War and shortages push Gaza hospitals to breaking point

In one of the chairs sits 14-year-old Ruwaa Muntasir Abdul Karim, from Jabalia in northern Gaza. Her small size makes her stand out in a crowded room full of patients.

Her left hand is connected to a dialysis machine. Her eyes follow the movement of the medical staff inside the room, but she remains silent throughout the session – the whole process has exhausted her.

Her father, Muntasir, sits next to her, his face full of concern.

“My daughter used to walk and play before the illness. Her life changed after surgeries and dialysis,” Muntasir said. “Every dialysis session keeps her alive. Any interruption causes her severe fatigue and shortness of breath.”

But the hospital department keeping Ruwaa alive is struggling itself, under the constant pressure to support the thousands of people in Gaza in need of treatment, without the necessary resources to do so.

Israel’s genocidal war on Gaza has decimated the Palestinian enclave’s medical sector through repeated attacks on hospitals, including al-Shifa, as well as harsh limitations on what can enter Gaza.

According to the Palestinian Ministry of Health, 50 percent of dialysis machines in Gaza have stopped working completely due to an ongoing shortage of sodium bicarbonate, which is required to operate the machines.

On top of that, the number of hospitals equipped to handle kidney failure patients has been reduced to four from seven, with some, such as the Noura al-Kaabi Dialysis Centre, destroyed by Israeli forces during the war.

The consequences mean that kidney failure patients are dying at an alarming rate in Gaza. Ministry of Health statistics show that there were 1,200 kidney failure patients before the war. That number has now dropped to about 700 patients after the death of more than 470, due to missed dialysis sessions and a lack of essential medications, according to the Palestinian Centre for Human Rights.

Osama Abu Rahma is head of the kidney department at Al-Aqsa Hospital in central Gaza, one of the four hospitals that can still treat kidney failure patients in Gaza.

“We have 51 dialysis machines, but 25 of them are completely out of service,” he said, adding that this had placed severe pressure on the facility and negatively affected the 240 patients receiving treatment there.

The facility has been forced to reduce both the number of sessions provided each week and the duration of each session.

Medical complications among patients are rising: general weakness, shortness of breath, heart and lung problems, and dangerously high levels of potassium in the blood.

Abu Rahma is clear – the situation is putting the lives of hundreds of patients at direct risk.

Back at al-Shifa Hospital, Ruwaa stares at the ceiling. Some of the older patients are asleep; the scene inside the ward reflects a state of continuous exhaustion.

Ruwaa’s father, Muntasir, watches the medical monitor next to her constantly, fixing his gaze on the vital indicators.

He remembers when she was in better health, but her condition has since deteriorated. Her weight has dropped from 65kg to 35kg (143 pounds to 77 pounds), while the number of dialysis sessions she receives each week has fallen from three to two.

The only permanent solution – a kidney transplant – should be within reach. “Everything is ready for a kidney transplant,” Muntasir said. “Her mother is the donor. The tests match.”

But Israel is once again hindering Ruwaa’s treatment. Her trip abroad – Israel must approve all journeys out of Gaza – has been pending for six months. The reality of Gaza’s healthcare situation means that the transplant cannot take place in the enclave. And so Ruwaa must wait.

The lack of access to treatment evident at Gaza’s dialysis facilities is a common issue across the Strip’s healthcare system.

Israel’s war has left more than 43,000 people in Gaza with injuries described by the World Health Organization (WHO) as “life-changing” – including thousands of severe limb injuries that resulted in amputations and permanent disabilities.

Even after being treated for the initial injury, Palestinians in Gaza who have had amputations then face a new challenge: rehabilitation and access to basic mobility aids.

In Khan Younis, southern Gaza, physiotherapist Aya al-Shaltouni explained that the lack of prosthetics, wheelchairs, and crutches has become part of patients’ daily reality, with demand far exceeding supply.

“There is a clear and major shortage of mobility aids,” al-Shaltouni said. “Many patients wait for long periods, and some do not receive anything.”

She noted that this shortage does not only affect physical suffering but completely changes the patient’s life path. Ultimately, access to proper rehabilitation tools can determine whether a patient is able to recover to some form of independent life.

“We create treatment plans, but without proper assistive tools we cannot reach the desired results, and progress remains limited,” al-Shaltouni said.

The physiotherapist added that rehabilitation centres in Gaza are operating with limited resources and cannot compensate for the major shortage in essential equipment, leaving a clear gap in the treatment system.

Zaki Jumaa Salem Abu Harb has seen both sides of the coin. A 60-year-old farmer from northern Gaza, he lost a leg after being injured in an Israeli attack in March 2025.

“My whole day changed in a moment,” he said. “After the attack, I woke up injured and couldn’t move like before.”

Having spent his life active in his fields, his movement was suddenly severely limited, and he depended on others to move between home and hospital, with continuous medical visits and follow-ups.

But after months of waiting, he was recently able to receive a prosthetic limb. It’s been a major positive development, but Zaki is also aware of the others – WHO estimates that there are between 5,000 and 6,000 amputees as a result of the war as of October 2025 – most of whom are still waiting for prosthetics.

“There are many people who don’t have wheelchairs or crutches,” Zaki said. “They are forced to find any way to move, sometimes using a tree trunk or any piece of wood.”

“There are children who lost their limbs,” he added. “Some of them don’t have devices to help them walk properly. When I see them, I feel deeply affected. You feel they’ve been deprived of the simplest rights in life.”

With Gaza’s limited resources, the focus has often been on prioritising treatment for physical injuries. But the healthcare crisis in the Palestinian territory does not stop there, and extends into the psychological and social traumas that are the natural result of nearly three years of devastating war.

On the outskirts of al-Aqsa Hospital, inside a small tent surrounded by other displacement tents, 22-year-old Hadeel sits in front of a simple fire used for cooking. Instead of sitting in a university classroom preparing for exams, Hadeel divides her time between caring for her seven siblings, securing their needs inside the tent, and trying to continue a life that stopped at the beginning of the war.

At the beginning of the war, her family took shelter in a relative’s house, before a violent strike hit a nearby home, forcing them to flee in chaos and panic.

“That night of the bombing, we woke up to the sound of children and women screaming … we were running and trying to find each other,” Hadeel paused, and then continued. “My mother was under the rubble … only her fingers were visible. Neighbours helped us pull her out. The sound of my mother calling our names and her image never left me.”

While her mother was receiving treatment, Hadeel found herself fully responsible for her siblings as the eldest daughter. Life became a constant shift between grief and endurance, and responsibilities that never stop.

“Some days I feel depressed, and other days I have to continue and take care of them,” Hadeel said.

Over time, signs of psychological stress became more visible, including frequent crying episodes, difficulty sleeping due to constant thinking, and the weight of memories and responsibilities.

Hadeel added that she suffers from emotional exhaustion, where daily responsibilities mix with recurring memories of bombardment and loss of safety, making moments of calm rare and interrupted.

Hadeel’s is just one story among many in Gaza. According to Asil Abu Shaweesh, a 27-year-old psychologist in central Gaza, the mental health crisis in the enclave is widespread, due to the war, repeated displacement, loss of loved ones and destruction of homes.

“Everyone in these conditions needs psychological support, and this need will continue, making mental health a priority that needs to be responded to,” Abu Shaweesh, who works with an international organisation providing psychological support, said.

Abu Shaweesh has observed widespread disorders, including depression, anxiety, post-traumatic stress disorder, insomnia and panic attacks, as well as issues among children such as bedwetting, aggressive behaviour, difficulty concentrating, recurring nightmares and excessive attachment to caregivers.

And while providing support to people suffering from these disorders is essential, Abu Shaweesh noted that mental health workers face major challenges, including “constant psychological pressure, lack of safety, high demand, shortage of resources, and difficulty reaching patients”.

But Abu Shaweesh knows how important the services she provides can be – and is willing to be stretched thin to provide people with the help they need.