Health workers at Gaza’s Nasser Hospital, where hundreds of wounded people arrived after Israel resumed its bombing campaign, say they’re struggling to manage the mass casualties with limited resources, forcing them to make difficult decisions about who to treat first, Al Jazeera reports.

“Child after child, young patient after young patient” was rushed into the facility, visiting British surgeon Sakib Rokadiya said. “The vast, vast majority were women, children, the elderly.”

Among the injuries he and other medics encountered were a young girl with shrapnel in her brain, a six-year-old boy with holes in his heart, and a 29-year-old woman with a crushed pelvis.

“I was overwhelmed, running from corner to corner, trying to find out who to prioritise, who to send to the operating room, who to declare a case that’s not salvageable,” said Haj-Hassan, a nurse at the facility.

“It’s a very difficult decision and we had to make it multiple times. I cannot process or comprehend the scale of mass killing and massacre of families in their sleep that we are seeing here. This can’t be the world we’re living in.”