Surgeon Flees Gaza City’s Last Functioning Hospital after Anesthetics Run Out

Smoke billows following an air strike on the northern part of the Gaza Strip, as seen from Sderot, southern Israel, 17 November 2023. (EPA)
Smoke billows following an air strike on the northern part of the Gaza Strip, as seen from Sderot, southern Israel, 17 November 2023. (EPA)
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Surgeon Flees Gaza City’s Last Functioning Hospital after Anesthetics Run Out

Smoke billows following an air strike on the northern part of the Gaza Strip, as seen from Sderot, southern Israel, 17 November 2023. (EPA)
Smoke billows following an air strike on the northern part of the Gaza Strip, as seen from Sderot, southern Israel, 17 November 2023. (EPA)

Hundreds of patients desperately needed his help, but now there was nothing he could do.

With Al Ahli hospital shaking from Israeli tank fire and no more anesthetics left to operate, British-Palestinian surgeon Ghassan Abu Sitta told his team it was time to leave the last fully functioning hospital in Gaza City.

"It has been a living nightmare - leaving 500 wounded knowing that there's nothing left for you to be able to do for them, it's just the most heartbreaking thing I ever had to do," Abu Sitta told Reuters on Friday, a day after leaving the hospital and walking to Nuseirat refugee camp in central Gaza.

In a post on X, he wrote: "No longer able to provide surgeries at Ahli Hosp. The hospital is now effectively a first aid station. Hundreds of wounded now at hospital with no access to surgery. They will die from their wounds."

Israel has ordered the entire northern half of the Gaza Strip, including Gaza City, to be evacuated as it presses its campaign to wipe out the Hamas group that governs the territory. All northern hospitals have effectively ceased functioning.

Gaza's health ministry said that as of Nov. 16 only nine of the enclave's 35 hospitals were functioning even partially.

Earlier this week, it put the confirmed Palestinian death toll at over 11,500, including at least 4,700 children, but has said communications blackouts throughout the territory have made it impossible to provide regular updates.

Gaza hospitals have been overwhelmed and short of supplies since Israeli forces began their campaign to wipe out Hamas following the Palestinian militant group's Oct. 7 attack on Israel, which Israel said killed about 1,200 people.

"Al Ahli was completely inundated with wounded. And we were operating all through the night (on Wednesday)," Abu Sitta said in an internet call. "And by the early hours (of Thursday) ... we realized that we have basically run out of medication for the anesthetic machines and we had to stop the operating room."

‘Inundated with wounded’

Abu Sitta said he and his team had been particularly busy in the past week treating patients after an Israeli air strike on a nearby mosque, and after Israeli forces surrounded and then entered Gaza's biggest hospital, Al Shifa.

Abu Sitta said a message had been received at Al Ahli hospital saying it had been surrounded by Israeli tanks.

Reuters could not immediately verify the situation at and around Al Ahli. Israel's military says Hamas has tunnels and command centers beneath and adjacent to some hospitals, a charge Hamas denies.

Hamas' armed wing, the al-Qassam Brigades, said on Friday that no hostages taken during the Oct. 7 attack were being held at hospitals, but were taken to care centers for treatment due to the seriousness of their condition and to save their lives.

On the five-hour walk from Al Ahli to the refugee camp, Abu Sitta said he saw "scenes of destruction" and bodies lying on the street.

He said patients needing treatment remained at Al Ahli, and that another hospital in northern Gaza had been unable to take them.

"Basically, the whole of northern Gaza now has no functioning hospital," he said.

His immediate plan is to rest.

"We've been operating non-stop for the last week since Al Shifa (was surrounded). I just made the decision that I needed to sleep, until I figure out what I wanted to do next," he said.



Libya’s Sabratha on Alert after Killing of Militia Figure ‘Al-Amo’

Members of the Apparatus for Combating Security Threats (file photo)
Members of the Apparatus for Combating Security Threats (file photo)
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Libya’s Sabratha on Alert after Killing of Militia Figure ‘Al-Amo’

Members of the Apparatus for Combating Security Threats (file photo)
Members of the Apparatus for Combating Security Threats (file photo)

Security forces fanned out across the coastal city of Sabratha, 70 km west of Tripoli, after militia leader Ahmed al-Dabbashi, known as al-Amo, was killed during a raid, triggering clashes that left two members of a state security body dead, residents and officials said.

Witnesses reported a heavy security presence across the Libyan city on Saturday, as the Apparatus for Combating Security Threats, a formation aligned with the Government of National Unity, said it had established control over Sabratha after neutralizing al-Amo.

The apparatus said late on Friday that two members of its western branch died of their wounds after what it described as an attack by criminal groups loyal to al-Amo near a traffic light by the city hospital. It said the deaths would be recorded in its roll of military honor, and vowed to keep pursuing anyone it deems a threat to Libya’s security.

Earlier, the apparatus said al-Amo was killed when its units stormed a hideout used by his network. It said his brother, Saleh al-Dabbashi, was arrested and that six of its personnel were seriously wounded and taken to intensive care.

A Libyan security source, speaking to local media on condition of anonymity, said the Defense Ministry in the Tripoli-based government was reviewing the situation after losing influence in several districts from Janzour in the east to the outskirts of Ajilat in the west.

The source accused the ministry of having previously backed and directed al-Amo to tie down forces from the nearby city of Zawiya on Sabratha's western flank. The Defense Ministry did not immediately comment.

Although the apparatus is an official body within the unity government, it operates with a degree of autonomy in the field, putting it in frequent friction with Defense Ministry-aligned formations in western Libya. The apparatus’s deputy chief is Mohamed Bahroun, known as “al-Far,” a powerful figure in the west.

Strategic coastal hub

Sabratha sits on the main coastal highway that runs from the Tunisian border through western towns to Zawiya and Janzour on the approaches to Tripoli.

Control of the city confers leverage over a vital overland supply route between Tunisia and the capital, and helps block any western advance toward Tripoli.

Sabratha also offers access to a small port and lies close to energy infrastructure, including the strategic Mellitah oil and gas complex.

Since 2014, the city has been a flashpoint for competing authorities in Tripoli and their allied local forces, as well as factions aligned with eastern-based rivals.

It has seen repeated bouts of fighting and shifts in control, most dramatically in 2016 when ISIS briefly seized the city before being driven out with US air support. The episode cemented Sabratha’s weight in both local and international security calculations.

In recent years Sabratha has become a center of gravity for the Apparatus for Combating Security Threats, which reports to the Interior Ministry. That presence has fueled regular friction with Defense Ministry units and long-standing local militias.

Power balance shifts

Analysts say the killing of al-Amo and the apparatus’s subsequent sweep through the city mark a sharp turn in the local balance of power, strengthening the apparatus while dealing a blow to Prime Minister Abdul Hamid al-Dbeibah’s government west of the capital.

The developments came as al-Dbeibah inaugurated Libya’s National Museum in Tripoli on Friday evening at an event attended by foreign diplomats, describing the museum as a repository of national memory and a legacy for future generations.

Al-Dabbashi, long wanted internationally on allegations of human trafficking and narcotics smuggling, retained loyalists in and around Sabratha despite periodic crackdowns.

His death, the arrest of his brother, and the deployment of state units across key intersections suggest an effort by the apparatus to consolidate control and deter reprisals.

The situation in Sabratha remained tense on Saturday, residents said, with security units maintaining checkpoints and patrols along the coastal road and within the city.


Hezbollah Creates New Entities to Evade Pressure on Al-Qard Al-Hasan

One of Al-Qard Al-Hasan’s buildings in Beirut’s southern suburbs. AP file photo
One of Al-Qard Al-Hasan’s buildings in Beirut’s southern suburbs. AP file photo
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Hezbollah Creates New Entities to Evade Pressure on Al-Qard Al-Hasan

One of Al-Qard Al-Hasan’s buildings in Beirut’s southern suburbs. AP file photo
One of Al-Qard Al-Hasan’s buildings in Beirut’s southern suburbs. AP file photo

Hezbollah in Lebanon has begun taking steps that appear likely to lead to the closure of its financial arm Al-Qard Al-Hasan, or to sharply curtail its role, after mounting US pressure and measures by Lebanon’s central bank. 

The moves are part of what sources describe as a legal repositioning inside the country, aimed at easing international and domestic pressure to shut the institution down.

As part of this shift, the group has established a licensed commercial entity that has begun carrying out part of Al-Qard al-Hasan’s activities by providing loans to its supporters. There are expectations that additional institutions could be created to take over other functions.

Hezbollah had previously rejected US demands conveyed through Lebanese authorities to close the institution, accusing Washington of seeking to “dry up financial resources in order to eliminate the party’s presence and prevent it from providing social services,” according to remarks by its Secretary-General Naim Qassem in a speech last month.

In recent years, Al-Qard Al-Hasan has been known as an institution that provides interest free loans, secured by gold or financial guarantees from other depositors. 

The number of its clients exceeded 300,000 people in 2024, benefiting from its concessional loans. It also provided agricultural, industrial, and commercial loans to small enterprises. 

The institution, which operated more than 34 branches across Lebanon, also distributed financial checks to those affected by the war, funded by Hezbollah after the latest conflict.

Amid international pressure on Lebanon to shut it down, the institution appeared to adopt what financial sources told Asharq Al-Awsat was a “legal repositioning policy,” seeking “legal alternatives that would allow it to continue operating,” following a series of domestic measures, including a decision by the Banque du Liban barring dealings with it.

Commercial entity

Al-Qard Al-Hasan has indeed begun to transform, with the first signs appearing in the form of a commercial company specializing in the buying and selling of gold on installment plans, which was established and began operating in early December. 

Two sources in Beirut’s southern suburbs told Asharq Al-Awsat they were surprised, after completing transactions at the institution, to receive invoices issued by an entity called “Jood,” rather than Al-Qard Al-Hasan.

One of them said they went to the institution to obtain a small loan of $1,800 secured by his wife’s gold, only to discover that procedures had changed. “They did not carry out a gold pledge transaction as before,” they said. 

“Instead, the process was conducted through two contracts. The first involved purchasing the gold in exchange for an official invoice, followed by another commercial transaction in which the same quantity of gold was sold back to us on installments, also against an official invoice.”

Under the purchase contract, he said, payments are made over 18 months in fixed monthly installments, with the gold delivered 15 days after the final installment is paid. “It is the same method used in the past, but the paperwork is different,” they added.

Promise of sale by installments

The second source said they were also able to obtain a loan in the same way and found that the installment purchase invoice included a contract with four conditions. They explained that the invoice was issued by “Jood” and included the company’s registration number and a fiscal invoice number, indicating it is subject to Lebanon’s commercial transaction laws and applicable regulations.

Asharq Al-Awsat reviewed the terms of the invoice included in the contract, which state that the invoice “constitutes a promise of sale by installments, and the sale is not considered final until the full value of the invoice is paid.”

The second clause states that all installments become immediately due if the buyer fails to pay two installments. It also authorizes the buyer, as the invoice holder, to make payment on his behalf. The fourth clause stipulates that the buyer must collect the gold within a period not exceeding 15 days from the date of paying the final installment, and that in the event of a delay, storage fees of $0.02 per gram per month will be added.

Fragmentation of services

This step is seen as part of a broader transformation plan by the institution in response to external and domestic pressure to shut it down. 

Lebanese sources familiar with international demands said the shift “signals the failure of all attempts to rescue it through talks between the party and Lebanese authorities.”

They added that “the party’s conviction has pushed it to fragment the services provided by the institution in a way that allows it to continue offering some services if it complies with demands to close it entirely.”

The association states online that it “aims to help people by granting loans for specified periods, contributing to solving some of their social problems,” and that it seeks to “strengthen the spirit of cooperation, mutual support, and solidarity among members of society.”

The sources said that following the fragmentation of services, gold pledging has been removed from the institution’s functions and transferred to the commercial entity, enabling it to continue providing services within the bounds of the law. This follows the suspension of other services, including ATM services. 

The move also sends a message to Lebanese authorities that these services are being offered within a legal framework, through official invoices, and are subject to taxes and commercial transaction regulations.

However, the same sources noted that in this arrangement, official financial disclosure applies to clients rather than depositors and sources of funds, “which complicates the assumption of international acceptance of this transformation.”

They said three proposals had previously been submitted to regularize the status of Al-Qard Al-Hasan, all of which were rejected by the United States. The first was to operate as a mutual aid association. 

The second was to become a licensed financial company, which was also rejected by the Banque du Liban. 

The third proposal was to operate as a financial cooperative providing concessional loans, similar to cooperatives that exist in Lebanon and abroad, subject to Lebanese law and declaring its clients. All proposals were “rejected outright,” the sources said.

US rejection

This assessment aligns with Lebanese financial estimates that any transformation by the institution is unlikely to gain US approval. A senior Lebanese financial source told Asharq Al-Awsat it was “unlikely that this repositioning will be accepted by the US Treasury Department, which scrutinizes tedious financial details in Lebanon.”

Lebanon, the source said under conditions of anonymity, is “under strict oversight by the US Treasury due to widespread cash circulation,” and US estimates indicate that cash outside the banking sector cannot be controlled. 

“This measure is part of the cash economy operating outside the banking sector,” they said.

They added that the repositioning would not satisfy the United States, which has decided the institution must be shut down and has conveyed that to the Lebanese state. 

“Changing the form will not satisfy them as long as the core remains,” they said, referring to the continued existence of Al-Qard Al-Hasan and the continuation of its services in another guise.

“From a legal standpoint, and under Lebanon’s prevailing laws, excluding the central bank, a commercial company can carry out buying and selling activities, including installment sales,” they said. 

“But that does not mean the fundamental problem has been resolved, which is US rejection, because liquidity will remain outside the banking sector and will continue, from the American perspective, to be viewed with suspicion under the current political circumstances.”
 


Trump Pledges Retaliation After 3 Americans Killed in Syria

Trump Pledges Retaliation After 3 Americans Killed in Syria
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Trump Pledges Retaliation After 3 Americans Killed in Syria

Trump Pledges Retaliation After 3 Americans Killed in Syria

US President Donald Trump said Saturday “there will be very serious retaliation” against ISIS after three Americans, two soldiers and their civilian interpreter, were killed by a single gunman in an ambush targeting a joint US-Syrian government patrol in central Syria.

“We mourn the loss of three great patriots in Syria. We know how it happened, an ambush,” he told reporters at the White House.

Earlier, the Pentagon said initial assessments showed the attack was carried out by ISIS.

However, a Syrian Interior Ministry spokesperson said the attacker was a member of the Syrian security forces who held extremist ideas.

Nour Eddin al-Baba said Syrian forces had issued intelligence warnings to US-led forces and that the assailant was known to authorities ahead of the deadly attack.

He told Syrian state television that leadership in the country’s Internal Security Forces in the Badia region had alerted the US-led international coalition against ISIS in Syria about preliminary information “indicating a possible breach or expected ISIS attacks.”

“However, (coalition) forces did not take the Syrian warnings into account,” al-Baba said.

According to the Pentagon, the attacker was killed by “partner forces,” in a sign to the Syrian government forces.

Syrian state news agency SANA quoted a security source as saying that Syrian service personnel were injured, without providing further details.

US Secretary of Defense Pete Hegseth wrote on X, “Let it be known, if you target Americans — anywhere in the world — you will spend the rest of your brief, anxious life knowing the United States will hunt you, find you, and ruthlessly kill you.”

The US-led coalition has carried out airstrikes and ground operations in Syria targeting ISIS suspects in recent months, often with the involvement of Syria's security forces. Syria last month also carried out a nationwide campaign arresting more than 70 people accused of links to the group.

The United States has troops stationed in northeastern Syria as part of a decade-long effort to help a Kurdish-led force there.