When he sleeps, Nooh al-Shaghnobi, a rescue worker in Gaza, is haunted by the cries of those he could not save.

The memories of the past 14 months come flooding back, nightmares of collapsed buildings with no equipment to dig out survivors.

“We hear the voices of the people under the rubble,” he said in an interview between rescue calls. “Imagine there are people under the rubble who we know are alive, but we can’t save them. We have to leave them to die.”

For more than a year now, Gaza’s rescue workers, paramedics and ambulance drivers have toiled on the front lines of the war, racing to the sites of countless Israeli airstrikes to try to save those who survived and recover the bodies of those who did not. In the war’s first seven weeks alone, Israel fired nearly 30,000 munitions into Gaza, unleashing one of the most intense bombing campaigns in contemporary warfare.

The International Committee of the Red Cross has said that Gaza rescuers face dangerous conditions without sufficient equipment, vehicles or fuel. They are mostly left to dig out survivors from under tons of broken stone, concrete and twisted metal with their hands and rudimentary tools.