Sachiko Kawase, a nurse at Osaka Red Cross Hospital, has returned to Japan from Gaza following her evacuation earlier this month, carrying with her the grave words of her former colleagues who continue to care for civilians caught in the crossfire of the Israel-Hamas war.

"The armed conflict started abruptly, changing the entire cityscape of Gaza," Kawase said. "It became a landscape that I didn’t recognize at all, completely different from the Gaza I knew. "

While Kawase evacuated to the south of Gaza not long after the Oct. 7 assault by Hamas militants in Israel, several of her Gazan colleagues stayed behind in the north, providing emergency aid and relaying information to her on the state of the hospital where they were based. Meanwhile, bombs were being dropped just tens of meters away from the facility.

She was dispatched to Gaza by the Japanese Red Cross Society in July after remotely assisting nurses there for nearly a year.

On the ground with workers from organizations such as the Palestine Red Crescent Society and the International Committee of the Red Cross, she led nursing education and training at Al-Quds hospital in northern Gaza — the enclave’s second-largest hospital and one that recently ceased operations.

For the almost three months that she was stationed at Al-Quds, she recalls walking through bustling streets full of children lined by tall buildings and shops, with an occasional horse-drawn carriage or goat crossing her path.

“I was regularly asked where I was from while walking the streets, and when I told them Japan, they often thanked me for coming to help,” she said. “Complete strangers would then give me bread or sweets.”

However, her time there was cut short once large-scale conflict broke out on Oct. 7.

"It became a completely different Gaza than the one I’d gotten to know.”

Kawase broke into tears as she spoke to reporters at the Japan National Press Club on Friday about her experience following the start of the Israel-Hamas war.

Her main takeaway from the three weeks between the start of the war and her evacuation to Egypt was the strength of local aid workers, she said.

“There were times filled with anxiety, with tears, but the reason I was able to make it through those three weeks is because of their work ethic,” she said. “Witnessing their continued efforts to find ways to deliver humanitarian aid made me realize that I needed to find things I could do at least while I was there.”

When she informed her colleagues that she’d be evacuating to Egypt and eventually returning home, one of them, a Gazan, expressed joy for her, but sorrow at the current state of his home.

“‘What wrong did we do? Everyone's life should hold the same value, yet today, this world is not fair. The world is attacking us, we have no human rights, we are truly miserable,’” she quoted him as saying.

While Al-Quds Hospital is no longer operating, Kawase said a number of her former colleagues there are providing aid at other facilities, while one who has remained in the north is currently sheltering with family.

Now that she's returned to Japan, Kawase said her responsibility is to communicate to the world the voices of Palestinians caught in the conflict and the reality of what she saw in Gaza.

According to the Japanese Red Cross Society, there are aid efforts are underway by different Red Cross societies in Gaza, Israel and Egypt involving the provision of medical aid, ambulances and mental health support, as well as facilitating deliveries of supplies and hostage releases.

More than 235 Israeli hostages were thought to be held by Hamas as of Wednesday. Meanwhile, medical officials in Gaza have said more than 11,000 people have been killed in Israeli strikes, with around 40% of them being children. Two-thirds of Gaza’s population of over 2.3 million have reportedly been internally displaced.

Israel has reported that 1,200 people were killed by Hamas in its Oct. 7 attack.