GAZA CITY, Gaza — The facade of Shifa Hospital, in the heart of Gaza City, is riddled with bullet holes. And the hospital’s intensive care unit looks like a fortress.

Hamas, the Palestinian militant group that wrested control of the Gaza Strip in 2007, has been forced to post guards in front of the unit’s heavy steel doors to prevent chaos as patients and loved ones storm the building following Israeli attacks.

Despite its “only in Gaza” quirks Shifa is the coastal Palestinian territory’s top medical facility, where many of the area’s local hospitals funnel their most serious cases.

But even Shifa is ill equipped to handle most patients. And as it struggles to contend with border restrictions imposed by Israel and Egypt, which are intended to isolate and weaken Hamas, portions of the hospital have fallen into severe disrepair.

While most medical supplies are not prevented from entering Gaza, doctors at Shifa said that security measures at the border and bureaucracy between governments makes bringing supplies here an agonizing challenge.

For a territory so accustomed to conflict, the intensive care unit has only 12 beds. When war broke out with Israel last year, hospital administrators scrambled to convert several other units of the hospital to accommodate so many critical patients.

“All the time here we have problems with instruments, doctors and nurses,” said Kamal Abou Abada, 54, who works in Shifa’s intensive care unit and is a 25-year veteran doctor in Gaza. “We have many troubles at the hospital.”

One of the most serious problems, Abou Abada said, is that the border controls have made it difficult, if not impossible, to bring in new medical equipment. Furthermore, he said, when new equipment does make it to Gaza, few doctors, unable to travel abroad for training, know how to use it.

“We’re stuck in the Gaza Strip, and we’re forgetting everything we learned,” said Raed Jazzar, director general for Shifa’s Prince Naief Center for Radiodiagnosis and Radiotherapy.

The Prince Naief Center may be the most striking casualty of Shifa’s struggle to get talent and equipment back and forth across its borders.

Donated by Prince Naief bin Abdul Aziz al Saud, Saudi Arabia’s interior minister, the unit, at first glance, looks like one you’d more likely find in a first world hospital. It’s new, orderly, clean and modern. It hosts state-of-the-art medical equipment used to diagnosis and treat cancer patients.

But it doesn’t work.

In fact, of the four main devices, only the CT scan is operational. A gamma camera, the MRI machine and the radiation therapy machine are all not working because, Jazzar said, each machine entered Gaza with several key components missing.

Abdel Hay Abed, a doctor in the Prince Naief Center, said it would only take another $3 million to fund the missing pieces. Jazzar blames officials in Gaza who bought the equipment and corruption from European salesmen for the failures.

There was a “lack of experience from people who bought the equipment,” he said. “And there was some corruption from the German and French companies.”

As a result, the center is largely quiet these days. Occasional patients pass through for CT scans, Gaza’s only such device, but the unit that was designed to be a cutting-edge cancer treatment center for Palestinians has again been forced to send most of its patients abroad.

That, Jazzar said, is placing a massive financial, medical and psychological burden on the patients.
“We try everything,” he said. “We try to help the cancer patients. Can you imagine? It takes a month to get permission to go to Egypt and get treatment for two minutes every two days. From waiting, people are dying.”

Several doctors blamed hospital administrators who, they said, are doing little to improve the hospital’s plight. In fact, Hamas seems more intent on consolidating power within the hospital walls — by replacing key personnel with those loyal to the militant group — than improving services, doctors say.

Ahmed, a 25 year-old waiter, said that he’s been trained as a nurse but is being forced to work at a central Gaza restaurant for refusing to support Hamas.

“I don’t support Hamas or Fatah,” he said, referring to the two main Palestinian political groups, “but I don’t think I’ll ever be able to get a job at Shifa while Hamas rules Gaza.”

Editor's note: In the fourth century B.C., Alexander the Great forged a path from Greece through the modern Middle East to Persia. It was a path of conquest that empires would follow through the ages. Traces of each can be seen today in the culture, monuments, continuing military presence and people along the route, which ended for Alexander in Babylon, in modern-day Iraq. In this project, GlobalPost correspondent Theodore May sets out to see how Alexander’s influence lives on. He will be blogging about his travels at Backpacking to Babylon.

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