One Year After 'Ceasefire,' Gaza's Health System Still in Freefall

On October 10 last year, when the "ceasefire" was announced, many Gazans hoped to use the lull to repair a health system that had been severely damaged. They imagined medicines and equipment would arrive more regularly, hospitals and clinics would gradually be restored, patients could travel abroad for treatment, foreign emergency medical teams could enter to support exhausted health workers, and plans could finally be made for healthcare in the months and years ahead. But according to an article in Al Jazeera, none of that happened.

Three years into the war, Gaza's health system has had almost no time to breathe. Medical staff are still carrying a workload far beyond what a devastated system can bear, while the supply of medical materials remains restricted and medical evacuations remain stalled.

The article says patients are still arriving at clinics with bomb and shrapnel wounds, because Israeli attacks continue. More than 1,470 people have been killed since the "ceasefire" took effect. Even reaching a health facility has become dangerous. As security conditions worsen, services supported by Medical Aid for Palestinians (MAP) in many areas of Gaza have been forced to suspend operations. Last month, a 65-year-old patient was shot dead by an Israeli military drone as he tried to seek treatment at a MAP-supported health center in Jabalia.

While taking in new patients with new wounds, doctors must still care for those requiring treatment lasting months or years. Amputees need rehabilitation, prosthetics and further surgery, but Israeli authorities strictly restrict the necessary supplies. Children who once suffered acute malnutrition now live with anemia and stunting, while people with diabetes and high blood pressure struggle to obtain medication. Cancer patients cannot access radiotherapy, and kidney patients cannot rely on regular dialysis.

The article recounts the case of Iktimal, the aunt of a colleague working for MAP in Gaza. In February, she felt something was wrong with her body and had a biopsy, but the laboratory, like many others in Gaza, did not have enough supplies to process the test in time. More than a month later, she learned she had cervical cancer – a disease that is often curable if caught early. She had surgery in April, but recovery was slow and painful, and she then developed kidney complications requiring specialist treatment unavailable in Gaza. Her family applied for medical evacuation, but the process was slow, opaque and heavy with paperwork. By the time Israeli authorities approved it, her condition had become critical. She traveled to Egypt hoping for treatment, but died two weeks later.

Iktimal's case is not isolated. According to the World Health Organization (WHO), more than 15,000 people in Gaza are still waiting for medical evacuation; if delayed too long, many of them could die from preventable causes.

A month ago, another tragic case: a newborn with severe heart disease died at Assahaba Hospital, where MAP provides support. The baby needed emergency surgery that was not available in Gaza. Doctors knew what needed to be done but had no way to do it.

Sometimes treatment is blocked by the lack of even basic medical supplies. Hospitals lack IV fluids, anesthetics, surgical materials and even oxygen. Staff at many hospitals must carry oxygen cylinders to a central station for refilling. Across Gaza, more than 500 patients depend on oxygen, some continuously: cancer patients, people with pulmonary fibrosis, heart disease, newborns and children in intensive care units.

In August, the Palestinian Ministry of Health warned that 22 of Gaza's 34 oxygen stations had stopped functioning, and only 4 of 30 cylinder-refilling machines were still working. The remaining stations could soon break down. Israeli authorities continue to block spare parts needed for repairs, classifying them as "dual-use" items. For the same reason, Gaza has no functioning MRI machines, and only one or two CT scanners serve a population of about two million.

At times doctors must make decisions without scans, tests or ordinary medicines. A cancer that could have been caught early becomes harder to treat. A wound that could have healed with rehabilitation becomes a permanent disability. A child who needed proper food and treatment can suffer chronic malnutrition, stunting and lifelong developmental delay.

It was once said the "ceasefire" would give Gazans time to recover and rebuild. That did not happen. The restrictions that stood between Iktimal and diagnosis, treatment and evacuation remain in place, and her story is just one of thousands of similar cases in Gaza over the past year.

Every delay comes at a cost. Every week a medicine is withheld, a scan cannot be performed, a patient is denied permission to leave, someone passes beyond the point of being saved. Iktimal has run out of time. And right now, thousands of people in Gaza are running out of time too.

The Al Jazeera article notes that the views expressed are the author's and do not necessarily reflect Al Jazeera's editorial stance.