Children with missing limbs and bullet wounds to the head are just some of the “absolutely awful” injuries British doctors have tended to in Gaza over the past year.

Dr Ammar Darwish and Dr Nizam Mamode have been to Gaza over the past year as volunteers with a medical team organised by the charities Medical Aid for Palestinians (MAP) and the International Rescue Committee (IRC), spending their time at Nasser Hospital in Khan Yunis.

Despite having worked in conflict zones across the world, they described their time in Gaza, since violence escalated after Hamas’s October 7 attack on Israel last year, as one of their “most difficult” and “surreal” experiences.

Dr Darwish, a general and major trauma surgeon from Manchester who is also the clinical director at the David Nott Foundation, went to Gaza twice this year, from January 10 to 20 and a month from August 12.

Both times he went as part of a team of four with MAP to work alongside local doctors and other medical teams.

He told the PA news agency he is “lucky” to be able to speak about what he witnessed after his expected two-and-a-half-week mission in January was cut to 10 days after a guest house he was staying at with other emergency medical personnel in Al-Mawasi, Rafah, was hit by an Israeli air strike on January 18.

“Thankfully, we got away with minor injuries, which was a miracle really,” he said.

“If that rocket was three or four metres closer, it would have hit inside the house where our rooms were and I most likely would not be speaking with you today.”

During both missions, Dr Darwish’s tended to injuries alongside supportive and “absolutely brilliant” local doctors, with roughly 70% of patients being women or children.

“You get crush injuries from buildings falling on people and many would come in with shrapnel-penetrating injuries to the head, chest and abdomen because of missiles and bombardment of these buildings and tents,” he said.

“These kinds of injuries don’t end with only one operation when they first come in – patients will often need further surgeries, reconstructive operations, rehabilitation and physiotherapy, and the problem is they simply don’t have any of these facilities in Gaza due to the collapsed health system.”

Dr Darwish said even though he had to tend to the most critically injured young patients, there were glimmers of hope.

“On the second trip, I had a four-year-old girl who came with a bullet straight to the head that was embedded in her brain,” he said.

“Her level of consciousness started to drop when she arrived and our team put her to sleep, intubated her and we took her straight to theatre.

“We operated on her with the neurosurgeon – we made a hole in the skull to evacuate the haematoma that’s pressing on the brain to stop the brain from being compressed.

“We didn’t think she would survive, but then she started to breathe on her own, she opened her eyes, recognised her mum and called her name out.”

He added the girl was discharged from hospital two days before he left Gaza, but when he said she could go home, she replied: “I don’t have a home any more.”

He said there was a “shortage of everything”, from anaesthetic medicine and pain relief to antibiotics and antiseptics, and Gaza will see further casualties as violence escalates in the Middle East.

“It terrifies me when I see the news now,” he said.

“I’ve done more than 50 humanitarian missions and Gaza has been one of the most difficult ones.

“What we’re seeing in Gaza, this continued conflict, means we’ll see more civilian casualties and more injuries, more people that are suffering, more displaced people – it’s just going to go on and on and on.

“I don’t know how they can be expected to take any more of this war or this blockade on essentials.”

Dr Mamode, 62, went to Gaza for a month from August 12, alongside three others as part of a team with MAP, including Dr Darwish, and told PA it was a “surreal world”.

The doctor, who practices general surgery, vascular surgery and transplantation and lives in Hampshire, said of the general state of Gaza: “It looks as though an atomic bomb (has gone off).

“There were around a million to a million and a half people packed into the small area and the conditions were appalling.

“You see tents everywhere and when I say tents, they’re usually bits of plastic and carpet tacked to sticks or posts.”

He said many patients had injuries which were so severe they ended up dying.

“The injures were absolutely awful,” he said.

“We would have children who’d been shot by drones, children who’d lost limbs from blast injuries, children with single bullet wounds to the head where they’d clearly been deliberately shot and this just happened day after day.

“Many patients didn’t survive and many of those we operated on subsequently died.”

A lack of resources and sanitation meant many wounds became infected fairly rapidly, with Dr Mamode adding: “I saw several wounds with maggots in.”

He added: “The targeting of aid and medical workers was absolutely astonishing – ambulances were being shot when they were going out to rescue people from a bombing.

“Medical aid is not being let in and there are bizarre restrictions like no soap and shampoo for a million and a half people crammed into this small area.

“I’ve never come across a conflict where people are just penned in and then bombed.

“What’s happened and is still happening in Gaza should not be visited on any other population in the world at all.”