BEIRUT (AP) 鈥� Dr. Hassan Hamdan was one of the few trained plastic surgeons in Gaza, a specialist in wound reconstruction. His skills were vitally needed as Israel鈥檚 military onslaught filled hospitals with patients torn by blasts and shrapnel, so the 65-year-old came out of retirement to help.
Earlier this month, along with his wife, son, two daughters, a daughter-in-law, a son-in-law, six grandchildren and one other person, as his family sheltered in their home in an Israeli-declared 鈥渟afe zone.鈥�
Israel鈥檚 9-month-old in Gaza has . Israeli raids have wreaked physical destruction on hospitals, and health facilities have been hit and evacuated. But also, it has devastated Gaza鈥檚 medical personnel. More than 500 health care workers have been killed since October, either during assaults on hospitals or in strikes on homes, according to the U.N.
Israel says it is targeting Hamas, which it claims has embedded itself in the medical system, using hospitals as military command centers and ambulances to carry fighters. Gaza鈥檚 health workers deny the accusation.
Many of those killed in the campaign have been specialists like Hamdan.
Dr. Ahmed al-Maqadma, also a reconstructive surgeon and a former fellow at U.K. Royal College, was found shot to death alongside his mother, a general practitioner, on a street outside Gaza City鈥檚 Shifa hospital after a two-week raid on the facility by Israeli forces in April.
One of Gaza鈥檚 most prominent fertility doctors, Omar Ferwana, was killed along with his family in a strike on his home in October. The territory鈥檚 only liver transplant doctor, Hamam Alloh, was killed in a hit on his home in Gaza City.
Tank shelling on a northern Gaza hospital during a siege in November killed three doctors, including two doctors working with Doctors Without Borders, according to the group. They are among a total of six staffers from the international charity killed in the war.
Israel has detained doctors and medical staff. At least two have died in Israeli detention, allegedly of ill-treatment: the head of Shifa鈥檚 orthopedics department, , and the head of a women鈥檚 hospital, Iyad al-Rantisi. Israel has not returned either man鈥檚 body. Hundreds of other medical workers have been displaced or left Gaza altogether.
Along with the personal toll, their deaths rob Gaza鈥檚 medical system of their skills when they have become crucial.
Since the Hamas attack against Israel on Oct. 7 鈥� which left some 1,200 people dead and 250 kidnapped 鈥� Israel鈥檚 campaign has killed more than 38,000 people in Gaza and wounded more than 88,000, according to local health officials. Malnutrition and disease have become widespread as hundreds of thousands of Palestinians cram into squalid tent camps.
Dr. Adam Hamawy, a former U.S. Army combat plastic surgeon who volunteered in Gaza in May, said Hamdan鈥檚 death 鈥渓eaves a significant void that will be hard to fill.鈥�
Like many in Gaza, he believes Israel is deliberately destroying the health system. Israel has besieged, raided and occupied at least eight hospitals, causing heavy destruction, and has hit medical convoys and ambulances.
The Israeli army said in a statement that Hamawy's accusation was 鈥渙utrageous.鈥�
Israel has accused Hamas of gathering and regrouping its forces in hospitals and has shown evidence of some Hamas presence in hospitals, including weapons caches, a single dead-end tunnel under Shifa hospital and video of militants bringing several wounded hostages to hospitals. But the evidence it has made public has not appeared to show significant command centers.
Under international humanitarian law, hospitals enjoy protected status, but they can lose that status if they are used for military purposes. Even then, any military operations against them must be proportional to the threat and weighed against harm to civilians.
Twenty-three of Gaza鈥檚 36 hospitals are out of service, and the rest are only partially functioning, according to the latest U.N. figures. Only five field hospitals out of nine are operational. And more than 60% of Gaza鈥檚 primary health facilities have shut down.
Hamdan鈥檚 death leaves only one other specialist in reconstructive plastic surgery in Gaza. Other doctors have had to learn the skills of repairing major wounds on the job amid relentless daily waves of maimed patients.
Hamawy saw firsthand the need during his work in Gaza as part of an international medical team that came to help the territory鈥檚 health workers.
During three weeks at the European General Hospital in Khan Younis, he said he performed 120 surgeries, more than half of them on children, and all but one of them for treatment and reconstruction of war wounds. Two colleagues at the hospital were killed in strikes on their homes while he was there, and he spoke to doctors who had been released from Israeli detention and , he said.
Hamawy said a general surgeon at the hospital stepped in to fill the demand for plastic surgeons, but he had no formal training. Five medical students volunteered with him.
They 鈥渁re doing their best to fill in the gap,鈥� Hamawy said.
On July 2, the European General Hospital evacuated its staff and patients, fearing it would be attacked. That left Al-Aqsa Martyrs Hospital in Deir al-Balah and a field hospital in Rafah as the only facilities able to offer reconstructive surgery, said Dr. Ahmed al-Mokhallalati, Gaza鈥檚 last reconstructive plastic surgery specialist.
Al-Mokhallalati said he has been rushing between hospitals, at one point overseeing treatment for 400 patients in one and 500 in another. At the Rafah field hospital, he was doing up to 10 surgeries a day.
鈥淚t is a very critical situation,鈥� he said.
Hamdan founded the burns and plastic surgery department in Khan Younis鈥� Nasser Medical complex in 2002, after serving at the territory鈥檚 first such unit, at Shifa hospital. He headed the department at Nasser until 2019, when he retired.
When the Israeli army invaded Hamdan鈥檚 home city of Khan Younis in December, he returned as a volunteer at Nasser, Gaza鈥檚 second largest hospital, said his son Osama Hamdan, an orthopedic surgeon. His colleagues said he was cool under pressure. 鈥淭he smile never left his face,鈥� said Dr. Mohamad Awad, a surgeon who worked with him.
Soon after, Israeli forces besieged and raided Nasser Hospital, forcing its evacuation. Hamdan was displaced, taking shelter in the home of one of his daughters in Deir al-Balah, further north.
Troops occupied Nasser hospital for weeks, wreaking extensive damage. After they withdrew, the facility was rehabilitated. In mid-June, Hamdan returned home and was discussing returning to work with hospital officials.
On July 1, Israel ordered another evacuation of Khan Younis. Hamdan and his family fled again, returning to his daughter鈥檚 home in Deir al-Balah.
Only hours after they arrived, an airstrike hit the building on July 2 鈥� 鈥渁 direct hit with two rockets on my sister鈥檚 apartment,鈥� Osama Hamdan said. He said no one in the family was affiliated with militant groups.
The Israeli military did not respond to requests for comment on the strike.
Osama was on duty in the emergency room at Nasser hospital when he received the call. His wife and two sons 鈥� 3 and 5 years old 鈥� were among those killed.
鈥淚 was only able to collect some body parts of my kids and their mother because of how huge the explosion was,鈥� he said.
One of his sisters died days later in the hospital from her wounds. Another sister remains in intensive care.
Osama is feeling partially responsible. 鈥淚 had pressed him to leave Khan Younis,鈥� he said in a text message, marked with two broken hearts emojis.
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This story has been corrected to show that Israel ordered the evacuation of Khan Younis on July 1, not July 2, and that the airstrike that hit the building in Deir al-Balah took place on July 2, not July 3.
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Sarah El Deeb, The Associated Press
