An Irish trauma surgeon who was inside Nasser Hospital in southern Gaza last week when it was hit by an Israeli missile recorded the chaos unfolding in the immediate aftermath and has shared his footage exclusively with Prime Time.
Dr Morgan McMonagle, who had been volunteering in Khan Younis with Medical Aid for Palestinians, captured what happened after the 23 March attack which killed a reported five people.
The dead included a 16-year-old boy who was recovering from surgery and Hamas official Ismail Barhoum.
Israel has said Mr Barhoum was the target of the attack.
In footage taken by Dr McMonagle from inside the hospital the impact of the strike is clearly visible.
"The hospital was hit above the emergency department second floor," Dr McMonagle says in footage taken for Prime Time as a part of an extensive video diary, "we heard an enormous explosion, and the entire hospital rattled."
Dr McMonagle spoke to Prime Time presenter Miriam O'Callaghan about treating patients in Gaza following Israeli strikes like the one that hit the Nasser Hospital.
"This is by far the worst that we've had to deal with...because of the number of children, just shy of 50% of the Gazan population under the age of 14," he said.
"If you're going to send in a large explosion into a residential area and your only shelter is tents or buildings that are already condemned buildings because of previous bombing, you're going to have at least 50% of the deaths and injuries are going to be children."
A severe lack of supplies and medicines, malnourishment, makes it more difficult to treat patients when they arrive at hospital.
On the night the Nasser Hospital was hit last week, Dr McMonagle said:" We started at about 3am and I did my last case at about 10pm that night. But many children be pronounced dead straight away. Some died in the operating theater, some died the next day."
"I remember I went back to the residence at about maybe lunchtime, 2 in the afternoon, when things calmed down a little bit, I could get something to drink, something to eat. I walked through the intensive care unit and all the beds were full. It's a 20-bed intensive care unit. I went back at about 7 or 8 in the evening and it was only half full because they died."
"That's the problem with shrapnel and blast. It causes such devastating injuries through every system of the body, head, neck, chest, abdomen, pelvis, that your chances of survival are very, very low with blast injury."
During the ceasefire, Dr McMonagle said bombs weren't falling but people needed to be treated for other effects of war: "We had a lot of falling buildings, people coming in, injured falling in buildings, trying to loot a lot of the vehicles carrying supplies in, run over."
"We had a lot of what we call tertiary or quaternary effects of war, where you're dealing with complications because people either couldn't come to hospital on time to deal with maybe cancers or diabetes, or indeed, they were having a lot of wound problems."
"Once the ceasefire ended," he said, "it was all shrapnel. It was pretty much all shrapnel. A few bullet wounds, but mostly shrapnel. And again, mostly children."
Now back in Ireland, Dr McMonagle says he feels both anger and guilt.
"I think anger is one of the big things because this is all manmade...It is purely 100% preventable. It is a political problem with a political solution."
"I think the emotion I carried most leaving was probably guilt. I felt quite guilty leaving a lot of these patients behind. I felt a lot of guilt leaving my colleagues behind."
Dr McMonagle said he ended up staying an extra two weeks during this trip, as their group couldn't get out. When they were driving to the Israeli border in an armored UN vehicle, his Palestinian driver said to him "'that anybody who's left in Gaza now is either dead or will be dead.'"
A full report from Dr McMonagle's most recent trip to Gaza is broadcast on the 1 April edition of Prime Time on RTÉ One and the RTÉ Player at 9.35pm.
