On the morning of Oct. 7, Maiko Shirane, a 36-year-old Tokyo native, woke up to the sounds of missiles and explosions.

The Doctors Without Borders human resources officer was in the last month of her second dispatch to the Gaza Strip. Much of her role there included managing and recruiting local personnel — that is until Oct. 7, when everything changed in an instant.

“I’d previously witnessed conflict during my dispatch in Gaza from 2018 to 2019, but the number of missiles I saw that morning was unlike anything I had ever seen before — a completely different level of violence,” Shirane said from Cairo on Saturday.