Baby Naya was born during the ongoing war in the Gaza Strip through a cesarean section at 1 PM last Saturday, November 11, in the southern part of the territory. Samah Qashta, 29, embraced her newborn and examined her small face and dark eyes, then soon burst into tears as she felt shame for being forced to give birth at a time when she couldn't provide anything for her. Although she works as a midwife, Samah suffers from severe shortages like most other mothers in Gaza. She came to the hospital with only a few diapers, a box of baby formula, and a bottle of water to prepare the milk.
Shortly after her birth, while Samah was lying in bed next to the window with Naya, a nearby house was bombed in an air raid. Samah said, "I was scared and held her close... I was afraid at any moment I would be bombed, so I felt I should embrace my daughter tightly out of fear." She later learned from the nurses in the hospital that people had died in the attack.
The war between Israel and the Palestinian Islamic Resistance Movement (Hamas) began on October 7 when Hamas militants attacked Israeli towns, resulting in the death of at least 1,200 people, mostly civilians, according to Israeli data. In response, Israel imposed a blockade on Gaza, cutting off fuel, food, and electricity to the population. Health officials in Hamas-run Gaza report that over 12,000 Palestinians, 70% of whom are women and children, have been killed due to the ongoing bombings by Israel from air, land, and sea.
Israel states that its war with Hamas, designated as a terrorist group by the United States and most Western countries, and the near-complete blockade it enforces on the strip aims to prevent vital supplies from reaching the militants. Hamas has governed the Gaza Strip since 2007.
In a statement to Reuters, the Israeli army said that Hamas militants continue to attack Israel from various parts of Gaza, accusing the group of hiding among civilians. The army declared its intention to end these attacks, stating, "We will strike Hamas wherever necessary."
The 2.3 million residents of Gaza are suffering due to this conflict. Civilians live under siege following Israel's closure of the borders since October 7. The Rafah border crossing with Egypt is mostly closed. Two Egyptian security sources said that just over 7,000 people have been allowed to enter Egypt. Samah was following news of the war from the nurses inside the hospital where she gave birth. Residents throughout the strip are astounded by events in Gaza City, the main city in the territory, where Israeli tanks surround Al-Shifa Hospital. Doctors at the hospital report that patients are dying and incubators are out of operation.
The Emirates Crescent Hospital for childbirth, where Samah delivered her daughter, is located in Rafah on the border with Egypt. The hospital is about 30 kilometers south of Gaza City and 20 kilometers south of the evacuation line declared by Israel. People here feel similarly trapped, as cities like Rafah are subjected to airstrikes.
Reuters has a team of eight journalists and their families in Gaza. They initially stayed in Gaza City but have now moved south to Khan Younis, about six kilometers from Rafah, like hundreds of thousands of other residents. At Nasser Hospital in Khan Younis, where Samah works, a Reuters journalist met the midwife for the first time as she was assisting other women in childbirth. Near the maternity department is the morgue, where Director Said Al-Shourbagy records the dead.
This account of births and deaths in Khan Younis is based on reports from Reuters journalists inside Nasser Hospital and the daily observations of the team in the city.
### Under Siege in Khan Younis
Khan Younis has roots that go back to the 14th century and includes a large refugee camp named after it, initially set up to house Palestinians who fled at the announcement of Israel's founding in 1948, and is administered by the United Nations. The town and the camp stretch from the border fence with Israel to near the Mediterranean Sea.
At night, explosions can be heard in the city, some distant and others nearby. During the day, a constant buzzing sound comes from Israeli drones patrolling high above.
There is a severe shortage of supplies due to the blockade imposed by Israel, which has prevented the delivery of fuel, electricity, and most foodstuffs. The Strip is also experiencing a water crisis. The United Nations World Food Program warns that civilians face a "danger of dying from hunger soon" due to food supply shortages.
Typically, around 440,000 people live in Khan Younis, but this number is believed to have doubled now. On October 13, Israel warned over a million people living in the northern Gaza Strip to move south. U.S. officials reported that all responded to the warning except about 300,000, many of whom came to Khan Younis.
Israel has announced that it will expand its operations in the south in pursuit of Hamas. On Friday, Israeli planes dropped leaflets calling on residents of some eastern neighborhoods in Khan Younis to leave, which may force many families who had come from the north to be displaced once again.
Among the displaced is Abla Awad, an elderly woman who has already suffered displacement specifically in 1948 with the establishment of Israel. Abla was five years old when her family left the village of Halikat, which Israel later annexed. She said, sitting on the sandy ground in front of her tent, "I remember how they displaced us there (before this). They packed us into bags, our parents did, and took us to Gaza. God, just like these days."
Abla moved to Khan Younis from the Jabalia refugee camp in northern Gaza.
While the vegetable market in Khan Younis continues to operate, prices have doubled. At bakeries, hundreds line up from dawn until sunset. Traders call out the prices of various goods but at exorbitant rates, from cans of tuna to hairbrushes, clothes, underwear, and detergents. The rising prices lead to constant scuffles.
Piles of garbage and swarms of flies are everywhere. The lack of water and poor sanitation facilities have led to outbreaks of skin diseases. Many have gone without bathing for weeks and suffer from visible rashes.
A few fortunate residents have solar panels on their homes that help pump groundwater from wells and charge their mobile phones. Many others have to stand in lines from early morning to fill small containers with water from nearby wells.
Despite being south of the "evacuation line" designated by Israel, Khan Younis has not escaped from daily Israeli air raids and shelling. Airstrikes have flattened entire buildings. Local health officials report that a total of 1,300 people have died in the Khan Younis area since October 7.
Hamas and its ally Islamic Jihad continue to launch rocket barrages at Israel every few days.
Practically, there is no escape for residents except for those holding foreign passports. United Nations data indicates that even before the war broke out, fewer than 50,000 were allowed to leave each month, about 35,000 to Israel and 12,000 to Egypt, after approval from Israeli security authorities. However, many have never left Gaza.
In recent years, sporadic protests against Hamas had occurred in Gaza due to its failure to improve the dire living conditions. Today, few are willing to discuss their policies with journalists. Most say they fear being targeted by Israel.
Susan Bseiso, a 31-year-old Palestinian-American currently in Cairo after being allowed to leave through the crossing, stated her opposition to the killing of "any civilian or person on the ground," including Israelis killed by Hamas on October 7. However, she also said that Israel's killing of thousands in response to Hamas's attack cannot be justified. She remarked, "This war is not against Hamas. It is against civilians in Gaza." She added, "They unleash their anger on civilians and innocents."
Jan Egeland, the Secretary General of the Norwegian Refugee Council, stated that Israel is obliged to open its borders to protect innocents. He told Reuters, "It is the most horrific thing that Israel does not only impose a total blockade on civilians who are under attack and live in the line of fire, but it also prevents women and children trapped in a small area from escaping across the border."
However, Israel disagrees. Israeli Prime Minister Benjamin Netanyahu told NBC's "Meet the Press" on November 12 that civilian casualties occur in "every legitimate war, sometimes referred to as 'collateral damage.'" He added that these are "another way of saying there are unintentional human losses."
The Israeli army, in its statement to Reuters, said that Israel bombs military targets in accordance with international law, and its forces take "all possible precautions" like issuing specific warnings to minimize harm to civilians. It added that attacks occur only "after an immediate assessment shows that the anticipated incidental damage to civilians and their property is not excessive compared to the expected military gains from the attack."
On its Facebook page, Nasser Hospital, the main hospital in Khan Younis and the largest hospital in southern Gaza, publishes "Al-Aqsa Flood Statistics"—the name Hamas gave to its attack—daily lists of the names of the "martyrs" of this war.
Reuters monitored the hospital from November 1 to 11 and conducted repeated visits, observing the arrival of the dead and injured. During that time, the hospital recorded a total of 139 deaths from airstrikes, 54 of whom were men (39%), 42 women (30%), and 43 children (31%).
On November 7, a Reuters journalist witnessed the arrival of bodies due to an attack in Khan Younis around 6:30 AM near the municipal offices. Relatives stated that nine members of a family, including three boys, were killed. Only one 16-year-old girl survived, and she was in a state of severe shock that prevented her from speaking. Reuters could not confirm the reason for Israel's destruction of the residential building the family lived in or whether a warning was issued.
### Exhaustion in the Morgue
Said Al-Shourbagy, 50, manages the morgue at Nasser Hospital, relying on volunteers, with eight working each shift. The morgue is only 30 meters away from the maternity department.
He arrives before 6 AM, an hour before anyone comes to identify the bodies. Reuters journalists observed Al-Shourbagy over several days as he witnessed the arrival of the dead, most of whom were casualties of nighttime shelling.
Al-Shourbagy, a father of six daughters and two sons, suffers from a lack of sleep. He said, "You sleep feeling tense, and your sleep is interrupted, which tires you out more." He may wake 40 times in six hours with every bombing. He added, "There is no normal sleep. What can you do? You can only sleep and wait for God's mercy."
The Al-Shourbagy family has lived in Gaza for generations before the state of Israel was established in 1948. According to the United Nations, four-fifths of Gaza's population are classified as "refugees" of Palestinian families who fled or were forced to leave their homes at that time.
A charity manages the morgue and is supported by local donations. The morgue provides its services free of charge. Al-Shourbagy and his team identify the deceased, wash their bodies, and send them to the mosque for funeral prayers before burial. Close family members are allowed to enter the morgue to recite the Quran and say prayers while kissing their loved ones' bodies. Other relatives stand behind barriers. Some shout in anger, "God is Great" or "Martyr."
People sometimes gather to perform funeral prayers before carrying the dead to their final resting place instead of holding the rituals as usual in one of the mosques. Volunteers often rush to perform this duty when no family members remain alive or when the number of dead exceeds the capacity of the mosques.
Amid all this chaos, the voices of vendors offering tea, coffee, and overpriced cigarettes mix with rising noise. Scuffles often break out over limited resources such as water and food.
Al-Shourbagy takes on many tasks himself. He mentioned that the workload is so heavy that sometimes a colleague has to assist him in drinking water while both hands are stained with blood dealing with bodies. During the conversation, the body of a man in his fifties was brought in, covered with dirt and his face smeared with blood.
The morgue's coolers are designed to accommodate 50 bodies. However, on some days, they are filled to twice that number, with bodies laid on the hospital floor. Outside the coolers is a washing station for the bodies. There is also a lounge area with a television screen that continuously shows Al Jazeera.
Like everyone here, Al-Shourbagy refers to the deceased as "martyrs."
The challenge lies not only in managing the number of bodies arriving but also in the morgue's lack of fuel in Gaza, sending out appeals for help to carry the deceased to the mosque and cemeteries. Finding space in the graves is difficult and dangerous, as the main cemetery in the town has been bombed to the point that many have to dig graves themselves in the city and refugee camp.
Al-Shourbagy said war evokes overwhelming emotions and severe tension that sweep through the building as mourners enter. Some cannot accept the reality that the Israeli bombings have mutilated "a loved one who once wore the most beautiful clothes." Dust covers some relatives as they dig through the rubble searching for survivors.
Al-Shourbagy noted that in his six years working at the morgue, he has never witnessed such injuries. Some corpses remained as mere pieces of meat, making it difficult to distinguish between limbs, and entire families were mixed together. He continued, "At one point, inside the morgue, we had a father who died, and his two-year-old son was still in his arms, still cradling him." He added, "We couldn't separate the father from the son; we will leave them like that and bury them like that too."
The morgue director has lost relatives in the war. He recalled learning of a young family member's death. He expected to receive the body in the morgue he manages. However, the father of this young man contacted him to explain that his son's remains were so mixed with those of others that he had to be buried in a mass grave.
The following day, the father came to the morgue. Al-Shourbagy felt confused and asked him, "What brings you here?" The father replied, "My son died and was buried; I came to smell the scent of blood. I didn't smell the scent of my son or see him." He repeated, "I came to smell the scent of blood, and I didn't see my son."
Al-Shourbagy's voice faltered as he recounted the story. He paused, then continued, "I couldn't speak to him; I stood shocked. I left him and walked away, feeling I didn’t dare to console him."
He added that everyone in Gaza "pays the price for this war" after losing family or relatives. Some have been fortunate; he mentioned that a rocket hit a house containing 25 women and children, but it did not explode. He said that a second rocket fell 15 minutes later, but by the time it hit, everyone had been evacuated.
By 6 PM, the morgue director counts the dead and sends the tally to Gaza's Ministry of Justice, which oversees the morgue. He then returns home to join his family in searching for water, electricity, and bread.
He does not speak about his work when he returns home. He describes the sights, memories, and daily details as horrific. He added that when his family asks about his day, he simply replies that he received a number of "martyrs."
### In the Maternity Ward
The Reuters team met midwife Samah Qashta for the first time while she was pregnant in early November. She was in the middle of a 24-hour shift at Nasser Hospital in Khan Younis. Samah woke up on that day at 6 AM in Rafah. The weather was still mild, so her family kept warm through the night despite the power cuts. However, her sleep that night was broken, both due to her pregnancy and because she dreamed of her parents, Hosni and Suheila, who died before this war.
She prepared breakfast for her three children and then walked from Rafah to the hospital in a journey of over an hour. At times, she had to navigate through debris and rubble after airstrikes. She said, “There are moments I will never forget.” She wanted to run, but she couldn’t due to her pregnancy.
Upon arrival at Khan Younis and Nasser Hospital, she found chaos. The hospital resembled a temporary shelter where washed clothes hung randomly, children were playing, and the cries of infants mixed with the voices of grieving relatives. She had to weave her way through the displaced people's tents in the parking lot before entering the hospital building. Hallways and stairs were crowded with families seeking shelter, barefoot children running, and elderly people sitting on plastic chairs, while clothes, mattresses, luggage, and piles of laundry were scattered everywhere.
A pungent odor filled the air—a mix of blood, urine, feces, and bodies that had not been washed for some time. Samah immediately put on her mask.
Inside, Walid Abu Hatab, the head of the maternity department, told Reuters that 50,000 pregnant women in Gaza are facing health crises, a number confirmed by United Nations agencies. He added that miscarriages and stillbirths have increased by 20% in Khan Younis, and all pregnant women are at risk due to the collapse of primary healthcare and overcrowded hospitals, with scabies beginning to spread in Nasser Hospital.
Abu Hatab said that the operating rooms designated for cesarean sections are being used to treat victims of airstrikes, adding that they face tough times. The sewage system also poses a significant risk. Doctors report that restrooms are overcrowded in the hospital, with up to 5,000 people using the same toilets. Reuters observed long lines and muddy, wet floors amid a shortage of soap and water. Ambulance workers told Reuters that pregnant women are at risk of urinary tract infections and other illnesses that may lead to the death of their babies.
Inside the ward, a young woman named Iman Abu Matal praised Samah for helping her deliver her twins. Their father, Ayman Abu Awda, said he will name them Hamza and Adi after two of his nephews who were killed in an airstrike on their home during the war.
After this attack, Abu Matal and the couple's eight children had to live in a tent inside a school without mattresses or blankets for seven days. Abu Matal said the situation is tough, but God blessed them with "two champions."
Samah was supposed to undergo a cesarean section in late October but delayed the delivery hoping for a ceasefire. Due to a shortage of medicines, the only anesthesia she received when giving birth to her child on November 11 was for the lower part of her body. The next day, an ambulance dropped her off as close to her home as possible, as the streets were closed due to damage from airstrikes. She stated, "I walked for about half an hour after a cesarean with my newborn."
She returned to her other children, Nourcine, a seven-year-old girl, Muhammad (three), and Musa (six), who welcomed their new baby sister Naya.
Before giving birth, Samah and her husband managed to obtain only one pack of diapers and one box of baby formula. She said she doesn’t know what the family will do next to care for Naya. Due to medical reasons, Samah needs to use formula to feed her newborn.
Getting necessities is extremely challenging. Her husband, who works as a cashier in a shopping center, has to stand in line for hours hoping to obtain essential items like bread. They mainly live on tea and biscuits with dates provided by a UN agency. She said, "There is no gas to heat water... We light wood to boil water for the baby's milk."
As she recovers from giving birth to Naya, Samah plans to return to work in January at the maternity ward in Nasser Hospital. She said that if this war ends, this department will serve as a window of hope.
She mentioned hearing the sounds of shelling, alarm sirens, and the cries of the families of the martyrs, along with the screams of women in labor. She added that each time she assists a woman in giving birth, and each time she holds a newborn, she thanks God. She expressed joy that God has blessed them with a new life and a new baby.
