
Hamawy and his team arrived six days before Israel closed the vital Rafah crossing to the south, temporarily trapping them inside the territory, while the United States continued to supply the bombs raining above what Israeli officials had deemed a “safe zone.”
To HuffPost, he described his time at European Hospital in Gaza, where most of his patients were children: “There was a wide variety of wounds, very typical combat wounds that were a combination of explosive injuries — which are both burns, traumatic amputations and penetrating injuries — as well as internal injuries from the trauma that occurs with large explosives.
“You know, bombs falling on patients, and all the shrapnel and debris that goes into their bodies,” he said.
Dr. Adam Hamawy via MedGlobal
Israel began its military offensive in Gaza after Hamas militants killed 1,200 people and captured about 200 in an October 2023 attack on southern Israel. As of Tuesday, Gaza’s Government Media Office says that Israeli forces have killed more than 61,700 people, saying thousands of missing Palestinians buried under rubble are presumed dead. Some international organizations now describe Israel’s actions as genocide.
After 15 months, Israel and Hamas agreed to a pause in fighting to exchange hostages and allow surviving Palestinians in Gaza some semblance of peace. But the territory’s health care system has been decimated, and rebuilding it will be a long-term project — one international medical workers like Hamawy hope they can help.
“There’s really been a call for plastic surgeons, there’s a call for orthopedic surgeons, there’s a call for trauma surgeons,” he said. “And when you see that call going on and no one is answering, what other choice do you have? How do you sleep at night and know that you’ve not answered that call? What excuse could I give when you compare yourself to the Palestinians and what they’re going through? So that’s my reasoning. I have no excuse.”
Hamawy spoke exclusively with HuffPost for this story — once in January before his post-ceasefire mission, and once this week, after he returned to New Jersey — to give an eyewitness account of what providing medical aid was like during the offensive, and how it compared with conditions there after the ceasefire went into effect.
“One of the loudest voices against this [war] has been the doctors and the nurses coming back and speaking out, because we have witnessed it, we did see it with our own eyes,” he said. “And unlike most of the outside journalists who aren’t allowed to be there, it’s really the humanitarian aid workers that have experienced this and survived it. So we’re coming and saying, this isn’t fake news.”
Anas Zeyad Fteha/Anadolu via Getty Images
Israel’s decimation of Gaza’s health care
During the offensive, Gaza’s hospitals were frequently subjected to Israeli raids that detained or sometimes killed Palestinian health care workers and patients. Photos and testimony depict Israeli soldiers forcing health workers and patients to line up and kneel while stripped, bound and blindfolded.
“These are our colleagues — they are being targeted, they are being tortured, they’re being abducted for the crime of caring for their patients,” Dr. Adlah Sukkar said on Wednesday, speaking as part of a coalition of health care workers in the U.S. that’s demanding an end to Israel’s attacks and the U.S. government’s support for them. Sukkar said that Israeli forces have killed more than 200 members of her husband’s family.
One of the highest-profile cases is that of Dr. Hussam Abu Safiya, the director of Kamal Adwan Hospital and chief physician in Gaza for Chicago-based nonprofit MedGlobal. Abu Safiya has remained in detention without charge for months — first, allegedly, in the Sde Teiman camp, before he was transferred to Ofer prison, his family said last week. Israeli officials have provided little detail about Abu Safiya’s detention, only confirming his incarceration and that they consider him a terror suspect, though they have not provided evidence.
Abu Safiya, who over time has become a kind of symbol for Israel’s war on Gaza’s health care system, could potentially be released on Saturday during the first phase of the exchange. On Wednesday, Israel published footage of the doctor in captivity at Ofer, in what his family says is “yet another form of psychological terrorism.”
“Dr. Abu Safiya detailed the various forms of torture and abuse to which he has been subjected both during his unlawful arrest and throughout his arbitrary detention by Israeli forces and authorities,” said the Al Mezan Center, which is legally representing the doctor. Israeli authorities did not admit to torturing Abu Safiya, though the prison is known by Palestinian medical workers as a place where similar abuses have allegedly occurred.
Israel’s attacks on hospitals have also forced remaining medical staff to work in inhumane conditions, without sufficient medical supplies and sanitation. Hamawy alleges Israel imposed “deliberate” restrictions on humanitarian assistance, leaving it “sitting in trucks outside the borders to come in, just waiting approval.” The military has repeatedly denied the claim.
“We didn’t have enough antibiotics for our patients. We didn’t have a clean environment, so we had flies in the operating room,” Hamawy said. “We had instruments and supplies that normally are one use, that you’re supposed to use and throw away, that we had to recycle and wash — including breathing tubes that you put down into people’s lungs.”
“We didn’t even have proper soap, so we weren’t able to properly wash our hands. We had some betadine that we poured on our hands, and you kind of did your best.”
Like other aid workers coming out of Gaza, Hamawy described the layers of guilt that linger even after leaving. The guilt stems from being able to exit the territory while Palestinians remain trapped, from having access to food while Palestinians starve — and from knowing that Western governments, particularly the U.S.’, have been financially and diplomatically supporting the carnage.
Dr. Adam Hamawy via MedGlobal
A ‘more normal’ hospital experience
Hamawy intended to help out in flattened North Gaza this time around, which Israeli forces had walled off until recently. But because of the often arbitrary and stressful security process aid workers say they face at Gaza’s borders, Hamawy says he and his group had limited time in the territory and could only stay in the south. The plastic surgeon entered Gaza from Jordan last month and was assigned to Nasser Hospital. There, he said, he was surprised to see a huge backlog of elective cases that had been put off due to frequent mass-casualty events.
The ceasefire meant that Hamawy saw no patients with explosive injuries, and very few with gunshot wounds. He was able to actually tackle a long list of scheduled procedures, most of which were children who had congenital malformations like cleft lips and palates.
“This time I was really operating on children that were a year and a half or 2 years old, because they were the ones that were born during this time,” he said. “I did take care of some teenagers as well, with some facial abnormalities that needed to be taken care of. And then some revision surgeries and reconstructive things from the war.”
The facility was cleaner and quieter — partly because Gaza was finally receiving soap deliveries, and partly because the winter had killed off the insects that would prey on dying patients. Tens of thousands of displaced Palestinians from North Gaza who had been living on hospital grounds in the south began returning home, allowing health care workers to better maintain the hospital.
“This felt more normal. We were taking care of surgeries and were hopeful we were changing lives,” Hamawy said. “Children were being discharged the next day with their families to go home. I got to see them again the day before I left — I had a clinic and they all came in. They were doing well. That’s how things should be.”
Dr. Adam Hamawy via MedGlobal
More aid, but not enough
There were, importantly, more aid trucks entering the territory after the ceasefire, he said. Nutritious food was increasingly available to the public, and had drastically come down in price. The World Food Program says it has served 7 million hot meals since the ceasefire took effect — and with aid groups restarting feeding stations for malnourished Palestinians, Hamawy said, patients will have stronger immune systems to fight off infections and heal faster from procedures.
But Israel is still limiting medical aid, he added. Despite the improved conditions, only 51% of the territory’s hospitals — 18 out of 35 — remain only partially functional, according to a Feb. 2 health cluster cited in a Tuesday report by the UN’s Office for Coordination of Humanitarian Affairs.
“I didn’t have, for example, the ideal sutures I wanted to use,” Hamawy said. “Many of the instruments, you’re kind of improvising with what you had. Luckily they had instruments to take care of cleft lips and palates. But a lot of the fine tools that we need — the sutures, the materials for dressings and care — were still not available. We’re not able to take them in, they’re not getting supplied.”
Up to 14,000 Palestinians — about a third of whom are children — remain in dire need of medical evacuation in order to receive specialized care that the territory’s health system can no longer provide, according to the World Health Organization.
Hamawy also stressed that Gaza’s health care system was still feeling economic pressure, as Trump administration makes massive budget cuts aimed at ending foreign aid. Palestinian doctors get paid very little by the Health Ministry, he said, so in order to earn more money they will often do to part-time work for medical aid organizations.
But when the Trump administration withdrew from WHO, which helps fund global public health, Hamawy said, many Palestinian doctors lost their jobs overnight. On Jan. 29, the State Department defended the foreign aid freeze by touting “commonsense waivers for truly life-threatening situations.”
“Now many of these field hospitals basically shut down — you’re not shooting health care workers, but you’re eliminating another place and point of care,” Hamawy said. “And then again, these doctors have families. These nurses and staff all have families. This isn’t money that’s going to Hamas or anyone, this is money going to the people so they could survive after we’ve been bombing them for the last year and a half.”
A federal judge on Feb. 13 ordered the Trump administration to lift its funding freeze for U.S. aid abroad, though it’s unclear how long the reversal will last. The administration’s lawyers argued on Tuesday that officials should not have to abide by the judge’s temporary order.
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A shaky truce with no shortage of violence
Even though the truce went into effect last month, human rights groups, policy organizations, humanitarian aid workers and journalists — such as Drop Site News, EuroMed-HR and the Institute for Middle East Understanding — have all documented multiple ceasefire violations by the Israeli military. Israeli forces have reportedly continued to shoot civilians, launch one-off airstrikes and severely limit the amount of aid entering the territory. Israel has maintained that it does not intentionally target civilians.
According to WHO, Israeli forces have killed more than 800 Palestinians in Gaza this month alone, almost a third of whom are children.
Earlier this month, soldiers allegedly shot three Palestinian boys playing in Rafah after ordering them to strip down, put their shirts over their heads and run, according to Dr. Sarah Lalonde, who was overseeing their care at European Hospital. Two of the boys died.
“This is one of the examples of violations of the ceasefire agreement,” Lalonde said in a recorded video sent to HuffPost. “They were not in the red zone in Rafah.”
Hamawy recalled that even his first patients in his post-ceasefire Gaza mission were children with gunshot wounds.
“The forces are in Rafah, and there were people getting shot. I’m even told by the Palestinians [that] many people just get shot returning to their homes, because if they ended up getting too close to where Israelis are, and they’re outposted in different neighborhoods, they would shoot anyone coming near them,” he said. “Doesn’t matter man, woman or child. You get close to them, they’ll shoot you.”
During the truce, Israeli forces have also joined settlers in the West Bank in attacking Palestinians and destroying their homes.
Dr. Adam Hamawy via MedGlobal
A ceasefire hanging in the balance
Hamas said it would delay exchanging more hostages on Feb. 10, accusing Israel of not holding up its end of the bargain and threatening to end the truce. The militant group pointed to the continued blocking of fuel and shelter aid, as well as far-right Israeli officials’ support for President Donald Trump’s plan to forcibly expel Palestinians from the territory.
After threats by both Israel and the U.S. to resume fighting unless all remaining hostages were returned by Feb. 15, Hamas agreed to continue releasing captives as previously planned. As of Thursday, the truce is still in place.
Hamawy said that he still plans to return later this year, regardless of the ceasefire’s status. He stressed that Palestinians and aid workers must remind themselves that they cannot control their government’s actions, only their own.
“I hate to say this, I expect there to be fighting. The Palestinians expect it, no one is fooled by the ceasefire,” Hamawy said. “So whether it’s this Saturday or the following Saturday or next month, everyone expects them to break the ceasefire.”
But that doesn’t mean the doctor wasn’t outraged when, from Gaza, he heard that Trump wants to take control of the territory and forcibly remove Palestinians from their homeland with no right of return. Palestinians in Gaza didn’t take the American president seriously, he said. Many long ago accepted that if they die in the war, they will at least die on their own land.
“I want you to know that the Palestinians themselves are still standing. The bombing stopped, they came out of their homes, they started cleaning up the streets, and they started rebuilding. They seem unbreakable, and that’s what makes them who they are,” he said. “So for us to come and say, ‘It’s time to move,’ is just completely silly, and it shows how little we understand about them, about Israel and even about ourselves.”
“I’ve grown up here, lived all my life in the United States. And we talk about, ‘We love freedom,’ ‘Home of the free and the brave,’ and I don’t see that anymore,” he continued. “You want to talk about free and brave? That’s the Palestinians. And if we really believe that, we would see that and we would help them.”
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