Dr. Nil Ekiz, a Turkish anesthesiologist and intensive care specialist in Norway, recently shared her experiences treating civilians in Gaza during a humanitarian mission with the Norwegian Humanitarian Aid Committee.
What was the difference between hospitals in Gaza and Norway?
The biggest differences were the number of patients and the types of patients — almost all of them were people injured in warfare, and almost none were admitted for reasons that are common in Norwegian hospitals. Patients with conditions such as heart attacks, strokes, diabetes, or cancer died in their tents or out on the streets. There were no diagnostic tools, treatment options, or follow-up available. The hospital had more than enough to do caring for people who had been shot or injured by shrapnel or explosions. Many of the injured patients had to undergo surgery again and again. Their injuries would not heal because they were so undernourished, and their bodies lacked the building blocks needed for recovery. Poor nutrition also weakens the immune system, and combined with a hospital environment that was impossible to keep clean, many of them developed infections as well.
In addition, we lacked essential medical equipment, and the equipment we did have was worn out. At times, we barely had any monitoring available for severely injured patients while they were being operated on. We also lacked medications needed to provide safe and adequate anaesthesia, sufficient pain relief after surgeries, and we did not have enough intensive care beds. Patients who had undergone major surgeries — for example, gunshot wounds to the chest or abdomen — had to be woken up right there in the operating room and moved to a regular ward. These are patients who, under normal circumstances, should have been transferred to an ICU, kept sedated and closely monitored, and only awakened once everything was stable.
When I returned to my everyday work in Norway and saw how we treat both children and the elderly, it struck me that I had not seen any elderly people in the hospital in Gaza. The patients were only children, teenagers, and young adults.
What led you to accept the mission to Gaza? What considerations influenced your decision?
Ever since I was a medical student, I have always had in the back of my mind that I wanted to combine working in Norway with doing humanitarian work abroad. Due to personal circumstances, I wasn't able to do this until now.
There are several reasons why I wanted to go to Gaza. One is that Norway is indirectly involved through investments made by the Oil Fund. We saw international law being violated without anyone reacting, and it became clear that human rights do not apply equally to everyone. For me, all people have the same value regardless of background, skin colour, religion, ethnicity, etc. The racism my family and I faced growing up in Norway also triggered something in me.
I contacted the Norwegian Aid Committee (NORWAC), an organisation that has worked in the region for more than 40 years, and was accepted as part of the 15th team sent there after October 7, 2003.
Could you describe the hospital environment in Khan Yunis?
When we arrived at Nasser Hospital, more than 800 patients were admitted. The hospital has 340 beds. There were literally patients everywhere. Some had beds, but most were lying on the floor with or without mattresses — in the hallways, stairwells, in front of elevators, and on the ground outside the hospital. Tents had been set up around the building to make room for even more patients. By the time we left the hospital four weeks later, there were over 1,000 patients. While we were at Nasser, the residents of Gaza City were ordered to evacuate and move south toward Khan Yunis, which caused the number of patients to increase dramatically.
The hospital clearly showed signs of having been attacked multiple times. Just one week before we arrived, the hospital was bombed and 20 people were killed, including several journalists.
How would you characterize the experience of providing care under war conditions?
Providing care under war conditions is unlike anything I have ever experienced. The constant insecurity, the overwhelming number of critically injured patients, and the lack of even the most basic medical resources change everything about how you work. You are forced to make decisions no healthcare professional should ever have to make — choosing who can be helped and who cannot, simply because the resources are not there.
You work under pressure, with limited equipment, exhausted staff, and a continuous stream of trauma patients. At the same time, you are surrounded by the sounds and realities of war, which affect both patients and staff. Despite this, you try to create moments of calm, humanity, and professionalism in the middle of chaos. It is emotionally heavy, ethically challenging, and physically exhausting — but also a powerful reminder of why humanitarian work is so important.
It felt like being inside a horror movie — except it wasn't a movie, it was real. Seeing children lying in rows in the intensive care units, but also in the regular wards, with bandaged heads because they had been shot — I have no words for that. The youngest child who was operated on while I was there was a six-month-old baby girl. She had been shot through the lung, and the projectile had lodged in her abdomen. She survived the operation but died a few hours later. One day, six dead children were brought into the emergency department. It was surreal.
How did you manage the challenges? How did this experience affect you psychologically?
Before we were granted permission to travel to Gaza, each of us had to be assessed by a psychiatrist. It was the psychiatrist who gave the final approval for me to go. While we were there, we had weekly conversations with her over Teams, and we could also contact her more often if needed. I travelled with a team of three others — two orthopaedic surgeons and an operating theatre nurse. All three had been to Gaza before, and having experienced colleagues around me helped enormously. In addition, I got to know so many wonderful Palestinian colleagues, as well as healthcare workers from the US and the UK. Being surrounded by so many good people was a form of protection for my mental health.
During the first few days especially, I experienced a kind of fear I had never felt before. For the first time in my life, I heard drones and bombs. On the first night at Nasser Hospital, I was woken by a powerful explosion that shook the entire building. I lay there awake, waiting for the shaking to subside, and wondered why it was taking so long — until I suddenly realised that it was not the building shaking, it was me. My heart was beating so hard and fast that my whole body trembled. In that moment, I felt an overwhelming fear combined with deep sorrow for all the people lying out there in the tents, where bombs, drones, loss, and fear had been their everyday reality for so long.
As the days went by, I somehow became used to the sound of the bombings. I watched how my Palestinian colleagues reacted to the different blasts and learned from them. Most of the time, they did not react at all.
I also want to add something about our Palestinian colleagues: I am overwhelmed with admiration for the strength they showed. In the midst of this apocalyptic existence, they simply kept working. Even though many had lost more than ten kilos, some walked around with IV cannulas in their arms to receive extra fluids because they felt dizzy, they lived in tents without electricity or water because their homes had been destroyed, they were kept awake at night by bombings and drone activity that intensified around 3 a.m., and they had experienced losses we cannot even begin to imagine — yet they showed up for work every single morning.
In an impressive way, they managed to find solutions and use equipment in alternative ways, because they had to. They smiled, joked, and laughed, but the grief in their eyes and the sense of hopelessness were unmistakable.
