Working at Shifa requires ingenuity.
The power goes off repeatedly as aging hospital generators buckle under daily rolling blackouts Gaza residents have lived with for years. Many items are in short supply, from gauze to adrenaline. They also lack spare parts for worn equipment, with bedside trolleys clattering down hallways on rusted wheels.
Only three of Nayef's four ICU beds have ventilators. One broke down long ago and can't be repaired. He says he once made a special wire for cardiac pacing from a spliced Ethernet cable.
Shifa's problems began well before this round of fighting. They are rooted in the decades-old Israeli-Palestinian conflict and more recently in the rivalry between Hamas and Western-backed Palestinian President Mahmoud Abbas.
Israel captured Gaza in 1967, along with the West Bank and East Jerusalem. Abbas' goal of a Palestinian state in all these areas remains elusive after two decades of failed negotiations. Hamas envisions an Islamic state in all of historic Palestine, including what is now Israel, and has carried out bombing, shooting and rocket attacks against Israel since the group's founding in 1987.
Israel withdrew from Gaza in 2005, leaving it to Abbas' Palestinian Authority, and Hamas seized the strip from Abbas by force two years later. In response to the Hamas takeover, Israel and Egypt have blockaded Gaza, restricting trade and movement. The blockade has set Gaza back years, and now the growing financial problems of Hamas and Abbas' Palestinian Authority, based in the West Bank, have compounded the shortages.
Israel says it allows in medical supplies except for "dual-use" items — anything it suspects could be diverted by Hamas for military purposes — but won't say what it has blacklisted.
Gilbert, the Norwegian volunteer helps out at Shifa several times a year. This time, he brought headlamps, useful for surgeons, but says they are on Israel's list of banned items.
He feels a strong personal bond with his Palestinian colleagues, saying they provide good care under challenging circumstances, but feel hurt by the world's seeming apathy toward Gaza.
Gilbert, 67, is currently the only foreign doctor at Shifa.
"I am not the hero," he says. "These people are the heroes. When we leave, they stay behind."