This volunteer doctor arrived in Gaza during the ceasefire. On Tuesday, the war began again

It was about 2 or 2:30 in the morning when Dr. Feroze Sidhwa was startled out of sleep by the sound of the door to his living quarters smashing into the closet behind it. It was March 18 and Israel had resumed its bombing campaign in Gaza, bringing a forceful end to the ceasefire agreement.

The 43-year-old is currently on his second volunteer trip to Gaza, working at the Nasser Medical Complex in Khan Younis. He entered the territory on March 6, when the sounds of war were silenced.

But soon, the all-too-familiar sounds of chaos and explosions filled the air, and Sidhwa was plunged into yet another mass casualty event. 

"On the morning of the 18th, things changed pretty dramatically," he told CBC News in a video call on Thursday. "But I expected the attack to resume in full force while I was here so it wasn't exactly a surprise." 

The ceasefire went into effect on Jan. 19, a three-phased deal that included hostage and prisoner releases while delaying talks on Gaza's future to a next stage of the truce.

The first phase, a 42-day period primarily focused on hostage releases, expired on March 1 without agreement on a second phase.

On March 18, Israel resumed its bombing campaign, resulting in almost 600 dead, according to the Gaza Health Ministry, and leaving the first phase of the ceasefire in shambles.

Prime Minister Benjamin Netanyahu said this was "just the beginning" as Israel launched a ground invasion to put pressure on Hamas to release all remaining hostages. 

Sidhwa, a trauma surgeon based in California, says he and his colleagues were at the emergency room at Nasser within 15 minutes of being woken up and he was seeing patients 10 minutes after that.

He was in his first surgery of the day an hour later. 

He says one of the first things he had to do that day was explain to a father that his daughter would not survive her injuries. 

"There was this three-year-old girl with multiple shrapnel injuries to her face and head, agonal breathing [signifying that oxygen is not getting to the brain] and a very weak pulse," he said. "Even though she was technically not dead yet, she was going to die and there was nothing we could do about it." 

The hospital saw between 250 and 300 people that day, of which "40 or 50 per cent were women and children," he said.

All the injuries he saw were from shrapnel, he said.