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For one doctor, becoming a neurosurgeon in Gaza was an uphill battle

CAMILA DOMONOSKE, HOST:

The conflict in Gaza has displaced millions of people and killed tens of thousands. It's also led to brain drain of talented people who had the means to flee. Farah Yousry with Side Effects Public Media has this story about a neurosurgeon in Gaza who was determined not to abandon his patients. And a note - this story contains graphic descriptions of war injuries.

FARAH YOUSRY, BYLINE: As someone from Gaza, 43-year-old Dr. Husam Abukhedeir says times were often difficult with political turmoil and conflicts. But through it all, he remembers his parents telling him Gazans are destined to struggle, but tomorrow is going to be better. And he thinks that's why he wanted to become someone important - so he could help his people.

HUSAM ABUKHEDEIR: (Through interpreter) Since I was young, I've dreamt of studying medicine. I would always tell myself, Husam will not be anything except a doctor.

YOUSRY: But after high school in the late '90s, Abukhedeir came face-to-face with a realization - being a Gazan hamstrings you in many ways. Take travel, for example.

ABUKHEDEIR: (Through interpreter) You have to plan for it. You have to see if the crossing is open, if the crossing is closed - always so many things.

YOUSRY: This became very apparent when he applied for a medical school. He was accepted, yes, but there was only one school at the time, and it was in Jerusalem. He would need a permit from Israeli authorities to leave and reenter Gaza. Tensions between Gaza and Israel were constantly shifting. What if, at some point, he were denied access to Jerusalem altogether?

ABUKHEDEIR: (Through interpreter) Frankly, some people told me, at any point, you may be on your second or third year and they kick you out or not give you a permit. So I was always scared of that.

YOUSRY: So Abukhedeir decided to try and study medicine abroad. He landed a scholarship for a medical school in Sudan. It was a six-year degree, and he didn't go back to Gaza to see his family, not even once. He worried he would get stuck there due to Israeli restrictions. But when he graduated, he returned home to work at Al-Shifa Hospital, the enclave's biggest medical complex.

ABUKHEDEIR: (Through interpreter) I got a job as a general practitioner at the neurosurgery department, and honestly, I started to really love the specialty. It's a very delicate specialty, and I found myself in it.

YOUSRY: Then in 2008, war broke out between Israel and Hamas. Dozens of severely injured Palestinians were rushed to Al-Shifa Hospital, but in those days, very few doctors had the neurosurgical training needed to treat these patients, including Abukhedeir.

ABUKHEDEIR: (Through interpreter) And that made me more determined to become specialized, to be able to serve people the way they deserve to be served.

YOUSRY: But to become a neurosurgeon, that training did not exist in Gaza at the time. So Abukhedeir's only choice was to leave home once again.

ABUKHEDEIR: (Through interpreter) So I landed a scholarship to Jordan, thank God. I accomplished my goal and the dream I had. I knew that for me it is Gaza forever.

YOUSRY: When Abukhedeir returned to Al-Shifa Hospital in 2021, he was brought on as a neurosurgeon, and ultimately, he became head of the department.

ABUKHEDEIR: (Through interpreter) We built a good neurosurgery department. Years ago, we really needed a program like that. And finally we were able to build it for the trainees. I swear it was like a dream.

YOUSRY: Then came October the 7. Abukhedeir and his family could have left Gaza. He has U.S. residency. His wife and kids are American citizens. But he says...

ABUKHEDEIR: (Through interpreter) I couldn't leave my patients. But also, as the head of the department, I was supporting my team.

YOUSRY: So he told his family to go ahead and leave without him, but they refused. Abukhedeir moved his wife and five children into a small office at the hospital, where he hoped they would be safe. Meanwhile, he was in the operating room all the time. He recalls children as young as 2 with devastating injuries.

ABUKHEDEIR: (Through interpreter) Skulls that are completely crushed, sometimes shrapnel's filling the brain.

YOUSRY: Patients with severe wounds, barely conscious, were often brought in with no IDs, no family members. So Abukhedeir and his team would write on their bodies - anonymous patient 1, anonymous patient 2. Then a 40-year-old woman was brought in. Sixty percent of her body was covered in burns.

ABUKHEDEIR: (Through interpreter) Frankly, I couldn't even recognize her from how burned she was.

YOUSRY: That patient was not anonymous. It was Abukhedeir's own sister. Her name is Dalia.

ABUKHEDEIR: (Through interpreter) It was the hardest thing ever to receive her in such a state and how many burns she had.

YOUSRY: She died shortly after, but Abukhedeir had no time to mourn. Water, fuel and essentials like anesthesia were running out. Doctors were forced to answer a harrowing question - who lives and who dies?

ABUKHEDEIR: (Through interpreter) It was so hard. These are my people, my community. Your goal as a physician is to heal them, not to decide who I'm going to treat and who I will not treat.

YOUSRY: Then Israeli forces encircled Al-Shifa Hospital, alleging there was a Hamas command center beneath the complex. Inside the hospital, it was chaos.

ABUKHEDEIR: (Through interpreter) We were no longer able to offer patients any service because there was no electricity. Most of the patients who were in the ICU actually died because there were no resources.

YOUSRY: Abukhedeir had become a mere witness to the suffering and death of his people. He decided it was time to get his family and himself out of Gaza. In late November, they crossed the border into Egypt.

ABUKHEDEIR: (Through interpreter) I don't think we will be able to go back soon. My house is gone, and everything is gone.

YOUSRY: Today, he's in the United Arab Emirates. He keeps in constant contact with his young trainees who are still in Gaza, as are his elderly parents. He says he lives in dread that each phone call will bring more bad news. But when he talks to his children, he pushes those darker thoughts away and repeats what his parents told him so many years ago - tomorrow will be better. For NPR News, I'm Farah Yousry. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Farah Yousry covers health equity for Side Effects Public Media, in partnership with the Indianapolis Recorder. She focuses on healthcare disparities in minority communities across the Midwest. Before moving to the U.S., she worked as a journalist for local news organizations in Egypt during the Arab Spring and the contentious political period following the Egyptian revolution. She has worked with the BBC World Service for over five years, producing radio, television and digital features for an audience in the tens of millions across Europe and the Middle East. Farah speaks Arabic, English and Mandarin Chinese.