Four days a week, 5-year-old Ibrahim Abdullah travels three kilometers from his family’s tent in Al-Mawasi to Nasser Hospital in Khan Younis, where he spends nearly four hours connected to a dialysis machine. He is the youngest dialysis patient in Gaza.

The trip consumes most of the day. Ibrahim’s parents take turns accompanying him while the other stays behind in the tent with their three daughters. If security conditions allow and a hospital bus is available, they use it. Otherwise, they take whatever public transport they can find — often damaged cars, small buses, or donkey- and horse-drawn carts — that can cost at least five times more than before the war. When no transport is available, his father Mohammed pushes him in a wheelchair through streets scarred by the war.

“He hates going to the hospital,” Mohammed told +972. “He gets exhausted. We leave the tent around 7 a.m. and return around 5 p.m. His mother and I try to distract him with any snack or chocolate we can find.”

The wheelchair is a recent addition. A few weeks ago, Ibrahim suffered a brain hemorrhage due to high blood pressure that paralyzed the left side of his body. He has since begun to recover, but now requires neurological rehabilitation alongside his regular dialysis and blood transfusions.

Before the war, Ibrahim was an energetic child who loved playing with his siblings and friends, his father said. He and his 9-year-old sister, Naima, both suffer from hereditary kidney atrophy, but their conditions were manageable. 

“There was healthy food and clean water in Gaza,” Mohammed recalled of the time before the start of the genocide. “Doctors were monitoring their cases and hoped one day they would receive the medical procedures they needed, including a kidney transplant.”

Now, when Ibrahim is not at the hospital, he often prefers to be alone. “He says he doesn’t want to see anybody,” Mohammed said, “because he is always tired.”

His deterioration reflects a much wider crisis. Across Gaza, people whose survival depends on sustained medical care are finding that even routine treatment can no longer be counted on. Amid Israel’s tight blockade, regular dialysis has been disrupted by shortages of medication, equipment, clean water, and adequate food. Cancer patients are struggling to access chemotherapy and other essential treatment.

Hospitals have been destroyed, families repeatedly displaced, and drugs and medical supplies depleted. Simply reaching one of the few functioning facilities can be an ordeal. Conditions once considered treatable or manageable have become increasingly dangerous.

For Ibrahim, the sharp decline began soon after the war started. He had been taking vitamin B6 to treat recurring kidney stones, but within months pharmacies ran out. His family spent seven months searching for the medication.

“Ibrahim’s health deteriorated rapidly,” Mohammed said. “He passed nine stones. Some were as big as chickpeas.” The stones grew larger and more frequent, causing bleeding and swelling and further damaging Ibrahim’s kidneys.

At the same time, Israeli military operations near the family’s tents in Al-Mawasi repeatedly prevented them from reaching hospitals or clinics. “We were eating whatever food was available during the famine, mostly lentils and pasta, and drinking the water we could get from charities, which is not clean,” Mohammed said.

By July 2025, Ibrahim’s condition became so severe that he remained in hospital through September. His blood levels had fallen dangerously low, Mohammed said, and doctors determined that he needed urgent dialysis. He now receives blood transfusions during those sessions as well.

But doctors say he needs dialysis far more often than Gaza’s devastated healthcare system can provide. Dr. Nabil Ayad, head of the nephrology department at Al-Rantisi Hospital, told +972 that Ibrahim should receive dialysis almost every day, but shortages affect nearly every aspect of his care.

Essential kidney medicines such as epoetin alfa, used to treat anemia in dialysis patients, are in short supply, along with basic dialysis equipment. “Dialysis catheters are not always available either,” Ayad said, explaining that doctors are often forced to rely on temporary catheters, “which adds further risks and complications.”

Naima, Ibrahim’s 9-year-old sister, is deteriorating too. Ayad said she now also needs dialysis, though doctors are trying to delay starting it for as long as possible as they ration the limited medical supplies and prioritize the most urgent cases. Eventually, both siblings will need kidney transplants.

In December 2025, Ibrahim received a medical referral to leave Gaza for treatment, according to his father. Eight months later, he is still there. “Doctors told me his condition is getting worse due to lack of treatment,” Mohammed said. “He needs to travel for treatment, or, at least, to have his medication brought to Gaza, before I lose him.”

‘We are dying slowly’

When +972 first met 47-year-old Basel Al-Dahdouh three months ago, his son Osama had pushed him three kilometers in a wheelchair, along streets covered in rubble and sand, from the family’s tent on Al-Shuhada Street in central Gaza City to Al-Shifa Hospital. There, Basel waited for hours for dialysis. By the time he was helped into the chair, his face was pale with exhaustion.

Even that treatment was only a fraction of what he had received before the war. His dialysis sessions had been cut from four hours to three, increasing the risk of serious complications, while medicines he depended on had either vanished or become prohibitively expensive.

“Before the war, my health was good. Now I can’t even go to the toilet without help because of the shortage of medicine,” he said.

A father of four, Basel began dialysis in 2020. Gaza was already under severe restrictions, but compared with the care available today, he remembers the prewar system as “perfect.” Ambulances took him to the hospital. Dialysis lasted four hours. His medications were consistently available.

Now even basic treatments can be difficult to obtain.

“The injections to increase my blood’s [hemoglobin] levels are missing,” Basel said. “Even if you find them, they cost NIS 700 ($234) instead of NIS 40 ($13). Even calcium vitamins are no longer available at the hospital, so we have to buy them ourselves.”

Years of illness, compounded by starvation, displacement, and harsh living conditions, had already taken a visible toll. Basel could barely walk and depended on crutches. A retinal hemorrhage had severely damaged his vision.

When Israeli forces raided Al-Shifa Hospital in November 2023, Basel was sheltering there. He recalled patients being left without adequate food, water, or electricity, forcing dialysis treatments to stop.

“They beat us and started asking questions like, ‘Tell us where the hostages are and we’ll transfer you to Israel for treatment,’” Basel said. “I barely see or walk — how could I possibly know? They cut the electricity and food. I couldn’t receive dialysis for weeks.”

During that period, his condition became dire. Basel said his body retained more than 15 kilograms of fluid, and he temporarily lost his sight. “I begged them to shoot me. I couldn’t take the suffering anymore,” he said.

The International Committee of the Red Cross (ICRC) eventually transferred him to Al-Aqsa Hospital in Deir Al-Balah, where he resumed dialysis and later regained his sight.

“All of us [dialysis patients] were so sick,” Basel said. “Many people died because of what happened.”

Three months later, Basel’s condition has deteriorated dramatically. When +972 spoke by phone with family members who were with him at the hospital, Basel was too exhausted to speak.

Two weeks before the visit, his dialysis schedule had been reduced again: from three weekly sessions to two, each lasting just three hours. His brother, 52-year-old Qasem, said doctors had warned that the hospital’s supply of bicarbonate, an essential component of dialysis fluid, could run out before the end of the month.

“Two sessions are not enough to remove the toxins from his blood or regulate the water and salt in his body,” Qasem said. “His blood sugar is constantly high.”

But reduced dialysis was only one part of the family’s crisis. In October 2025, a rat had bitten one of Basel’s toes in the displacement camp. The wound did not heal. His family attributed that to a combination of diabetes, shortages of medical supplies, inadequate sterilization, and the difficult hygiene conditions in their tent. The wound became infected and developed into diabetic gangrene.

Doctors amputated one toe, then a second, then a third. Still the infection spread. Eventually, they concluded that Basel’s leg would have to be amputated below the knee.

“When doctors told him they might amputate one toe, his blood pressure dropped from fear,” Qasem recalled. “He started sweating and fainted. He was terrified. We kept telling him it was only one toe and that he would still be able to walk with a prosthetic. But the infection kept spreading.”

After the amputation, Basel spent nearly a week under observation at the Palestine Red Crescent Society’s Al-Saraya Field Hospital. Gaza’s severe shortage of pain medication made the recovery harder. During one ambulance transfer for dialysis, Qasem said, Basel’s pain became so intense that he nearly lost consciousness.

He was grieving, too. Two weeks earlier, his 57-year-old sister, Bushra, had died after months of tremors and recurrent nosebleeds related to a pre-existing condition. Shortly before the war began, she had received approval to seek treatment outside Gaza and was scheduled to leave on Oct. 13, 2023. She never made it out.

Now Basel’s family fears the same fate for him. They also do not know how they will manage once he leaves the hospital. Even before the amputation, getting him to dialysis meant pushing his wheelchair along Gaza’s shattered roads, where he frequently fell and often arrived too dizzy to stand. “With one leg, the journey will be even harder,” Qasem said.

Like all dialysis patients, Basel also requires a tightly controlled diet, with restrictions on potassium, phosphorus, sodium, and fluids, as well as reliable access to clean drinking water. For a displaced family living through Gaza’s food shortages and economic collapse, those requirements are almost impossible to meet.

“He eats whatever we can find: beans, canned food, and meals from charity kitchens,” Qasem said. “We can’t afford fresh food or fruit. Besides food, he needs vitamins, medical care, and, more than anything, a safe and clean place to live.”

Before the war, Basel lived with his family in a large house in Beit Lahiya. It was destroyed in an Israeli airstrike during the first months of the war. “He had a garden, trees, cold drinking water, and two bathrooms,” Qasem said. “He had a dignified life. Compared with today, we were living in heaven.”

Now he lives in a tent without a toilet, surrounded by rats and mice and exposed to punishing heat. “Many times [Basel] has told me that he would rather die than continue living like this,” Qasem said.

The contrast between Basel’s life before the war and his life now illustrates how illness in Gaza has become inseparable from the displacement and deprivation patients are forced to endure. “Our life in Gaza is only pain and suffering,” Qasem lamented. “We love life and want to live with dignity. Animals outside Gaza live better than we do. We are sick, dying slowly.”

‘Every day of delay costs more lives’

Dialysis patients are far from alone. Gaza’s cancer patients are confronting the same collapse of sustained medical care, amid severe shortages of chemotherapy drugs, pain medication, and other essential treatments.

Thirty-nine-year-old Maisaa Eliwa has advanced cancer that began in her upper jaw and has since spread to her right breast and lungs. One tumor in her lungs has grown to 18 centimeters. 

She now lives in a tent near the coast west of Gaza City. An Israeli airstrike destroyed her home in Shuja’iya in November 2024, killing her husband, her son, and 28 other relatives.

So far, Maisaa received three chemotherapy sessions at Al-Shifa Hospital. But since July 14, she has received none. “Doctors told me there is no chemotherapy medicine because of the restrictions at the borders,” she said. “My temperature is always high, sometimes reaching 42 degrees Celsius [107 degrees Fahrenheit]. There is water in my lungs and right leg. I vomit blood every day, and my body hurts.”

Doctors also prescribed zoledronic acid injections to protect her bones, ease her pain, and help her remain mobile. The drug sometimes appears in Gaza’s pharmacies, Maisaa said, but at a cost of NIS 2,400 (around $800) it is far beyond her means. 

Her 18-year-old daughter, Arwa, first sold her gold earrings, then her phone, to pay for the injections. At other times, the family sold food they had received from charities, sold cooking gas, or borrowed from relatives and friends.

“Now no one can lend me anything because people are also suffering economically and I have no source of income to repay them,” Maisaa said. Without the injection, she added, “I lie in the tent unable to move my body.”

Six months ago, Maisaa received an urgent medical referral to leave Gaza. Doctors told her she needs surgery to remove tumors from her right lung and breast. She is still waiting.

Even when chemotherapy was available, reaching treatment could take hours. Maisaa would leave her tent around 7 a.m. and search for transportation. If she could not find any, she faced a three-hour walk to the hospital. Once there, doctors first had to determine whether her body was strong enough to receive chemotherapy.

“The doctors know that I come to the sessions without having eaten, so they give me an IV nutritional solution for two hours before I receive the treatment,” she said.

Overcrowding in the hospital presented another problem. “There were not enough beds in the hospital while I was receiving therapy, so sometimes I had to sit with two other women on the same bed.

“We cancer patients have the right to receive treatment in Gaza, or at least to be evacuated with our medical referrals, receive treatment, and then return,” Maisaa continued. “We are living in harsh conditions in tents, without cleanliness or the basic necessities of life. I die a thousand times every day.”

“The reason for all our suffering is the Israeli occupation, which denied us our fundamental rights and refused to let us live as normal people,” she added. 

Dr. Mohammed Abu Nuda, head of Gaza’s Cancer Centre at Nasser Hospital, told +972 that Gaza now lacks crucial cancer services, including radiotherapy and advanced diagnostic testing. The result, he said, is delayed diagnosis and interrupted treatment.

“There is a 60 percent shortage of chemotherapy supplies, supportive medications, pain management drugs, and targeted therapies in Gaza,” he said.

With resources so depleted, medical teams have been forced to ration supplies and decide which patients receive treatment. The center has appealed to the World Health Organization (WHO), the ICRC, and other international organizations to facilitate the entry of medicines and equipment and the evacuation of critically ill patients.

Around 11,000 people in Gaza are currently living with cancer, Abu Nuda said, with roughly 2,000 new cases diagnosed each year. Some 4,000 patients have urgent referrals for treatment abroad but remain unable to leave. “Three patients die every day as a result of being unable to receive chemotherapy and travel abroad for treatment,” he said.

“Cancer patients in Gaza need more than drugs,” Abu Nuda continued. “They need urgent humanitarian intervention that guarantees access to treatment.” He called on Egypt, Qatar and Turkey — countries that have acted as guarantors of ceasefire and humanitarian agreements — to pressure Israel to allow the unrestricted entry of medicines and diagnostic equipment, including mammography machines, ultrasound devices, CT scanners, and MRI systems. 

“Every day of delay costs more lives,” he said.

For 58-year-old Sana Abed from Rafah, displacement, hunger, and loss ultimately proved devastating. She had been diagnosed with liver cancer before the war and traveled to Egypt for treatment, where she spent eight months preparing for a liver transplant. Her 39-year-old son, Mohammed, planned to donate part of his liver.

Doctors first wanted Sana to lose weight before the operation, Mohammed said, so mother and son returned to Gaza while she continued following a dietary program. They arrived just two days before the war began.

Repeated displacement and food shortages soon made the prescribed diet impossible. Within months, the medications they had brought from Egypt were gone.

“Most of these medications were not available in Gaza, so her health began to deteriorate, especially during the famine [in the south of the enclave in June 2025] and the complete closure,” Mohammed said.

As the cancer spread, Sana received another medical referral and was placed on a waiting list to leave Gaza for treatment, but permission never came.

In September 2025, two of Sana’s sons were killed in an Israeli attack. Mohammed said the loss profoundly affected his mother. As her physical condition worsened, “she seemed to lose her will to live.”

Eventually, the cancer spread through her digestive system and her kidneys began to fail. Doctors determined that she needed dialysis, and she received one session at Nasser Hospital.

Sana died the following day. A week later, the WHO called Mohammed to tell him she should prepare to travel for treatment.

Ibtisam Mahdi contributed to this report.