For three days in late January, Dr. Mohamed Hwaihi watched Israeli tanks move closer and closer to Nasser Medical Center, knowing that it would soon be time to make a decision.
For weeks, he had been discussing the impending scenario with his wife, Dr. Ruba Al Kurd. He had two choices. If he left, returning to the shelter in Deir al-Balah, in the central Strip, where Ruba was living with their three young children, his patients and the hospital would be without a vascular surgeon. If he stayed, and Israeli forces entered the building, there was no telling what might happen to him, and whether he would ever see his family again.
In late January, as communication signals around Nasser faltered, Ruba tried to send her husband messages, telling him to come home. “We—myself and his mother—were begging him that, if things become intense, just please leave,” she told me. For days, the messages didn’t go through. Ruba feared that he’d been detained or killed.
On January 19th, the messages were finally delivered, and she sent her final plea to him. Ruba, who is also a doctor and has worked intermittently since the war began, told him, “Remember that our kids are also your responsibility, not just your patients, and you have obligations toward us. I can’t do it alone, and if you were stuck in Nasser or arrested, worrying about you will kill me!”
The night before, the couple told me later, the sound of bombs in the distance hadn’t stopped. Mohamed had estimated that Israeli tanks were just a few hundred feet away. After more than a hundred days in the hospital, he performed his last surgery, amputating the leg of a fifteen-year-old girl, and left, returning to the shelter.
There, Mohamed reunited with Ruba and their three children: Amin, who is seven years old and dreams of becoming an artist; Jannah, who is six, with curly hair inherited from her mother; and Reem, who was born during the May, 2021, war and had just begun speaking full sentences. Their shelter is on the second floor of a temporary structure, with cinder-block walls, a sheet-metal roof, a rudimentary bathroom, and a couple of mattresses and blankets on the floor. It’s far better than the living conditions of most in Gaza—but, still, the family has struggled to find clean water. All three kids have suffered long bouts of diarrhea, for which medicine is difficult to find. Ruba told me that, as a doctor, it hurts to be unable to help her children with such a curable ailment.
Ruba, who is thirty-three, is a close friend of mine. We met in 2022, while I was a communications manager for Doctors Without Borders in Gaza. She worked out of an M.S.F. clinic for burn patients, most of whom were children. I needed a doctor to give me an injection, and she, in her powder-pink scrubs, was between patients.
We formed an emotional bond quickly, and I’d duck into Ruba’s clinic during her breaks to share a Turkish coffee, or meet her on weekends to window-shop Gaza City’s main streets, Reem toddling ahead of us. We’d complain and laugh about our micromanaging boss, or the know-it-all male physicians who tried to direct the clinic’s activities. She told me that she had fallen in love with Mohamed in 2013, when she was in medical school and he was a resident, in part because, despite his giftedness at surgery, he lacked the machismo she had seen in some of her classmates. She loved his gentle personality, and would often show me photos of him sitting on the ground, having his hair styled with headbands and accessories by Jannah and Reem.
At the end of my contract in Gaza, in December, 2022, I told Ruba that I was looking for work in other conflict zones. I would go home to Canada only briefly, between assignments. Her demeanor changed, and for the first time in our friendship I felt that she was angry at me. She told me that she would give her life for her kids to grow up in a peaceful environment like Canada, reminding me how, when she was about to deliver Reem, she’d feared that the hospital she was in would be bombed. She was tired of the bravado she correctly sensed in expat humanitarian workers, who chased conflict zones for bragging rights. Why would I choose danger when my family was waiting for me to return safely home? I knew that she was right. I went back to Canada, and travelled to the West Bank to report, though I was never able to enter Gaza again.
We texted each other during the August, 2022, and May, 2023, conflicts, but we both knew that after October 7th things would be different. Mohamed said that he and Ruba had heard about the attacks while they were getting the kids ready for the day. By midmorning, he was told to get to the hospital as soon as possible. Ruba was supposed to go to work, too, at the burn clinic in Gaza City, where, in previous conflicts, she saw nonemergency overflow and follow-up cases. But, when Israeli forces told Gazans in the north of the Strip to evacuate, she reluctantly took her children to the Deir al-Balah shelter, near their extended family.
By November, Ruba was seeing patients at clinics and hospitals, while Mohamed’s mother watched the kids. She described the injuries she saw as complex: combinations of infections, fractures, and burns layered on top of poor hygiene and malnutrition—which made it difficult for the wounds to heal. Mohamed was in surgery all day. “The staff was burned out even before the war,” he told me, and under further stress the hospital staff argued constantly. At first, they received two meals a day; after a month, they were down to one, “and I missed my meal many times” Mohamed said, because he was in the operating room.
In October, Mohamed and Ruba got news that their apartment building had been destroyed; the clinic where Ruba and I had met was caught in fighting and destroyed, by fire, in November. I began to worry about Ruba’s mental health. She called me and announced that her home was gone, over and over again, following up later by showing me old pictures: Reem eating waffles in her favorite corner of the kitchen, or the kids squished together with their cousins on a teal couch for movie nights. Ruba’s voice used to be jovial; now it was hoarse, and she spoke at a slow cadence.
Her calls were terrifying, reminding me of an incident in which my cousin had contacted me, in the early morning, as he was attempting suicide. I had been able to call an ambulance to his home and save his life. If Ruba called me during an air strike, what could I do?
Once, during a communications blackout, Ruba heard that the refugee camp where her sister was sheltering had been bombed. No one in her family could find her. Ruba, being the family doctor, went to a facility where the bodies from the attack were being identified. She tried looking at the victims’ feet, but they were too mangled, and amid the chaos she couldn’t remember what her sister’s looked like. Finally, she recalled her sister’s C-section, and she checked the abdominal remains, leaving without finding a match. Days later, someone found her sister alive, wandering the streets, appearing to be in extreme psychological distress.
I sensed that Ruba’s inability to protect her family and her patients was at the core of her anguish. When I told her to try to get some rest, she replied, “I can’t sleep, knowing I have failed at my job as a mother and failed my obligation as a doctor.” Increasingly, her thoughts have turned to death. Since Mohamed returned from the hospital, the family has tried to be together as much as possible, so an air strike will not leave any of the children orphaned, or Ruba or Mohamed without each other. They sleep as close together as possible.
Early in the morning on February 12th, an air strike hit the building across the street from the family’s shelter. Ruba hunched over Jannah, and Mohamed over Reem and Amin. The blast shattered windows and sent debris flying into their shelter. The next day, Ruba said that her back felt tender, because the debris had hit her with such force. Since then, the children’s nightmares have worsened. “We are alive, but we are not fine,” Ruba told me.
On February 15th, Israeli troops stormed Nasser, claiming that it was sheltering militants and that hostages were being held there. An emergency team of World Health Organization doctors entered the hospital on February 18th to transfer I.C.U. patients. The W.H.O. reported that Nasser had no electricity or running water, and that “medical waste and garbage are creating a breeding ground for disease.” A United Nations official who took part in the transfers told Al Jazeera, “The conditions are appalling. There are dead bodies in the corridors.” The I.D.F. did not respond to a request for comment.
Weeks after the raid on the hospital, Mohamed still had not heard from colleagues who’d remained there. “It makes you ask yourself, ‘When is my turn?’ ” he said. He told me that he and Ruba have “surrendered to our helplessness.” They’re going to keep working when they can, but air strikes continue throughout the night, and news continues to roll in about the deaths of family friends and acquaintances. They struggle to find food, each day grinding on.
When they met, eleven years ago, Mohamed and Ruba dreamt about buying their own plot of land where they could build a house and raise a family. After finishing medical school and working for a few years, they purchased a small plot in northern Gaza. This past June, they hired a civil engineer to design the house. Ruba and Mohamed put together digital albums of videos and pictures for inspiration. She hoped to host her siblings and their families, to create an oasis of peace in Gaza. She thought they should first remove trees from the building site, but Mohamed told her that he wanted to wait to harvest the winter oranges. They agreed to start building in January.
“But the war came in October,” Ruba said. They never ate the oranges, or cleared the land. “I might not be able to reach the land we worked so hard for.” ♦