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Gaza City, Gaza Strip Under the dialysis of Gaza City’s Al-Shifa Hospitalthe same events are repeated every day. The machine runs without stopping. Patients sit in organized queues. Medical tubes connect bodies to life for a few hours.
In one of the seats sits 14-year-old Ruwaa Muntasir Abdul Karim, from Jabalia in northern Gaza. His small size makes him stand out in a room full of patients.
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His left arm is connected to a dialysis machine. His eyes follow the movement of the medical staff inside the room, but he remains silent the whole time – the whole process has bored him.
His father, Mr. Muntasir, is sitting next to him, his face is worried.
“My daughter used to walk and play before she got sick. Her life changed after surgery and dialysis,” said Muntasir. Every dialysis session helps him live.
But the hospital department that maintains Ruwaa is struggling alone, under constant pressure to help thousands of people in Gaza who are in need, without the resources to do so.
Israel’s terrorist war in Gaza has damaged the Palestinian medical sector due to repeated attacks on hospitals, including al-Shifa, and barriers to access to Gaza.
According to the Palestinian Ministry of Health, 50 percent of the dialysis machines in Gaza have stopped working due to a shortage of sodium bicarbonate, which is needed to operate the machines.
In addition, the number of hospitals equipped to treat kidney disease has decreased to four from seven, and others, such as the Noura al-Kaabi Dialysis Center, destroyed by the Israeli army during the war.
The results mean that kidney failure patients are dying at an alarming rate in Gaza. Statistics from the Ministry of Health show that there were 1,200 patients with kidney problems before the war. The number has now dropped to around 700 patients after more than 470 deaths, due to missed dialysis sessions and lack of essential medicines, according to the Palestinian Center for Human Rights.
Waiting for salvation
Osama Abu Rahma is the head of the kidney department at Al-Aqsa Hospital in the central Gaza Strip, one of four hospitals that can still treat kidney patients in Gaza.
“We have 51 dialysis machines, but 25 of them are not working,” he said, adding that this has put the hospital at risk and inconvenienced the 240 patients receiving treatment there.
The center is forced to reduce the number of sessions offered each week and the duration of each session.
Medical problems among patients are on the rise: general weakness, shortness of breath, heart and lung problems, and dangerously high levels of potassium in the blood.
Abu Rahma is clear – this is putting the lives of hundreds of patients at risk.
Back at al-Shifa hospital, Ruwaa is looking at the ceiling. Some of the elderly patients are sleeping; the scene inside the ward shows a state of constant exhaustion.
Ruwaa’s father, Muntasir, has a doctor by her side all the time, keeping an eye on her vital signs.
He remembers when he was in good health, but his illness has taken a turn for the worse. His weight has dropped from 65kg to 35kg (143 pounds to 77 pounds), while the number of dialysis sessions he receives each week has dropped from three to two.
The only permanent option – a kidney transplant – should be accessible. “Everything is ready for the kidney transplant,” said Muntasir. “His mother is the donor. The test is compatible.”
But Israel is also blocking Ruwaa’s support. His foreign travel – Israel must accept all travel from Gaza – has been on hold for six months. Gaza’s health situation means that the installation cannot take place in the enclave. So Ruwaa waits.
The importance of prosthetics
The lack of access to care seen in Gaza’s dialysis station is a common issue in 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 leg injuries that led to amputations and permanent disabilities.
Even after healing from their initial injuries, Palestinian amputees in Gaza now face a new challenge: rehabilitation and access to basic mobility aids.
In Khan Younis, south of Gaza, physiotherapist Aya al-Shaltouni explained that the lack of prosthetics, wheelchairs, and crutches have become part of the patients’ daily lives, and their importance exceeds food.
“There is a clear lack and a serious lack of mobility aids,” al-Shaltouni said. Many patients wait a long time, and some receive nothing.
He said that this decrease does not only affect the physical suffering but it completely changes the life of the patient. Ultimately, finding the right resuscitation equipment can determine whether a patient can recover to some form of independent living.
“We make support plans, but without the right support tools we cannot achieve what we want, and progress remains limited,” al-Shaltouni said.
The physiotherapist added that rehabilitation centers in Gaza are working with limited resources and cannot compensate for the great lack of necessary equipment, leaving a clear gap in the treatment plan.
Zaki Jumaa Salem Abu Harb has seen both sides of the coin. A 60-year-old farmer from northern Gaza, he lost his leg after being injured in an Israeli attack in March 2025.
He said: “My whole day changed in an instant. After the attack, I woke up injured and unable to walk like before.”
Having spent his active life in his fields, his mobility was limited, and he relied on others to move him between home and hospital, with constant medical visits and follow-ups.
But after waiting for several months, he recently received a transplant. It’s been a great development, but so has Zaki to know about others – WHO estimates that there are between 5,000 and 6,000 war amputees as of October 2025 – many of whom are still waiting for prosthetics.
“There are many people who do not have wheelchairs or crutches,” said Zaki. They are forced to find any way to move, sometimes using the trunk of a tree or any tree.
“There are children who lost their legs and arms,” he added. Some of them do not have the equipment to help them walk properly. When I see them, I am deeply moved.
Health care support
With Gaza’s limited resources, attention has often been focused on treating the wounded. But the health problem in the Palestinian territory does not end there, and extends to the psychological and social problems that are the natural result of almost three years of destructive war.
Outside al-Aqsa Hospital, inside a small tent surrounded by other displaced tents, 22-year-old Hadeel sits in front of a simple fire used for cooking. Instead of sitting in a university class preparing for exams, Hadeel divides his time between taking care of his seven siblings, taking care of their needs inside the tent, and trying to continue the life that stopped at the beginning of the war.
At the beginning of the war, his family hid in a relative’s house, before the threat of violence fell on a nearby house, and they fled because of the chaos and fear.
“The night of the bombings, we woke up to the sound of children and mothers screaming…we were running and trying to find each other,” Hadeel paused, then continued. My mother was under the rubble…only her toes were visible. Our neighbors helped us get them out.
While her mother was receiving treatment, Hadeel found herself taking on the responsibility of her siblings as the eldest child. Life became a constant alternation between grief and endurance, and responsibilities that never ended.
“Some days I feel depressed, and other days I have to go on and take care of them,” said Hadeel.
Over time, symptoms of depression began to appear, including frequent crying, falling asleep due to incessant thinking, and the weight of memory and responsibilities.
Hadeel added that he suffers from emotional exhaustion, where daily responsibilities are mixed with repeated memories of bombings and loss of security, making moments of peace strange and disrupted.
Hadeel’s is just one story among many in Gaza. According to Asil Abu Shaweesh, a 27-year-old psychologist in central Gaza, mental health problems in the region are widespread, due to the war, repeated displacement, loss of loved ones and destruction of homes.
“Everyone in these situations needs psychological help, and this need will continue, making mental health an important issue that needs to be addressed,” Abu Shaweesh, who works with an international mental health organization, said.
Abu Shaweesh saw common problems, including depression, anxiety, post-traumatic stress disorder, insomnia and panic attacks, as well as children’s issues such as bedwetting, aggressive behavior, depression, recurring nightmares and caregiver attachment.
And although providing support to people suffering from this disease is important, Abu Shaweesh said that mental health workers face serious challenges, including “constant mental pressure, lack of security, high demand, lack of resources, and difficulty reaching patients”.
But Abu Shaweesh knows the importance of the services he provides – and is willing to stretch himself to help those in need.
