CAIRO (AP) — The 35 American and other international doctors came to Gaza in volunteer teams to help one of the territory’s few hospitals still functioning. They brought suitcases full of medical supplies and had trained for one of the worst war zones in the world. They knew the health care system was decimated and overwhelmed.

The reality is even worse than they imagined, they say.

Children with horrific amputations. Patients with burns and maggot-filled wounds. Rampant infections. Palestinian doctors and nurses who are beyond exhausted after seven months of treating never-ending waves of civilians wounded in Israel’s war with Hamas.

“I did not expect that (it) will be that bad,” said Dr. Ammar Ghanem, an ICU specialist from Detroit with the Syrian American Medical Society. “You hear the news, but you cannot really recognize ... how bad until you come and see it.”