Saraa fainted from the pain as the last of the bandages were peeled from her hands. The 16-year-old Syrian survived an Israeli airstrike on the southern Lebanese city of Nabatieh earlier this year. She threw her hands across her face as the blast tore through her neighbourhood, killing her parents and leaving her severely burned.
When she woke in the medical centre of the American University of Beirut (AUB), Dr Ghassan Abu-Sittah was waiting. The British-Palestinian surgeon examined her hands, adjusted her dressings and offered quiet reassurance before moving on to the next patient.
The 57-year-old chair of conflict medicine at AUB treats children wounded in the wars in Lebanon and Gaza at the hospital clinic. Moving swiftly, he checks dressings, reads X-rays, teaches medical students and fields phone calls. On days he is not in the clinic, he is in the operating theatre.
“The problem is, even though we bring in mental health support, the children are so traumatised that their pain threshold is completely altered,” he told The Observer, as he moved down the ward. “Everything hurts.”
Abu-Sittah now faces a public battle for his professional credibility as allegations of antisemitism have left him facing a hearing at the high court next year. The activist legal group UK Lawyers for Israel (UKLFI) referred him to the General Medical Council in 2023, highlighting a 2018 newspaper article and reposts on social media in which he referred to Palestinian “revolutionary violence” and killed Palestinian militants as “martyrs”.
In the article in the Lebanese newspaper Al-Akhbar, Abu-Sittah described Ahmad Jarrar, a young Palestinian believed to be a member of Hamas and suspected of killing Rabbi Raziel Shevach – an Israeli rabbi in the West Bank – as a “hero”.
Abu-Sittah’s lawyers argued that he did not know Jarrar had been involved in the killing of Shevach and that the article was intended to condemn what Abu-Sittah regarded as an extrajudicial killing of Jarrar himself, rather than to endorse the murder. “The people have no weapon left but revolutionary violence,” he wrote.
Abu-Sittah also reposted a tweet that said: “We congratulate our brothers in Hamas and our comrades in the Popular Front on the anniversary of their inception.”
His accusers claimed the comments amounted to support for terrorism and were antisemitic. But in January, the Medical Practitioners Tribunal Service concluded that the allegations could not be proved. After hearing expert evidence on the Arabic language, Palestinian political discourse and the context of the posts, the panel found no basis of misconduct and allowed Abu-Sittah to continue practising.
UKLFI disputed the ruling and complained to the Professional Standards Authority (PSA), claiming that relevant evidence had not been fully considered. In an unprecedented move, the PSA then joined the General Medical Council to appeal against the decision to clear Abu-Sittah in the high court.
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In a February report, a GMC panel acknowledged that Abu-Sittah had “devoted his career to working in humanitarian medicine”. But it said the newspaper article and social media posts “appeared objectively to be supportive of violence and terrorism, and of a proscribed organisation”. At the high court in January, they will argue the original ruling to exonerate Abu-Sittah failed to protect the public.
Abu-Sittah believes that he was targeted after sharing evidence of alleged Israeli war crimes in Gaza with the international criminal court and the international court of justice. The case has placed him at the intersection of medicine, law and global politics that has been tearing at the medical community since the October 7 attacks.
Abu-Sittah has been treating children the world over for almost 40 years. He made his first trip to Gaza as a medical student during the First Intifada in 1989, returning to the strip to provide medical assistance during the second Palestinian uprising in 2000.
Since then, he has made three more trips to Gaza, and has worked in conflicts in Lebanon, Yemen and Syria, along with missions to treat cleft lip and facial deformities in India, Ecuador and Vietnam.
Trauma, he believes, changes more than the mind. “There is evidence that pain receptors become more sensitive after trauma, and later in life, this can lead to dependence on opioids,” he said. “You’re not just operating on this child; you’re operating on the adult they’re going to become.”
As Israel launched its assault on Gaza after the 7 October terror attacks by Hamas in 2023, Abu-Sittah rushed back to the war-torn territory. He crossed into the strip from Egypt on 9 October, the day Israeli prime minister, Benjamin Netanyahu, vowed a response that would “change the Middle East”.
Over the next 43 days, the surgeon worked between al-Shifa and al-Ahli hospitals in Gaza City as Israeli airstrikes pounded the area and supplies dwindled. He is forthright about the horrors he witnessed, as the wards were overwhelmed with the dead and wounded.
At one point, he was forced to cut shrapnel and infected tissue out of a girl without anaesthetic.
“She screamed, as her father was crying and holding her. I just wanted to die and for things to stop and to be somewhere else,” he said with a sigh. “That’s when I thought: ‘I’ve just started torturing children.’”
The two hospitals became the focus of a furious propaganda campaign in the first weeks of the war. Israeli claims that Gaza’s hospitals were being used by Hamas militants as command centres and patients as human shields remain bitterly disputed. Each side blamed the other when a rocket killed scores of civilians seeking shelter in the car park of al-Ahli hospital. Through it all, Abu-Sittah and his colleagues kept working, under siege.
“You know when you’re in the sea and there’s a wave, and you lose your footing and the wave submerges you… When you’re completely submerged and you can’t…” his voice trailed off.
“I slept in the operating room. I would clean one of the trolleys and sleep on it, then operate and then go to sleep at 2am,” he went on. “You were never finished. You do 12 cases a day, but there’s still 150 waiting. And you have to keep doing them. So you felt that you’d gone under.”
UN figures show at least 20,179 children have been killed in Gaza and more than 44,143 injured since the 7 October attacks by Hamas. In Lebanon, at least 257 children were killed by Israeli strikes and 1,036 injured since Israel and Iran-backed militant group Hezbollah resumed their war on 2 March, according to Lebanon’s health ministry.
Since leaving Gaza, Abu-Sittah has campaigned against what he alleges are Israeli “war crimes” and has condemned the offensive as “a genocide”, unlike any conflict he had seen before. He recounted his experience in the 2024 documentary A State of Passion, gave first-hand testimony to the Metropolitan police war crimes unit and submitted evidence to the international criminal court (ICC).
‘Leaving Gaza felt like a betrayal to the people. But the war doesn’t stop for my war-wounded children as aftercare is a constant battle for them and for me. It never stops, even if the guns go silent’‘Leaving Gaza felt like a betrayal to the people. But the war doesn’t stop for my war-wounded children as aftercare is a constant battle for them and for me. It never stops, even if the guns go silent’
Dr Ghassan Abu-Sittah
Abu-Sittah believes evidence he shared in 2024 with both the ICC, and the international court of justice in the case brought against Israel by South Africa, has put a target on his back.
“I gave evidence, and I believe that my evidence was part of the case against [former Israel defence minister Yoav] Gallant and Netanyahu,” he said. “The reason I believe I am being targeted is that all of the [ICC] judges who signed the arrest warrants have now been put on the [US] sanctions list.”
He added: “They are going after ICC judges and they are going after Isis. That’s the dystopian world the Americans have created.”
Abu-Sittah has received messages of support from across the medical community. But he said the case against him, such as the US- and Israeli-led campaign to discredit the ICC, sets “a dangerous precedent”, as his accusers attempt to undermine medical tribunals to “get the right political result” and bring him down.
His clinic was packed as he talked with The Observer, with a steady stream of wounded children being carried into the examination room.
Among them was Abdelaziz, 19, who steered himself into the room in a battery-powered wheelchair, weaving expertly between desks and chairs. An Israeli airstrike in Gaza left him paralysed from the waist down after shrapnel shattered his spine two years ago. There are no facilities left to treat him inside the besieged territory but he was one of the lucky ones granted permission to be medically evacuated.
Abu-Sittah lifted him on to a bed and began dressing the pressure ulcers that have opened on his hips from spending most of his time lying on his side. Then he applied silver nitrate to the deep wounds across Abdelaziz’s back. He explained that the damaged soft tissue must heal before surgeons can attempt to straighten his spine.
“What you’re seeing in this clinic is the idea that you can delineate where the physical wound ends and the psychological wound starts; where the psychological wound ends and the social wound starts. But their whole world has been destroyed,” Abu-Sittah said.
He explained that he remains shattered by his experience in Gaza and the current Israeli assault on southern Lebanon. But his experience with paediatrics means he is the best placed for the job and he refuses to leave Beirut.
“Leaving Gaza felt like a betrayal to the people,” he said. “But the war doesn’t stop for my war-wounded children as aftercare is a constant battle for them and for me. It never stops, even if the guns go silent.”
Portraits by Oliver Marsden for The Observer
Additional photograph by Hamza Z. H. Qraiqea/Anadolu via Getty Images