With the power out, the water off, medical supplies short and hundreds of conflict-injured and sheltering Palestinians crowding the Al-Shifa Hospital in Gaza City, Ahmed Abunada was faced with impossible choices, AFP reports.

“Who do I let die, this woman or that man?… I do not have the time to do reconstructive surgery on this child, I will have to amputate,” said the 47-year-old surgeon.

“These are very difficult decisions for a doctor,” said the German doctor of Palestinian origin.

“We were operating on the floor, on gurneys. There were no beds left,” he told AFP about his time in the hospital. “The week that I left the hospital, the situation got worse. We had no more electricity, no more water, no more oxygen.”

Without oxygen, it was no longer possible for Abunada to operate. “That is why I left, on the 28th day of the conflict.”

“I worked there as a doctor and I did not notice anything like that,” Abunada said when asked about Hamas’s alleged presence at the facility.