Three weeks in Gaza: A Pakistani-American doctor's account of medicine under siege

KARACHI:

As Dr Irtaza Khan prepared to leave Al-Nasser Hospital after three weeks in Gaza, a young man approached him – a hospital worker who'd smile and exchange pleasantries as the international doctors made their rounds.

He'd spent the night sleeping on the hospital stairs, waiting. When Khan emerged at dawn, the man said he had an amana (trust, responsibility). Before Khan could refuse, the young man stated: "Tell the world what is happening to us. That is my amana to you."

The thought

Khan had been watching Gaza since the conflict reignited in October 2023. Israel's military has now accepted that approximately 71,000 Palestinians have been killed, according to Gaza's Health Ministry – a figure excluding those buried under rubble.

Every night, Khan scrolled through footage – buildings reduced to rubble, children pulled from wreckage. He donated, attended protests in Chicago where he practices as a pulmonologist and ICU physician, and in Pakistan where he visits family.

"There comes a time when you feel that regardless of what you're doing, your voice is not getting heard," he says. "That's all we saw, the mortality going up, people dying, babies dying."

In August 2025, he realised he held both Pakistani and American passports and could use his US nationality to enter Gaza as a physician.

He reached out to several organisations. The responses were uniform: "What kind of experience do you have working in a war zone?" To this, Khan says, "ideally speaking, in an ideal world, people would say we have no experience."

The Palestinian Children's Relief Fund (PCRF) responded within 48 hours. Before accepting his application, they wanted to prepare him. "Whatever you're seeing is going on over there, make it a thousand times worse," the PCRF lead told him. "The ground realities are absolutely horrible."

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Israel controlled all entry to Gaza, providing no guaranteed visa. Rejection could come at any moment – at the border, without explanation. Doctors had traveled 30-plus hours only to be denied entry.

Only two entry days existed per week: Tuesday and Thursday, and each NGO could bring only three people at a time.

The restrictions bordered on absurd. No medical instruments beyond a stethoscope, no candles, despite Gaza being pitch black with only three hospitals maintaining generators. When a medical team from England tried to bring baby formula for infants, Israeli authorities destroyed it in front of them.

"It takes a special form of cruelty to do that," Khan says. His 80-year-old mother's response surprised him most. While other friends and family urged him to reconsider, she said simply, "sure, do it."

Crossing the border

Khan boarded one of two buses carrying 80 people – United Nations (UN) staff, Doctors Without Borders, physicians from multiple NGOs. They were warned: Israeli security agents would try to provoke responses. Don't engage.

As the convoy passed through the military crossing, a female Israeli soldier called out cheerfully: "Oh, you're going to Gaza? Enjoy, have fun!"

Then they entered Rafah. Pin-drop silence fell across both buses. Even UN staff who'd made this journey multiple times sat wordless.

"Absolute devastation. Absolute annihilation," Khan says. "Those Hollywood movies where a nuclear attack has happened, the day after, nothing left except nuclear winter. That's what it looked like."

92% of buildings were destroyed or damaged. Children's shoes scattered in rubble, mattresses half-buried under concrete, a pharmacy sign reading "Saeed Ali - Open 24 Hours" charred and dangling, roads bombed into dirt tracks, animal carcasses lining the sides.

View of destroyed buildings in Gaza. PHOTO: DR IRTAZA KHAN

"You stop for a moment and imagine that these were houses where people lived and laughed and kids played," Khan says. "And literally I was sitting there with tears in my eyes thinking, 'God, I hope the children ran away.'"

As they crossed the yellow line – the boundary beyond which 58% of Gaza remains under Israeli control – people began appearing. Hundreds lined both sides, watching the convoy pass.

"Those zombie movies where people come out and they have this dead look in their eyes," he says. "They were standing there, men, women, children. They are you and me, and they have nothing left."

The majority now live in flimsy tents. Those without even this live in partially collapsed buildings, while others sleep under the sky. Without electricity or gas, people burn salvaged furniture and plastic bottles to cook.

Post-ceasefire

Al-Nasser Hospital in Khan Yunus, where Khan arrived in October 2025, is the largest remaining medical facility in Gaza. Israeli forces had attacked it multiple times, including a strike that killed six journalists.

The hospitals once had 100 generators, Khan says, though only 45 remained. Israel blocks spare parts. When Israeli forces invaded Al-Nasser in early 2024, administrators told Khan that soldiers shot medical equipment – dialysis machines, CT scanners, chemotherapy units – at point-blank range. Of seven MRIs, all destroyed. Of 25 CT scanners, only six are functional.

Khan arrived as the first volunteer group after the October 10, 2025, ceasefire. But the "ceasefire" proved hollow. Six to ten explosions rumbled daily while drones circled constantly overhead, Khan recalled.

One day, Khan kept telling his coordinator, "It's too quiet today. What's happening?" The coordinator explained: when the drones disappear, it means missiles are coming.

On his third day, the area around the hospital was attacked at dawn. Khan heard the whoosh of the missile before impact.

A one-year-old girl had been pulled from rubble with half her face gone and one eye dangling from its socket. Five surgeons operated for hours: splenectomy, chest surgery, facial reconstruction, eye removal. But even after five major surgeries, they couldn't keep her in the ICU. They had to send her to the pediatric ward.

"They said as much as she's been bombed, she will not be the sickest one," Khan recalls.

Habibi, this is war

On his third day, Khan stopped asking certain questions. He'd been requesting standard emergency interventions – dialysis, immediate surgery – only to watch colleagues say: "Habibi, this is war."

Globally, certain conditions trigger emergency treatment regardless of time or age. In Gaza, those same conditions wait two to three days. Not because doctors lack skill, but because they're triaging between children, adults and seniors, making choices no physician should face.

"You're picking who gets emergency treatment now and who has to wait, knowing that if they wait, they may not survive. A 22-year-old should not die just because they did not get treatment."

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His first patient consultation: pulmonary alveolar proteinosis, a rare disease. The Palestinian doctors had correctly diagnosed it, something Khan wouldn't expect from general physicians in the US. Treatment required washing out the lungs with 18 to 30 liters of water. Khan knew how to perform it.

But the woman and her husband asked, even if you know how to do it, do you think our hospital knows how to take care of me afterwards?

"I told them that if you don't do it, there's almost a total chance that you will die. But if we do it, there's a small possibility that you will survive." She chose not to take the chance. She'd rather see her family, be with them, than get the procedure and possibly not wake up.

Another woman with six children – two her own, four orphaned relatives – developed septic shock from an infected cut. She needed hospital admission or she would die. She refused because if admitted, those six kids would die of hunger.

"We were trying to tell her that if you die, those kids are gonna die anyway. But there are lots of households where there is only one adult and everyone else is a child."

Dr Irtaza treating a patient in Gaza. PHOTO: DR IRTAZA KHAN

A 22-year-old man had enlarged lymph glands – likely lymphoma, likely treatable. Anywhere else, Khan could perform a bronchoscopy within 24 hours. But he couldn't find a needle to do the biopsy. Without proof of cancer, the young man would wait months on the evacuation list.

As Khan examined him, the young man grabbed his hand. "Am I going to die?" The answer was yes but Khan told him no.

"The last thing I wanted to do was take his hope away. So I said, 'No, Inshallah, we're trying everything.' But deep down inside, I knew if this is lymphoma and it's not treated, he will die."

A 15-year-old boy whose mother, Khan, had to tell: her only surviving child was going to die. In the US, doctors can at least say they tried everything, but Khan had no such comfort. "I know the next ten things I could do to save him. But I don't have the first thing to treat him with," he notes.

Israel doesn't permit critically ill patients to leave for treatment abroad. Another 15-year-old died waiting for approval that never came.

Meanwhile, after the ceasefire, only 10% of the needed aid enters. Israel agreed to allow 600 trucks daily but permitted far fewer. Israel separated tent poles from tents, rendering aid useless. When transportation was destroyed, residents tried using donkeys. Israeli snipers shot the donkeys.

"There's no rhyme or reason. It's just another way of torturing people."

Pakistan's name

When Khan's translator mentioned he was from Pakistan, patients' faces would transform. They'd sit up, smile and take his hand.

"The minute they heard 'Pakistan,' literally, they would sit up in bed and smile and tell you they love Pakistan."

Despite the destruction, the hospitality bordered on overwhelming. Khan's coordinator, Khalid, would refuse food, saying, "there are people suffering more than I am, give it to them."

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An OR technician greeted him daily: "Please come over to my house for dinner. You are our guest." Khan assumed he'd been spared personal tragedy. Then he learned the man had lost 30 immediate family members – parents, wife, children, siblings, nieces, nephews – all killed. Yet each day, he came to work and asked, "Is there anything you need from me? Is your family okay?"

A young resident continued making rounds despite a severe burn on his hand from a molten plastic bottle. When Khan offered to write orders, the resident refused. "No, it's my job."

The only pulmonologist

Khan was the only surviving pulmonologist in all of Gaza. Every other pulmonologist was dead, imprisoned or displaced. Consults came at all hours. The morning the hospital was attacked, his day began at 4.30am with casualties pouring in.

An 18-year-old girl arrived coughing severely. Khan prescribed inhalers. A week later, the cough was gone. "All she needed was access. Basic access to medication."

But for every success, there were dozens of failures. Khan organised a three-day bronchoscopy training course for local physicians. One doctor was reluctant. "So what happens when I'm not here and you don't have a pulmonologist? What happens when the procedure doesn't get done?" "People die," he replied.

"If you learn this procedure, you may kill the first five, first ten patients you bronc. But then you'll end up saving the others," Khan responded. He added that in a war zone, a 1% chance of survival beats 100% chance of death.

Coming back

While in Gaza, Khan slept fine. He worked, saw patients, and adapted to constant drones and explosions. Looking at the population in tents while he slept on a mattress, he felt privileged. "When everyone around you is going through the same thing, you just do what needs to be done," he says.

But when he returned to Chicago, it hit him; survivor's guilt and sleepless nights. Every time he closed his eyes, he saw faces – young people who'd say "I had four brothers, I'm the only one alive" before asking, "am I going to die?"

"When I was 25, 27, death never even occurred to me. But you go to Gaza and meet teenagers, and for them, death is something that can happen at any time."

A young man told him: "Israel took our hope away. Do you know what happens when you have no hope?" Another said, "We have not had the time to sit down and realise what we have lost. The day we do will be the day we collapse."

Friends in Gaza message Khan about standing in flooded tents all night, holding their children because everything is soaked. But Khan refuses to let the psychological toll define his response. "You can take any experience and decide what to do with it. You can sit and wail and be miserable, or you can turn it into something positive."

View of tents in Gaza. PHOTO: DR IRTAZA KHAN

Since returning in November 2025, he's given talks in Karachi, Lahore and across the US. Students from Bayview Academy wrote letters, which Khan forwarded to Gaza. Colleagues who are Jewish, Christian, Hindu, or atheist have approached him in tears. A Jewish colleague stopped him mid-story: "Why do we not know about this? The media doesn't cover this."

"If there's one thing I hear unanimously, it's that the media is not telling us these stories."

He was supposed to return in February 2026, but decided his impact would be greater in the US. He's organising physicians who've served in Gaza to brief US senators.

"If I talk to 100,000 people but manage to get this message across to one, I would consider myself lucky. It's just about spreading the message and not forgetting."

The amana

That young hospital worker who spent the night on the stairs – Khan still doesn't know his name.

When the man said, "Tell the world what is happening to us," Khan felt the weight of desperation behind the words. This is how helpless they feel. This is what it means to be abandoned.

"I tell his story everywhere I go. I tell people this is his amana that I'm passing on."

Khan shows audiences photos and shares medical cases. Even ICU physicians and nurses who see death regularly break down when they hear what's happening.

"Humanity transcends race, religion, boundaries, and nationalities. An injured child, a hurting child, a dead child is unacceptable to everyone."

Would he return to Gaza? Without hesitation. "That's a no-questions-asked decision," he states.