Beyond the point of no return: the doctor describes how hunger in Gaza is driving mass death

Massive hunger now defines life in the Gaza Strip for 2.1 million Palestinians.

Despite allowing an additional meal in response to global outrage, Israel is continuous policies that have produced generalized hungThe conditions of the Palestinians Ously have deteriorated. In the next few days, the cost of war and blood, which has killed at least 60,000 Palestinians, is likely to shoot.

Israel Prime Minister Benjamin Netanyahu saying Israel will allow “minimum humanitarian supplies” as the country’s army, the Israel Defense Forces (FDI), continue its offensive supported by the United States in Gaza. Echoing Israel’s narrative, President Donald Trump blamed Sunday The situation in Gaza in the Palestinian militant group Hamas, saying that it “hardened” in the conversations by a truce with Israel; He did not question Israeli policies. The United States and Israel abandoned the negotiations with Hamas on Thursday for the launch of several dozen hostages, mostly Israelis and the future of Gaza. On Monday, Trump rejected Netanyahu’s statement that there is no hunger in Gaza, saying: “That cannot be pretended,” but only vaguely refers to greater American assistance without offering details.

Although Israel is allowing airplanes, instituting “pauses” of 10 hours in attacks on parts of Gaza and organizing “humanitarian runners”, these measures have a limited impact and there is no guarantee They will continue until the needs of the Palestinians are met. Tel Aviv continues to criticize the United Nations, the key player in the delivery of effective aid.

Meanwhile, Israeli air attacks in progress and shots delicate Dozens of Palestinians in the last 24 hours, including children and people looking for help. Netanyahu is still promising “total victory” over Hamas, citing his attack on October 7, 2023 that caused the war and killed 1,200 people, and does not seem to be open to the type of help mass of help and approvals for the humanitarian efforts that previously sticks the deaths among the Palestinians during the assignees of Israel-Ahamas for two months of this year and in November 2023.

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News themezone argued on Sunday what can come later with Mark Brauner, an American emergency doctor who traveled to the region for two weeks in June on a voluntary trip organized by the beneficial organization Rahma worldwide.

Based in Eugene, Oregon, Brauner has practiced for 20 years and previously joined medical missions in Mozambique, Haiti and Mexico. In Gaza, he worked at the Nasser hospital in Khan Younis, after many in his group, particularly non -white doctors, faced last minute Israeli denials at his entrance; He had to pay a surprise tax for bringing his cell phone, which led him to join a border officer that his tax dollars were already financing the Israel War; And then, those who were still in the company made a surrealist trip from Jordan through the “beauty” of Israel, then through huge steel doors to the “absolute moor” of northern Gaza.

While Brauner worked, he heard explosions almost every 10 minutes in the vicinity of the hospital, sometimes making his teeth shake, but was “promoted” by the labor ethics of Palestinian medical staff.

A month after his return, given his training and the level of despair he saw on the ground, Brauner feels that “the turning point has already happened” because of the unprecedented death for the starvation in Gaza. Below is our conversation, slightly edited for clarity and length.

Let’s start with the cumulative effect of the forced hungry Palestinians who have been lasting. There have been at least 147 deaths due to hunger, even among babies without pre -existing conditions, and we are talking about a population in which the vast majority have been displaced by force several times, while facing 22 months of attacks backed by the United States. From a medical point of view, how vulnerable is the population of Gaza now?

They are incredibly vulnerable. But they have really moved beyond vulnerable. Unfortunately, the turning point has already happened for a large number of children, babies and young children and adolescents: these are definable age categories in which the level of starvation and malnutrition has passed the turning point, where July already saw a great escalation in the death number, but Augusta will be significantly higher, because much of the children has already passed the point of not having been a point of view in the point of view. Cause death itself. The intestinal coating has begun to automatically digest and will no longer have an adequate absorption capacity for water or nutrition. Unfortunately, death is imminent to probably thousands of children.

AHMED JIHAD IBRAHIM AL-ARINI / ANADOLU / GETTY IMAGES

When I left 26 [of June] The group of four American doctors, we launched a campaign called Gaza Formula Countdown 25 And we expected that we were going to facilitate the specialized formula movement in the [Nasser hospital complex] Because there were so many children who were literally 48 hours after not having a formula. A little formula dripped here and there, but these are many medically complex children who required a special formula, and unfortunately, many of those children are dead, including one that died, his name was Hassan … A couple of days after we left. And yesterday, a young woman named Zainab died of toxic enterocolitis, which is the process of self-destination of the small intestine and the colon. These were preventable deaths.

In August and September, there will probably be extremely high lethality and a large number of deaths because children have already passed the turning point. If we begin to obtain large amounts of the correct formula and the correct protein and food in general, we can reduce deaths at the end of September, October and in the future. There is an international gradation called “acute global malnutrition” or GAM, we are already in more than 15%[ofGaza’s[ofGaza’s1 million children fulfill that criterion]. Severe acute malnutrition, between 5% and 10% of children already meet the criteria. Then, for moderate acute malnutrition, 20% of children under 5 comply with this.

Beyond the acute process that is happening, there is no doubt that the level of malnutrition is at such a high level that it will probably cause chronic neurological dysfunction for many children. Its vitamin B levels and specifically thiamine are so low that it causes permanent neurological dysfunction and neuropathies and cognitive dysfunction, so their ability to learn and be members of high function society have already been negatively affected and these are very large amounts of children.

Israel has allowed “minimum humanitarian supplies.” We do not know if a great increase will materialize, but with the supplies they are talking about and the level of vulnerability that people already have, can they talk about the broader image beyond children?

When I was in the emergency department, I spent most of my time in the resuscitation room where we were taking care of patients with unstable and unstable trauma. For adults, the average percentage of body fat was probably 1%, if that; Actually, many of them were skeletal. We were doing emergency surgical procedures in people where all ribs were completely shown, there were no problems between the ribs to put in tubes in the chest.

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Trauma in this environment is a chronic disease, so we would see people with severe acute injuries who were already healing injuries that occurred three months ago. So we would see people who had a chest tube that, on the other side, it could be seen that they had a supposed wound of a chest tube that had had months before … due to lack of nutrition and lack of proteins, [including] Albumin, which is critical to cure wounds. Even if you are not injured, walking in this destroyed environment, you get cuts and scrapes all the time. Therefore, people were covered with minor cuts and scratches that were not healing; They had secondary and clean water infections to wash their wounds.

We had so many family members who would be presented with patients who had acute traumatic injuries, but family members themselves were almost incoherent, where they were malnourished to the point that they could not speak and think correctly. They were stumbling, falling and fainted.

It was so unreal to see this population that not only experienced traumatic injuries [from gunfire or airstrikes] But they were experiencing the sequel to violence by hunger that affected the cognitive function and function of the central nervous system to the point that people had difficulty speaking. The elderly had difficulty swallowing and drowning in the water because their brainstem was too flexible to coordinate swallowing. The sequel to militarized starvation is so pathological that it is crazy.

Adults who experience neurological morbidity due to malnutrition, their response to feedback is very variable; Some people will have a complete recovery, others not. It is probably multifactorial, from genetics to complex neurohormonal things that the repair dictates.

But it will require a sustained return of adequate nutrition. When you get these occasional scoring moments in which they eat for three or four days in a row, but a month later he returns in a situation of starvation, that is not really useful. Theoretically I could do even more worse or potentially longer. When refuting patients with severe malnutrition, they really require consistent feeding, not these ridiculous air situations that only create chaos, terror and violence.

Medical workers and Palestinian journalists trying to help their community are experiencing deprivation. When you were in Gaza, how were the medical personnel supporting this moment at this time? It was clear that we headed to this moment of extreme alarm? And did we talk about the Israeli claims now weakened with Hamas Redirection Supplies?

The first real group of people we connected were medical students because they functioned as our interpreters most of the time. Some of them had been in medical schools that no longer exist; All records are gone, the facilities have gone, half of the people are dead. All his experience in the Medicine School has been erased from the planet. Then they were fighting, without knowing what the future holds.

Daily, we would hear about their families. A medical student one day seemed depressed as we walked down a hall and she told me that her favorite uncle, his wife and four children were killed that night in a bomb. He was absolutely devastated, but nevertheless, he walked four miles through dangerous halls to get to the hospital to function as my interpreter.

I made a really strong connection with one of the internal medicine residents who was also in a hospital that essentially erased from the Earth. He was marched from the hospital and put in prison for four months and beaten daily and then thrown into the street. He appeared at Nasser; People knew him. He is an evilly intelligent and very generous person who smiled all the time and was extremely worker and helpful. But when we really took a few moments to sit down, his body posture would change, his face would change, there was certainly a deep depression.

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A couple of nurses told me that they have thought about suicide in the past. They are such strong and beautiful people who said: although I thought about this, I still feel that I need to get up and go to work and help people.

This was a residence training program, but residents were really executing the program because the higher assists are very few and distant, many of them have been killed or missing. In the past, they were paid a little money every three or four months, but it is not enough; Their families starve.

These doctors were being fed with a small amount of food once a day. Three weeks ago, that stopped. Now they are completely alone. There have been doctors and nurses who have simply passed out in the middle of the emergency department; There are people who faint during surgery. This is a completely new phenomenon in the last three weeks. When we were there, each person in our team lost between 12 and 15 pounds.

All these doctors and nurses and people with environmental services would work from 16 to 18 hours, then they would walk home, sometimes an hour or an hour and a half, to enter their small tent with their family, then they got up at 5 or 6 in the morning and returned and did it again. It is simply extraordinary.

I spent countless hours throughout the hospital. I saw people tired with empty pockets and broken sandals; I didn’t see any people of Guerrero and I didn’t see a weapon all the time. Not a person with whom I had intimate and deep conversations said something violent against Israel and the Jews. They were firmly against Zionism and violence, but I did not hear an anti -Semitic and violent rhetoric, and I really hoped to do so. This only showed how incredible these people are.

Nothing more than a drip [of aid] He has arrived in Gaza from March until I left … and these so -called help distribution points [set up under the U.S.- and Israeli-supported Gaza Humanitarian Foundation, established earlier this year and defended by Israeli troops and American military contractors] -It was like a clock: 30-40 minutes after they started a distribution, we would only hear ambulances and cars flying, we would receive many, many patients after these things. [The GHF denies enabling violence.]

One of the things I thought was really remarkable was how young people came from their young people. These were young children who were being heroic and went to these things despite the knowledge that they were a shooting gallery. I cannot tell you how many children between the ages of 8 and 18 I saw with a gunshot wound directly between the eyes, the forehead or the side of the temple.

It was almost as if they were changing the game sometimes because we received all the lesions in the head, then we would have several hours or a day of all the neck injuries, or the whole chest. Or all the injuries in the groin that are particularly terrible, because there are large blood vessels everywhere; People often bleed, generally have a fairly slow death and injure the intestine or rectum, so there are stool soaked injuries that are extremely painful and difficult to handle. [The IDF maintains that it respects the laws of war and minimizes harm to civilians.]

I think of all the PTSD in the long term that the entire population will experience and is very deep and so unnatural. It will take generations to recover from this poly-trauma. I think of Israeli soldiers; Many of them are young men who do not have a fully developed prefrontal cortex, which are still very impressionable and will do things they would not have done if they had been more mature. He will hit them at some point. They will realize what they did. It is another population that will experience generational trauma.

It is organizing a campaign for Congress to review the FDI for accusations of gross human rights violations, which could trigger Leahy’s law, except for the support of the United States to foreign military units that are accused in a credible way of such behavior. What is the progress of the campaign until now, and how he is widely thinking about the responsibility of the United States for the suffering of Gaza since the United States allows Israel’s offensive under President Joe Biden and President Donald Trump?

I just published an opinion article in Common Dreams and we have a request on Moveon. We are interested in understanding the world [the Leahy Law] Because this is an important policy of the United States and all governments should have a similar policy. We hope that this has a direct impact on American voters because it should be important for Democrats, Republicans and independent equally … to trigger an exhaustive review of all IDF, which I think is justified, it would have a great effect on the Israeli army. I understand that the Israeli government can end only on this issue and continue with the genocide, but we are demanding that the United States stop its military and financial support.