SPECIAL REPORT-At a Gaza hospital, a midwife brings new life and volunteers tend to the dead

Under relentless bombardment from air, land and sea, over 12,000 Palestinians have been killed, 70 per cent of them women and children, health officials in Hamas-run Gaza say. Israel says its war is with Hamas, a terrorist group in the eyes of the United States and much of the West, and its near-total blockade is designed to prevent crucial supplies from reaching the militants.

Naya, meaning "deer or "flute" in Arabic, is a baby born into war. She emerged by Caesarian section at 1 p.m. on Saturday, November 11, in southern Gaza. Samah Qeshta, 29, cradled her newborn and surveyed the tiny face and raven-black eyes. Then Qeshta wept, because, she later recalled, she was ashamed that "circumstances forced me to deliver at a time when I am unable to provide her with anything."

Though a midwife herself, Qeshta is facing the same acute shortages as most other Gazan mothers. She came to the hospital with a few diapers, a packet of baby milk and a bottle of water to mix it. Shortly after giving birth, she was in a bed by the window with Naya when a house nearby was hit in an airstrike. "I was scared and held her tight," Qeshta said. "I was afraid that any moment we could be bombed. All I thought was to hold her close." She later learned from hospital nurses that people died in the strike.

The Israel-Hamas war began on Oct. 7 when Hamas militants from Gaza attacked Israel, killing at least 1,200 people, mostly civilians, including the very young and very old. Striking back, Israel is laying siege to Gaza, restricting imports of fuel, food, and electricity to the population. Under relentless bombardment from air, land and sea, over 12,000 Palestinians have been killed, 70 per cent of them women and children, health officials in Hamas-run Gaza say.

Israel says its war is with Hamas, a terrorist group in the eyes of the United States and much of the West, and its near-total blockade is designed to prevent crucial supplies from reaching the militants. Hamas has ruled Gaza since 2007 when it wrested control from other Palestinian factions. In a statement to Reuters, the Israeli military said Hamas continues to attack Israel from across all of Gaza, and it accused Hamas of hiding among civilians. Israel "is determined to end these attacks and as such we will strike Hamas wherever necessary," the statement said.

Caught in the vice is Gaza's population of 2.3 million. Civilians are trapped. Since Oct. 7, Israel has closed the border. The crossing into Egypt is mostly shut, too. Just over 7,000 people have been let into the country, according to two Egyptian security sources. In the hospital, Qeshta followed news of the war from the nurses. Across Gaza, people were transfixed by events in Gaza City, the enclave's main city. Israeli tanks were surrounding the Al Shifa Hospital there. Patients were dying and incubators switched off, doctors at the hospital reported.

The Al-Helal Emirati maternity hospital where Qeshta gave birth is in the town of Rafah, on the border with Egypt. It lies about 30 kilometres south of Gaza City and 20 kilometres south of an evacuation line that Israel declared. People here feel besieged, too: Towns like Rafah are being hit by airstrikes. Reuters has a team of eight staff and their families in Gaza. Originally stationed in Gaza City, they – like hundreds of thousands of Gazans – have now moved south, to the town of Khan Younis, about 6 km from Rafah. It's in Khan Younis, at the Nasser Hospital where Qeshta works, that a Reuters reporter first met the midwife as she delivered babies. A short distance from the maternity ward is the mortuary, where director Saeed Al-Shorbaji records the dead.

This account of life and death in wartime Khan Younis is based on reporting by Reuters journalists at the Nasser Hospital and the daily observations of the team in the town. UNDER BLOCKADE IN KHAN YOUNIS

Khan Younis is a dusty town, dating back to the 14th century, that merges with a sprawling refugee camp by the same name. The camp was set up for Palestinians who fled when Israel was founded in 1948, and it is operated by the United Nations. Together, the town and camp stretch from the border fence with Israel to close to the Mediterranean Sea. By night, there are explosions; some distant, others close by. By day, a constant hum like a revved-up 2-stroke engine comes from the drones – Israeli unmanned planes that circle high above, appearing here and there beneath the cloud.

And there are dangerous shortages. Israel's blockade of fuel, power and most food to Gaza has been tight. Water is in short supply. On Friday, the U.N.'s World Food Program said civilians face the "immediate possibility of starvation" due to a lack of food supplies. Normally home to about 440,000 people, there are now maybe twice that number in Khan Younis. On Oct. 13, Israel told over 1 million Gazans living in the north of the strip to move south. All but about 300,000 heeded the warning, according to U.S. officials, and many came here.

Israel says that, in its pursuit of Hamas, it will expand its operations in the south. On Friday, Israeli planes dropped leaflets telling residents of some eastern districts in Khan Younis to evacuate, an instruction that could force many families who came from the north to move again. Among the displaced is Abla Awad, an elderly woman who fled once before – in 1948 at the creation of the state of Israel, an event Palestinians call the "Nakba", or catastrophe. Awad was five years old when her family left the village of Hulayqat in what became Israel. "Our families carried us along with their bags, and they took us to Gaza. I swear it's the same as what's happening today," said Awad, sitting outside a temporary shelter on a patch of sand. She travelled to Khan Younis from the Jabalia refugee camp in northern Gaza.

The Khan Younis vegetable market is still open but prices have doubled. Bakeries draw hundreds of people willing to stand in line from dawn until sunset. Merchants tout an array of overpriced wares, ranging from canned tuna to hairbrushes, clothes, underwear and cleaning products. The high prices trigger constant arguments. There are piles of garbage and swarms of flies everywhere. The scarcity of water and lack of sanitation have caused skin ailments. Many people have endured weeks without a shower and have visible skin rashes.

The few lucky ones have solar panels on their homes to draw groundwater from pumps and charge their mobile phones. Many others have to join lines that form early in the morning to fill small containers with water from nearby wells. Though Khan Younis is south of Israel's "evacuation line," it has not escaped daily raids by Israeli warplanes or missiles. Strikes have pummelled entire blocks. A total of 1,300 people have been killed in the Khan Younis area since October 7, local health officials say.

Hamas and its ally, Islamic Jihad, continue, every few days, to send volleys of rockets towards Israel. There is virtually no escape for residents except those with foreign passports. U.N. data shows that even before the war, less than 50,000 people per month were permitted, after approval by Israeli security authorities, to exit Gaza – some 35,000 to Israel and 12,000 to Egypt. Many people have never left Gaza.

In recent years, there have been scattered protests in Gaza against Hamas over its failure to improve poor living conditions. Today, few are prepared to discuss their politics with reporters. Most say they are fearful of being targeted by Israel. Suzan Beseiso, a 31-year-old Palestinian American who is in Cairo after being permitted to cross the border, said she opposed the killing of "any civilian, any religion, any person on earth," including Israelis killed by Hamas on Oct. 7. But she also said the thousands killed by Israel in retaliation cannot be justified. "So this war is not against Hamas. It's against civilians in Gaza," she said. "They're taking their anger out against civilians and innocent people."

To protect the innocent, Jan Egeland, secretary general of the Norwegian Refugee Council, says Israel is obliged to open its borders. "It is the cruellest possible thing when Israel not only lays a total siege on the civilian population that comes under attack and cross-fire, but also denies women and children trapped in a small place an escape across the border," he told Reuters. Israel disagrees. Israeli Prime Minister Benjamin Netanyahu told NBC's "Meet the Press" on November 12 that civilian injuries were "as happens in every legitimate war, are sometimes what are called 'collateral damage.' That's a longer way of saying unintended casualties."

In its statement to Reuters, the Israeli military said Israel is striking military targets in accordance with international law and its forces take "all feasible precautions," such as issuing specific warnings, to mitigate harm to civilians. Strikes only take place, it said, "after a real-time assessment that the expected incidental damage to civilians and civilian property is not excessive in relation to the expected military advantage from the attack." The war has been labelled by Hamas as "Operation Al Aqsa Flood," referring to the mosque compound in Jerusalem's Old City that is the third holiest site in Islam, also revered by Jews as the Temple Mount - a vestige of their faith's two ancient temples. Nasser Hospital, the main hospital in Khan Younis and the biggest in southern Gaza, uses the same term on its Facebook page where it lists the daily "martyrs" in this war.

Reuters monitored the hospital between Nov. 1 and Nov. 11, visiting frequently and observing the arrival of dead and injured. In that period, the hospital recorded a total of 139 dead from air strikes, of which 54 were men (39%), 42 were women (30%) and 43 were children (31%). On Nov. 7, a Reuters journalist watched bodies arrive from a strike that took place in Khan Younis at around 6.30 a.m. near the town's municipal offices. Relatives said nine members of one family, including three teenagers, were killed. A 16-year-old girl was the only survivor. She was too upset to talk. Reuters could not establish why Israel destroyed the apartment block where the family was living and whether it gave a warning. A total of 26 bodies were brought to Nasser Hospital that day – including 11 women and 10 children.

OVERWORKED IN THE MORGUE Saeed Al-Shorbaji, 50, runs the Nasser Hospital mortuary. He relies on volunteers working eight to a shift. The morgue is only 30 metres from the maternity unit.

He arrives before 6 a.m., an hour before the first family members come for their dead. Reuters reporters spent several days watching Shorbaji at work and witnessing the arrival of the dead, most of them killed in night-time bombings. A father of six daughters and two sons, Shorbaji is sleep-deprived. "You wake up anxious and sleep is interrupted, and this makes you more tired." In six hours, he might wake up 40 times, with every explosion. "There is no normal sleep. What can you do? The only thing you can do is wait for God's mercy."

Shorbaji's family has lived in Gaza for generations, since before the creation of Israel in 1948. Today, according to the U.N, around four-fifths of Gazans are classified as Palestinian "refugees:" of families who fled or were driven from their homes at that time, never to return. The morgue is run by a charity and funded by local donations. It serves the community for free. Shorbaji and his staff identify the dead, wrap them in white fabric and send them to the mosque for prayers and then to the cemetery. Close family members are allowed into the morgue to recite Quranic prayers and kiss the body of their loved one. Other relatives stand behind railings. Some shout in anger: "God is Great" or "Shaheed!," martyr.

Sometimes people gather to perform burial prayers before carrying the dead to their final rest, a deviation from the customary practice of conducting these rites in a mosque. Often, volunteers at the hospital step forward to fulfil this task when there are no remaining family members or when the number of casualties overwhelms the capacity of mosques. Amidst the disarray, the sounds of vendors hawking tea, coffee, and cigarettes at high prices mingle with the rising cacophony. Scuffles occasionally erupt over limited resources such as water and food.

Shorbaji handles much of the work personally. He said the workload is so intense that sometimes his colleague assists him in drinking while his hands are occupied with handling bodies and are covered in blood. As he spoke, a body of a man in his 50s, covered in dust and bloodied on his face, was brought in. The morgue's coolers are designed to hold 50 bodies. But some days there are twice that number and bodies are placed on the hospital floor. Outside the cooler there is a washing room where bodies are prepared. There is also a sitting room where a TV screen continuously airs Al Jazeera, the Arabic news channel that's covering the war closely.

Like everyone here, Shorbaji refers to the dead as "martyrs." The challenge in wartime is not just coping with the number of bodies that arrive. The morgue is struggling with Gaza's fuel shortages. It is appealing for help to get the dead to the mosque and to the cemetery.

Finding a spot at the cemetery is difficult and dangerous. The town's main burial place has been shelled so often that people have dug graves themselves in the city and refugee camp. Shorbaji says wartime brings intense emotions and tensions that wash into the building with the bereaved. Some can't cope with the knowledge that a "beloved person who once dressed well, behaved well" has been mutilated by an Israeli bomb. Some relatives are covered in dust from sifting through rubble for survivors.

In six years working at the morgue, Shorbaji has never seen such injuries, he said. Some of the dead are nothing more than flesh, a leg indistinguishable from a hand. There are whole families whose remains have been mingled together. "As we speak, inside the morgue we have a father who died while his son, who is two years old, was in his arms and he is still hugging him," he said. "We could not separate the father from the son, we will keep them that way and they will be buried that way."

The morgue director has lost relatives of his own in the war. He recalled learning that a member of the extended family, a young man, had died. Shorbaji expected to receive the body in his morgue. But the man's father called to say his son's remains were so mixed up with the body parts of others that he had to be buried in a mass grave. The next day, the father arrived at the morgue. Shorbaji was puzzled: "What brought you here?" he said.

The father replied: "My son is dead and buried. I came here to smell blood. I did not smell his blood or even see him." He repeated: "I came to smell the smell of blood, I did not see my son." Shorbaji's voice cracked as he told the story. He paused, then continued. "I couldn't talk to him. I stood there in shock. I left him there and walked away. I didn't even dare to offer my condolences."

Everyone in Gaza, he said, has "paid a price for this war" having lost family or relatives. Some have been lucky. A house with 25 women and children was struck by a missile, he said, but it failed to explode. A second rocket hit 15 minutes later. But by then everyone had evacuated. By 6 p.m., he tots up the death toll and sends it to Gaza's Department of Justice which oversees the morgue. He returns home to his family to join in the hunt for water, power and bread.

He does not mention his work at home, "the horrible scenes and the horrible memories and the horrible details" of his day. "They ask me, 'How was it at work today?' and I tell them that we had X number of martyrs, and I leave it at that." IN THE MATERNITY UNIT

The Reuters team first met midwife Samah Qeshta, then heavily pregnant, in early November. She was in the middle of a 24-hour shift at the Nasser Hospital in Khan Younis. Qeshta had gotten up that day at 6 a.m. in Rafah. The weather was still mild so her family was keeping warm at night, despite the absence of any electricity. But it had been a fitful night. She'd been kept awake by her pregnancy and dreams of her parents, Hosny and Suhaila, who had both died before this war.

She prepared breakfast for her three children then walked more than an hour from Rafah to reach the hospital in Khan Younis. Sometimes she had to walk through the aftermath of a bombing – shrapnel and falling debris. "Those are moments that I will never forget." She wanted to run but couldn't while pregnant.

On reaching Khan Younis and the Nasser Hospital, there was chaos. The hospital now effectively doubles as a temporary shelter, where laundry hangs haphazardly, children play, and the cries of infants mix with the sounds of grieving relatives. Qeshta had to navigate her way through the tents of refugees in the car park before entering the building. The corridors and staircases are crammed with families seeking shelter, children running barefoot and elderly people seated on plastic chairs. Clothes, mattresses, suitcases and hanging laundry block everywhere.

The smell is overpowering – a mixture of blood, urine, faeces and unwashed skin. Qeshta put on a mask straight away. Inside, Waleed Abu Hattab, director of the maternity and nursery department, told Reuters the 50,000 pregnant women in Gaza are in a health crisis – a number confirmed by U.N. agencies. Miscarriages and stillbirths are up 20% in Khan Younis, he said. All pregnant women are at risk because of the collapse of primary health care and overburdened hospitals. At Nasser Hospital, scabies has been spreading. Operating theatres intended for caesarean sections are being used to treat injured from bombings. "Harsh times, harsh measures," said Abu Hattab.

Sanitation is a major risk. Toilets are overburdened in the hospital, doctors say, with up to 5,000 using the same one: Reuters saw large queues, wet, muddy floors, and no soap or water. Pregnant women, medics told Reuters, risked catching urinary and other infections that could go on to kill babies. Still inside the ward, one young woman, Iman Abu Mutlaq, was thanking Qeshta for her help in delivering twins. Their father, Ayman Abu Odah, said he would name them Hamza and Uday after two of his nephews who were killed in an air strike on their house in the war.

After that strike, Abu Mutlaq and the couple's eight children had to live in a tent inside a school, where they had no mattresses and no blankets for seven days. "The situation is difficult but God offered me two babies, two heroes," said Abu Mutlaq.

Qeshta had been due to have a C-section delivery in late October but she delayed the birth in hope of a ceasefire. Because of drug shortages, the only painkiller she received when she did give birth on Nov. 11 was a lower-body anaesthetic. A day later, an ambulance dropped her as near to her home as it could. Streets were blocked because of the damage from air strikes. "I walked for about half an hour to the house after a C-section and with a baby," Qeshta recounted.

She returned to her parents and her other children. Nourseen, a girl aged 7, and two boys, Mohamed, 3, and Mousa, 6, scampered out to greet newborn Naya. Before the delivery, Qeshta and her husband had managed to scavenge just one packet of diapers and one box of baby food. "We don't know what we will do after it is finished," she said of the meagre food supply. For medical reasons she needs to supplement her breast milk with baby formula. Obtaining necessities is a struggle. Her husband, a cashier in a shopping mall, must stand in line for hours in the hope of getting basics like bread. Mainly they are surviving on tea and biscuits containing dates, provided by a U.N. agency. "There is no gas to heat water. We burn wood and boil water for the baby's milk," Qeshta said.

When she's recovered from Naya's birth, Qeshta plans to return to work in January in the maternity ward at the Nasser Hospital. If the war is over. "This department is like a window for hope and light," she said. "We hear bombing, sirens, screams from martyrs' families, and the screams of women in labour," she said. "So every time I help a woman give birth, every time I hold a newborn baby in my hands, I thank God. I feel happy that God offered us a new life, a new person."

(This story has not been edited by Devdiscourse staff and is auto-generated from a syndicated feed.)