Nurse from Canada who worked at Gaza hospital under siege describes difficult decision to leave

Looking for a moment's refuge inside the staff room at the overcrowded European HospitalnearRafah, Ahmed Kouta throws himself on a paltry mattress in the corner and props himself up on a pack of cotton balls. It's been a week since Kouta, a trained nurse, walkeddown the perilousSalah el Din road from Gaza's north to the south.

He stopped at the hospital to lend a hand where he could. The carnage inside the medical centre reminds him ofthe fighting he witnessed inthe north, the sieges on Al-ShifaHospital and how the war has affected the thousands of Palestinians strugglingwithout meaningful access to food or water.

Kouta documented the hardship to his 400,000 followers onInstagram, where the Palestinian Canadian isknown as Prince Kouta.

"Everybody's life has changed," said Kouta, 23. "Everyone in Gaza has either lost their home, lost their family member, lost themselves, lost their life. Everybody has lost something in Gaza."

Kouta spoke to CBC News twice in the last week to chronicle his time in Gaza. Palestinian health officials say more than 34,000 people have died in the enclave since Israel launched its military offensivefollowing the Hamas-led assault that Israel says left 1,200 people dead and saw more than 200 kidnapped.

On Sunday, Koutafinally crossed into Egyptfrom Gaza, en route toCanada to be reunited with family inLondon, Ont. His journey through the war-torn territory to Cairois one account of an attempt to survive the intensity and suffering of the war.

The interviews with him have been edited and condensed for clarity.

Tell us how you came to be in Gaza before the war.

I came to Gaza [from Canada] just to finish up my thesis [for a masters in health-care administration]. I was supposed to be here for at least a couple months and head back in February. However, the turnout has been completely different. And now we're stuck in a genocide.

I made it to Gaza on the 11th of September. The morning of Oct. 7,I was supposed to bewith the [IslamicUniversityof Gaza]discussing with my professor the thesis that we had talked about and the proposal that I've already completed. Then the 7th of October came and the whole life just paused.

WATCH | 'Every day of this war feels like a whole year':

Relief, guilt after escape from northern Gaza

55 years ago

Duration 0:58

Ahmed Kouta says he feels relieved after making it from Gaza's north to Rafah in the south but says he's thinking about those he left behind. 'When you make it to the south and leave everybody all alone in desperate need of help ... you get the feeling of guilt,' he said.

When did you realize the gravity of the attack on Oct. 7?

People in Gaza usually thought it would be only for a couple of days. Every aggression just escalates for a couple of days and then goes back to the normal state. However, this time it's been something completely different.

I was asleep the night before ... then the morning of,everybody in our area wasfreaked out. Everybody was thinking, 'Something is wrong, something wrong is going on.' And then when we went down in the streets and checked the news.We understood the situation that was happening. We, again, thought it was only going to be for a very small while until everything escalated. It escalated very quickly in a very different way.

How quickly did your instincts kick in, as a nurse at Al-Shifa Hospital?

Our daily routine, when you enter the hospital, you already know that you have a jammed day. The hospital would not stop from receiving any patients. The bombardments were always heard, even though we were inside the ER, and it's a place that bombardment shouldn't be heard. So while we're working and hearing all the bombardments, the strikes,the screaming, the crying, the bloodshed and the ER just in a situation of being very chaotic inside of us, we had that very stressful feeling, but we had to hold ourselves to be able to continue.

You barely have any time to rest. You're up for over 24 hours. Sometimes your shift is extended. Sometimes you have to cover up for another colleague. You can't say no because you know that people here need you. You know that your colleague probably has somebody he lost.

WATCH | A 'chaotic' ER, running on fumes:

Ahmed Kouta describes 'chaotic' hospital environment in Gaza

55 years ago

Duration 1:30

As a nurse, Ahmed Kouta says health-care resources were already stretched in Gaza before Oct. 7, but the outbreak of war has made the situation even more dire. 'The bombardments were always heard, even though we were inside the ER, and it's a place that bombardment shouldn't be heard,' he said of his time working in Al-Shifa Hospital in northern Gaza.

And then an airstrike hit thehospital on Nov. 10.

That was the worst day that I livedin the whole 200 days being in Gaza.That day itself needs a whole documentary to talk about. I can't explain.

You've shared your experience on Instagram. How did that begin?

As the aggression started, I had a lot of requests. A lot of international news outlets have contacted me to do interviews and talk about the situation in Gaza.

I started going livein the hospital.I started posting the situation on my stories. I believed it was not a very safe situation, as there's a lot of people that were going on social media that have been targeted. However, after a while, I realized that the situation is going to go for a long time and, asI have the ability to speak, then I would take the opportunity and chance with a couple of videos that I've made.

I woke up the next morning and realizedthat my page has been increasing in followers. At that moment, I thought that this was the best chance to keep speaking, keep amplifying the voices of people in Gaza, the voices of Palestine to reach the world.

WATCH | CBC spoke with Kouta's brother when he left Gaza last month:

Canadian leaving Gaza for Cairo describes 'horror movie' in besieged territory

6 months ago

Duration 1:54

Mahmoud Kouta, 21, said he and his family lived under the constant threat of bombing and starvation for 160 days while they waited to be evacuated from Gaza. The London, Ont., man and his brother boarded a bus from Rafah to Cairo on March 12.

Your two brothers left Gaza weeks ago. Why did you stay behind?

Being in the north, it was very difficult to find a safe pathway to make it to the southern part as there was a checkpoint and it was a very big risk to take that decision to leave from the north for the south.

The other big reason was the amount of help I was able to give to people. It was the aid we were able to distribute. It was the patients that were left behind, the patients who had nobody,as there's been a big number of medical members,a big number of people, who have evacuated the north of Gaza.

How did you come toleave?

I left north Gaza on April 16. I remember at the intersection of leaving, where the vehicle dropped us off,we had to walk for a long distance. The trip took us about from 9 a.m. until almost 4 or 5 p.m. I believe most of the trip it was walking. Wewere on our feet. I looked on myphone that day and I checked that we walkedabout 10 kilometres. It was a really hard trip.

I spent almost 13 days to two weeks in the southern partof Gaza. I came, I put my stuff in this tent with relatives. The next moment, they all thought I was crazy;after a really hard trip,the next morning, at about7 a.m., I already had my stuff and I left for the European Hospital. Iwent to see an old colleague. Wewere together at Al-ShifaHospital ... and found myself helping patients again.

WATCH | How Canada helped Kouta get out:

Ahmed Kouta appreciative of '24/7' support from Canada to leave Gaza

4 months ago

Duration 1:24

Palestinian Canadian Ahmed Kouta is finally getting out of Gaza after months of sharing his experiences of the Israel-Hamas war on social media. He says Canadian officials gave him hope of being able to leave even when he was in the north of the enclave.

How did it feel, finally reaching the south?

I honestly kept on delaying [leaving Gaza entirely], as I wanted to stay in the Strip as much as I can in order to help as many people as possible, be ableto stay, suffering with my people, because I'm not any better than any of them. However, God's plan made it so that I'm able to evacuate. It's not something that I wanted to do, but at the end of the day there's avery limited extent on what you can do.

After living for about 195 days in the north, living every bad situation of the war on Gaza all these strikes, all the days at the hospital, all the times we've been displacedmaking it to the south is some sort of a relief and especially after crossing through the checkpoint. However ... when you make it to the south and leave everybody all alone in desperate need of help, you get a really bad feeling. You get the feeling of guilt. But at the end it's a matter of safety alife-or-death situation.

As soon as I get an opportunity to make it back to Gaza even if the war isnot over then it's a decision that I will be taking. I am looking for other [organizations or groups] that are entering into Gaza that I'm able to enter back with them, with utilities and equipment to help as many people or reach as many people as we can.

WATCH | Hoping to return:

Ahmed Kouta leaving Gaza due to 'external pressure' but hopes to return to help

4 months ago

Duration 0:57

Ahmed Kouta, a Palestinian Canadian nurse who is leaving Gaza after months of sharing his experiences of the Israel-Hamas war on social media, says he's already thinking of how to return to provide aid.