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RIYADH: Nearly two years into Israel’s military campaign in Gaza, the enclave’s shattered health system is collapsing under siege, bombardment and hunger.

Few outsiders have seen its decline as closely as Dr. Nick Maynard, a consultant surgeon at Oxford University Hospitals who has volunteered in Gaza for 15 years with Medical Aid for Palestinians.

Appearing on the Arab News current affairs program “Frankly Speaking,” Professor Maynard offered one of the starkest eyewitness testimonies yet. Asked whether any particular medical cases continue to haunt him, he grew somber.

“Golly, I mean, I could spend hours telling you about moments that haunt me,” he told “Frankly Speaking” host Ali Itani, standing in this week for Katie Jensen.

Initially, most cases were explosive injuries from bombs, shells and drones. But recently, he said, “we saw a huge increase in gunshot wounds.”

“They were predominantly young teenage males, 11-, 12-, 13-, 14-year-olds, who were being shot at the Gaza Humanitarian Foundation food distribution points.

“I saw these gunshot wounds almost daily. And the narrative we were getting from the victims, from their families, and indeed from Gazan healthcare colleagues of mine who used to go to these food sites to get food for their own starving families, the narrative was identical.

“These young teenage boys who were getting food for their starving families were being shot by Israeli soldiers. And these are terrible gunshot wounds.”

On his second or third day in Nasser Hospital, a 12-year-old boy died on Maynard’s operating table. “We couldn’t save his life because of the severity of his injuries, having been shot by an Israeli soldier.”

What struck him most was the pattern of wounds. “On one day we saw four young boys who all came in with gunshot wounds to the testicles,” he recalled.

“The clustering of these injuries, the pattern of the gunshot wounds was so striking that it was beyond coincidence in our view … it was as if the Israeli soldiers were playing target practice.”

Alongside war injuries, hunger is now claiming lives. “The malnutrition I saw was just awful. Newborn babies dying of starvation, children dying of starvation, adults dying,” Maynard said.

Two children stand out in his memory. “Zainab, who was a seven-month-old girl who died because there was no formula feed. There was no infant formula feed to feed her at all in Nasser Hospital.

“And while she was dying, from the luggage of American doctors I knew who were coming into Gaza with formula feed in their luggage, the formula feed was being taken out by the Israeli border guards.

“Every single can of formula feed was removed and those cans could have saved Zainab’s life.”

Then there was Habiba, aged 11. “I spent the whole night repairing her esophagus only for her to die four weeks later because we couldn’t get the right nutrition to feed her.”

The long-term effects of the hunger crisis will be catastrophic, he said. “Even if there was unlimited food going into Gaza today, there would still be catastrophic consequences from the existing malnutrition for many, many years to come.”

Maynard rejected Israel’s claims that its strikes on Gaza’s hospitals were intended to target Hamas militants. “I was in Gaza in May 2023, five months before the events of Oct. 7,” he said.

“I’d gone out there for a week to carry out cancer surgery and we were caught up in a massive aerial bombardment from Israel when Islamic Jihad were firing rockets into Israel and we saw, we witnessed with our own eyes, how sophisticated the targeting of the Israeli bombing could be.

“Roll forward to post-Oct. 7, we’ve seen whole communities, whole towns, whole camps being destroyed by indiscriminate bombing. This is not targeted bombing. This is not protecting civilians. This is a widespread attack on the whole infrastructure of living in Gaza.”

Asked about repeated denials by Israeli officials of famine and civilian targeting, Maynard was blunt.

“They’re lies. And I think that the world media need to call them out for these lies and not keep asking people like me or keep telling us in interviews that the Israelis claim this hasn’t happened,” he said.

“I think our governments, our media need to call them out, to their faces, and say no, you are lying about this.”

He added: “We have multiple eyewitness testimonies from healthcare workers from abroad who’ve been in Gaza and come back with photographic evidence, with detailed testimony. So, they need to be called out and they need to be told to their face that we know you are lying.”

For Maynard, Western governments and institutions have failed Palestinians. “I think that academic institutions and medical institutions in my country, in the UK, and indeed around the Western world, have failed Gaza. They’ve largely been silent,” he said.

Drawing a comparison with how the same institutions responded to the war in Ukraine, he said: “The double standards and the hypocrisy are extreme.”

Western leaders, he believes, are “complicit” in Israel’s actions. “The Gazan population is being destroyed and the Western world, our Western governments, are allowing that to happen. You are all complicit in this.”

Maynard believes doctors cannot stay silent. “I do believe we have a duty to share it and to tell the world what is going on, because our governments are not doing that, our media are not being allowed to do that.”

He added: “Gaza has been fundamentally let down by the Western media; is being fundamentally let down by our Western governments.”

Maynard has worked in Gaza throughout the period since Israel imposed its indefinite embargo on the enclave in 2007 and has witnessed several upticks in violence during that time, but he says the devastation of the past two years far surpasses anything he has seen before.

Even before the Oct. 7, 2023, Hamas-led attack that triggered the current war in Gaza, the blockade made care difficult. Now, he says, it is nearly impossible.

“On the last trip I was there just a few weeks ago, the health system has been almost completely destroyed,” he said.

“And even in Nasser Hospital, where I was working, which is the last remaining major hospital, that’s only very partly functioning.

“Every single hospital has been attacked by the Israeli military assault. Nasser has been attacked several times.

“The most recent attack was just after I left, although they claimed they were attacking Hamas militants, they in fact bombed the roof of the intensive care unit, the roof of the operating theater complex. So, a significant part of Nasser Hospital has been destroyed.”

Shortages compound the devastation. “The fuel to keep the hospital going almost runs out every week,” he said. “You don’t know whether you’ll be able to power the ventilators, the lights, the operating theaters, the incubators.”

“The materials we use in the operating theater — the gauze swabs, the sterile drapes, the sterile gowns, the sterile gloves — they’re in extremely short supply. We often run out of all of those things and you have to use other equipment to try and make up for the lack of sterile equipment.

“The instruments we use are failing, so you’re having to do operations with sometimes very unfamiliar instruments. So, it is dire and you never know from day to day whether there’s going to be enough equipment to treat patients the following day.”

For Maynard and his colleagues, there is little respite.

“You never really get a chance to relax at all because you never know when you’ll be needed. You’re living in the hospital, so you’re effectively on duty 24 hours a day and you could be woken up any second to go and treat mass casualties,” he said.

“Every day we had mass casualties, sometimes two or three times a day. So, there is no chance to relax.”

But he is quick to stress that for Gazan doctors, this has been daily life for nearly two years. “They’ve been living every second like this. So how they’ve coped with it is quite remarkable really.”

Maynard says he intends to return to Gaza, despite the risks. “What keeps me going is my love for the people of Gaza … . It is the Gazan people who are the most heroic, the most inspirational people I have ever met in my life,” he said.

And despite the devastation, Maynard remains convinced Gaza’s health system can recover if given the chance.

“They have the most remarkable ability to rebuild these structures. So, yes, once there is a ceasefire, with the help of the rest of the world, they absolutely can rebuild it,” he said.

Until then, he warns, “what we do is a drop in the ocean compared to the atrocities that continue every single day.”