Australian surgeon Bushra Othman was surprised so many young Palestinian men were being shot in their groins and legs in Gaza and suffering instant infections.
She soon found out it was so they would be paralysed.
The brutalities of war and crippling lack of resources were quickly laid bare to Dr Othman when she returned to her homeland for three weeks to treat casualties of the devastating conflict in the Middle East.
“I was surprised that almost every patient got a wound infection within 24 hours, which is almost unheard of in an Australian setting,” she said, referring to a lack of sterile conditions.
“One thing that I saw a lot of was the number of young men shot in their groin areas and their legs so they would be paralysed - it was just devastating.”
The Melbourne surgeon watched with horror as the conflict in Gaza unfolded and knew she had to do something to help.
"Surgeons like to do things with their hands ... I felt honestly it was a duty, it was imperative for me to go," she told AAP.
Dr Othman was introduced to the atrocities of the conflict at Al Aqsa Hospital in Deir el-Balah in central Gaza, one of the few operational facilities, where she worked long hours in unbearable heat with hardly any electricity between June 13 and July 3.
The crushing defeat of being unable to save every patient torments her.
"Should I refer to the young boy who survived an explosion but had his right abdomen and flank torn open from front to back with eviscerated organs and subsequently died despite emergency surgery?" she said.
A 17-year-old patient, Anwaar, suffered extensive wounds to her genital area, a right hip fracture and multiple burns. She developed septic shock and respiratory failure.
"We couldn't save her despite exhaustive efforts in intensive care," Dr Othman said.
"I was the last person she would have looked in the eyes before she was anaesthetised for her procedure and never woke up again."
She recounted the anguish of the parents of six babies born with severe heart conditions who needed urgent care in Egypt but could not cross the Rafah border.
"All of them died within their first few days of life."
It was a traumatic homecoming for the surgeon with a father from Jerusalem and a mother from Jenin.
She quickly got used to waking to the sounds of bombs in the distance, loud sirens and constant humming buzz of lethal drones.
Dr Othman's humanitarian and life-saving work had been nurtured by training with skilled senior surgeons in Geelong during the last four years who volunteered in medical missions across the South Pacific.
She and NSW-based surgeon Jamal Marei were the first Palestinian-Australian doctors to join scores of other international medical professionals to treat people in Gaza, where more than 38,000 Palestinians have been killed, including more than 14,000 children by Israeli forces, according to the local health ministry.
The military operation was in response to Hamas militants killing about 1200 Israelis and kidnapping 250 hostages on October 7.
In the summer heat and intermittent electricity to keep theatres cool and well-lit, she operated for long hours on the torch-lights of mobile phones.
Movement within Gaza was restricted but Dr Othman had brief moments to survey the overwhelming damage to infrastructure and to witness the endurance of Gazans.
"When we were over there, it definitely made it much easier to form connections as a Palestinian ... you integrated quickly because you had language, heritage and ethnicity," she said.
One of those connections she holds onto in Melbourne is a colourful drawing of her name in Arabic adorned with flowers by 10-year-old Mohamad - a displaced refugee living in the grounds of the hospital.
She described Gaza as an open wound that would never close without a ceasefire.
"Medical missions and medical aid that enter Gaza is like applying a bandaid to a wound that is constantly being reopened," she said.
"It provides some minor help and support, but in reality a more permanent solution is needed.
"It's an open wound because there needs to be a ceasefire.
"The fact on the ground is ... all the casualties that we're seeing are just civilians that are coming in - disproportionately children and women."
The hardest day was being told the mission had come to end and she had to say her goodbyes to her patients within a few hours.
"It was very, very emotional. It felt like your final goodbyes are stolen from you,'' Dr Othman said.
"This is what people feel every single day when all of a sudden you hear a bomb explosion in the apartment and you've got to run out with your family and kids.
"If it was up to me, I would have stayed in Gaza for much much longer."
