(NEW YORK) — A doctor inside Gaza has warned the health sector is on the brink of total collapse.

“We’ve reached the point where the fuel is running out everywhere. And so most of the hospitals are going to run out of fuel,” Ghassan Abu Sitta, a British-Palestinian plastic surgeon, who works at both the Shifa and Al Ahli hospitals in northern Gaza, told ABC News on Tuesday.

“The catastrophe is actually all of this is going to end within four days,” he added. “There’s not a single hospital left in Gaza with enough fuel to sustain its generators beyond four days.”

The Palestinian Health Ministry says that 18 out of the 35 hospitals in Gaza and 51 out of the 72 primary health care clinics have been forced to close either due to a lack of fuel or damage from Israeli bombardment. The Israelis are not allowing fuel to enter the Gaza Strip and have accused Hamas of stockpiling fuel intended for hospitals and humanitarian use and diverting it for terror purposes.

The hospitals in Gaza that are still functioning are doing so at a reduced capacity and are stretched beyond their limits, battling with a lack of medical supplies and fuel, an overflow of patients and the threat of Israeli bombardment.

“There was a bomb this morning that really shook the whole building to its core,” Abu Sitta said, talking to ABC News from the Shifa Hospital in northern Gaza. “And driving in here, you know, this morning we were hearing the sound of planes and then you see one damaged neighborhood after another. And some of the buildings have the smell of decomposing bodies coming from them.”

Israel has bombed the Gaza strip relentlessly for the past 32 days, retaliating for the Oct. 7 Hamas surprise terror attacks that killed at least 1,400, with hundreds of hostages taken, according to Israeli officials. According to the Hamas-run Gaza Health Ministry, over 10,000 people have been killed and more than 25,000 have been wounded in Gaza since the conflict began.

The Gazan health system cannot cope, with patients’ needs far outstripping the hospitals’ capacity, meaning “only the most lifesaving surgeries can now go to the operating room,” which can have devastating consequences, Abu Sitta explained.

“And so we have patients now coming in two weeks after when they should have gone to the operating room with fly larvae in their wounds and pus pouring out because they’re just not making it to the operating room in time,” he said.

Those that are operated on have minimal pain relief, Abu Sitta said. Hospital staff have been using ketamine as the morphine supply has run out.

“There’s no pain relief. I mean, we operate on patients and then we give them all paracetamol [known in the U.S. as acetaminophen]. We’ve run out of morphine two weeks ago,” he said.

And after an operation, Abu Sitta explained, there is nowhere for the patients to go, “because you can’t discharge patients home if the reason they’re here is that their homes have been bombed. And that’s the nightmare … you do operate, and then there’s nowhere safe for them to go to recuperate.”

The hospitals are overcrowded with both patients and people who have fled to them for safety, Abu Sitta said.

Referring to Shifa Hospital, Abu Sitta said, “It was a hospital with a bed capacity of 600 and now has over 2,000 wounded in it, in addition to the 50,000 internally displaced.”

Shifa hospital has lost 50% of its operating rooms, Abu Sitta explains, due to the lack of power, and so procedures are happening in the wards and corridors and he calls some of the surgical procedures he has performed “medieval.”

The United Nations Relief and Works Agency for Palestine Refugees in the Near East announced just the second delivery of supplies since the beginning of the war was delivered on Wednesday, but “the quantities we delivered are far from sufficient to respond to the immense needs in the Gaza Strip.”

Abu Sitta is particularly concerned with the effect this war is having on the children of Gaza, saying, “These kids are traumatized.”

Of the over 10,000 Palestinians killed in Gaza, more than 4,000 of them are children, according to the Hamas-run ministry. But many of those that survive the bombardment have been left orphaned.

“And there’s a designation now that, you know, a wounded child with no surviving family and you come across one every few days. It’s heart-wrenching,” Abu Sitta said. “From the minute you see them in the emergency room with no one around them, you realize.”

And if the hospital’s systems fail, its youngest patients, babies in incubators, will be among the first to die.

“You have no ability to run ventilators. Shifa has 150 patients on ventilators, critically ill patients. Fifty incubators will no longer work. Blood banks and blood bank fridges will no longer work and the lighting inside the hospitals will no longer function,” he said.

“And so these hospitals will transform from a place of life to mass graves,” he added.

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