In September, when Médecins Sans Frontières deputy medical co-ordinator for Gaza, Dr Mohammed Abu Mughessib, discovered he had been accepted for an MSF advisory job based in Ireland, he was staying in an MSF office in Al Mawasi with two watchmen. “The three of us hugged each other and cried.”
The watchmen wanted to cook a dinner for him. They had a can of meat between them. One went to try and find an onion. “Onions were very expensive. It cost around $20 (€17) for one onion.” But then he found he couldn’t eat. “I was happy and sad. I called my wife [she was in Egypt]. She didn’t believe it. She was crying.”
Mughessib worked for MSF in Gaza throughout the war. He was born in Kuwait to Palestinian parents and has lived in Gaza for 25 years. He left on September 17th. Before that, he distributed everything he still owned among his friends: “Winter clothes, blankets, my mattress, my pillow, a jerrycan of water. These are the precious things during this war.”
On October 7th, 2023, Mughessib was woken up by his wife, who said she could hear rockets. At first, he thought it was some sort of training exercise. “Sometimes,” he says, “Hamas fired rockets into the sea.” When they turned on the television there was no relevant news but there were all sorts of rumours. One person rang and said the rockets were related to an assassination attempt in Beirut. Eventually the truth emerged about what Hamas had done. “A horrible thing,” says Mughessib, speaking in Dublin, where he now lives and works.
READ MORE
Mughessib knew there would be a response. He moved his family into the MSF headquarters. “Each of us took a backpack.” Soon there was an evacuation order telling all residents of Gaza City to move to the southern valley.
For 80 days he and his extended family lived in part of a compound owned by a colleague in what became the Nusairet Refugee camp. There was no clean water: 500 litres of water cost $150. They bought flour because there were no bakeries. They grew accustomed to the sound of drones and bombs. Mughessib helped co-ordinate the medical response and he and his colleague worked on burn injuries.
Israel, he says, divided Gaza into areas, and they were right next to a zone designated for bombing. It felt untenably dangerous. His sister, who worked with the UN, got a small room in a UN compound in Rafah for her family and Mughessib’s family and their elderly father. Mughessib’s son slept in their car because there was so little room. “My wife was waking up crying at night. My sister was completely depressed. She called my brother [who lived abroad] at the end of January, and said, ‘We are dying here.’”
They put together the €33,000 required to evacuate to Egypt. On February 24th, 2024, he went to the border with them. “My wife was crying. She said, ‘I will stay with you.’ I almost had a fight with her. My daughter said, ‘Who will cook for you?’ I said, ‘There’s no cooking.’ My son said, ‘I want to stay.’ I said, ‘No, no, no … I will follow you later.’ And then when they crossed, [an Egyptian soldier] said, ‘You’re smiling. We are kicking you back to Gaza.’ I said, ‘I’m smiling because my family will not die.’”
Why did he stay? “I worked with MSF for 20 years. I could not abandon it like this ... I remember that first night I had a room the size of this table. I had my cat, Nino. I slept well.”
The doctors in Gaza are part of the general population. As they work, they are constantly worrying about their own families. Many have seen their own children come in with injuries. The phone network was terrible, so if you were worried about someone, it was difficult to contact them. “Every time I suffered, I compared myself with people who had families there. [My colleague] has three kids and he cannot feed them. He cannot provide shelter for them. If he has to run, he runs with the children and his wife and his father and his extended family.”
Trying to operate a medical service in an ever-changing war zone is incredibly difficult. The main challenge was finding a safe place to work. Mughessib was constantly moving from place to place with his sleeping bag. “There is no existing health system any more,” he says. “Everyone is working on a daily basis. Today, you are here. Tomorrow you have to work in another hospital. Today there is electricity, tomorrow there is no fuel to run the generators ... We were lacking sterile gauze, or there are no painkillers.”
What happens then? “Some of our colleagues at the beginning of the war, they were operating on patients without painkillers, [continuing] amputations without painkillers. There were difficult decisions all the time. But the Palestinian doctors adapt quickly. They will not stop working. When the tanks arrive to the hospital and ask them to leave, they will leave at that point. They could be killed, they could be arrested, but they will work until the last moment. You can evacuate patients who can walk, but the majority of patients cannot walk. ICU patients. Babies in incubators.”
He likens the hospitals of Gaza to public markets. Patients are on the ground and in corridors. There are queues for operation rooms and intensive care units. “You have 100 patients with bad injuries arriving at one time. People shouting, this one is bleeding, this one is crying, this one is dying. Doctors running ... They manage as much as they can with minimum resources.”
They dealt with horrific injuries. He tells me about a three-year-old who lost both her legs and a pregnant woman who lost her baby and her leg, as well as most of her family. “I co-ordinated the evacuation to bring her to our hospital. She wanted to say ‘thank you’. I was not able to see her. I couldn’t stand it ... Genocide is a soft word. A very sweet word. We have to find something bigger to describe it.”
By August 2025, famine was officially declared in Gaza. Mughessib stresses that he and his colleagues were in a better position than most because they had salaries. “But there was nothing to buy. If you find a can of beans that normally costs a euro it could be €20, and you would cheer up. That would be breakfast, lunch and dinner. There was no rice. Flour cost €30 for one kilo. That made 10 pieces of bread. I was the richest guy with my 10 pieces of bread, enough for 10 days. It was actually enough for three days because I shared. I’m not a water drinker. But I was drinking water to make my stomach full. By July and August the starvation was very bad. The main topic in the hospital was ‘What do we find to eat today? Did you find coffee in the black market?’ It was a treasure, coffee. One cigarette was €20. We would drink very bad coffee that has made with some cereals and date seeds. It’s not a coffee but you pretend it’s a coffee.”
‘Hope’ is a fragile word in the Gazan dictionary. We don’t count on hope any more
— Dr Mohammed Abu Mughessib
He would wake every night with the ground shaking from the bombs. He had bad dreams. Whenever he was outside, he’d check who was nearby, wondering whether they were a Hamas member that might be targeted by Israel. “Now [in Ireland] as I walk the streets, I’m trying not to look over my shoulder. They target Hamas when they’re standing beside children in queues for food and water. Eight per cent killed and injured are civilians ... 20,000 children killed; 15,000 women; 17,000 orphans; 5,000 amputees. These are the numbers which are registered, the ones who reached the hospital. There are more under the rubble.”
How did he cope with the fear? “I didn’t express my fear in front of people, but during the last six months, I would wake every day in the morning with my hands stiff like this.” He curls his fingers so his hands resemble claws. “I’m 53. I thought it was maybe arthritis … The morning after I crossed out of Gaza to Amman, it stopped.”
He ended up leaving on the same day as his friend, a social worker, who was going to Australia. “His name is Rami, a Palestinian Christian. For 20 years on Thursdays he would bring whiskey and we would talk all night … [At the border] it was an emotional moment. Rami left his group, and I left my group … We hugged each other, and he was saying to them ‘He’s not a friend, he is a piece of my heart’.”
How did it feel when he left? “The first thing I did when I crossed was I went to buy coffee and to smoke ... There were 14 students with me. They were joking. ‘Finally we have a banana.’ These were things we didn’t see in the two years of war.”
Things began to sink in for him, he says. “Everything you have built in your life, memories from when I was born in Kuwait, things from my childhood, I left and they were erased – the albums of photos, the house. You have nothing but your clothes, a mobile phone, a charger, and some money. You’re not allowed take souvenirs of Palestine. Not even sand. When you cross the border, you realise you’ve lost everything ... My soul is there. My memories are there. My cat is there.”
His wife is visiting when we meet. His family will travel to Ireland from Egypt once he can find a home. She spent every day he was in Gaza worrying whether he was alive or dead. She says: “I don’t care what you lost. You are alive, and you are with me here. Forget about what you lost, what we lost. Our kids are with us. And we can start a life from scratch.”
In the days after the ceasefire was announced, he did a Zoom call with his exhausted colleagues and saw them eating chicken for the first time in two years. Some returned home to find their houses destroyed. Some homes were destroyed days before the ceasefire.
Mughessib believes the true challenge will be in rebuilding their country. “There’s no infrastructure, no water supplies, no sewage system, no electricity. Six hundred aid trucks have entered but we’ll need 1,000 trucks every day for at least three months to sustain the market of food ... We need millions of tents. More than one million people have lost their homes in Gaza. It will take decades to rebuild what has been destroyed.”
Is he hopeful? “We still don’t trust the ceasefire to hold because Israel can break any ceasefire with any excuse,” he says. “‘Hope’ is a fragile word in the Gazan dictionary. We don’t count on hope any more.”
