Cambridge-Trained Physician Back from Gaza: “There’s a very dark side to the Israeli State”

CONTRIBUTORS05/26/2024

Moosa Qureshi, The Watermelon Reports. (Moosa Qureshi is a British National Health Service Haematology Consultant, Award-winning Legal Campaigner, PhD Cancer Science, LLB Hons, Microsoft Certified Systems Engineer.)

The Watermelon Reports Video: “War Crimes Or Not? British Surgeon’s Testimony from Gaza”

Computer generated transcript from YouTube, edited by ChatGPT 4. I tried to check it a bit against the video but some minor errors may remain. I think it came out as very readable, and, indeed, powerful. – JRIC.:

Dr. Khaled Dawas (Excerpts): “There’s a very dark side to the Israeli state that people are not aware of, and we’re seeing it in front of our eyes at the moment. It’s changing the whole makeup of the Gazan population. You walk around in the hospitals and see people with amputations everywhere. There are a lot of children who I met also who had lost all their families. He describes being blindfolded and handcuffed for days and beaten with metal bars. He said to me, “I’m not the only one that was beaten with metal bars; everyone in there was beaten with metal bars on a regular, often daily basis,” and he showed me his wrists—his wrists were both swollen from the handcuffs, and he showed me the X-ray. The X-ray clearly showed he had multiple rib fractures on both sides. So therefore, anybody who sits on the other side of this argument and says, “Well, this is a complicated issue; we should perhaps stay neutral and let it be,” I don’t think understands the scale of what’s going on.”

This is Moosa Qureshi from the Watermelon Reports.

Dr. Khaled Dawas is a senior surgeon from the United Kingdom. His diary from Gaza has recently been published in one of the UK’s major newspapers, The Telegraph. In addition, he works as a senior surgeon in one of the foremost hospitals in the United Kingdom—that’s University College London Hospital. He supervises researchers in one of the most prestigious institutions in the world—that’s University College London. Of course, he’s speaking here in a purely personal capacity, but I wanted to make his seniority a matter of record. He is here with us today, and we’re very pleased to welcome him. Welcome, Dr. Dawas.

Dawas: Thank you very much Moosa.

Qureshi: Now, the first time I met you was just after your first visit to Gaza a few months ago. I’ve met several doctors such as yourself who have gone over to Gaza and volunteered their time, and they’re all motivated by—usually—altruism; they want to do some good. They feel devastated by seeing the destruction of Gaza on their television screens, and they feel that they want to use their medical skills to help the population. And I’m sure that’s the case for you yourself as well, but you said something that night which actually struck me. You said that one of the reasons you wanted to go to Gaza was to provide testimony; you wanted to come back and say that you had seen this with your own eyes. Can you tell us a bit more about why you think testimony is so important?

Dawas: We’ve seen what’s happening in Gaza happen multiple times over and over again over the years, and not just in Gaza, but also in the West Bank. We know a couple of years ago with the attack on Jenin, which resulted in a lot of death and a lot of destruction, these are happening over and over again, not to the same scale that we’re seeing at the moment. This is, not to overuse the word, unprecedented in our lifetime, and therefore I think it’s important, thinking about the future, about how we try and prevent this happening again. And that’s about waking people’s minds up to what is really happening; to the real nature of the Israeli state.

There is a problem with there’s a very dark side to the Israeli state that people are not aware of, and we’re seeing it in front of our eyes at the moment. And I think this is something that we’ve got to record; we’ve got to be able to use to wake governments and people up to the reality and say that there’s more than just one side to the story. To those who believe there’s only one side, which is the Israeli side—a state that has recognition and credibility worldwide—the fact that Palestinians do not have a state, an internationally recognized state that is recognized on international forums in the same way, is a problem. But the reason that is a problem is because it’s not allowed to be an internationally recognized state. And the testimony that we provide is very important to try and prevent these things happening over and over and over again.

People that we all admire, the strength of character, the resilience of Gazans and Palestinians. But they are human beings, and ultimately those reserves need to be replenished; they need to be supported. And it’s our role, on the outside, who see it differently because we don’t live under those awful circumstances, to make sure that those things are recorded and testimony is recorded to get to that endpoint that I’m talking about: the prevention of this recurring theme over and over again.

Qureshi: So, Dr. Dawas, talking again about your experiences in Gaza recently, the numbers are that there’s something like 2,000 Palestinian deaths at the moment. The Israeli government claims that over 600 of those deaths are Hamas fighters. So when you were working at Al Aqsa Hospital, what sort of patients were you seeing with your own eyes? What’s your testimony? Were a third of the people you were treating fighters? Give us an idea of what sort of patients you would see.

Dawas: I mean, the straightforward answer to that question is that I did not see a single Hamas fighter, as far as I know, in the time I was there. And I was there, overall, for about a month. And I can also say, on behalf of colleagues, many of whom I’ve spoken to who’ve been on the missions in between the first which I went on and the most recent one which is the last one I went on as well, I don’t know anybody who can say, hand on heart, that they’ve met any Hamas fighters during their time there. Which does beg a question as to, you know, where are these supposed injured fighters going? But also, it’s a re-emphasis of the point that the vast majority of the casualties—the dead and the injured—are civilians. The numbers that we hear about, which is 70% women and children, I think, is true. Our experiences certainly support those numbers. And there are also the forgotten population, and I do go on about the idea that we should not be neglecting the young men.

Young men, just because they happen to be of fighting age, they should not be categorized instantly as therefore legitimate targets. And that is what’s happening. We see a lot of young men, clearly a third of the population of patients that I had to treat were young men. These are young men in their late teens and early 20s with all injuries, amputations, life-changing injuries, and a long stay in the hospital. And their crime is that they happen to be in that wrong age group, which means that Israel feels it’s a legitimate thing to do to target them. And these are young men who are brothers, husbands, sons. And they are in Gazan communities; they’re a very important part of the population. They are productive, and they do a lot of the work that’s required in Gaza. So out of those, I do not know a single man that I treated, young man I treated, who I can say hand on heart is a fighter.

Now you know, people say, “Well, how would you know? You wouldn’t recognize them.” But I think you know, we’re not stupid. You can recognize by body type, you can recognize by the way they speak, you can recognize other things which will tell you, indicate to you, give you a sign that who you’re dealing with is somebody who’s a fighter. And I cannot say anybody I treated had those characteristics.

Qureshi: We all know that in wartime young men are killed in disproportionate numbers. But it does sound like if Israel is saying that 600 Hamas fighters have been killed, they have decided that every young male in the Palestinian population is a Hamas fighter, which is clearly a bizarre and ridiculous proposition. In Gaza, can you tell us what were the main types of injuries you saw, and what do you think those injuries tell us about Israel’s military strategy?

The injuries were shrapnel injuries, shrapnel, shrapnel, and some bullet injuries. So blast injuries. And if you see one of the myriad of videos available on social media of what happens when something is targeted in Gaza, you see the stones and the rocks and the debris, wood, and so on flying at incredible speed towards the camera, if it happens. You’ll realize the power of shrapnel because people might underestimate the power of shrapnel. Shrapnel could be a grain of sand, a few millimeters wide, but the heat and the speed it travels at to enter someone’s body causes a lot of damage. It is like a bullet; there’s no doubt about it. And so you saw we saw a lot of injuries shrapnel related. And I, because of by virtue of my specialty, I was dealing with injuries in the abdomen and the chest. So in the abdomen, you were dealing with heavy bleeding, you were dealing with perforated bowel, perforated kidneys, bladder, liver injuries. We had to do quite a few removals of spleens because the spleens were bleeding from the injuries. I had to deal with a very unusual ruptured esophagus because the esophagus was again torn to shreds by shrapnel. And in the chest, dealing again with bleeding, with severe lung injuries. And also, on one occasion, I had to deal with somebody who had a ruptured aorta, which is the biggest vessel coming out of the heart. And that’s because shrapnel had entered his chest and gone right through the chest bone into that vessel. So that’s the majority of injuries.

Of course, people who are at the epicenter of the targeting, die; they get killed. We don’t see those people; we see them as body bags coming to the hospital. And I saw those coming to the hospital as well. And then it’s the people around, probably a radius of about maybe 15 meters, who are the ones who survive it, who come into hospital with the awful shrapnel injuries. Now they come in, and surgeons there do their best. And you can temporize and perhaps repair the damage that’s been done in the short term. But what I also noticed was many of them were dying in the first few days after surgery. So there is that population of patients who are not surviving the initial operation, the initial injury, but dying a few days later because of the complications of the surgery, the severity of the injury.

Now, what does it tell you about Israel’s military strategy? I mean, it tells you from what I can see, and certainly from the stories of people who I spoke to. I spoke to a lot of people, particularly this time around. There is what I would term a scorched earth policy. There is an attempt to try and destroy everything. And of course, we know, and we have been told by many Israeli spokesmen, that they will target a particular person, and the cost of targeting that particular person is, in some ways, irrelevant. If they kill 10 times the number of people they’re targeting as a byproduct of that targeting, that is an acceptable thing to them. But those people are killed. And then you’ve got multiple numbers of those people who are being injured in ways that are life-changing. It’s changing the whole makeup of the Gazan population.

You walk around in the hospitals; you see people with amputations everywhere. Who’s going to look after these people? And there are a lot of people, a lot of children who I met also, who had lost all their families. I met two or three of them as I was walking around the hospital. And I had to remind myself of where I was because my instinct was not to believe it; it can’t be true that you’ve lost absolutely everybody. And then I had to remind myself of where I was; I was in Gaza, and this is happening on a daily basis. And these children were being looked after by neighbors, perhaps, or family friends who would take them in and look after them. But what’s going to happen to them in the long term? So the strategy, it seems, is about just going in and destroying everything in front of you. And taking the excuse that you are targeting a particular population within Gaza, and that is the fighters, the militants, whatever they want to call them.

Qureshi: That’s very devastating testimony you’ve given about the indiscriminate nature of Israel’s military strategy which in itself is a war crime. Did you see any other evidence of direct war crimes? For instance, targeting children, gunshot wounds, things of that nature.

Dawas: Which I’ll describe to you, perhaps what I saw, and I think it’s important and worthwhile that people listening to this, even just make their own minds about this, about the answer to that question. I mean, I’ll tell you what I saw. So even traveling through Gaza, as I did the first time around, because we traveled much more from the residence that we had to the hospital. That house was hit, by the way; the house, the guesthouse as it was called, which is where we were staying in a place called Al Masi in Khan Yunis on the west side near the coast, was hit. That’s the guesthouse for the medical personnel, from Medical Aid for Palestinians; is that right? That’s yes, so it was hit a week after we left it when there was the second mission staying in the house, and that was hit.

As you drive along from the house, the guest house, to the hospital, in those days you would see the destroyed houses along the way. There were many houses that had been destroyed completely by missiles or shells. You would see people having to scrounge for water; there was no water. Water had been turned off, as we know, by the Israelis at the beginning of all this. In October, there was no electricity, and people were having to put up their own tents. What we saw also this time around is that we drove past the house which housed the MSF team, Médecins Sans Frontières, which is another organization that many people will know. And I could see the room that was targeted by an Israeli missile because you could see the fire. It had scorched the frame of that particular room on the outside. And we know that that house was hit, I think maybe twice, but certainly once, and that’s visible. That house is now empty.

In the hospital itself, I met two people who gave me some pretty, well, they were very disturbing stories. One was — I met him one night, one morning, as I was doing a ward round. And he is a man who is wheelchair-bound; he has a chronic problem with his spine. And he described being taken out of a hospital not far from where we were, dragged out, and kept in detention in an Israeli Army detention camp for a few weeks. Because he’s wheelchair-bound, he can’t move. But he was handcuffed to something and he was blindfolded for weeks on end. And he developed pressure sores on both sides. So his hip bones, his femur, was visible on both sides because of the pressure sores from lying in a single position for those weeks on end. So obviously, he would have been lying, moving from one side to the other, but not being able to move more than that. And he developed these awful pressure sores. And I asked him about how he sustained this, and he told me his story. He told me he was handcuffed and blindfolded for weeks on end and then released somehow in the south of Gaza. And he found his way to the hospital. His wife looked after him in the ward, so she was his carer. And I inspected those wounds myself because we would change his dressings on the ward sometimes. And an incredibly stoic man, I have to say, I remember thinking when he told me the story, “How can you tell me the story with a smile?” He said it with a smile, with a gentle smile.

And then the next morning, I was walking through the emergency department, and I met another man who came up to me with his wife and his phone. And people over there carry their x-rays as screenshots on their phones. And he approached me and said, “Doctor, can you look at this; this is my chest x-ray; is it okay?” And, as I did with most people I met, said, “What happened? What’s your story?” Well, I was in an Israeli camp just outside of Khan Yunis, on the Israeli side of the fence, taken out of Al-Nasser Hospital, and kept there for days. And I saw people being dragged out by their external fixators. External fixators are the devices, like skeletons like scaffolds, people have around their limbs which are fractured and which are drilled into the bone to try and bring the bones together. And they’re very commonly used in wartime situations, where you don’t have the facility to try and fix the fracture immediately with the usual gold standard, which is to fix the bone because of all the infections and time constraints and so on. So he described people being dragged out by their external fixators along the street, along the floor, dragged out by the soldiers, and then dumped into these detention camps. And he was one of them, and he didn’t have a fracture at that time. He describes being again blindfolded and handcuffed for days and beaten with metal bars. He said to me, “I’m not the only one that was beaten with metal bars. Everyone in there was beaten with metal bars on a regular, often daily basis.” And he showed me his wrists. His wrists were both swollen from the handcuffs, and he showed me the X-ray. The X-ray showed clearly he had multiple rib fractures on both sides.

Now I, you know, I think anybody listening to these stories will tell you there is something wrong. And anybody who denies that there are crimes going on there needs to rethink all this. Yes, extremely disturbing stories. We can only hope the ICC actually takes action soon; there are rumors that might happen. I can only observe that it’s just—it seems almost unbelievable that the Israeli Army, supposedly the most or one of the most professional and courageous armies in the world, feels that it needs to blindfold and handcuff a man with a spinal injury in a wheelchair for weeks on end—it speaks volumes. Also, that maybe on the last day, as I was, in fact, the day I left, there were scores of people brought in with bullet injuries to their heads. And they were all ages, starting from early teens up to late 20s, and they were sitting in our hospital in the emergency department. A lot of them obviously were going to die; these are injuries not going to be survivable, particularly in those kinds of conditions. So again, this happened, and I saw this on the last day, in my last trip to Gaza, bullet wounds to the head.

Okay, well, I mean, it’s very difficult to believe that bullet wounds to the head are accidental. Just going back to your work in the hospital, did you feel that medical facilities were being targeted? Healthcare workers were being targeted, either deliberately or just generally undermined by the Israeli Army? And if so, how so?

There’s the testimony of people I spoke to, people who’ve been working at Al-Nasser Hospital, who’ve been working at Al-Shifa Hospital. When we were traveling to Gaza this time around, I met somebody at Al-Arish in Egypt, in Sinai, who had just come out of Gaza. And he was a doctor who worked in Al-Shifa and described to me and showed me the footage that he had of the conditions in Al-Shifa Hospital. And he described how at the end of November, before he was forced to leave, he was allowed by the Israeli soldiers in the hospital grounds to bury only 20 of the bodies that were accumulating, that were piling up in the grounds of the hospital. And then they were stopped, and a forklift came along and just picked up the bodies and took them somewhere, and we don’t know where that went. But also, there are testimonies of people from Al-Nasser Hospital, amongst them this man who I described who was taken from that hospital and left in a camp outside an army camp outside of Khan Yunis.

When I was there in January, the reason we had to stop working at Al Aqsa Hospital was that on one particular day, we were operating, and a missile came in through the hospital wall and lodged into one of the windows of the Intensive Care Unit. And that meant that it was too dangerous, and in fact, that night we were told we could not go back to Al Aqsa Hospital. So this is back in January. So, there is targeting that I’ve seen, there’s targeting that I’ve heard about, and we’ve seen—we’ve all seen the footage of what’s happened to Al-Shifa and Al-Nasser Hospital.

Qureshi: I’ve read your article in The Telegraph. It’s incredibly moving. I’d encourage all our viewers to try to read it if possible; it’s freely available on the Internet. One of the things you mentioned, apart from the stories which you’ve also described for us during this interview, was that this time around, on your second trip to Gaza, you saw much more end-stage cancer, much more infection, and much more malnutrition. Can you explain, perhaps to some of our viewers who are not medically trained, what that means for a population?

Qureshi: So in any population, you expect a certain incidence of cancers and chronic diseases. And as we all know, cancers are best treated when they’re caught early. When they’re late, they are, unfortunately, a death sentence for many people. But also, in the context of what’s available for treatment in Gaza, the prognosis is even worse. So what I was seeing this time around, and I saw this from day one, were patients of fairly young age with cancers which are way too advanced to hope for any cure from. I saw cancers of the pancreas, I saw cancers of the liver, I saw colon cancers on one of the patients who I operated on, on the second day when I was there, is a 36-year-old man who had a cancer of his colon which has obstructed his bowel, so that he was very distended, blown up like a balloon, couldn’t open his bowels, very uncomfortable. And so he was only 36, and I operated on him the next morning, and unfortunately he died a few days later. Now, for somebody like that, who’s a young man, and to have this kind of condition and to get to that point, is, I think, a reflection of what we’re going to see in Gaza for the next few years. We’re going to see a huge number of excess deaths from maltreatment, or unavailable treatment for a lot of these diseases.

Qureshi: That’s a very bleak picture you’ve painted. I wonder, just going into a little bit more detail about the cancer deaths you’re seeing, the malnutrition you’re seeing, the infection you’re seeing. Could you explain to viewers what this means in terms of are we seeing the total destruction of Gaza’s healthcare system? Because initially a lot of the deaths were trauma, but are we now seeing sort of secondary deaths? And what do you think will be the scale of mortality associated with this complete destruction of the healthcare system? We’re now going to see excess deaths not as a result of the trauma but as a result of the consequences of having a healthcare system which is destroyed.

Dawas: The healthcare system in Gaza was reliant on two major healthcare centers: Al-Shifa in the north and Al-Nasser complex in the south. Al-Shifa, we’ve seen; we know is completely destroyed. It’s now a shell, and it’s burnt out, and any facility within it has been destroyed. The Al-Shifa people, the employees of Al-Shifa, tried to rejuvenate it after the Israeli Army withdrew from it back a few months ago, and they were successful in trying to reestablish a primary care center. This is a center that could at least look after patients who needed some painkillers, some fluids, some wound management, and maybe some very basic surgery. And then the Israeli Army went back in again a few weeks ago and destroyed all that. And we know killed scores, if not hundreds, of people. We’re now discovering the mass graves that have been unearthed. Al-Nasser Hospital, again, is the same situation—been completely destroyed. We had one of our colleagues who helped work with us in Al Aqsa, he’s not a physician or a doctor, but his home is in Khan Yunis, and his father went back to check on his home which is in the Amal district in the center. And he came back extremely upset because his home, plus the whole city, was destroyed. In fact, his words to me were, “This is worse than what you’re seeing in Gaza because in Gaza at least there are some houses which are upright. In Khan Yunis, in the center, there’s nothing; everything’s been completely leveled out.”

So this destruction of the healthcare system and the two major centers in Gaza—Al-Nasser and Al-Shifa—means that the only hospitals left are the hospitals that used to operate as peripheral small centers of healthcare which can do a certain amount of good, but they cannot cover a population of 1.8 million. As I said Rafa, does not have a hospital system that can cover any of the population it has over there. So, 1.8 million people in a town which used to populate a quarter of a million and has a total number of four operating theaters, no CT scanners, no intensive care beds. You cannot look after trauma patients in that setting.

Qureshi: So then get on to the point of the issue of field hospitals. How good are field hospitals? If you had a very sophisticated army and a huge system of welfare and the funding to do it, you might be able to set up field hospitals that can do their job. But these take a long time; they’re not as good as having hospitals which are already existent in terms of their structure and in terms of the building that they have. They’re not the same thing.

You are one of a few surgeons and physicians who have gone to Gaza to try to alleviate suffering. You are also one of those who have come back and provided testimony to try to motivate our population, our medical establishment, and our politicians to do something. What would you like the British medical establishment to do?

Dawas: In the UK, our healthcare system is looked upon as a model by many people outside of the UK. And we, those of us who work within the system here, of course, we criticize aspects that we think we can improve. But from outside, people look at our system and say this is a system that we would want to emulate. And many people want to come and work in the healthcare system in the NHS in the UK. But also, the education system is also the envy of many people outside of the UK. And I think on those two fronts, it’s important that we make sure that we use that leadership role that we have by default and the model that we have to try and push further what we do well, which is public health. We do that very well. We have a fantastic societal healthcare system that does not cater for people’s ability to pay but rather for their need. And this is an example here in Gaza where we in the UK can also lead in terms of deciding and, not just deciding but rather advising and coming up with a response that I think many of the world will follow.

The healthcare system in Gaza we know has been destroyed. The targeting of individual clinicians and educators in Gaza has been documented as well. And anybody who goes to Gaza and who has a clear picture of what’s going on there cannot fail to understand the tragedy that’s going on. There is no—it’s very—you know. It’s impossible to go and argue that there’s some reason for continuing with what’s going on. The destruction, the war, the killing—there’s no justification for that at all. So therefore, anybody who sits on the other side of this argument and says, “Well, this is a complicated issue; we should perhaps stay neutral and let it be,” I don’t think understands the scale of what’s going on.

We also have a duty as humans. We are lucky in the UK; we are able to express our opinions. We are able to form policies based on evidence. Many people can’t do that. We need to use that ability, our freedom, and also the excellence that we have in the UK to be an example to the rest of the world. And I think that also that opportunity has to be grasped by the politicians to empower us to empower the healthcare system to do so. There is nothing wrong, and there is nothing criminal, if that is any suggestion, in us supporting the people of Gaza and supporting their healthcare system and their education system. This is what’s going to make them come back from the abyss of what it is like now. And I think, you know, this will also be something that will live on our conscience for years and generations to come if we let this opportunity go away. And people who come after us, generations after us, will look back and ask us what we did when this was happening in front of our eyes. We know how history looks at this; we’ve seen this happening in the past. And why we should be allowing it to happen now is way beyond me.

Qureshi: The British government, what would you like them to do?

Dawas: I’d like the British government to think beyond what I recognize as the realpolitik. The realpolitik and about having mutual interests when dealing with other nations is one thing. But as a government that represents a population that has very strong feelings about what’s going on, and I would say I think it’s very visible by the strength of feeling of people that go out on the peaceful marches that we see on a regular basis, that there is a segment of the population which is significant if not a majority. It may well be a majority now who feel that what we’re doing as a country and represented by our government is not right. There needs to be a stronger voice about what is wrong and what is right. Yes, dealing with the economy is one thing, and that is the bottom line, I understand, for many governments. But that’s, I think, that’s also a short-term view. What we do ethically and what we do as a nation that projects an international image is also very important. And I do think that at the moment we are lagging behind. You know, we could say we could argue that perhaps our government and a small minority of other governments are the only remaining ones at the moment that are willing to stand there and say that what is happening in terms of the killing that’s going on is justifiable and that it should carry on until whatever end result the Israeli government feels is appropriate at. And at what cost? The cost is another—you know—sort of tens of thousands have killed. The figures we talk about the 2,000 so far, that’s an underestimate. We know there are thousands of people still buried under the rubble in Gaza. We know that those people who are injured will have an inability to contribute to their lives, to their economies, for many years to come. So to allow this to happen and for our government to say that we should not vote, for example, on a ceasefire, an immediate ceasefire because there are still things to be done, is very difficult to understand from a human point of view. I do hope that there will be some awakening within those who decide policy and can see that they need to represent us, those people who feel that what is happening is wrong and needs to stop immediately. And I hope that change of mind happens very fast; every day counts.

Qureshi: Yeah, so I’m hopeful that testimony such as yours will have an effect. As you said, realpolitik is one thing, but I think once you’ve got genocide, you really—you know, you have to take action, because otherwise, it undermines the entire rules-based system. The population starts thinking, well, you know, why are you saying one thing about Ukraine and another thing about Palestine? And people are not dumb nowadays; we’re seeing everything on social media, and they’re starting to see through politicians. And if we ever had any faith in politicians, I think that faith is well and truly damaged now. Anyway, thank you very much, Dr. Dawas, for your account of your work in Gaza and for your views on the political measures that need to be undertaken in order to put a stop to this terrible, terrible health catastrophe.

Qureshi: Thank you. No, thank you very much, Musa. Thanks for your time, and thanks for what you do as well.

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