KAHN YUNIS, Gaza — Raneem Hejazi was eight months pregnant, sleeping in an aunt's apartment with her husband, mother-in-law and other members of her extended family, when the building was hit by an Israeli airstrike. Seven members of the family were killed.
Hejazi's arm was crushed and her legs were broken and badly burned, but she was alive. She told her husband, Asad, to leave her to die. But somehow they pulled her out from the rubble. An ambulance rushed her to the Nasser Hospital in the city of Kahn Yunis, in southern Gaza.
The hospital was crowded and chaotic when she arrived. The baby had to be delivered if there was any hope it would survive. Even though the hospital had no electricity, Dr. Mohammad Qandeel decided they needed to do an emergency cesarean section.
Cell phones illuminated the operating table while the medical team worked, Dr. Qandeel says. "We have no water – I don't have water to wash my hands," he recalls. There were also no antibiotics to fight infections.
On a day with so much death a baby girl was born. They named her Mariam – after her husband's sister – one of the family members who died in the airstrikes.
Daily births amid destruction and death
Dr. Qandeel says Raneem Hejazi's story is – tragically – not unique. In fact, her emergency C-section was one of two that night at Nasser Hospital. "The babies are ok – thank God – and the mothers are in the ICU facing severe devastating injuries," he says. They aren't equipped to properly care for the women at the hospital, given the lack of resources, so they are trying to facilitate their transfer to Egypt. "If they stay in the ICU without evacuation they will also face death soon."
"We have hundreds of severely injured patients, 70% of them are women and children," he says. Hospital staff are often working without electricity or water. "Every day is horrible," he says.
Even for pregnant women who aren't injured, the situation in Gaza is horrific, says Dominic Allen, the U.N. Population Fund's representative in East Jerusalem.
"As a population fund, which focuses on reproductive health as part of our mandate, our big concern is the 50,000 pregnant women in Gaza right now," Allen says.
Many of these pregnant women are fleeing their homes, trying to find safe places to stay, he says. "Every time you're moving, you're dodging bombs and airstrikes, with that pressure and stress of not only trying to find safety in that moment but to think ahead to – am I going to be able to give birth in a safe environment? And – what's the world I'm bringing my unborn child into?"
He adds that his U.N. agency is distributing medical supplies and hygiene kits for women, including items like sanitary towels. It's also supporting a helpline for women and youth. But Ammal Awadallah, the executive director of the Palestinian Family Planning and Protection Association, says it's unclear how many pregnant women can reach helplines given the lack of electricity and internet.
Hospitals are far from a haven. She says hospitals are telling pregnant women they can't receive care unless they are fully dilated and ready to deliver. And their stay will be short.
"With the overcrowded hospitals, women and their newborns are being dismissed only a few hours after delivery," Awadallah says. Hospitals are overwhelmed with people injured from airstrikes.
And for families whose homes have been destroyed, there's nowhere to go after leaving the hospital.
Water and warmth
One of Allen's colleagues is a reproductive health specialist on the ground in Gaza. "She is receiving phone calls from pregnant or new mothers and they're asking some of the most basic questions around – my child's been born, I don't have access to clothes, what do I wrap my baby in?" Allen says.
A major concern is access to clean water, he says. Mothers who are breastfeeding need to drink extra water to be able to produce milk for their babies. "What we're hearing is that, as water is running out, the only water is in small quantities [and] it's brackish, unhygienic water," he says. He says his staff spoke with a woman with a seven- or eight-month-old child who had been nursing but whose milk supply had dried up.
Allen echoes the U.N. Secretary General's call for a humanitarian ceasefire.
For Raneem Hejazi, Mariam's mother, there's a long road ahead. Her arm was amputated in a six-hour surgery. She remains in the hospital and will need more surgeries. Asad visits her and their newborn every day. Doctors tell her family that she needs to go to Egypt to get better care than the hospitals in Gaza can give. So far, the borders are closed, and no one is getting out.
Liz Baker contributed reporting from Tel Aviv, Abu Bakr Bashir and Fatima Al-Kassab contributed reporting from London.
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