The voices of those who could not be saved are haunted by the voices of the rescuers in Gaza

When Noah Al-Shaghnoubi, a rescue worker in Gaza, sleeps, he is haunted by the cries of those he could not save.

Memories of the past fourteen months come flooding back, nightmares of collapsing buildings with no equipment to retrieve survivors.

“We hear the voices of people under the rubble,” he said in an interview between rescue calls. “Imagine there are people under the rubble that we know are alive, but we cannot save them. We have to leave them to die.”

More than a year ago, in Gaza Rescue workersParamedics and ambulance drivers toiled Front lines From the war, they race to the sites of countless Israeli airstrikes to try to rescue those who survived and recover the bodies of those who did not. In the first seven weeks of the war alone, Israel fired about 30,000 shells into Gazaunleashing one of the most intense bombing campaigns in contemporary warfare.

The International Committee of the Red Cross said rescue workers in Gaza were facing dangerous conditions without sufficient equipment, vehicles or fuel. They are mostly left to extract survivors from under tons of broken stone, concrete and twisted metal with their hands and makeshift tools.

The massacre took a heavy physical, mental and emotional toll on rescuers, with Israeli raids killing at least 118 of them during the conflict, according to Local rescue officials.

“First responders are suffering from untold levels of stress, anxiety and frustration,” said Hisham Muhanna, spokesman for the Red Cross in Gaza. “We heard them describe feelings of helplessness toward the victims they were unable to save, and the intense pain of losing their colleagues in service.”

Since the beginning of the war – which began after the Hamas-led attack on Israel on October 7, 2023 – rescue workers have been there. Struggling to keep up with the pace of air strikes. In the first year of the war, the Israeli military said it hit more than 40,000 targets in an area the size of Detroit with about 60,000 bombs and other munitions.

Residents and aid officials say this war was unlike any other Gazans have experienced, with no safe place to take shelter and no target off limits. The Israeli army said it was taking “possible precautions to mitigate harm to civilians.”

Despite the shock, Mr. Al-Shaghnoubi, 23, said he had to continue his rescue work with Gaza Civil Defense, the emergency services agency, knowing he could save at least some lives.

He said he regularly shares videos and photos on social media to draw attention to the suffering in Gaza.

In one Video posted in October In the Zaytoun neighborhood of Gaza City, he called out for a young boy whose muffled screams could be heard from under the rubble.

“Don’t be afraid,” shouts Mr. Al-Shaghnobi, issuing a series of quick instructions: “Rashed, don’t bother yourself. Don’t talk. Don’t lose consciousness.”

The rescuer, illuminated by a headlamp, crawls between collapsed floors to reach Rasheed’s partially exposed head, the rest buried in cement and crushed stone. Three hours later, Rashid was pulled alive from under the rubble.

“Every day is more difficult than the day before,” Mr. Al-Shaghnoubi said. “My soul is tired of this war.”

The Red Cross, which provided masks, shoes, protective uniforms and body bags to rescuers, also provided limited mental health counseling. Mr. Muhanna, the Red Cross spokesman, said that given the extreme trauma of the situation, the sessions were not enough.

Amir Ahmed, a paramedic, said that a few months ago, his nightmares became too much for him, and he left his job with the Palestinian Red Crescent Rescue Service.

“You get to a point where you can’t keep this up anymore,” he said recently.

Mr. Ahmed said that he worked in antiquities preservation before the war, and also volunteered with the Red Crescent during the many conflicts in Gaza because he was trained as an emergency medical technician. He said that he was called to serve on the second day of the war.

He said that as the conflict continued, he found himself falling into a state of deep depression. At home with his wife and three children, he became increasingly stressed and angry.

Some days, he tried to avoid talking to anyone and wanted to spend all his time sleeping, even when they had to camp out in tents or crammed into one-room apartments.

“I was dreaming of people who were body parts that I picked up with my hands,” he said, lowering his voice.

He said the smell of blood remained on his hands for several days after one rescue and recovery operation, adding that there was almost no psychological support or mental health assistance.

Although he felt guilty about leaving his job as a lifeguard, he said he did not regret his decision.

Some rescue workers accuse Israel of targeting them, an accusation echoed by the Red Crescent and Civil Defense in Gaza.

The Israeli military said it had never targeted rescue workers, and would not do so intentionally. “The Israeli army also recognizes the importance of the special protection granted to medical personnel under international humanitarian law and is taking measures to prevent harm to them,” a military statement said.

They lost contact with Red Crescent dispatchers shortly after arriving at the scene, and were found approximately two weeks later Dead people in the burning ambulance. Hind was also found dead inside her family’s car.

The Red Crescent accused the Israeli forces of bombing the ambulance upon its arrival “despite prior coordination” between the organization and the Israeli army. The Israeli army did not comment on the attack despite repeated requests.

Al-Shaghnoubi said that early in the war, he and his fellow rescuers said goodbye to each other every night, unsure of how long they would survive the Israeli attack.

He said that in November 2023, he was with colleagues at the site of a seven-story building that had been destroyed by an Israeli airstrike days earlier, trying to save it. The bodies of a family are recovered.

As rescuers were combing through the rubble, another Israeli airstrike struck, killing two rescue workers and two surviving family members, according to accounts from relatives at the time and Mr. Shagnoubi.

He captured the immediate aftermath of the strike On video.

“Why does this happen to those of us who only save people?” He said recently. We have nothing to do with weapons or resistance. All of our work is humanitarian work. Why are the Israelis targeting us?

Naseem Hassan, a paramedic and ambulance driver, said that his brother was killed about a year ago in Al Amal Hospital while working with the Red Crescent. The surviving brother said that he died in an air strike after he climbed onto the roof of the hospital to turn on an electric generator. The Israeli army said it was “not aware of the incident.”

Hassan, 47, said he was exhausted due to the stress and exhaustion resulting from rescuing war-wounded people.

He said that when the struggle began, he weighed 190 pounds. Now, after living mostly on canned food and insect-infested bread, and enduring physically exhausting days spent digging through rubble, his weight is down to about 150 pounds.

“Mentally, we are patient and determined, because we have to be,” he added. “If we have a nervous breakdown, who else will save the people? Who will recover the bodies? Who will bury them?”

Patrick Kingsley Contributed to reports.