After six months of war in Gaza, the Palestinian medical infrastructure has collapsed, leaving tens of thousands of pregnant women without a safe place to deliver. Reporters Gabrielle Berbey and Salman Ahad Khan follow one mother over the final months of her pregnancy after she’s forced to leave behind her home, work and doctor in Gaza City.
We begin with the reporters’ first call to Lubna Al Rayyes five weeks into the war, as she is seven months pregnant with her third child. Before the war’s start on Oct. 7, Al Rayyes ran a prestigious school in Gaza City and her husband owned a clothing store. After being forced to evacuate their home, they fled to Khan Younis, but that city soon came under attack by the Israeli military as well. After being in regular contact with Al Rayyes for more than a month, the reporters lost contact with her.
Berbey and Khan then track down Al Rayyes’ sister, who was able to leave Gaza and relocate to Canada because of her husband’s Canadian citizenship. Canada’s Palestinian community lobbied the government to create an asylum program for displaced people in Gaza, but the program became mired in delays. Berbey and Khan eventually reconnect with Al Rayyes, who explains what happened with her delivery.
Beyond the collapse of the medical system, the health of Palestinians in Gaza is threatened by food shortages. Khan speaks with Tessa Roseboom, a Dutch researcher who’s been looking at how famine affects the development of babies in their mothers’ womb. We then meet Dr. Ghassan Jawad, an OB-GYN from Gaza who was forced to deliver babies in cars, shelters and even on the street as the medical system stopped functioning. Jawad had worked at Al-Shifa hospital, which was heavily damaged in a recent attack by the Israeli military.
Dig Deeper
Read: Inside Gaza’s Primary Maternity Hospital Where Babies Are Being Born Smaller, Premature and with Congenital Disorders (Jezebel)
Read: How Famine and Starvation Could Affect Gazans for Generations to Come (Reveal)
Credits
Reporters and lead producers: Gabrielle Berbey and Salman Ahad Khan | Producer: Neroli Price | Editor: Taki Telonidis | Fact checker: Nikki Frick | Production managers: Steven Rascón and Zulema Cobb | Digital producer: Nikki Frick | General counsel: Victoria Baranetsky and Gary Bostwick | Original score and sound design: Salman Ahad Khan, Jim Briggs and Fernando Arruda | Interim executive producers: Brett Myers, Taki Telonidis and James West | Host: Al Letson | Special thanks to Shaimaa Ziara, Dr. Mohammad Ziara, Reem Farhat, Najib Aminy, Nadeen Shaker and Tessa Moll
Additional audio courtesy of UNFPA/Bisan Ouda.
Support for Reveal is provided by the Reva and David Logan Foundation, the John D. and Catherine T. MacArthur Foundation, the Jonathan Logan Family Foundation, the Ford Foundation, the Hellman Foundation, the Robert Wood Johnson Foundation, and the Park Foundation.
Transcript
Reveal transcripts are produced by a third-party transcription service and may contain errors. Please be aware that the official record for Reveal’s radio stories is the audio.
| Al Letson: | From the Center for Investigative Reporting and PRX, this is Reveal. I’m Al Letson. Back in October, just a few weeks after the Hamas attack on Israel and the Israeli counterattack that followed, a Palestinian journalist named Bisan Ouda visited Al-Shifa Hospital in Gaza City. Bashan makes her way to the maternity ward. |
| Speaker 2: | [foreign language 00:00:29]. |
| Al Letson: | She’s interviewing women for the United Nations Population Fund about what it’s like to be pregnant and give birth in this war. |
| Speaker 2: | [foreign language 00:00:41]. |
| Al Letson: | The stories are hard to listen to. A thirty-year-old woman is in the hospital after having a miscarriage while her neighborhood was bombed. |
| Speaker 2: | [foreign language 00:00:59]. |
| Al Letson: | Another woman tells the reporter she just had a C-section after her house was bombed, her older son was killed in the bombing. |
| Speaker 2: | [foreign language 00:01:10] |
| Al Letson: | Paying close attention to these stories were two reporters based in New York, Gabrielle Berbey and Salman Ahad Khan. They wanted to know more about the women in Gaza who were pregnant, and there are 155,000 pregnant and breastfeeding women at high risk of malnutrition in Gaza right now, according to the United Nations. How are these women planning for their deliveries? What’s it like for doctors caring for them and their newborns? We start with the story of one expectant mother who Salman and Gabrielle were able to connect with by phone in November, about five weeks into the war. |
| Lubna Al Rayyes: | Yes. |
| Gabrielle Berbe…: | Lubna. |
| Lubna Al Rayyes: | Gabrielle? |
| Gabrielle Berbe…: | Yes, it’s Gabrielle. |
| Salman Ahad Kha…: | [inaudible 00:02:02] How are you? |
| Lubna Al Rayyes: | Hi, Salman. |
| Gabrielle Berbe…: | Her name is Lubna Al Rayyes. Can you hear me? |
| Lubna Al Rayyes: | Yeah, yeah, I can hear you. Yes. |
| Gabrielle Berbe…: | The connection is pretty weak. Lubna is in Gaza and it’s November 15th. |
| Lubna Al Rayyes: | We going to have some internet connection while we are talking. |
| Gabrielle Berbe…: | She’s from Gaza City. She has two teenage daughters and is pregnant with her third child. How many months pregnant are you right now? |
| Lubna Al Rayyes: | I am in the seventh month right now, I think so. |
| Gabrielle Berbe…: | Lubna is 42-years-old, so she’s high risk and she’ll need a C-section. She had C-sections when she delivered her two daughters, so she’ll need one again. Right now, this is her biggest worry. How will she give birth in war zone? |
| Speaker 6: | Some women are reportedly being forced to have C-section deliveries in the dark and without anesthesia. Others have suffered miscarriages triggered by the trauma of trying to survive Israel’s war. |
| Gabrielle Berbe…: | Because of Israel’s siege, there’s barely any anesthesia in hospitals, so doctors are having to pick which procedures get anesthesia and which ones don’t. Aid organizations have started handing out these emergency delivery kits to pregnant women like Lubna. The kits have a bar of soap, gloves, scissors, umbilical tape, a plastic sheet to deliver on, and a pamphlet instructing women how to deliver their own babies. |
| Lubna Al Rayyes: | It’s like a nightmare all the time. I’m thinking about it, especially that I have to deliver my baby by C-section. |
| Gabrielle Berbe…: | Lubna is due in eight weeks and her delivery feels like a time bomb. |
| Lubna Al Rayyes: | I feel depressed. I feel down, really. This is not the life we used to have. |
| Gabrielle Berbe…: | In the life she used to have, Lubna ran an elementary school in Gaza, a prestigious one, the American International School. She met her husband in Gaza City. He owned a clothing store there. They got an apartment together, had two daughters. This pregnancy was her first after 14 years. It was a surprise. Just before the war, they had a gender reveal party. Her doctor and her whole family helped plan it. |
| Lubna Al Rayyes: | My doctor, he put the gender in the envelope. My brother, he took it and he put the blue car in a balloon. |
| Gabrielle Berbe…: | She found out she’s having a boy. They want to name him after his grandfather, Fatih, she’d already planned what his birth would look like. It would be with her whole family in her hospital in Gaza City. |
| Lubna Al Rayyes: | And I dream about how I’m going to hold the baby in my hands. I think it’ll be great. |
| Gabrielle Berbe…: | But even in that life, she and her husband had arguments about leaving Gaza. He wanted to leave, she didn’t. They’d lived through five wars already. He was done with life there, but Gaza is her home. |
| Lubna Al Rayyes: | I’m very related to my city. I love my city Gaza and I don’t like to leave my family. Why to leave my family and why to leave my city. And I was dreaming about building in this city and about teaching and education, but now, I think no future for us here, honestly. |
| Gabrielle Berbe…: | Lubna didn’t think any of the wars would get as bad as this one. |
| Lubna Al Rayyes: | We can’t build anymore. They are destroying everything. |
| Gabrielle Berbe…: | Since this war started, Lubna’s been having nightmares about her delivery. In one nightmare, she gets to the hospital and they tell her they have to do her C-section without anesthesia. In another, the hospital is bombed as she’s delivering. It’s mid-November and Lubna can’t even get to a hospital. Women are delivering wherever they can, in the streets, shelters, in cars. A month earlier on October 10th, Lubna had to evacuate her home in the north, in Gaza City. They left in the middle of the night. |
| Lubna Al Rayyes: | We were running out with our pajamas. Oh yeah. |
| Gabrielle Berbe…: | She said when they ran out in their pajamas, they only grabbed a bag with their passports and some emergency supplies. Now they’re in Khan Younis with 30 family members. It’s a city about 20 miles south from Gaza City. The Israeli military said they would be safer in Khan Younis, but Israel has begun bombing there too. Thousands of people have started sheltering at one of the hospitals closest to Lubna called Nasser Hospital. So Lubna’s afraid to leave the house, let alone go to a hospital. |
| Lubna Al Rayyes: | Even hospitals, they are not safe places. The Israelis, they are even bombing the hospitals. So this is something scary, but people, where should they deliver? I don’t know. |
| Gabrielle Berbe…: | At this stage being older, high risk, and in the third trimester, she should be having multiple ultrasounds and also doctor’s appointments at least every week, but she hasn’t seen any doctor since the war started. Nasser Hospital is running out of fuel and water. And doctors there are reporting that women are bleeding to death during their deliveries, and if Lubna delivers there early, there’s a chance the hospital won’t have fuel for incubators. At Al-Shifa Hospital, Gaza’s largest hospital, 31 premature babies were just evacuated because that hospital ran out of fuel. Then, on November 23rd- |
| Speaker 7: | Hamas and Israel have agreed on a humanitarian pause in Gaza. |
| Gabrielle Berbe…: | There’s news of a ceasefire for the next day. |
| Speaker 6: | The humanitarian pause will allow the entry of a large number of aid convoys, including fuel for humanitarian needs. |
| Gabrielle Berbe…: | Lubna thinks that maybe she’ll see a doctor then. Around this time, the phone connections get worse, so she starts sending voice memos. |
| Lubna Al Rayyes: | Hi, Gabrielle, it’s 6:00 PM. |
| Gabrielle Berbe…: | She does not sound good. |
| Lubna Al Rayyes: | I became sick. I catch a bad flu. During the humanitarian pause, I was able to go to a doctor at clinic, which he has ultrasound. I waited there about three hours waiting for my turn. |
| Gabrielle Berbe…: | The power went out just as she was about to have her appointment. The doctor had backup power, but said that he could only take three women. Lubna was one of them. |
| Lubna Al Rayyes: | When the doctor told me the ultrasound was normal, I was happy, thank God. And I asked him about the weight of the baby because we are not having healthy food right now, and he told me everything is okay. |
| Gabrielle Berbe…: | Now, Lubna is due in four weeks. She’s been having contractions from all the stress of the bombing, so she asks the doctor if he has anything that could delay her delivery just until the war is over. But the doctor tells her she doesn’t need that right now. The humanitarian pause lasts only seven days. And after, the Israeli military begins bombing Khan Younis again where Lubna and her family are, and this time even harder. |
| Lubna Al Rayyes: | We wake up in the morning and even in the night when we sleep, bombing are all around us. And today, they bombed a building, it was very close to us. |
| Gabrielle Berbe…: | The Israeli military begins circulating maps online and dropping leaflets from planes. They’re instructing sections of neighborhoods to evacuate even further south to Rafah on the border with Egypt. |
| Lubna Al Rayyes: | But the problem, Gabrielle and Salman, that we don’t have a place to go there. What shall we do? I don’t know what Israelis need or what Israelis want. We evacuated from our homes, from our city, from Gaza to the south to Khan Younis as they told us, and now they are telling us to go to evacuate it more to the south. Where shall we go, really? Shall we stay in the streets? |
| Gabrielle Berbe…: | The next day, we get a text from her. It says, I left to Rafah. She sends us pictures of what looks like a building under construction. It’s small, bare, paint and water stains dripping down the walls. There are a few mats on the floor, bags pushed to the side, shoes neatly placed in a line along the corner. Her text says, “Look, this is our situation.” She’s in a refugee camp and there are 25 family members with her. Lubna’s due date is in just a few weeks. The nearest hospital is a field hospital the United Arab Emirates set up just a few days earlier. |
| Then, Lubna goes dark, stops responding to our messages. We write again a few days later, still nothing. We don’t know if she’s had her baby, if she’s still in Rafah or if she’s even alive. What we do know is that she has a sister in Canada. She told us on one of the calls and we hear there’s a WhatsApp group of Palestinian Canadians. Since the start of the war, they’ve been lobbying the government to get their family members out of Gaza. We ask someone in the group, if anyone there knows Lubna or who her sister is. One person connects us to their friend who connects us to another person and then to another. And through this winding network, we get a name and a number for Wafaa Al Rayyes, Lubna’s sister. | |
| Al Letson: | After the break, Gabrielle and Salman try to reach Lubna’s sister in Canada. You are listening to Reveal. |
| From the Center for Investigative Reporting and PRX, this is Reveal. I’m Al Letson. Reporters, Gabrielle Berbey and Salman Ahad Khan had spent a month talking to Lubna Al Rayyes when they lost contact. She was one of hundreds of thousands of people who’d evacuated to Rafah in the south of Gaza. Lubna was pregnant, supposed to give birth in a few weeks. Gabrielle and Salman didn’t know what had happened to her, so they tried to find her sister, who they heard was in Canada. They tried to reach her through Facebook but couldn’t find her. But then they connected with a WhatsApp group of Palestinian Canadians. One thing led to another, and then finally, on December 16th- | |
| Wafaa Al Rayyes: | Hi, good morning. |
| Gabrielle Berbe…: | Hi. Good morning. I’m Gabrielle. I’m here with my colleague, Salman. Lubna’s sister, Wafaa is in Toronto and she’s only been there for one month. |
| Wafaa Al Rayyes: | I was evacuated from Gaza Strip. |
| Gabrielle Berbe…: | Oh, wow. |
| Wafaa Al Rayyes: | Yeah, yeah. I was stuck there for about more than a month with my two sons and I was with Lubna in the same place, actually. |
| Gabrielle Berbe…: | Oh my God. Yeah. Yeah. Wafaa had talked to Lubna recently. She’s alive and hasn’t delivered yet, and she’s still in Rafah. We end up talking about the first moments of the war. She said on October 7th, she and her two sons, one 12, the other one eight, were in their apartment in Gaza City. And then, her husband got a call from the Israeli military. They had to leave immediately, so she went to her parents’ house. |
| Wafaa Al Rayyes: | Then it became worse and worse and worse. |
| Gabrielle Berbe…: | And then a knock on the door. It was Lubna. |
| Wafaa Al Rayyes: | So she was there running and frightened, and she was pregnant. Can you imagine this? |
| Gabrielle Berbe…: | Wafaa and Lubna stayed at their parents’ house for a few days. And then, they got another call, they had to evacuate again. This time out of Gaza City. |
| Wafaa Al Rayyes: | It’s like imagine that you’re living a regular day, right? Okay, you wake up, you took your kids to school, right? School is destroyed. You’ll go to the gym, okay? In the morning, gym was destroyed. You’ll go to get groceries, destroyed. Go back to my house, destroyed. Everything is destroyed. Every single thing. There’s nothing left. You know what I’m telling you? When I tell you there’s nothing left, there’s nothing left. |
| Gabrielle Berbe…: | Wafaa and Lubna left together to Khan Younis, and they were glad to at least be together. The two sisters have always been close. |
| Wafaa Al Rayyes: | We are together every day. If we don’t see each other every day, we talk over the phone, WhatsApp, video calls. |
| Gabrielle Berbe…: | Wafaa was with Lubna when Lubna told her family she was pregnant again. |
| Lubna Al Rayyes: | [foreign language 00:16:46]. |
| Gabrielle Berbe…: | She said Lubna was excited and a little nervous. |
| Wafaa Al Rayyes: | She said, which won’t be easy to have this baby. I know. |
| Gabrielle Berbe…: | She’s older, 42, but ultimately Lubna thought this baby was a gift. Months later, when the sisters evacuated to Khan Younis, Wafaa noticed a change in Lubna. |
| Wafaa Al Rayyes: | I saw her just sitting and thinking and not talking to anyone. I keep telling her, Lubna, it’s going to be okay. She told me maybe it was wrong for me to bring another baby to this ugly world. No? |
| Gabrielle Berbe…: | What did you tell her when she said that? |
| Wafaa Al Rayyes: | I kept telling her, things will be okay. This baby will come and bring joy to our lives. |
| Gabrielle Berbe…: | Had you ever seen Lubna like this before? So quiet. |
| Wafaa Al Rayyes: | No, no, no. Lubna is a very, very, very positive person. She’s a happy person. She gives hope to everyone. I’m very sad she’s going through this. Yeah. |
| Gabrielle Berbe…: | On November 7th, Canada announced it evacuated the first group of Canadian citizens out of Gaza. Wafaa’s husband is a Canadian citizen, so she and her kids, they also have Canadian citizenship and their names were on that first list. |
| Wafaa Al Rayyes: | When I had my name on the list to evacuate Gaza, when I left, I couldn’t say goodbye to my mom and dad. I didn’t say goodbye to anyone, just to Lubna because we were staying in the same place. And when I left her, it’s like I can’t tell you what I felt. It’s like I’m leaving her to death. Her daughter, she keeps telling me, please, aunt, take me with you. Can you imagine what I felt that time? Is my life more valuable than theirs? No, it’s not. Are my kids more important to me than their kids? No, they’re not. I feel like I left my parents and my family to death. |
| Gabrielle Berbe…: | Since Wafaa made it out of Gaza, she’s been calling the Canadian immigration and refugee offices almost every day, telling them to get Lubna out before her due date in January. |
| Wafaa Al Rayyes: | I told them she’s pregnant and she need a C-section and they said, okay, they will try to do what they can. |
| Gabrielle Berbe…: | When she doesn’t call, she emails and she gets the same response to every message. |
| Wafaa Al Rayyes: | We know this is a very difficult time for everyone in Gaza. Please encourage your family to do what they can to stay safe. We appreciate what you’re going through. We appreciate the hard times. They don’t, they don’t appreciate, and they don’t care. You know what, they don’t care. |
| Gabrielle Berbe…: | Wafaa is one of nearly 50,000 Palestinians in Canada, and many of them are trying to get their family members out of Gaza. They’ve been organizing for months, speaking to the press and calling on their members of parliament to do something, anything to get their family members out. And then in late December, something finally happens. The Canadian government announces it’ll evacuate the family members of Canadian citizens. Maybe Wafaa could finally get Lubna out before her due date, but she’s not optimistic. |
| Wafaa Al Rayyes: | I don’t think it’s enough. |
| Gabrielle Berbe…: | First, Canada won’t even open applications to evacuate anyone until January 9th. That’s about 20 days away, and that might be too late for Lubna’s delivery, and Wafaa doesn’t know if her sister will even be alive in 20 days. |
| Wafaa Al Rayyes: | Can they guarantee that my family will be safe until 9th of January? No. No. |
| Gabrielle Berbe…: | Then there was the problem with the requirements to actually qualify for the program. The Canadian government wanted applicants to provide documentation like biometric data, a record of every passport they’ve ever held, even a record of every scar they have on their bodies, an employment history since the age of 16. But a lot of that wasn’t possible for people, so many of them had evacuated their homes with just a few minutes warning they didn’t have anything with them. Family members began pointing out that when the war in Ukraine started, Ukrainians didn’t even have to be related to Canadian citizens to qualify. There was no cap on how many people could apply, and Ukrainians coming to Canada were offered financial support. Palestinians in Canada were asking, why can’t we have the same thing for our families? |
| Wafaa Al Rayyes: | You want to help, just help. Just don’t let us just wait and wait and wait. Just do something. Many people die in one day, you know that. Hundreds of people. |
| Gabrielle Berbe…: | Have you spoken with Lubna recently? |
| Wafaa Al Rayyes: | Yesterday, actually. Actually, I keep telling her that she has to drink lots of juice and lots of water and fruit juice, and she said, okay, you know we don’t have juice right now, can’t have juice. |
| Gabrielle Berbe…: | Two days after Wafaa’s conversation with Lubna, we get a text from Lubna. It’s the first time we’ve heard from her in weeks and her due date is just days away. |
| Lubna Al Rayyes: | So Gabrielle, today is Sunday and now it’s 8:20 in the evening and I’m recording from the south of Gaza Strip in Rafah City. |
| Gabrielle Berbe…: | There’s a low humming in the background. |
| Lubna Al Rayyes: | Well, that noise is the warplanes, Israeli planes. |
| Gabrielle Berbe…: | Israeli drones. They hover over the refugee camps in Rafah. Since coming to Rafah, Lubna hasn’t seen any doctors, and she still dreams of returning home to Gaza City after her baby is born. |
| Lubna Al Rayyes: | I wish I could have my baby after everything will finish and I can go back to my home and to have my due date safely in my home and in my city, in Gaza City. |
| Gabrielle Berbe…: | So January 9th comes, the day the program in Canada launches, and then it passes. Canada doesn’t evacuate anyone. Then Lubna’s due date arrives and it passes. And Wafaa and Lubna responding to texts. The news keeps reporting the same thing. No one is getting out of Gaza through Canada’s program. And then a few days later I get a text, it’s from Wafaa. She says, Lubna delivered and she and the baby are in Egypt. |
| Lubna? | |
| Lubna Al Rayyes: | Hello. Yes, Gabrielle. Hi, Salman. |
| Gabrielle Berbe…: | Hi. |
| Lubna Al Rayyes: | Hi. |
| Gabrielle Berbe…: | Lubna, it’s so good to hear from you. How are you doing? |
| Lubna Al Rayyes: | I am okay. [inaudible 00:24:59]. I’m recovering. |
| Gabrielle Berbe…: | So you delivered your baby? |
| Lubna Al Rayyes: | Yeah, I have delivered my baby on the 17th of January. |
| Gabrielle Berbe…: | Oh my God, congratulations. How is the baby? |
| Lubna Al Rayyes: | He is very cute. I am so happy now with the baby that he’s in a good health and Alhamdulillah, he’s okay, and because it has been a long time since I had a baby, so it’s a nice feeling. Yeah. |
| Gabrielle Berbe…: | What’s his name? |
| Lubna Al Rayyes: | Fatih as his grandfather. |
| Gabrielle Berbe…: | Oh my God. |
| Lubna Al Rayyes: | Yeah, as his grandfather. Yeah. |
| Gabrielle Berbe…: | Are your daughters and your husband with you? |
| Lubna Al Rayyes: | Yeah, my daughters and my husband, my mother, my father, my sisters, their husbands, my brothers, their wives, my aunt, her family. Yeah, all of us. We go out of Gaza. |
| Gabrielle Berbe…: | Lubna and her family, they’re in Cairo now. They didn’t get out through Canada’s official program, no one had gotten out through Canada’s program. Instead, Lubna and her family evacuated with the help from cousins in Egypt. People trying to get out of Gaza were checking a Facebook page where every day a list was posted with names of people who could cross into Egypt. |
| Lubna Al Rayyes: | It was maybe 10:00 P.M. and we opened the Facebook waiting for the list, so when we find our name, we were screaming, shouting and talking to each other and crying because we will be out of this war, out of this death. |
| Gabrielle Berbe…: | And then they waited. |
| Lubna Al Rayyes: | I didn’t sleep this day, this night, and also my parents, my husband, because we were afraid still. And this night, the airstrike and the bombing, it was very, very, very high. So what if we were killed this night? We are afraid that we will die. |
| Gabrielle Berbe…: | They got up at 6:00 AM to leave for the Rafah crossing and she says hundreds of people were already there, some sleeping, some waiting to hear their names, all of them outside what she called the Palestinian Hall. Many people have been getting on these lists by paying thousands of dollars to middlemen and border guards. One person shouted the names of people who could enter into the Palestinian Hall to cross over. Lubna and her family waited, listening for their names. And then- |
| Lubna Al Rayyes: | Al Rayyes. |
| Gabrielle Berbe…: | … she heard them. |
| Lubna Al Rayyes: | Al Rayyes family. |
| Gabrielle Berbe…: | They checked her documents and then they crossed into the Egyptian Hall. |
| Lubna Al Rayyes: | And it’s something funny. It’s just minutes, guys, between Rafah and Egypt. Just you pass the door, okay, minutes, and we can find everything. Food, water, clean water. |
| Gabrielle Berbe…: | They even had a cafeteria in the Egyptian Hall, which was hard for her to wrap her head around. How could there be so much food here when on the other side of that door, there’s nothing. Starvation. |
| Lubna Al Rayyes: | We were like, okay, buying from the cafeteria there and we ate small sandwiches of burger. It’s like, wow. Something I need. Yeah, it was something. |
| Gabrielle Berbe…: | From the border, Lubna and her family drove to their cousin’s home. |
| Lubna Al Rayyes: | I feel safe now, to reach a safe place, but you feel that you have something sad or something in your heart. You feel something missing, something, I don’t know, you feel that you are not you anymore. |
| Gabrielle Berbe…: | By the time they crossed, Lubna’s due date had already passed, but she wasn’t ready to have her C-section. She was exhausted, physically and mentally. She found a doctor in Cairo. |
| Lubna Al Rayyes: | When I go to the doctor, I told him, I can’t have my baby right now. I need time. Just give me 10 days. |
| Gabrielle Berbe…: | The doctor agreed, but only a couple days. He told her that the skin on her stomach was already too thin. |
| Lubna Al Rayyes: | Gabrielle, I want to talk about the surgery. |
| Gabrielle Berbe…: | Yeah, tell me. |
| Lubna Al Rayyes: | Yeah. When I go to hospital to make the surgery- |
| Gabrielle Berbe…: | Unlike in her nightmares about her delivery, Lubna did have anesthesia. It was only local, so she was awake for her C-section. |
| Lubna Al Rayyes: | So during the surgery, I start crying and crying and the doctors and the nurses, they are saying, “Is there something, is there pain? Do you have pain?” I said, “No, no. My feelings are not okay.. I am emotional pain.” Really, all the emotions, all the feelings, this is not the place I should be when I have my baby, this is not the place. I should be in Gaza in this moment, and it should be a nice moment. This moment, it should be there. Well, our feelings is not okay. We have something broken in our hearts. |
| Gabrielle Berbe…: | Lubna, how do you think you’re going to tell him about what it was like to carry him? How are you going to tell him about this when he can understand? |
| Lubna Al Rayyes: | I think I will tell him everything. I’ll tell him the story, how brave he was in my belly, and how the difficulties we went through and how I feel when I put him in my hands. That it’s a miracle. He comes after [inaudible 00:31:39] and he went out of death, really. We went, me and him, out of death, out of war. |
| Gabrielle Berbe…: | Where will you go now? |
| Lubna Al Rayyes: | I don’t know. I’m staying now in Egypt. And to be honest, I’m telling you the truth that I don’t have plans. I don’t have plans. You have to think and it’s not easy to think about it. I feel that I have this bond between us and between our country and our home. We will go back. |
| Gabrielle Berbe…: | I know you have to get back to your baby. |
| Lubna Al Rayyes: | Yeah. Yeah. I think I have to go back to him. |
| Gabrielle Berbe…: | But I just want to say thank you for talking to us throughout this whole- |
| Lubna Al Rayyes: | You are welcome. Okay. You are welcome. |
| Gabrielle Berbe…: | We’ll be in touch. |
| Lubna Al Rayyes: | You’re welcome, Gabrielle and Salman. |
| Gabrielle Berbe…: | Okay. |
| Al Letson: | Our story was reported and produced by Gabrielle Berbey and Salman Ahad Khan. For now, Lubna, her newborn son, two daughters and husband are refugees in Egypt. They applied for residency in Australia, but were denied. They also applied in Canada and have not heard back yet. As of the end of March, Canada still had not evacuated anyone from Gaza. |
| It’s estimated nearly 200 women are giving birth in Gaza every day. In a moment, we hear from an OBGYN who’s helped many women deliver in the middle of this war. | |
| Dr. Ghassan Jaw…: | Every simple case, now it’s like a very serious case. |
| Al Letson: | That’s coming up on Reveal. From the Center for Investigative Reporting and PRX, this is Reveal. I’m Al Letson. |
| Lubna Al Rayyes was lucky. She was able to evacuate Gaza and give birth to her son in Egypt, but 60,000 pregnant women are still in Gaza right now. And beyond staying safe from the fighting, they’re facing a new danger, famine, as widespread food shortages are being reported throughout Gaza. | |
| Dr. Tessa Roseb…: | I’m very worried not only about the people who are currently experiencing the situation in Gaza, but because of the research I’ve done, I’m so worried about the long-term consequences this will have for the generation that isn’t even born yet. |
| Al Letson: | Dr. Tessa Roseboom is a Professor of Early Development and Health at the University of Amsterdam. Her research shows that war and famine can cause changes in how babies develop that will affect their health for the rest of their lives. Reporter Salman Ahad Khan spoke to her about what impact Israel’s siege on Gaza will have on Palestinian babies born there. |
| Salman Ahad Kha…: | Starvation has been used as a weapon of war for centuries. Some recent examples include the war in Yemen, the Biafran war in Nigeria and the Holocaust, but Dr. Roseboom has been looking at another example from World War II. It’s called the Dutch Hunger Winter. |
| Dr. Tessa Roseb…: | This was a period of famine that occurred during the Second World War in the western part of the Netherlands that had not been liberated yet. |
| Salman Ahad Kha…: | The German occupying forces started blockading all food supplies heading to the Dutch territories. |
| Dr. Tessa Roseb…: | And that acute period of famine lasted for about five or six months until the Netherlands was liberated and food was much more freely available again. |
| Salman Ahad Kha…: | It’s estimated 25,000 people died during the Dutch Hunger Winter and Dr. Roseboom has a personal link to the famine. She’s from the Netherlands and both her grandmothers were pregnant back then. |
| Dr. Tessa Roseb…: | I interviewed my grandmother and she told me her story of how she delivered my father at home when there was no light and there were bombings going on, and that was obviously a really, really stressful time to bring new life into the world. |
| Salman Ahad Kha…: | When we think of the health impacts of traumatic events like war and famine, we usually focus on the people living through those crises. But Dr. Roseboom has been focusing on a different question, what happens to babies still in their mother’s bellies during those events. |
| Dr. Tessa Roseb…: | In almost three decades of studying men and women who were being shaped inside their mother’s womb during the Dutch Famine, we know that the lack of nutrients to actually build your body left lasting marks on the organs and tissues that were forming at the time. These brains were smaller. When these people were adults, their brains were wired in a different way. |
| Salman Ahad Kha…: | She says their metabolisms were getting ready for a world with less food, but when the famine eventually ended and those babies grew into adults in a world where food was available again, their bodies couldn’t cope. They became more susceptible to all kinds of diseases. |
| Dr. Tessa Roseb…: | I’m really worried about the developmental potential of the unborn babies in Gaza at the moment because the stress levels they are experiencing is wiring their brains, is wiring the way their bodies respond to food. It’s going to affect their ability to learn. It’s going to affect both their physical health, so their risk of diabetes, their risk of cardiovascular disease, even certain types of cancer, and it’s also going to affect their mental health, making people more susceptible for stress, addiction, depression, in particular, but also schizophrenia. |
| Salman Ahad Kha…: | And researchers are discovering that when those children become adults and have their own kids, those physiological traits can even get passed on to the next generation. Dr. Roseboom says it’s not possible to ever fully make up for these impacts, but it is possible to reduce some of the negative effects. If those same kids get social support, get access to healthy diets, regular exercise, that could go a long way, but you need resources for that. Gaza doesn’t have any. The medical system itself has collapsed. |
| We wanted to know how have doctors in Gaza been managing this collapse, especially those who’ve been caring for pregnant women there. So we tracked down an OBGYN. His name is Dr. Ghassan Jawad. He’d recently evacuated to Egypt when we first spoke. Dr. Jawad lives in a small apartment in Cairo with his wife, two sons, and his wife’s family. It is so good to see you again. | |
| Dr. Ghassan Jaw…: | Me too. |
| Salman Ahad Kha…: | How are you doing? |
| Dr. Ghassan Jaw…: | It’s first time- |
| Salman Ahad Kha…: | Before the war, Dr. Jawad ran a private clinic and he was an on-call doctor at Al-Shifa, Gaza’s largest hospital. You might’ve heard of it. It’s the one that’s been attacked multiple times by the Israeli military. In the first days of the war, Dr. Jawad pivoted to treating critical cases at the hospital. |
| Dr. Ghassan Jaw…: | When the war started, we cannot just imagine what kind of war we are going to. The amount of killing and the amount of dead cases, it was so uncountable. |
| Salman Ahad Kha…: | Within the first six days of the war, Israel dropped 6,000 bombs on Gaza, killed more than 1400 people. After four days, Dr. Jawad says the hospital could barely function. |
| Dr. Ghassan Jaw…: | From 7th of October till 10th or 11th of October, all of our storage of medicine and the IV fluid and equipment like cannulas, syringes, medications, gauze, sponges, we already use most of them within first one week. So all of us as a medical team was in shock. How we are going to complete this war if it’s continue at one month [inaudible 00:40:26]. |
| Salman Ahad Kha…: | The doctors decided they had to come up with a system to conserve supplies. So with every incoming case, they ask themselves a difficult question. Is this a hopeful case or a hopeless one? |
| Dr. Ghassan Jaw…: | So dealing with hopeful one and let the hopeless case to die in peace. Don’t touch with them because he will cost us a lot of surgical interventions, a lot of equipment. |
| Salman Ahad Kha…: | And the doctors would have to explain their decision to the family members. |
| Dr. Ghassan Jaw…: | We explain to the family, your case is a hopeless case, that another case can be survived if we’re dealing with her. |
| Salman Ahad Kha…: | But Dr. Jawad, the OBGYN at the hospital, says, choosing between hopeless and hopeful is especially complicated when you’re dealing with pregnant women. Obstetrics and gynecology departments were shutting down all over Gaza so Dr. Jawad delivered his patients wherever he could. One day, he got a call about a woman who was headed to the hospital in a donkey cart. She was in labor and wasn’t going to get there in time to deliver, so he went to her and delivered the baby on the street. |
| Dr. Ghassan Jaw…: | But this is the routine, Salman. We already deliver the cases sometimes in the street, sometimes in the school, sometimes in the roof of building and the ground in the hospital. |
| Salman Ahad Kha…: | He says he had to do invasive procedures without anesthesia, perform C-sections on women who were dying. But some of the most tragic cases for Dr. Jawad were ones that would’ve been easy to treat under normal circumstances. |
| Dr. Ghassan Jaw…: | Every simple case, now it’s like very serious case. |
| Salman Ahad Kha…: | He tells us about one of these simple cases. The patient is 20-years-old, four months pregnant. She has a urinary tract infection. It’s the most common infection during pregnancy, so the doctors give her antibiotics. They tell her, come back in five days. She says she doesn’t know if she’ll be able to. She doesn’t have a place to live right now, and there’s bombing everywhere. Two days later, she comes back. The pain is getting worse. Before the war, if a pregnant patient came back with worsening symptoms, they would’ve immediately admitted her, run all kinds of tests, but it’s the war now. She’s not bleeding, so she doesn’t get a bed. The next day she comes back again. This time though, she’s losing consciousness. Her family is holding her up. Now, she finally gets a bed. The infection is critical. She’s in septic shock, and the doctors realize they’ll need to terminate the pregnancy to save her life. They tell her family, she’s young, she can get pregnant again. The family agrees, but after the procedure, her condition gets worse. |
| Dr. Ghassan Jaw…: | After I examine her, I see something wrong inside the abdomen. |
| Salman Ahad Kha…: | She’s not breathing properly and he’s not a lung specialist. She needs to go to the ICU. So Dr. Jawad calls his colleague there. |
| Dr. Ghassan Jaw…: | I told him, I have a case, 20-years-old, her condition is not well. Temperature is elevated, there is hypotension. There is something wrong in breathing sounds. The case will be died if we don’t deal with it. [inaudible 00:43:49], unfortunately, he told me, I cannot do anything for you. We cannot accept this case and you cannot transfer to us. There is no space for her. |
| Salman Ahad Kha…: | He knows how to help her. She needs an operation, but he can’t do the operation because he doesn’t have the equipment. He’s been up for 24 hours. It’s midnight. The hospital is overcrowded. He can hear bombs outside. It’s getting really hard to think. The patient is hallucinating now. Feels like something is leaving her body. |
| Dr. Ghassan Jaw…: | She’s crying to her mother. Please call Dr. Ghassan just alone to dealing with me. Please tell him to be beside, I feeling I’m going to die. I explained to the mother, your daughter’s condition is very, very, very, very critical, and my capability is so limited. She’s shocked. She cannot find any answer. And she told me, “So what we are going to do to save her life? She’s just 20. What can we do for her?” We cannot do anything. We as a human, we do all of best we can do to help her. After one hour, she’s died. I told him to reading some Quran. I see the soul, her life is ended in front of my eyes. |
| Salman Ahad Kha…: | Before the war, would she have lived? |
| Dr. Ghassan Jaw…: | Yeah, definitely. |
| Salman Ahad Kha…: | Seeing this case go from hopeful to hopeless broke something in Dr. Jawad. It’s what made him decide he couldn’t live in Gaza anymore. |
| Dr. Ghassan Jaw…: | I start to believe we are not working as a doctors. We are handless, useless. |
| Salman Ahad Kha…: | I’d spoken with Dr. Jawad in mid-March, and it had been a few months since he’d last treated a patient. He told me he misses being a doctor like he was before the war. |
| Dr. Ghassan Jaw…: | I miss my job. I miss my cases. I miss my career. |
| Salman Ahad Kha…: | He wants to be that doctor again, but that’s not possible right now. He’s not allowed to work in Egypt. He says they won’t recognize his medical license. He still hopes he can return to Gaza and practice again. Then a few weeks later, as we were wrapping up the story- |
| Speaker 11: | Breaking news out of Gaza where Israeli forces are surrounding the Strip’s largest medical complex. There have been reports of deaths and injuries inside Al-Shifa Hospital. |
| Salman Ahad Kha…: | News reports started coming out that the Israeli army had raided Al-Shifa Hospital where Dr. Jawad worked. Since the start of the war, the Israeli military has conducted several raids on hospitals. In November, the military attacked Al-Shifa claiming that Hamas fighters could access tunnels from inside the hospital and that there was a command center underneath it, but a Washington Post investigation found no evidence of those claims. In this most recent raid, the Israeli military claimed that Hamas fighters were using the hospital as a base again. |
| They said it was a successful operation and that civilians were not harmed. Then the images started coming in. The hospital’s main buildings were completely devastated. Many of them scorched and barely standing. A surgeon there described the scene as a wasteland. At least 300 bodies were recovered from the destruction. I texted Dr. Jawad to ask if his friends and colleagues there were okay. | |
| Dr. Ghassan Jaw…: | Oh, unfortunately, my friend, Salman, there was- |
| Salman Ahad Kha…: | He sent me a voice memo. He had been in touch with people at Al-Shifa. |
| Dr. Ghassan Jaw…: | There’s a lot of stories I have heard from my friends there. They called me and they described the conditions they live during attacking of the Al-Shifa Hospital, how they’re killing them in cold blood. |
| Salman Ahad Kha…: | Dr. Jawad had just gotten a message about two of his colleagues, his friend Ahmed and his friend’s mother, Yusra, both of them doctors at Al-Shifa. |
| Dr. Ghassan Jaw…: | After Israel army, get out from Shifa Complex hospital, people go there and find out they died. He was my colleague and my friend. Something make me so crying, it’s tearing heart even. I’m so sad, so depressed, I’m so collapsed. There is no hope, no future in Gaza. |
| Salman Ahad Kha…: | He said he doesn’t see how he can go back to Gaza now. After this latest raid, he said, the message from the Israeli army was clear. |
| Dr. Ghassan Jaw…: | There is no hope to come back to live again in Gaza. So all our memories is destroyed and burned. We are so deeply, deeply scarred in our hearts. There is no hope to live in Gaza anymore until maybe after 20 or 30 years. But the end, we are Muslims, this is our fate just to thanks our God for everything, for happiness and sadness. We said, Alhamdulillah. Thanks for asking, my friend. |
| Al Letson: | That story was reported and produced by Salman Ahad Khan, Neroli Price and Gabrielle Berbey. Gabrielle and Salman were lead producers of this week’s show. It was edited by Taki Telonidis, with help from James West. Thanks to Nadeen Shaker, Shaimaa Ziara, Dr. Mohammad Ziara, Reem Farhat, Najib Aminy and Dr. Tessa Moll. Nikki Frick is our fact checker. Victoria Baranetsky is our general counsel. Our production managers are Steven Rascon and Zulema Cobb. |
| Original music for this week’s show is by Salman Ahad Khan, additional music and sound design by the dynamic duo, “Jay Breezy” Mr. Jim Briggs and Fernando “My man, yo” Arruda. Our interim executive producers are Brett Myers and Taki Telonidis. Our theme music is by Comorado Lightning. Support for Reveal is provided by the Reva and David Logan Foundation, the Ford Foundation, the John D. and Catherine T. MacArthur Foundation, the Jonathan Logan Family Foundation, the Robert Wood Johnson Foundation, the Park Foundation, and the Hellman Foundation. Reveal is a co-production of the Center for Investigative Reporting and PRX. I’m Al Letson. And remember, there is always more to the story. |