By Martin Patience
BBC News, Kemal Adwan hospital
The number of calls and injuries has jumped since Israel's incursion
Ambulance driver Khalil Sadawy spent Wednesday ferrying Palestinian casualties from Beit Hanoun - hit by Israeli shells - to the hospital.
He watched the next day as 13 bodies were loaded into the fleet of the ambulances.
The hospital staff, jostled by family and friends of the victims, struggled to close the vehicles' doors.
The ambulance sirens then blared and the vehicles inched out of the hospital grounds.
They were taking the victims home - and to their graves.
"We do what we can," said Mr Sadawy, 53, his hands tucked into his trouser pockets. "But often it's not enough."
Mr Sadawy is one of the 289 employees - doctors, nurses, cleaners, kitchen workers - at the Kemal Adwan hospital in Beit Lahiya, a town in northern Gaza.
The 77-bed hospital serves as one of the main emergency units for the area. In normal times, the building is a busy place.
But in the last few days it resembled a field hospital.
A week-long Israeli incursion into the area meant the hospital treated scores of casualties. At least 78 Palestinians have died during and after the incursion with many civilians among the victims.
"We were working 200%," said the hospital's director Dr Mahmoud Asaly.
In spite of gruelling hours and little pay, the hospital staff always respond to these big emergencies.
"As soon as they hear on the TV or radio that there has been an Israeli incursion or a big attack they rush to the hospital," said Dr Asaly, who often works 18-hour days.
Normally the first member of staff to hear is Mr Sadawy.
Ambulance drivers say Israeli troops sometimes fire at them
As the head of the hospital's six-strong ambulance fleet, Mr Sadawy co-ordinates with Israeli troops to reach Palestinian casualties.
It is very dangerous work. Israeli troops sometimes fire at the vehicles. The army says the ambulances have been used by Palestinian militants to attack their troops.
Mr Sadawy said two ambulance drivers from his team had been killed this week. Another two were injured.
The job takes a heavy emotional toll. "Sometimes the Israelis kill a Palestinian and we can't reach their body for a day," said Mr Sadawy.
"I've been to scenes that make me weep. I'm a human being in the end."
During the latest incursion, the ambulance chief had to draft in several four-wheel drive ambulances to reach the neighbouring town of Beit Hanoun.
Palestinian militants blocked off roads with mounds of sands and Israeli tanks chew up the roads making it almost impossible for regular ambulances to pass.
When the ambulances take casualties to the hospital, nurse Mohammed Marouf is often the first to treat them.
The 26-year-old said that scenes were often chaotic as relatives wanted information about a patient. He needs to force trolleys with injured people through the hospital's corridors.
But all this easy, said Mr Marouf, in comparison with the gruesome task of identifying body parts.
Sometimes the ambulances arrive with various limbs and Mr Marouf has to take them to the mortuary and place them with the correct body.
"I've done a lot of that this week," he said.