An Irish surgeon in Gaza: I have seen tiny bodies ripped apart, children eating grass
Gaza
had to be explained to me on my first visit there.
Working as a surgeon in University Hospital
Waterford
, I never had any use for the phrase 'wounded child, no surviving family'. But at the Nasser Hospital in Khan Yunis, it quickly became part of my medical vocabulary.
By the end of my second stint in Khan Yunis this March, the term had become so common that we had more or less stopped using it, as child after child woke from emergency surgery crying out for the embrace of parents who were no longer there to soothe them. 'WCNSF' had by now become the norm, so much so that those with surviving family were the exception.
Dr Morgan McMonagle
Famine unfolding in Gaza: 'Children are eating grass and weeds at the side of the road'
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23:23
Four months on, and now back home in Ireland, I still struggle to come to terms with the sheer numbers of children who arrived at our hospital every night. Some perfectly intact but already cold from death. Others still alive but with their tiny bodies ripped apart.
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Starving children with signs of wasting were a common sight, as were the horrific infections that rotted away young limbs. A routine day would include rapidly cutting open small chests and abdomens in an effort to stem the life-threatening bleeding caused by shrapnel. Others arrived to us with burns which would prove impossible to survive. Outside, makeshift graves were dug on the hospital grounds to bury the dead, some using what used to be the children's playground.
Yasmine (22) and her malnourished two-months-old daughter Teen await treatment at the Nasser hospital in Khan Yunis on July 24th. Photograph: AFP/Getty
All around us, Gaza was crumbling under the merciless assault from Israel's sophisticated war machinery. No running water. No flushing toilets. No street lighting. Children playing on the rubble of collapsed houses. Families living inside the ruins of what used to be their home. And everywhere, orphans. Hundreds and thousands of orphans.
The pictures of starving infants appearing on our TV screens every night appears to have finally awoken the world from the indifference it had been showing towards the suffering in Gaza. But why only now when the bloody images of children maimed by bombs and machine guns over the past 21 months did not?
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A father in Gaza: Our children are dying as the world watches. We don't want your pity – we want action
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It was clear from what I witnessed in Gaza this spring that people were already at the point of starvation. Children eating grass and weeds at the side of the road among piles of garbage. Families surviving on animal feed, ground down and mixed with measly bits of flour and stale bread, re-baked as a staple diet.
A former colleague tells me that he has begun getting his children to lick salt before bed to stave off the hunger pangs in an effort to help them sleep. I know it won't work but how do I tell that to someone whose children are starving in front of him?
There will be a stain upon our conscience forever if we don't do everything we can to stop this conflict when we have the chance
It is inexplicable that we were not collectively repulsed enough to stop the genocide before now. Many will be encouraged by the fact that some of Israel's staunchest allies such as
Britain
and
Germany
are finally expressing their unhappiness at how Israel is conducting itself. I desperately want to have hope too, but experience tells me we have been here before. We thought Germany was finally coming to its senses in late May when Chancellor Friedrich Merz declared that harming so many civilians could 'no longer be justified' when fighting Hamas.
Shortly after, Israel attacked Iran, and Merz was back on message. All criticism of Israel was forgotten and instead Merz praised the Israeli Forces for
doing the world's 'dirty work'
by sending missiles into Iran.
The speed and strength of Merz's U-turn is a worrying reminder that while even Donald Trump appears concerned at the suffering of Gaza's children right now, this unease may last only as long as the news cycle. Such lip service is both fleeting and ephemeral.
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Gaza death toll reaches 60,000 as global monitor warns of famine
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It is incumbent on all of us – and particularly Ireland's politicians – to take advantage of this brief window of opportunity to contact their counterparts around the world and demand immediate action.
The timing is favourable – with the broad terms of a trade deal having been struck with the United States, Europe can finally concentrate on ending this brutal conflict. The leaders of Ireland, Spain and other like-minded countries can raise the suffering of Gaza with the White House without fear of jeopardising trade talks.
I have no doubt that some of those conversations will be difficult. I have no doubt that ringing a powerful member of the United States Congress and urging them to stand up to Israel's lobbyists isn't easy. But there will be a stain upon our conscience forever if we don't do everything we can to stop this conflict when we have the chance.
In October 2023, only a few weeks after the bombardment of Gaza had begun, the journalist and novelist Omar El Akkad posted on X: 'One day, when it's safe, when there's no personal downside to calling a thing what it is, when it's too late to hold anyone accountable, everyone will have always been against this.'
We cannot wait until it's safe and risk-free to demand an end to this brutality. The chilling words of the UN-appointed driver who escorted us safely in an armoured car to the Kerem Shalom crossing when we finally exited Gaza on March 26th have stayed with me. As we said our goodbyes, he told us: 'anyone left in Gaza now, is either already dead, or will be soon. Goodbye and take care my friend'. I have no idea what happened to him after.
Morgan McMonagle is a consultant vascular and trauma surgeon who has completed two humanitarian missions to Gaza in 2024 and 2025
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Irish Times
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Letters to the Editor, August 5th: On loving Dublin, men reading books, Gaza, and a radical approach to the nation's health
Sir, – In the midst of a cost-of-living crisis and buckling health services, there is a renewed interest in structured programmes of nutrition to bolster prevention and delay the onset of chronic disease. Is it time to prioritise cost-effective prevention programmes to improve the nation's health? It takes a leap of faith to imagine a future where the dominance of junk food and takeaways on every street corner has vanished, replaced by public restaurants owned by communities serving hot, healthy food that doesn't break the bank. Impossible? It's been done before. During the second World War, the UK government opened more than 2,000 British restaurants, serving 600,000 affordable meals a day, designed to meet a third of the people's energy needs. READ MORE As well as food provision, diners could be co-designed to fulfil the social functions of food including dignity, cultural meaning and enjoyment. 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We know from decades of responding to famines, that when thousands of children are identified as suffering acute malnutrition it is just the tip of the iceberg – of hunger, disease, social breakdown and death. We know the weakest and most vulnerable families rarely make it to hospitals or food drops and don't have the money to buy what little over-priced food might be available in markets if any are still functioning. We know they weaken and die, usually from diseases, as the body fails before starvation gets them. We also know that once malnutrition takes hold in a population, the weakest and most severe cases need special foods and specialist medical care to prevent death and begin a slow recovery. In this situation the emaciated bodies of children or adults cannot cope with foods such as pasta or lentils. Personnel trained in dealing with malnutrition must be able to move freely and safely to identify those in dire need and provide assistance without forcing them to travel long distances or struggle to get food in the midst of violence. The effects of famine have profound multigenerational impacts, including on physical and mental health, on social and economic life and community cohesion. These outcomes are worse where most homes are destroyed and where there is almost no clean water, health, education or social services. In the case of Gaza we know something else; something that is profoundly disturbing. The malnutrition and hunger now stalking Gaza is the outcome of a deliberate policy by Israel, implemented – at least until recent days – with the knowledge and acquiescence of its allies. 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Irish Times
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Liver cancer: ‘The saddest part is that most of the cases are preventable'
Liver cancer kills more than 700,000 people each year. However, three in five cases could be prevented, according to a comprehensive analysis published in the journal Lancet. The research found that prevention could be accomplished by addressing the disease's major causes – hepatitis B, hepatitis C, alcohol -associated liver disease and liver disease linked to metabolic risk factors such as obesity . With nearly 900,000 new cases globally each year, liver cancer is the sixth most common cancer and the third leading cause of death from cancer. If cases continue to rise at the current rate, the number of new annual diagnoses will almost double, rising to 1.5 million globally in 2050, the study predicted. There are two broad categories of liver cancer – primary liver cancer and metastatic (secondary) liver cancer. About 370 people are diagnosed with primary liver cancer each year in Ireland. It is twice as common in men than it is in women. 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Irish Times
a day ago
- Irish Times
14 tips to prevent and treat insect bites and stings
A downside to hot weather is all the bugs that can feast on or sting us. Is there anything you can do to avoid this? And what should you do if you are attacked? Here's what pharmacists have to say about the best ways to prevent and treat stings and bites. Know which bugs to be wary of Pest controllers in Britain have warned of a rise in wasp activity due to recent heatwaves, something that is borne out by pharmacists. 'I am definitely seeing more wasps around at the moment,' says Claire Nevinson, senior pharmacist at Boots. 'We have seen an increase in people presenting with infected insect bites since April.' 'It is a bit of a shock when you are stung by a wasp,' says independent pharmacist Ian Budd. 'It is painful and, if you're unlucky, it can trigger an allergic reaction. Hornets and bees are less aggressive. Horsefly bites can cause inflammation and sometimes infection, because it is difficult to stop scratching them. Then there are midges.' There are mosquitoes in Ireland and Britain , although not the kind that carry malaria; however, they can still cause issues, says Budd. 'And we have ticks, in grassy and wooded areas, some of which carry Lyme disease.' READ MORE It is important to be more vigilant when you are in certain environments, says Virginia Chachati, a registered pharmacist and public health content creator. 'Midges and mosquitoes tend to be in forests and long grasses,' she says, so you need to watch out if you are camping or hiking. Some bugs are drawn to other animals, she adds: 'If you're visiting farm animals and want to pet them, just be aware that they may be carrying ticks.' Midges and mosquitoes can also be found anywhere there is still water, adds Chachati. 'Wherever there's water, even a puddle that sits for a long time, bugs can lay eggs and then multiply very quickly – in a few hours or days. So make sure you don't have still water around. Drain paddling pools after use. If the bugs are hungry, they will come and bite you.' Nevinson says you should take particular precautions if you're out in the morning or as the sun goes down. 'That is when the mosquitoes and midges will be at their worst.' Cover up with light, loose clothing 'Make sure you wear long sleeves and long trousers, particularly if you're camping or outdoors a lot,' says Nevinson. Anything not covered could be open to attack. Budd says: 'It is quite common to get bitten around the ankles and wrists – anywhere exposed is at risk.' [ Laura Kennedy: Long-haul flight tips from snore-proof ear plugs to tummy-friendly food Opens in new window ] Chachati advises wearing light colours. 'Some bugs, especially hornets, can be really attracted to darker colours because they're trying to hide from predators,' she says. 'If you're walking through long grass and you are wearing white trousers, it is also much easier to see if ticks have latched on to your trousers, and then you can easily pick them off. Definitely wear a hat as well, because some people get bites on their scalp, especially if they don't have hair.' Keep colours neutral, as 'yellow and bright colours can attract wasps', she says. Don't irritate wasps 'Sadly, it is just being in the wrong place at the wrong time with a wasp,' says Nevinson. 'Wasps will be particularly attracted if you're having a picnic. If there is food around, the wasps will hover around it.' With wasps, staying still is a good idea, rather than flapping your arms. Photograph: iStock 'If you're waving your hands around,' says Chachati, 'those air currents are going to really bother them and knock them out of the air, and they don't want to be knocked, so they're going to do whatever they can to defend themselves. Staying really still is a good idea.' This is easier said than done: 'If they land on you, you could use a piece of paper to gently slide under it, and put a see-through cup on top. Then take it away and release it.' Wear repellent Chachati has worked in travel clinics: 'Deet would be the number one thing I recommend, including for children. Use the highest percentage that you can tolerate without it irritating the skin.' In some places, 'if you get bitten, you can get diseases like malaria, dengue fever, Zika and tick-borne encephalitis. If you can't use Deet, there are other repellents such as icaridin and IR3535.' 'Deet is a really effective insect repellent,' says Budd. 'But there are questions about whether it is environmentally responsible for it to be used in large quantities. There are alternatives, like some citronella-based insect repellents, which are kinder to the environment. If you are still getting bitten with those, maybe move to the chemical ones.' Apply sunscreen first, then insect repellent. Photograph: iStock 'Always put on your sunscreen, then put your insect repellent on top,' says Chachati. 'When they land on you, they will be repelled by the insect repellent, because that is the outermost layer you've applied on your skin. Deet can lower the sun protection factor of the sunscreen, so you will need to reapply it more often.' It can also transfer ink to your skin, so be careful when handling printed matter while wearing it, says Chachati. Go fragrance-free 'It is a myth that only dirty people get bitten,' says Budd. 'Bugs are drawn to scents, not bad hygiene.' 'Don't wear perfumes, deodorants or moisturisers that are heavily scented,' says Chachati. 'These can attract bugs to you, because you smell like flowers.' Drinking alcohol could make you more attractive to mosquitos. Photograph: iStock Possibly avoid alcohol 'There was a very small study in 2002 where they tested whether or not drinking beer would make mosquitoes more likely to bite you,' says Chachati. 'Out of 13 people, the majority of them did get bites from mosquitoes [after beer ingestion compared with before ingestion]. So avoid drinking beer at barbecues,' which can be challenging, she concedes. Budd says it is also a myth that drinking gin and tonic is helpful: 'Originally, in countries where there was malaria, people would have loads of tonic water because they believed the quinine in the tonic protected them – you'd have to drink a lot of tonic water for it to be effective.' Clean bites and stings before treating If you do get a bite or sting, 'it is always best to wash the skin with soap and water to try to avoid any bacteria getting inside the wound,' says Chachati. 'If you don't have access to soap and water, you can use antiseptic wipes or cream.' 'In the main, if you just have a simple bite or a sting, it will sort itself out,' says Nevinson. 'If there is swelling, cold compresses are really good. If it's on a limb, keep it raised to prevent that swelling getting any worse.' 'Hydrocortisone cream is really good for inflammation,' says Budd. If you want to try something more natural, lavender or tea-tree oil 'may deter the insects, but they're also natural antiseptics once you've been bitten. Aloe vera is cooling and anti-inflammatory.' Don't scratch 'Antihistamine creams or tablets can really help with the itching, because scratching that itch makes it worse,' says Budd. 'It increases the inflammation and your risk of infection. When you're scratching the skin, you are interfering with the natural skin barrier, and you can be introducing bacteria into the inflamed area by taking away all the top layers of cells.' Use fine tweezers to remove a tick, grabbing it really close to the skin Remove stings and ticks carefully 'When a tick bites, the whole animal is attached to you,' says Budd. 'Use fine-tip tweezers, grab it really close to the skin, and pull upwards slowly with a steady and even force. Clean the area afterwards with soap and water.' Nevinson says: 'If a red ring appears around the bite, that is an indication that it could be Lyme disease, and it's really important you seek medical help. As long as it is treated quickly, it can be easily dealt with.' Chachati recommends keeping the tick to be tested. [ Ticks in Ireland: Lyme disease-carrying insects are coming for us and they're likely to hang around longer too Opens in new window ] 'Don't use tweezers for a bee sting,' says Budd, 'because you can push more venom into your skin. Scrape it sideways, either with your [clean] fingernail or a bank card. When you get stung by a bee, the sting continues to pump venom, even when the bee is gone. So you definitely need to remove that. Wasps and hornets do not leave a stinger in the skin after they have stung you, they have retractable stingers.' Take antimalarials 'Malaria can kill you,' says Chachati. Mosquitoes kill more people than any other creature in the world because of the various diseases they carry and it is essential to take antimalarials if you are going to a region where malaria is carried by mosquitoes. 'Look at a malaria map or the Fit for Travel website and always speak to a professional about which antimalarials to take.' Know when to seek medical help 'Your individual reaction to proteins in the saliva of the bug that has bitten you or the venom from a sting can cause an allergic reaction,' says Budd, 'from mild swelling to severe anaphylaxis, where it starts affecting your breathing and your tongue is swelling. This is usually picked up early on in life and you will need to carry an EpiPen. For a mild allergic reaction, an antihistamine or hydrocortisone cream should help. If you are experiencing difficulty breathing, dizziness or swelling of the face, seek emergency help.' [ From the archive: How to deal with health issues that arise when we travel abroad Opens in new window ] Also see a doctor if, 'a couple of days after being bitten or stung, you notice that there is pus, a hot, swollen red area around the bite that is noticeably spreading, or if you develop a fever, as these can be signs of infection,' says Budd. Ceiling fans disturb airflow, making it harder for bugs to land on you. Photograph: iStock Disturb the airflow 'Keep the air conditioning or ceiling fan on,' says Chachati, 'because that disturbs the airflow, so it stops mosquitoes from being able to land. It also makes the room cool, which they dislike, and disperses carbon dioxide, making it difficult for mosquitoes to detect humans.' Keep windows closed for this to be effective, she says, 'and definitely use a mosquito net over your bed and windows'. Take a shower 'Bugs are attracted to body heat and sweat,' says Budd. 'If your skin is warmer, you are more likely to attract bugs. If you have been exercising, there might be more lactic acid in your sweat, and insects are attracted to that, too.' Some people are just more delicious than others 'There is no specific reason why one person gets bitten more than another,' says Nevinson, 'but you often hear people talking about being prone to bites. It is likely to be to do with the skin type and the scent on the skin, which could be a result of a number of different things, diet or hormone-related.' Budd explains: 'Everyone has their own unique skin microbiome and it can make you either less or more attractive to biting insects. Your genetics can influence this. For some reason, people with blood type O may attract more mosquitoes.' He adds: 'Being pregnant could make you more attractive to biting insects because your skin temperature can be warmer.' Chachati says: 'It depends on your immune system and how you react to bites. Some people might be more sensitive compared with others. Mosquito bites may be worse in certain parts of the world that you are not used to being in, depending on how your immune system reacts. The first few bites may be quite a difficult experience to go through and then, if you get bitten again later in the holiday, it may not be as bad because your body knows how to handle it better.' – Guardian
