JERUSALEM and GAZA CITY - Emergency medical supplies were being flown to the Middle East yesterday to help Gaza's overstretched hospitals, where doctors say they are still struggling to cope with hundreds of injured patients.
Doctors at the Shifa hospital, a 585-bed complex which is the largest in Gaza, said they had treated patients on the floor and conducted operations with as many as three different patients and a dozen doctors crowded into each operating theater.
All 25 intensive care beds were full, said Dr Hussain Ashaur, the hospital director, and there were still another 87 patients in a critical condition waiting to enter intensive care.
He said there were severe shortages of medical supplies, including gauze, sterilization fluids and anesthetics. In total 135 types of medical supplies were needed and 94 separate medicines. Sheets and cloth for intensive care beds were in such short supply that they were being washed three times a day.
Doctors said they were overwhelmed on Saturday, with the first rush of large numbers of injured patients, although pressure had eased slightly on Monday and yesterday. Still, the hospital was in a fragile state, Ashaur said. "We're close to collapsing if this situation continues. We have shortages of everything," he said.
The hospital was running on generators yesterday after a break in the electricity supply, and already one of its three generators had broken down and could not be repaired because of a lack of spare parts.
The International Committee of the Red Cross was to fly in 11 tonnes of supplies to Tel Aviv, which it hoped would then be allowed into Gaza. A Red Cross surgical team is on standby to fly in as well, as soon as it receives permission from the Israeli authorities.
The World Health Organization is to fly 50 surgical kits from Norway to Israel, with enough supplies to treat 5,000 wounded people. Another nine basic health kits, enough for three months' treatment of 90,000 people with common illnesses, is also to be sent.
However, for several months Israel has allowed only limited supplies of humanitarian goods into Gaza and no other imports or exports. That has left Gaza's health system in a state of crisis, according to Physicians for Human Rights, an Israeli group.
It said even before Israel's latest bombing campaign began on Saturday that the Gazan health system was "operating under severe shortages and limitations". As well as shortages of medical equipment and trained personnel, there were shortages of medicine and a broader lack of knowledge and training in dealing with complex diseases and injuries.
Israel allowed around 100 trucks of humanitarian supplies into Gaza yesterday, a much higher number than usual but still a long way below the numbers passing through before the economic blockade was imposed last year.
Physicians for Human Rights said it knew of six patients in intensive care at the Shifa hospital who needed treatment outside Gaza but were too weak to travel the seven hours by road to Cairo.
The group said hospitals in Israel, as in the past, were ready to take the patients but the only crossing they would use out of Gaza, at Erez, had been closed since Friday. The group, together with other Israeli human rights groups, sent a letter to the Israeli defense ministry asking that patients be allowed out.
In the Shifa hospital yesterday doctors described working 20-hour days just to keep up with the flood of patients. "We thought we were in a critical situation in the past, but when we saw this we realised what had gone before was nothing," said Dr Nabil Shawa, head of orthopedics.
"We're not prepared for this number of casualties. There were so many people I couldn't move freely from one room to the next. Besides, I have my family, and my children were at school and I was trying to reach them to know that they were safe. You can just imagine the effort, the worry. We're exhausted."
Oxfam called for an immediate ceasefire to allow in sufficient humanitarian supplies. "What is needed is an immediate ceasefire to end the terrible levels of human suffering in Gaza," said Jeremy Hobbs, director of Oxfam International.