Good morning.
For over a year, Gaza’s already underresourced healthcare system has faced “relentless” attacks. As of 5 January, only 16 of the region’s 36 hospitals were partially operational and they had a collective capacity of just 1,800 beds. More than 100,000 people have been injured in Gaza.
Israel has long said that Hamas and other armed groups were operating from civilian infrastructure, including health facilities. But the UN high commissioner for human rights has pushed back on that claim, stating that Israel “has not provided sufficient information to substantiate many of these claims”.
Phase 1 of the ceasefire, which began two weeks ago and is set to last for 42 days, has brought a sense of cautious optimism in the region. More aid is entering Gaza and people are hopeful that this will be the start of rebuilding the devastated healthcare system. But there is no guarantee the ceasefire will lead to long-lasting peace, and with Israel’s government gearing up to ban Unrwa, there is still trepidation about what the future looks like.
To get a sense of what it was like working in a hospital in Gaza during wartime, I spoke with surgeon Nizam Mamode, who spent a month at Nasser hospital in Khan Younis last August. That’s right after the headlines.
Five big stories
Education | Moves to overhaul the way schools are inspected in England have been criticised by headteachers and teaching unions as “demoralising” and worse than the system they are aiming to replace. The changes by the Ofsted schools inspectorate would replace single judgments such as “outstanding” with a new report card for parents.
Politics | Yvette Cooper, one of Keir Starmer’s cabinet ministers, has said he stands for “respect and hard work”, after a new book claimed his chief of staff, Morgan McSweeney, described him as an “HR manager” rather than a leader.
US news | Investors are bracing for stock market falls after Canada and Mexico hit back against trade tariffs imposed by Donald Trump this weekend.
Health | Black people are eight times more likely than white people to be admitted to hospital with lupus, NHS figures show, with experts saying the “stark” inequality could be a result of delayed diagnoses.
Culture | Beyoncé and Kendrick Lamar ruled the Grammys during a night that also paid tribute to those affected by the California wildfires. The night’s biggest prize, for album of the year, went to Beyoncé for Cowboy Carter, the first time she has won the award. The singer is only the fourth Black woman to win the award. “It’s been many many years,” she said to loud applause.
In depth: ‘We had one or two mass casualty events every day’
Nizam Mamode, a transplant surgeon who retired from the NHS in 2022, travelled to Gaza alongside four others with Medical Aid for Palestinians (MAP), a British charity that provides medical services in the West Bank, Gaza, and Lebanon. Upon crossing the border, Mamode compared what he saw to Hiroshima and Nagasaki, such was the scale of the destruction. It was hard for him to comprehend what he was seeing. In November, he described to parliament the indiscriminate and deliberate targeting of civilians, stating: “It doesn’t matter who you are in Gaza. If you’re Palestinian, you’re a target.”
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Daily life in a hospital during wartime
Mamode did not leave the hospital during his time in Gaza. Travelling between MAP’s residence and work was too risky, especially as at the start of last year a MAP house had been hit by an Israeli airstrike.
Day to day, Mamode says the conditions were “atrocious”. “The hospital was overcrowded,” he says. “We had one or two mass casualty events every day, which would mean the emergency department would be full of people who were either dead or seriously injured, often lying on the floor because there was no space. There were patients in the corridors, patient beds were all turned together.”
For much of the war, staff struggled with a lack of basic medical supplies due to Israeli forces restricting aid. Israel has denied claims that it has limited access to aid, including medical supplies, however, many aid groups, such as Médecins Sans Frontières, have said they have been unable to deliver packages containing even simple items such as soap and toothbrushes. A CNN report also found that among the most frequently rejected items by Israeli authorities were anaesthetics, anaesthesia machines, oxygen cylinders, ventilators, and water filtration systems.
“Hygiene was essentially nonexistent because Israel had blocked really basic things like soap and shampoo from getting in,” says Mamode. “There were flies everywhere in the wards – often flies would land on the wounds while I was operating.” With no way to properly disinfect the surgical environment, civilians have been dying from infections.
Mamode says that in any conflict zone, surgery is a compromise, but the situation in Gaza was uniquely difficult. He describes running out of gauze swabs, drapes, gowns, gloves and certain types of catheters: “We lacked painkillers, so we did amputations and then people had to take paracetamol for pain relief, which is unacceptable.”
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Worse than other conflicts
Mamode has worked in a number of conflict zones around the world, including Sudan and Rwanda during the 1994 genocide. Everyone he spoke with, including experienced aid and healthcare workers, believed that what they saw in Gaza “was so much worse” than anything else they had witnessed, Mamode says.
“It was completely at another level,” he says. “You expect in a war zone to see some children and women injured from time to time. But every day, we had huge numbers coming in.” Mamode estimates that about 60 to 70% of the casualties he treated were women and children. He says it “was almost beyond comprehension. Civilians were being deliberately killed, wantonly. Children were being shot deliberately by drones or snipers. And that really is shocking.” Israeli officials have routinely denied deliberately or indiscriminately targeting civilians throughout the war.
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Life for Palestinian healthcare workers
Palestinian medical staff working in hospitals in Gaza face immense hardship. Not only must they contend with the general environment of war, but there is also increasing evidence that they have been deliberately targeted by Israeli forces. A UN commission concluded in October that Israeli forces have “deliberately killed, wounded, arrested, detained, mistreated and tortured medical personnel and targeted medical vehicles”, constituting the war crimes of wilful killing and mistreatment, as well as the crime against humanity of extermination. Israel rejected the commission’s findings, noting in particular “that the agency made its claims based on the outcomes of attacks instead of assessing the decision making process behind them”.
But Mamode says this kind of violence against healthcare staff and structures was routine: “While we were there, one of the ambulances was shot while picking up some wounded people.” Since October 2023, it is estimated that 1,000 healthcare workers have been killed in Gaza. Human Rights Watch published a report highlighting cases of medical staff from Gaza being tortured in Israeli detention.
Many of the staff Mamode worked with were living in tents and makeshift shelters. “The junior doctor who worked most closely with me was living in a tent with his father, his wife and two young children, with no running water, no electricity. While we were there, he had to evacuate on short notice and that happened again and again.”
It is hard to comprehend how people cope in these circumstances. Mamode was thinking about this when he first arrived in Gaza and made a comment praising the resilience of Palestinians. It was met with irritation from a colleague. “He said: ‘We’re not resilient, we just have to keep going. There’s nothing else we can do but go on.’”
What else we’ve been reading
Weeks after the LA wildfires devastated much of the landscape, people are returning to what is left of their homes. Jedidajah Otte and Jem Bartholomew spoke with locals about what their future potentially holds. Nimo
John Harris is on form in this foreboding column reporting from Rugeley, Staffordshire. “Unless there is a deep change in how people feel about their lives and the future of the places where they live,” he writes, “a British iteration of Trumpism may well rise to the top, much sooner than some people seem to think.” Charlie Lindlar, acting deputy editor, newsletters
Two weeks into Donald Trump’s presidency and it looks as though media barons and publications are bending to his will, writes Edward Helmore. Michael LaRosa, spokesperson for the former first lady Jill Biden, told Helmore that the president has become “America’s editor”. Nimo
As a self-confessed scaredy cat, I was morbidly compelled by Charlie Teasdale’s dispatch from horror convention UncannyCon on why so many of us (well, you) are besotted by spooky stories and paranormal podcasts. Charlie
Sophie Wilkinson spoke with residents of a London council estate grappling with mould, vermin, and chronic neglect. Frustrated by mismanagement, they say enough is enough in their fight to remove those in charge. Nimo
Sport
Football | Arsenal thrashed rivals Manchester City, in a decisive 5-1 victory, at Emirates Stadium. Meanwhile, Spurs finally broke what seemed like an unending streak of losses, with a 2-0 win against Brentford.
Cricket | India crushed England by a record 150-run margin in the fifth and final T20 in Mumbai, sealing a dominant 4-1 series victory.
Football | Spain’s former football chief Luis Rubiales will go on trial in Madrid today over the unsolicited kiss he planted on the World Cup winner Jenni Hermoso, a gesture that stunned millions of TV viewers and unleashed a backlash against sexism in sport.
The front pages
As investors anticipate stock market falls, the Guardian splashes with “Trump tariffs spark fears of global trade war as markets brace for fall,” while the Telegraph says “EU tells Trump we will not be bullied,” and the FT: “Trump faces backlash from business as trade war sounds inflation alarm.”
The focus at the Times on Monday is “Russia suspected of hacking into Sir Keirs email,” a topic also highlighted by the i, which leads with: “UK “Iron Dome” needed to guard against Russian attack, defence review set to warn.”
‘I’d rather be dead then put in a home,” says the Daily Express, while the Daily Mail focuses on businesses struggling to pay price of Starmer’s ‘Brexit reset’ running with the headline: “LABOUR’S NEW BETRAYAL.”
Today in Focus
Alice Weidel: the far-right banker Elon Musk wants as German chancellor
Alice Weidel is a politician of contradictions: a German nationalist who lives in Switzerland; a former investment banker who rails against elites; and a lesbian with two adopted sons, leading a party that defines a family as “father, mother and children”. Yet despite Weidel’s background she has risen to the top of Germany’s far-right Alternative für Deutschland (AfD).
Cartoon of the day | Ella Baron
The Upside
A bit of good news to remind you that the world’s not all bad
On holiday in the American south, Kent-born farmer John Ingall discovered that one of the local crops was being turned into remarkable works of art. He was touring Mississippi in an old RV when he and his wife, Jane, first spotted the plant that would change their lives: the hardshell gourd, a plump, squash-like fruit with a thick, woody skin. So he went home, grew his own gourds and set about transforming them – and himself.
“A lot of farmers don’t retire,” Ingall says. “They just carry on farming. I was very sure I wanted to do something different with my life.” He is now one of the only gourd artists in the UK. Ingall started by making lanterns, and now incorporates stained glass into the shells, and also creates what are known as thunder gourds: “Fix a drum skin to it, and when you shake it, it makes a sound like thunder.”
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Bored at work?
And finally, the Guardian’s puzzles are here to keep you entertained throughout the day. Until tomorrow.
