RAFAH, Gaza Strip (AP) — For a few hours every day or night, Dr. Suhaib Alhamss tries to sleep on a thin mattress in an operating room. He swings in and out of half-consciousness, both too tired to open his eyes and too tense to let go. Thunderous shellfire often rattles the windows of the hospital he directs in the southern .

But the worst sounds, Alhamss said, come from : the cries of tiny children with no parents and enormous wounds. The panicked screams of patients jolted awake to the realization that they’ve .

The , which started 100 days ago Sunday, has exposed him, his staff and the people of Gaza to a scale of unlike anything they had seen before. It has .

“This is a disaster that’s bigger than all of us,” Alhamss, 35, said by phone between surgeries.

His hospital, donated and funded by Kuwait’s government, is one of two in the city of Rafah. With just four intensive care beds before the war, it now receives some 1,500 wounded patients each day and at least 50 people dead on arrival — adults and children with shrapnel-shattered limbs and pulped bodies, bone-exposing wounds and tattered flesh.

Over 23,400 Palestinians in Gaza , according to the . The count does not distinguish between civilians and militants.

Israel, which mounted its blistering air and ground campaign in response to that saw 1,200 people killed and , holds the group responsible for civilian deaths by embedding militants in .

To make room for the daily rush of war-wounded, Alhamss has crammed a few dozen extra beds into the intensive care unit. He cleared out the pharmacy, which was largely empty anyway since Israel’s siege . Still, patients sprawl on the floors.

“The situation is completely out of control,” he said.

A urologist by training and a father of three, Alhamss has watched aghast as his city and hospital have transformed over the course of the war.

With its low-rise concrete buildings and trash-strewn alleys teeming with unemployed men, Rafah, the strip’s southernmost city, long has been a squalid place straddling the Egyptian frontier. Notorious as a smuggling capital during the Israeli-Egyptian blockade, it contains Gaza’s only border crossing that doesn’t lead into Israel.

Now it’s the flashpoint in one of the world’s worst humanitarian crises. Apartment towers have been blasted into flat, smoldering ruins. Israel’s have swelled Rafah’s population from 280,000 to 1.4 million, jammed into flimsy tents smothering the streets.

Most , waiting in motionless lines outside aid distribution centers and sometimes plodding kilometers (miles) on foot to carry back canned beans and rice.

The faces he sees around the city have changed, too, as Israel of destroying Hamas. Fear and strain crease the features of his colleagues, Alhamss says. Blood and dust smear the faces of the incoming wounded, while waxy gray skin and eyes circled by darkening rings are marks of the dying.

“You can see the exhaustion, the nervousness, the hunger on everyone’s faces,” Alhamss said. “It’s a strange place now. It’s not the city I know.”

Aid trucks have with Egypt. But it’s the besieged enclave’s surging needs, humanitarian officials say. In the absence of vital equipment, medical staff have applied their ingenuity to new ends. Alhamss dresses patients’ wounds with burial shrouds.

“Each day I have people who die before my eyes because I don’t have medicine or burn ointment or supplies to help them,” he said.

He is too overwhelmed to dwell on all that he’s seen, but some images spring up unbidden: the vacuous stare of a young boy who survived a strike that killed his entire family, a newborn rescued from his dead mother’s womb.

“I think, how will they go on? They have no one left in this world,” Alhamss said. His thoughts turn to his own children — 12-year-old Jenna, 8-year-old Hala and 7-year-old Hudhayfa — sheltering at their grandmother’s Rafah apartment. He sees them once a week, on Thursdays, when they come to the hospital to give him a hug.

“I am terrified for them,” he said.

Alhamss knows fellow doctors and nurses who were killed in their homes or on the way to work by artillery, missiles, exploding drones — so many kinds of incoming fire. He has lost dozens of his medical students at the Islamic University of Gaza where he teaches, ambitious men and women “with so much life left to live,” he said.

But grief is a luxury he cannot afford. When asked how he felt, he answered with a simple “It’s God’s will.”

“We all will die in the end, why be afraid of it?” Alhamss asked. “We have no choice but to try to live in dignity, to help those we can.”

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DeBre reported from Jerusalem.

Isabel Debre And Najib Jobain, The Associated Press