Updated July 21, 2025 at 3:35 PM CDT
Editor's note: This conversation includes the sound of gunfire and graphic descriptions of violence against children and teenagers.
Dr. Nick Maynard has spent 15 years traveling from Oxford, England, to Gaza, mentoring young doctors and training surgeons. One of his former students, a Palestinian woman who later became a doctor in the U.K., is now considered part of his family.
But since the war between Israel and Gaza began in October 2023, Maynard's mission has shifted. On his current trip, he is performing emergency surgeries under fire, treating malnourished children and helping care for trauma patients with catastrophic injuries.
Speaking to NPR from Nasser Hospital, the main medical facility in Khan Younis, Maynard describes a health system in collapse. Gunfire echoes just outside as he outlines what he says is a systematic effort by Israel to dismantle Gaza's civilian infrastructure: hospitals stripped of supplies, infants dying from hunger and children shot while trying to reach food.
The gunshots, he says, are not random.
"They're particularly common in young male teenagers, usually sort of [ages] 11, 12, 13, 14, who are being shot at the food distribution points. And we've seen that very frequently over the last few weeks that I've been there," he told Morning Edition.
The Israeli military denies intentionally targeting civilians. But aid groups and health officials report that these deadly encounters have become common, especially since May, as starvation deepens across the Gaza Strip and food lines increasingly bring civilians into direct contact with Israeli troops.
Following our conversation, NPR asked the Israel Defense Forces for comment. The IDF responded that it "categorically rejects the claims of intentional harm to individuals, and that binding orders prohibit forces from intentionally firing at minors, and casualties at aid distribution sites are under examination."
Maynard says he and other doctors have observed clusters of similar injuries — head wounds one day, abdominal wounds the next — raising questions about the intent behind the shootings. "[This] is beyond coincidence," he said.
"The clustering of symptoms is what makes it so dramatic. And it is something that we at all levels — ER doctors, general surgeons, urology surgeons, neurosurgeons — have all recognized this clustering of injuries."
The U.K.-based surgeon says most of his patients are severely malnourished, making it far harder for them to recover, even from injuries that would normally be survivable.
He believes the destruction is not collateral, but calculated.
"I think what we're witnessing is a very deliberate plan to erase the Gaza population from this land," he told NPR.
NPR sought comment from the Israel Defense Forces on what the doctor describes as "a deliberate destruction of the whole infrastructure of living in Gaza with the very clear aim of ethnic cleansing." The IDF referred the inquiry to the Israeli government, which then referred NPR back to the IDF.
This conversation is edited for length and clarity.
Interview highlights
Sacha Pfeiffer: What can you tell us about access to food based on what you've seen there?
Nick Maynard: Access to food is extremely difficult. There were many, many food outlets where food was distributed by UNRWA until several months ago, and the so-called Gaza Humanitarian Foundation food distribution sites — there are four of them in Gaza — and it is nothing like enough to provide food for the Gazan population to create chaos and rioting.
Pfeiffer: The shooting that we heard earlier that's happening so close to your hospital, are we hearing fighting? Are we hearing defense? What is happening that is so audible in the background?
Maynard: This is through fighting almost certainly between gangs or families who are fighting over food. We've seen this on several occasions. This is not the Israeli military and it's not Hamas, we're told very reliably. It's fighting gangs or fighting families who are trying to get food, and this is born out of desperation for food because they are all starving.
Pfeiffer: Did you see that in your last two trips as well, or has it gotten worse each time you've come?
Maynard: It's got much worse. Each time I've come, I saw the signs of malnutrition on both my previous trips in December '23, January '24 and then later that year. But the malnutrition now is much, much worse.
Pfeiffer: Would you give us more of a picture of what you're seeing in your hospital, on your operating table? What kind of volume of people? What kind of people? What kind of injuries?
Maynard: The Israelis are commonly using these fragmentation bombs, which release many, many thousands of very small metal pieces, which then tear through the body. I'm operating predominantly on abdominal injuries and some thoracic injuries. And the shrapnel causes the most appalling internal damage, destroying many of the internal organs. So needing very major surgery to repair them. And we're seeing a particular pattern of injuries whereby particular body parts are being targeted on particular days. So one day we will see mainly abdominal gunshot wounds. Another day we'll see head gunshot wounds. Another day we'll see neck gunshot wounds. So there is a very clear pattern that all, not just me but all of us, have seen in this hospital, whereby particular body parts are targeted on particular days
Pfeiffer: I mean, that's clearly a shocking claim. You don't think that's possibly just a coincidence that you're seeing certain body parts injured on certain days?
Maynard: I think seeing four young teenagers come in, in the space of one hour, with gunshot wounds to their testicles, which we have never seen before, is beyond coincidence. Seeing as one of my ER doctors did, seeing 12 or more patient[s], young teenagers coming in with gunshot wounds to the head and neck, all at the same time, is beyond coincidence. The clustering of symptoms is what makes it so dramatic. And it is something that we at all levels — ER doctors, general surgeons, urology surgeons, neurosurgeons — have all recognized this clustering of injuries.
Pfeiffer: Dr. Maynard, I've read that you have described what's happening, in your words, as the collective punishment of the population of Gaza. What do you think is the end goal?
Maynard: I think what we're witnessing is a very deliberate plan to erase the Gaza population from this land. I do not believe for a minute this is just about destroying Hamas. They are deliberately killing many, many, many thousands of innocent civilians by their withholding of aid and medicines and food. They are destroying the whole infrastructure of living here. They are destroying all the hospitals. It's not just bombing the hospitals. They're going in and dismantling all the laboratories, dismantling all the dialysis machines. They've destroyed the agricultural system. They've destroyed the fishing industry. They're targeting the water sanitation plants. So there's no doubt in my mind what we are witnessing is a deliberate destruction of the whole infrastructure of living in Gaza with the very clear aim of ethnic cleansing and getting the whole population out of this land.
Pfeiffer: This is obviously very difficult work to do in a whole range of ways. Why do you keep going back?
Maynard: I've been coming to Gaza since 2010. I love the country. I've made many friends and people I've considered family. I think what is being done to them is so unjust, terribly wrong and unjust. And I'm ashamed that my government, your government are complicit in this. And I have the ability to give help and therefore feel this overpowering need to come out here and help as much as I can.
Kaity Kline produced the radio version of this interview.
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