KARACHI, Pakistan

Australian doctors on the frontline of Gaza’s choked health system have recounted harrowing scenes as a fragile ceasefire in the war-torn enclave hangs in balance.

Neurosurgeon Dr. Mohammad Awad, and Dr. Chris Holden are among few Australians to have entered Gaza amid the Hamas-Israel war with access largely restricted as Israel controls Gaza's airspace, territorial waters, and two of its three border crossing points, with the third controlled by Egypt.

Awad recently returned home to Melbourne after spending two weeks volunteering in Gaza hospitals, many of which are overwhelmed, understaffed, and lacking in essential equipment and resources, local broadcaster SBS News reported on Sunday.

"You see it so much on the TV and social media, but it's very different when you see it in person, it really is quite confronting," he told SBS.

"It's almost surreal seeing that level of destruction; I don't think you're ever prepared for it until you see it."

During his time in Gaza, Awad mostly treated patients with brain tumors or spinal conditions that had been left untreated due to the war, as well as people who had experienced gunshots to the head or spine, and injuries from shrapnel.

He described the level of need as "intense", with hospitals full of inpatients and outpatients, as well as many others "hanging around the hospitals with nowhere else to go."

Most parts of Gaza have also lost electricity and struggled to access clean water throughout the war.

Dr. Holden, who has been volunteering in Gaza with the Palestinian Australian New Zealand Medical Association (PANZMA) for the last month, said he was shocked to see the destruction and the breakdown of the healthcare system in the besieged enclave.

"There are significant challenges on the ground. We've had a lot of loss of medical facility infrastructure ... and then what is remaining is therefore overwhelmed and currently partly due to the blockade of supplies coming in, it's very under-resourced materially as well," he was quoted as saying by SBS.

He said the destruction and the breakdown of the healthcare system resulted in "a lot of unnecessary death and harm to people."

Holden said one of his patients was a six-year-old with wounds to the face, head, and left eye after a projectile hit her as she slept in her family's tent.

- Not even a single MRI scanner in whole Gaza

Awad said there were also no MRI scanners — a crucial medical tool — on the whole Gaza Strip as they had all become damaged and were unable to be fixed due to the war.

"As neurosurgeons, we operate based mostly on MRI scans, seeing them and seeing scans of brains and spines, but not having them available meant we were having to make decisions based on CT scans and that was really, really difficult," he said.

"Operating on young kids with brain tumors and only having CT scans was really quite challenging."

Local doctors are fatigued, run down, and many have not had a lot of international experience or training.

For Awad, leaving Gaza was "bittersweet," as he hoped to stay in touch with local doctors and offer support for cases and patient care.