As Gaza’s doctors struggle to save lives, many lose their own in Israeli airstrikes

BEIRUT (AP) — 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’s 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, an Israeli airstrike killed him 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 “safe zone.”

Israel’s 9-month-old war with Hamas in Gaza has decimated the territory’s medical system. Israeli raids have wreaked physical destruction on hospitals, and health facilities have been hit and evacuated. But also, it has devastated Gaza’s 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’s 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’s Shifa hospital after a two-week raid on the facility by Israeli forces in April.

One of Gaza’s most prominent fertility doctors, Omar Ferwana, was killed along with his family in a strike on his home in October. The territory’s 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’s orthopedics department, Adnan al-Bursh, and the head of a women’s hospital, Iyad al-Rantisi. Israel has not returned either man’s body. Hundreds of other medical workers have been displaced or left Gaza altogether.

Along with the personal toll, their deaths rob Gaza’s medical system of their skills when they have become crucial.

Since the Hamas attack against Israel on Oct. 7 — which left some 1,200 people dead and 250 kidnapped — Israel’s 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’s death “leaves a significant void that will be hard to fill.”

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 “outrageous.”

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’s 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’s primary health facilities have shut down.

Hamdan’s 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’s 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 described being tortured, 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 “are doing their best to fill in the gap,” 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’s 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.

“It is a very critical situation,” he said.

Hamdan founded the burns and plastic surgery department in Khan Younis’ Nasser Medical complex in 2002, after serving at the territory’s first such unit, at Shifa hospital. He headed the department at Nasser until 2019, when he retired.

When the Israeli army invaded Hamdan’s home city of Khan Younis in December, he returned as a volunteer at Nasser, Gaza’s second largest hospital, said his son Osama Hamdan, an orthopedic surgeon. His colleagues said he was cool under pressure. “The smile never left his face,” 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’s home in Deir al-Balah.

Only hours after they arrived, an airstrike hit the building on July 2 – “a direct hit with two rockets on my sister’s apartment,” 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 – 3 and 5 years old – were among those killed.

“I was only able to collect some body parts of my kids and their mother because of how huge the explosion was,” 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. “I had pressed him to leave Khan Younis,” he said in a text message, marked with two broken hearts emojis.

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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This family handout taken in 2017 and provided by Osama Hamdan, shows his father Dr. Hassan Hamdan who was one of the few trained plastic surgeons in Gaza, a specialist in wound reconstruction who came out of retirement to help. On July 2nd, an Israeli airstrike killed him 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 “safe zone.” (Family handout via AP)

FILE - Palestinians displaced by the Israeli air and ground offensive on the Gaza Strip flee from parts of Khan Younis following an evacuation order by the Israeli army to leave the eastern part of Gaza Strip's second largest city on July 1, 2024. (AP Photo/Jehad Alshrafi, File)

FILE - Palestinians wounded in the Israeli bombardment of the Gaza Strip are brought to Al Aqsa hospital in Deir al Balah, Gaza Strip, on March 25, 2024. (AP Photo/Ismael abu dayyah, File)

FILE - Doctors perform surgery on a patient at Al-Aqsa Martyrs Hospital, in Deir al-Balah, central Gaza, on March 17, 2024. (AP Photo/Abdel Kareem Hana, File)

This handout photo taken on May 12, 2023 shows Dr. Adam Hamawy, right, a former U.S. Army combat plastic surgeon who volunteered in Gaza in May performing surgery on mangled hand from a blast injury at the European General Hospital, in Khan Younis, Gaza. (Adam Hamawy via AP)

This family handout taken in 2017 and provided by Osama Hamdan, shows his father Dr. Hassan Hamdan who was one of the few trained plastic surgeons in Gaza, a specialist in wound reconstruction who came out of retirement to help. On July 3rd, an Israeli airstrike killed him 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 “safe zone.” (Family handout via AP)

FILE - Dr. Suhaib Alhamss, the director of the Kuwaiti Hospital in Gaza's southern town of Rafah, performs surgery on a patient during his work day on Jan. 11, 2024. (AP Photo/Fatima Shbair, File)

This handout photo taken on May 12, 2023 shows Dr. Adam Hamawy, left, a former U.S. Army combat plastic surgeon who volunteered in Gaza in May and Dr. Mohammed Tahir, a British surgeon, performing surgery on mangled hand from a blast injury at the European General Hospital, in Khan Younis, Gaza. (Adam Hamawy via AP)

KANSAS CITY, Mo. (AP) — Lamar Jackson insisted the Baltimore Ravens were not seeking revenge after the Kansas City Chiefs beat them in the AFC title game seven months ago, denying him the opportunity to play for his first Super Bowl championship.

It sure looked as if he was trying to get some anyway Thursday night.

Jackson threw for 273 yards and a touchdown and ran for 122 yards, gamely rallying Baltimore from a late 10-point deficit against the two-time and defending NFL champions. And it looked for a moment as if Jackson had at least forced overtime when he hit Isaiah Likely in the back of the end zone with no time left in raucous Arrowhead Stadium to complete the comeback.

The final play immediately went to a video review, though, and the evidence was clear: The tight end's toe landed on the endline, putting him out of bounds. The pass was incomplete. The game was over. And the disappointment quickly set in.

It was a 27-20 loss, the fifth for Jackson in six tries against Patrick Mahomes and the Chiefs, and one that could only have been upstaged by the 17-10 loss that the Ravens endured on a cold January night with the Super Bowl in their sights.

“I believe everyone in our program — coaches, trainers, equipment guys, cafeteria women and men, and definitely the players,” Jackson said. “For us to lose to those guys in the way we lost, even though I don’t want to do it, I can’t be mad at my guys.”

Jackson has long been one of the NFL's premier quarterbacks, winning his second MVP award after last season. And he has not only proven his worth in big games but against some of the league's best quarterbacks, going 2-0 against Tom Brady before his retirement and winning four of his five games against Joe Burrow and the Bengals.

Yet he can't seem to beat Mahomes and the Chiefs, no matter what magic he brings to the field.

For most of the NFL's opener Thursday, Jackson was having another night against them to forget. His rebuilt offensive line was called for illegal formation three times in the first seven plays, and it broke down completely two series later, when Jackson was strip-sacked by Chris Jones deep in his own territory to set up an easy field goal for the Chiefs.

“Every time we almost had an explosive play, we had a penalty right after that,” Jackson said. “It's hard to get in the groove.”

He finally found his groove over the final two series, when Jackson began to play some sandlot-style football.

First, he a 12-play, 56-yard drive to set up Justin Tucker's field goal, closing the Ravens within a touchdown with 4:54 left in the game. And when the league's No. 1 scoring defense last season forced a quick punt, Jackson had one more opportunity.

He kept going to Likely, who had 111 yards receiving and a touchdown, and Jackson used his feet when he needed to, including a scramble on third-and-2 that gave the Ravens a fresh set of downs. Three plays later, he spied Rashod Bateman streaking down the Kansas City sideline for a 38-yard completion that put them at the Chiefs' 10-yard line with 19 seconds left.

“I thought his last drive was great,” Ravens coach John Harbaugh said.

Jackson's first shot to the end zone was a throw-away with nobody open, but Jackson appeared to miss Zay Flowers open in the back of it on the next play. With one last shot with four seconds to go, Jackson found himself under pressure, yet found enough space to keep the play alive and spot Likely coming open in the back of the end zone.

The throw was a bit high, but Likely thought he had made the catch — as did Jackson, who turned to see Harbaugh signaling for the Baltimore offense to remain on the field for a 2-point conversion that could have won the game.

The play had gone to video review, though, and the Ravens never got that opportunity.

“I felt that we did a great job,” Jackson said, “but you know, just coming down and the red zone, 10-yard line — whatever.”

AP NFL: https://apnews.com/hub/nfl

Baltimore Ravens quarterback Lamar Jackson runs with the ball during the first half of an NFL football game against the Kansas City Chiefs Thursday, Sept. 5, 2024, in Kansas City, Mo. (AP Photo/Charlie Riedel)

Baltimore Ravens quarterback Lamar Jackson throws during the first half of an NFL football game against the Kansas City Chiefs Thursday, Sept. 5, 2024, in Kansas City, Mo. (AP Photo/Ed Zurga)

Baltimore Ravens quarterback Lamar Jackson (8) scrambles as Kansas City Chiefs defensive tackle Tershawn Wharton (98) defends during the first half of an NFL football game Thursday, Sept. 5, 2024, in Kansas City, Mo. (AP Photo/Ed Zurga)

Baltimore Ravens quarterback Lamar Jackson (8) runs with the ball as Kansas City Chiefs safety Bryan Cook, right, and linebacker Leo Chenal (54) defend during the second half of an NFL football game Thursday, Sept. 5, 2024, in Kansas City, Mo. (AP Photo/Charlie Riedel)

Baltimore Ravens quarterback Lamar Jackson (8) scrambles as Kansas City Chiefs linebacker Leo Chenal defends during the second half of an NFL football game Thursday, Sept. 5, 2024, in Kansas City, Mo. (AP Photo/Ed Zurga)