American doctors uncertain how they will leave Gaza: A day in their life

As the Israeli military intensifies its fight against the militant group Hamas in and around the southern Gaza city of Rafah, thousands are being forced to evacuate and several U.S. citizens are caught up in the confusion after the Israeli military took over the Rafah Crossing on May 7.

Among those uncertain how they will get out of Gaza are a group of medics, who were volunteering with the Palestinian American Medical Association, working at the European Hospital in Khan Younis.

"The U.N. have been working to try to secure a safe passage," Monica Johnston, a burns nurse from Portland, told ABC News in an interview.

"We just don't know when that will be. We keep getting told tentative dates and it keeps getting pushed back. We have a team in Cairo waiting to come and relieve us."

Johnston and 18 other colleagues were meant to leave on Monday, but with the Rafah Crossing closed and Israel Defense Forces activity in the area increasing, the route out was deemed too dangerous.

Johnston told ABC News she didn’t want to leave until the replacement team had arrived. "I want to continue to provide help because I don't want these people abandoned," Johnston said, visibly upset.

"I want the world to know that there are so many innocent people being affected," Johnston told ABC News.

She explained that the longer this team has to wait for their replacements, the harder it is for them to do their jobs as the hospital is running so low on supplies.

"They need to come in, and they need to have their supplies as well," Johnston said, explaining that she is struggling to suitably treat patients as the hospital is running out of basics like soap, hand sanitizer, paper towels, medicines and equipment.

"We’re running out of medications, life sustaining medications that keep the heart running, the blood pumping. Pain medications we have to ration that and that in my position is extremely hard," she said.

"There’s such a lack of infection control. There’s bugs and flies and dirty linen everywhere. Most dressings should be changed daily ... some we are spreading out to every other day. We find that the wound is very contaminated – sometimes they have maggots," Johnston said.

The Rafah Crossing into Egypt has been the main access point for the Gaza Strip since this conflict began when Hamas militants stormed Israel on Oct. 7, killing at least 1,200 Israelis and kidnapping over 250.

On May 7, Israeli tanks entered the crossing and the IDF now control it. They are not allowing any access as they step up their efforts to confront Hamas in the area.

Minister of Defense Yoav Gallant was in Rafah Thursday and announced a ramping up of troops there. "Additional troops will join the ground operation in Rafah," Gallant said.

This increase in military activity has meant the journey in and out of for the PAMA teams is now far more complicated and potentially dangerous.

"The situation since May 7 has gotten even more dire than you can imagine," Johnston said, explaining that many hospital staff have fled the area after the Israeli military instructed the evacuation of nearby Rafah, adding a further burden onto the already over-stretched staff and volunteers who have remained.

"There have been lots of fights amongst people here ... over things like the use of water," Johnson explained. "I am concerned I don’t know how much longer our bottled water supply is going to last."

Tension is running high in the hospital among both patients and staff, Johnston said. "I was leaving the ICU last night and was quickly ushered out as there was a gun fight and a knife fight in the ER. I don’t know what it was over, but you feel the tension, you feel the stress, you feel the anxiety increasing in everyone here."

Johnston has not worked in conflict zones before but her colleague, Dr. Adam Hamawy, has. He was an army medic and served in Iraq where he was responsible for saving the life of Sen. Tammy Duckworth.

Sen. Duckworth has been in regular contact with Hamawy, posting to X (formally known as Twitter) on May 14, "I'm in direct contact with Dr. Hamawy and am working hard to secure his group's immediate evacuation. Aid workers and innocent civilians should always be protected. The Netanyahu admin must work to open the Rafah crossing, support evacuations and allow much more aid in."

Despite being no stranger to conflict, Hamawy said he is distressed by what he has seen in Gaza. "Every patient I have has a story. Every patient I have has been suffering for months. Every patient I have has lost family members. Many of my patients are children that are now orphans because they have lost both their parents," Hamawy told ABC News.

"And it’s not just the patients. It’s everyone that is here in the hospital. It’s the nurses, it’s the doctors, it’s the staff," Hamawy said. "This morning I was talking to one of the nurses that I met when I first came here," Hamawy said, explaining that this man looked exhausted.

"As soon as I asked him how he was and where he had been he collapsed and started weeping, telling me the ordeal he has been through," Hamawy said.

That nurse had evacuated his family out of Rafah, taking his wife and two young daughters to where the Israelis had indicated was safe.

"This place had nothing. It was basically desert. There was no water. There was no food, no shelter, no tents, no bathrooms. He said they lived like animals. When they had to use the facilities, they had to dig a hole. He said at night it was freezing and during the day he was extremely hot,” Hamawy said.

Both Hamawy and Johnston said they are filled with empathy and admiration for the patients they have treated and the Palestinian colleagues they have worked with.

"I feel very grateful to be here and provide that little level of comfort and safety for them," Johnston said, adding, "The amount of trauma that everybody has suffered here and the triggers that are going to happen lifelong is heartbreaking."