On August 21, the Israeli army ordered different areas in Deir al-Balah in the central Gaza Strip to evacuate their homes and newly-erected tents. This was the first step in the army’s invasion and campaign of destruction in Deir al-Balah, the last town that had not been completely leveled throughout the war. 

One of the blocks ordered to evacuate included the last fully operational hospital in central and southern Gaza, the al-Aqsa Martyrs Hospital. Affiliated with the Palestinian Authority, the governmental hospital has been working at four times its capacity, hosting over 700 patients.

As the military order spread among people in the area, dozens of doctors and nurses evacuated too, knowing what would likely happen to anyone in the hospital who remained, with the horrors of the massacres and mass graves at al-Shifa Hospital and Nasser Hospital still fresh in their minds. 

But there are others working in the hospital who have refused to evacuate under any circumstances, intent on remaining to care for the patients that keep streaming in.

Mondoweiss spoke to several medical workers at al-Aqsa Martyrs Hospital who refused to abandon their posts when the Israeli army ordered the evacuation. They preferred not to be identified and have been given pseudonyms in this story due to their fear of reprisal by the military. Based on numerous past experiences throughout the war, they believe that the Israeli army has been deliberately targeting doctors and hospital staff who refuse to adhere to evacuation orders. During the second invasion of al-Shifa Hospital in March, medical workers were singled out for killings and arrests, and the Director of al-Shifa was sent to the notorious Sde Teiman torture facility, only to be released in late June with no charges. 

Ayat is a physician who refuses to evacuate the al-Aqsa Martyrs Hospital. She also witnessed the al-Shifa invasion and was one of those forced to evacuate to the center of Gaza. She has remained at her post since the start of the war but is now biding her time, waiting until the last possible moment before she is eventually forced to evacuate or risk getting trapped in the hospital whenever it comes under siege. 

Ayat tells Mondoweiss she does not want to stay for an inevitable death, but is torn about leaving her patients. “Both choices are painful for me, but I know what the army is going to do when it invades the hospital. I’ve been at al-Shifa Hospital. They were running over people with bulldozers and tanks.”

“Will the world allow us as doctors and patients to meet such a horrifying fate? Is that the humanity and the Hippocratic oath that the world created?” Amani, an ICU nurse at al-Aqsa Martyrs Hospital

“There is no chance for survival inside the hospital if we are surrounded by the army,” she continues. “On normal days, we are short on everything: medical supplies, staff, and medical equipment. And this leads us to wonder what would happen if everything stopped coming in altogether for just one day, let alone a long siege.”

The hospital has not made an evacuation plan, but it has not made one for working under siege either — the choice of whether to remain or evacuate has been left up to each individual. 

Ayat is staying with the hope that the army would notify the staff ahead of invading, as they did with al-Shifa. “The Israeli army has not called the hospital so far, but we can’t trust them really,” she says. “They may invade any second, and they have already issued warnings to residents of the block where the hospital is located.”

“I’ve seen the army make no difference between doctors, nurses, civilians, patients, and even premature babies in incubators,” she says. “If I can escape at the last moment, that’s what I will do, but I refuse to witness the same massacre again.” 

‘Who is going to care for my patients?’

On Tuesday, August 27, the morning shift in the hospital is attended by three doctors and ten nurses. Over 700 patients were in the hospital before the evacuation began, but several hundred still remain today.

Hakeem, an emergency room physician at al-Aqsa Martyrs, tells Mondoweiss he is worried about what will happen to the injured and the sick who cannot evacuate with those who leave. “If we leave, who is going to care for my patients?” Hakeem asks. 

“We have no plan to evacuate and we have no plan to operate in the event of a siege. We don’t have anything stored for such a scenario,” he says. “We’re working under impossible conditions, but if we leave our positions, if we give up on our duties, we will fail ourselves and our society. We will fail our families and the friends who count on us.”

“We will try to do our best until our last breath.” Hakeem, a doctor at al-Aqsa Martyrs Hospital

Even after the Israeli warning was sent to residents in the area, injuries continued to arrive at the hospital, being the only possible refuge for people affected by the bombardment.  

“The injuries arrive every hour,” Hakeem says. “On normal days we’re overwhelmed, but now the number of cases has jumped dramatically. It’s beyond the capacity we’re able to deal with.” 

For 11 months, the hospital has not once gone out of service, but Hakeem says that its medical capacity is now less than it has ever been. “If the army surrounds the hospital, neither us nor the patients will be able to survive for very long. But we will try to do our best — until our last breath.”

“We chose this path, and we will stay with the patients and save their lives,” he vows.  

‘Will it be even worse than the other massacres?’

Despite their resolve, many of the medical workers cannot hide their fear of what may befall them if the army reaches the hospital entrance. The only encouraging sign is that the army has not called the hospital directly, but this only partially assuages their fears.

“We expect anything from the Israeli army, we saw everything,” Amani, a nurse operating in the ICU, tells Mondoweiss.

“We’re afraid because of what we saw at the other hospitals. If the army surrounds us, we’ve considered every possible scenario. Being killed, being buried alive, being burned — we imagine the Israeli army is capable of anything,” Amani says. “But we won’t leave our people,” she adds.

“Sometimes we think out loud with one another and ask, will it be worse than the other hospitals? Will the same massacres happen again? And will the world allow us as doctors and patients to meet such a horrifying fate? Is that the humanity and the Hippocratic oath that the world created?” Amani says.

Hassan Sulieh and Osama Kahlout conducted the interviews for this report from inside al-Aqsa Martyrs Hospital in Deir al-Balah, central Gaza. 


Tareq S. Hajjaj is the Mondoweiss Gaza Correspondent and a member of the Palestinian Writers Union. He studied English Literature at Al-Azhar University in Gaza. He started his career in journalism in 2015 working as a news writer and translator for the local newspaper, Donia al-Watan. He has reported for Elbadi, Middle East Eye, and Al Monitor. Follow him on Twitter at @Tareqshajjaj.