A week later, the hospital was declared out of service and the medical staff, including the director, Mohammed Salha, who recorded the voice note, were forced to evacuate and head south.
Patients were carried on stretchers and wheelchairs past mounds of rubble and bombed-out buildings to waiting ambulances.
With fewer than half of Gaza’s hospitals now running – and those that are only at a limited capacity – there are warnings from groups like the WHO and British Red Cross that the health system is being “systematically dismantled” and “on the brink of collapse”, as the number of casualties from the 20-month war continues to rise.
Al-Awda in northern Gaza is one of several hospitals across the territory to have ceased or reduced operations since Israel expanded its offensive last month, with the Israeli military accusing Hamas and other armed groups of operating in and around the facilities.
Over a period of two weeks, Salha sent regular voice notes to the BBC from inside the hospital, including at times when it could not be reached by patients or journalists, tracking its rapid deterioration until the moment it shut down completely.
We have corroborated key details with others’ testimony, including two medics who were inside the hospital at the time, as well as video and photo evidence that we have verified, and sent multiple enquiries to the Israeli military.
This is an account of one hospital’s final days.
The NGO-run al-Awda hospital is located in the northern Gaza town of Jabalia. It is supported by international groups including Action Aid and Relief International with the help of EU funding.
Overnight and in the morning the hospital receives “more than 97” patients injured by Israeli bombing, Salha says by voice note. The emergency room has only 12 beds.
Video footage later verified by the BBC shows an injured man being brought to al-Awda in a rickshaw, with a bandage and belt tied around his leg, and carried inside.
Among six bodies that arrive are Salha’s eight-year-old nephew Jamal and nieces Fatima and Hanadi, aged 10 and 28, Salha says. The two children had been sleeping at a nearby home in the neighbourhood of Tal al-Zaatar, when an Israeli strike hit leaving them under rubble for more than five hours before rescuers could retrieve their bodies, he says.
The strike on the home is reported by a local journalist, and an al-Awda hospital staff member says in a WhatsApp group seen by the BBC that children’s bodies were brought to the hospital that day.
The Israel Defense Forces (IDF), when provided with the street, timeframe and name of the family living in the building hit, said it needed more specific details before it could respond to questions on the strike.
On the same day, the United Nations releases a statement saying the reported killing of “at least 45 children in the Gaza Strip in the last two days is yet another devastating reminder that children in Gaza are suffering first and foremost, having to starve day after day only to be victims of indiscriminate attacks”.
A life-saving operation is performed on the children’s mother who has shrapnel in her liver, Salha says.
The director’s grieving relatives shout and cry in the hospital. He shuts himself in his office briefly to cry alone, before returning to work.
Women will give birth in the street’
The situation worsens at al-Awda, as the Israeli military continues its ground operations and strikes “terror targets” across Gaza.
Overnight, Israeli forces bombed nearby houses and the surroundings of the hospital, says Salha, causing damage to windows, doors, floors and ceilings – as well as the gas, water and electricity network.
A post on the hospital’s Facebook page in the morning refers to a “harsh night”, with damage caused by shelling in the immediate vicinity. Photos show damaged ceilings and walls and dust covering ambulances in the courtyard.
In a video shared overnight on social media and verified by the BBC, an explosion close to the hospital fills the courtyard with smoke and sends people scrambling into al-Awda.
BBC