Gaza doctors struggle with bereavement, overwork, trauma amid genocidal war 

Deir el-Balah, Gaza – Manar Fayyad, 29, an anaesthesiologist at Al-Aqsa Martyrs Hospital, has suffered severe psychological trauma since the start of Israel’s genocidal war on Gaza in October 2023.

The turning point came when he discovered that a man lying before him in the operating room was his own brother Shadi, who was killed in an Israeli air strike on December 27, 2023.

He recalled the moment he was summoned into the operating room to administer anaesthesia to a critically injured man before emergency surgery.

“He died before I could reach him,” he said. “When I arrived in the operating room, I recognised the man’s clothes. I had a strange feeling, so I approached him and uncovered his face. To my shock, he was my brother Shadi, who was 34.”

Since then, the hospital has become inseparable from the traumatic memory, and he has been unable to continue to work, ultimately bringing his professional career to a premature end.

He continues to struggle with the psychological effects of the experience, trying to cope with it on his own without professional help. He has withdrawn from social life and avoids people and noise as he searches for peace since his brother died.

Sitting by the sea and writing offers him some solace, helping him express his pain and process what has happened. Yet he remains preoccupied with the idea of leaving Gaza, hoping that distance might free him from the reminders of that day.

Having lost his brother, his profession and much of his social life, Fayyad now faces a different battle: one against trauma that he is trying to confront alone.

Khaled Raafat, 29, a nurse in the emergency department at Al-Aqsa Martyrs Hospital, stepped away from work for an extended period after losing his wife, children, mother and several siblings in an Israeli air strike on his family home on October 18, 2023. He was at the hospital at the time, trying to save their lives of others injured that day.

“Learning that I had lost my family marked a painful turning point in my life,” Khaled told Al Jazeera. “I could no longer do my job in the same way. The hospital, once associated in my mind with my humanitarian duty, became a reminder of personal pain that was beyond what I could bear. It deeply affected my ability to continue my professional and social life.”

Raafat said he eventually decided to rebuild his life.

“I realised that life could not stop at the tragedy and that I had to find a way to carry on. I decided to work towards my psychological recovery, got married and started a new family in an attempt to regain stability and hope,” he said. “I then returned to work at the hospital.”

At least 1,700 medical personnel have been killed in Israeli attacks during the war while 83 healthcare workers remain in Israeli detention, according to Gaza’s Government Media Office.

These figures do not reveal the deep psychological burden borne by medical workers who have lost family, friends and colleagues and witnessed horrific injuries and death on a daily basis. They have also faced continued displacement, relentless pressure and have been overworked for years.

A study found that 41 percent reported losing family members and 46 percent had experienced both personal bereavement and displacement from their workplaces, according to a report on the strain on medical workers in Gaza published in the Public Library of Science.

At least 78 percent of healthcare workers in Gaza lacked access to mental health services, showing the gap between the trauma healthcare workers endure and their access to psychological care. It has meant that Gaza’s health system is struggling to retain its remaining staff and prevent them from leaving the medical field.

Although it is difficult to assess how many doctors, nurses and other medical workers have left Gaza and their jobs, official reports have acknowledged a “loss of human resources” and “diminished capacity in the healthcare system”.

To help halt this brain drain and protect healthcare workers who have experienced psychological trauma – probably most of those in Gaza, they need psychological and social support.

“They are caught between their professional duty to save lives and the pain of losing the people closest to them,” Munir al-Bursh, director general of Gaza’s Ministry of Health, told Al Jazeera. “They find themselves treating others’ wounds while struggling to heal their own.”

Working under constant pressure without adequate support or rest deepens exhaustion and threatens healthcare workers’ ability to continue, he said.

“Protecting medical personnel is not just about securing medicines and equipment. It also means safeguarding their mental health and giving them time to rest and recover. Those who save others also need someone to reach out and help them.”

The acute shortage of medical staff after the killings, detentions and injuries of many healthcare workers makes it difficult to give those who remain enough time to recover, he added. This is compounded by the continuing arrival of patients and wounded people, shortages of equipment and a lack of replacement staff.

The experiences of these doctors and nurses reveal the psychological toll of war on Gaza’s healthcare system. Those accustomed to confronting death and saving the wounded have sometimes found themselves facing it as bereaved family members rather than medical professionals. Caught between their duty to save others and their own grief, some have paid a profound psychological price with consequences for both their professional and personal lives.

Nurse Hiba al-Tawil, 39, witnessed her brother’s death in the intensive care unit at the Nasser Medical Complex in Khan Younis, where she worked.

“Losing my brother at my workplace was a difficult experience that had a profound psychological impact on me,” she told Al Jazeera. “Being in the intensive care unit afterwards reminded me of what had happened and made it harder to cope with the loss.”

She later transferred to another department. which helped ease the psychological pressure she was experiencing and allowed her to distance herself from the place where her brother died.

The psychological clinic at the hospital treats doctors and nurses struggling with trauma caused by bereavement and their experiences during the war. In some cases, these experiences can develop into severe psychological disorders that affect their everyday lives and ability to work.

Reham Abu Rokba, a psychologist at the complex, said treatment begins with assessing the patient’s psychological condition, diagnosing symptoms and determining their impact before developing a treatment plan.

For patients with post-traumatic stress disorder, treatment may include cognitive behavioural therapy, which helps them understand their psychological responses to traumatic events and regain their ability to cope.

Depending on the patient’s needs, treatment may involve about 12 individual sessions and, when necessary, medication.

Reham said that continued psychological support, appropriate treatment and adherence to the treatment plan can help ease symptoms and lead to improvements.

“Recovery requires time and ongoing participation in psychological support sessions,” she told Al Jazeera. “Providing the appropriate treatment and ensuring adherence to it can help alleviate symptoms and lead to tangible improvements in an individual’s mental wellbeing.”