NERMEEN SHAIKH: This is Democracy Now!, democracynow.org, The War and Peace Report. I’m Nermeen Shaikh.

We end today’s show in Gaza, where relentless winter rainstorms have flooded thousands of tents of forcibly displaced Palestinians.

FORCIBLY DISPLACED PALESTINIAN: [translated] Due to the rain yesterday, water gathered over the worn-out tents and broke them, broke the wood, and water went down on those asleep. And we got up at 3 a.m. to try to gather what is left of the tent. This is our situation.

NERMEEN SHAIKH: This comes as at least six infants and one adult living in displaced camps in Gaza have died from the cold as winter temperatures drop.

Meanwhile, a United Nations report published today finds that Israeli strikes on and near hospitals in the Gaza Strip have, quote, “pushed the healthcare system to the brink of total collapse, with catastrophic effect on Palestinians’ access to health and medical care.”

The world is still calling on Israel to release Dr. Hussam Abu Safiya, director of Kamal Adwan Hospital in Gaza’s Jabaliya refugee camp, after he was detained in a raid on the hospital by Israeli forces and reportedly taken to a detention camp with his leg badly injured.

For more, we’re joined by two doctors who worked in Gaza this year. In Amman, Jordan, Dr. Mimi Syed is an emergency medicine physician. She just left Gaza for the second time this year. She volunteered for four weeks at Nasser Hospital in Khan Younis and Al-Aqsa Hospital in Deir al-Balah. Also with us is her colleague, Dr. Feroze Sidhwa, a trauma surgeon who volunteered at the European Hospital in Khan Younis in the early spring. His piece last month for Foreign Policy is headlined “The U.S. Must Support Gaza Before Winter: Seasonal rains and flooding portend further humanitarian catastrophe.”

We welcome you both to Democracy Now! Dr. Mimi Syed, if you could begin? You were just there in Gaza. Describe where you were and the conditions that you’ve seen in the hospitals that remain, where you worked.

DR. MIMI SYED: Hi. Thank you for having me. Yes, I actually just got back yesterday.

So, yeah, the conditions are terrible. They were terrible in August, but winter has kind of brought in a new level of destruction, the children that I saw just disproportionately affected by this. The malnourishment, the contamination of the water, everything is just tenfold now because of the dropping temperatures. You know, there’s the same type of airstrikes and the missiles and the targeting of children that I witnessed again. We saw the same type of shrapnel injuries, traumatic amputations, you know, blunt trauma, and then open skull wounds of children — just the same type of brutal aggression.

NERMEEN SHAIKH: And while you were in Gaza, you gave an interview to Sky News, Dr. Syed, and you said — while in Gaza, you said, quote, “Humanity is ending here,” that that’s what you see, humanity ending here in Gaza. If you could elaborate further on, in particular, this issue of water, why it is that so much of the water supply is contaminated, and what this means for people in Gaza, in hospitals, and, in particular, the most vulnerable — children, infants and the elderly?

DR. MIMI SYED: Yeah, I mean, I had an opportunity this time to actually walk around in the camps and talk to the families and actually visit inside of the tents, just deep inside those encampments, and the living conditions are just deplorable. I mean, they are not compatible with human life.

The contamination of the water is very high. I spoke to the infection control manager there that takes care of the water filtration system, and he was explaining to me that the filtration, the chlorine, the solvents that they need, the membranes that they need, none of that is available. The water is coming up, I mean, literally from a hose. Children fill, like, these dirty plastic containers, and it’s supposed to be filtered again, but those filters that are in front of residential areas, they’re generated — the power is generated by fuel, which, of course, is not available. So they end up drinking this water that’s actually just meant for, like, washing and such.

But that’s leading to this chronic diarrhea that children have, especially small babies, that are affected so much by this. Every child there that I saw in the emergency department had diarrhea. And then it leads — with the malnourishment on top of that, it’s leading to organ failure, things like kidney failure we’d see in children. I mean, it’s rates that you don’t typically see in other countries. And it’s all because of this water, very high in salt content. You can’t filter that out. It is seawater. And, you know, of course, the elderly are at the same risk of becoming ill, critically ill, that way.

NERMEEN SHAIKH: And, Dr. Feroze Sidhwa, if you could talk about — you’ve made remarks to the effect that hundreds of thousands of toddlers and elderly could potentially die in Gaza in February or by February. And respond specifically to the raid on Kamal Adwan Hospital, the last remaining functional major hospital in northern Gaza, and what the effects of that will be, and the fact that, of course, its director, Dr. Hussam Abu Safiya, has been detained, his leg badly injured.

DR. FEROZE SIDHWA: Yeah, as far as we know, Dr. Abu Safiya has been detained — don’t know where he is, don’t know what’s being done to him, may never find out. Who knows?

And yeah, Kamal Adwan has been destroyed. It’s really — it had barely been a functional hospital in any sense for months. It’s been under siege for at least a month. The Israelis — you know, there was one point at which it really just got incredibly sadistic. The Israelis allowed the only delivery of supplies during this time and then tank-shelled the little warehouse that it was put into in the hospital. It’s just — it’s pretty sadistic at this point. And the U.S. goes along with it, so we can’t really blame the Israelis for it. We’re the ones allowing it to happen.

But in terms of the public health situation in Gaza, I think it’s exactly like Dr. Syed just described. And it’s what Dr. Parkinson and I wrote about in Foreign Policy, like you mentioned. You know, Gaza is a half child population. The entire — you know, 90% of the population is homeless, meaning their homes have been physically destroyed or they’ve just been displaced from them. But regardless, they live in temporary shelters. As you heard from the — or, as the listeners heard from the — at the beginning of the program, when it rains, these shelters don’t provide any protection from the rain and the flooding that happens every year in Gaza.

And so, now the temperature is quite chilly. Well, the adults can survive a 50-degree winter, but even adults, not if they’re wet constantly. I mean, you’re talking about being wet for three months straight. And furthermore, they’re not just wet; they’re living in a land that literally doesn’t have a sewage system anymore. It’s one of the most crowded places in the world, the Mawasi, where most of these people are. The 1.8 million people that are concentrated there are living in a place that literally has no sewage system; 1.8 million people are living in a place that has 121 toilets. This is just outrageous. And then, on top of that, the Israelis aren’t even allowing soap to be brought into Gaza.

So, it’s not hard to figure out what’s going to happen when all of that is put together. It’s very likely that tens or even hundreds of thousands of people are going to die of the combination of malnutrition, displacement, exposure to the elements and hypothermia this winter. And at this point there isn’t actually anything that can be done about it.

NERMEEN SHAIKH: And, Dr. Sidhwa, if you could comment also — I mean, given the many, many reasons that people are dying prematurely in Gaza — hypothermia, hunger, etc. — what do you think of this, the count that’s always — 45,000 people have been killed in Gaza since the war began in October 2023. What do you think the actual count might be, given all of these reasons?

DR. FEROZE SIDHWA: It’s very hard to make accurate estimates. You know, Alex de Waal just wrote a good blog post at the Tufts peace center that he runs. He’s the leading historian of famine in the modern period. And he writes, what he wrote, that it’s extremely unlikely that fewer than 10,000 people have died, and he was hesitant to make any more — from what are called indirect causes of war. And he was hesitant to make more predictions than that. But, you know, if you look at the Integrated Food Security Phase Classification data, you can’t estimate that less than 60,000 people have died of starvation in Gaza. And that’s the only data that’s really available. There’s nothing else.

There actually was just a study published in a nutrition science journal. It just came across my desk yesterday, and I’ve requested it from our library, so I haven’t been able to read it yet, so I don’t know what it says. But the abstract was terrifying, saying that, basically, the entire population has lost weight, which, you know, Mimi and I having been there, we can definitely attest to that.

But it’s very likely that tens of thousands of people have starved to death in Gaza, many of them small children. But what’s more important than the number is that we don’t know. We’re doing this to an entire population of child refugees, and we don’t even know if we’re starving tens of thousands of children to death? That’s crazy. What kind of behavior is that?

NERMEEN SHAIKH: Well, Dr. Mimi Syed, let me get your response to that, in other words, you know, what the U.S. has been doing in all this time. They could have easily, as many have pointed out, pushed and made a ceasefire happen. That has not occurred. And now we have Trump coming in, in three weeks. He said if the hostages are not released by Inauguration Day, January 20th, all hell is going to break out. What do you imagine might happen then?

DR. MIMI SYED: Oh, I mean, it needs to stop, is the number one point. But there is absolutely no dignity left. And that’s what I mean when I say humanity has ended. You know, Feroze is talking about malnourishment. Absolutely. Every single child has some sort of hypopigmentation. And, you know, you and I both know as physicians, that’s the number one sign of acute malnourishment. Children are displaying these signs all the time.

And then, when we talk about dignity, imagine, you know, this population was not poor to begin with. The majority of people were well-to-do. They had professions like you and I do. They had education, 98% literacy rate there. Overnight, their lives were changed. Imagine living in a tent that’s made out of scraps in cold weather with about 20 other people. You know, on so many levels, that’s a violation of a person’s dignity and basic human needs. You know, I spoke to so many people, so many women especially, that commented on — you know, there’s no menstrual pads. They can’t even afford those.

NERMEEN SHAIKH: I’m so sorry, Dr. Mimi Syed. We’re going to have to end it there, American emergency medicine physician who just left Gaza, and Dr. Feroze Sidhwa, trauma surgeon who volunteered in Gaza. I’m Nermeen Shaikh. Thank you so much for joining us.