Global Courant
Deir el-Balah, Gaza Strip – Al Aqsa Martyrs Hospital, the only hospital still functioning in the central Gaza Strip, reached full capacity several days ago. Injured people lie on hospital floors, medical tents and mattresses with patients occupy the space outside the building, while dead bodies continue to enter the facility.
Thousands of displaced Palestinians have sought refuge here, locking themselves in hallways and waiting rooms. Meanwhile, many patients with chronic diseases who were treated in hospitals in the north of the besieged enclave are now at Al Aqsa Martyrs, having fled their homes following evacuation orders from the Israeli army.
For kidney patients, dialysis treatment is a matter of life or death.
Before the latest Israeli offensive began on October 7, the hospital had 143 patients requiring dialysis. Now the number of patients has more than doubled to about 300, including 11 children, all of whom have only 24 dialysis machines between them.
Iyad Issa Abu Zaher, director general of the hospital, said the facility is overwhelmed.
“We have resorted to rationing all resources and medical supplies,” he told Al Jazeera. “A kidney dialysis patient is now treated once or twice a week for an hour or two, but previously he came three times a week.”
Dr. Iyad Abu Zaher, director general of Al Aqsa Martyrs Hospital in Deir al-Balah, says the health facility is overwhelmed (Ashraf Amra/Al Jazeera)
Even before the war, Gaza’s Health Ministry had warned that the lives of 1,100 patients with kidney failure, including 38 children, were at risk due to a lack of fuel and an acute shortage of the necessary medical supplies needed for dialysis.
Last month, Alaa Helles, director of the hospital pharmacy department of the Ministry of Health in Gaza, said: said The area’s hospitals provided 13,000 dialysis sessions every month.
This requires more than 13,000 filters, 13,000 blood collection tubes and 26,000 blood cannulas per month, but with Israel and Egypt controlling the area’s border crossings, even before the war patients often had to wonder whether there would be enough supplies to treat them.
The Gaza Strip has been under an Israeli blockade for sixteen years, with the movement of goods severely restricted by Israel and Egypt. The blockade has only been tightened since October 7, following an attack by the armed wing of the Palestinian group Hamas in southern Israel. So far, only a few dozen emergency trucks have been allowed in – a “drop in the ocean” in terms of the assistance needed. Before the war, about 450 trucks arrived every day with supplies.
Breaking point
Abu Zaher said the healthcare system in the Gaza Strip has reached a breaking point, following Tuesday’s Health Ministry statement on the remaining operational hospitals.
According to the ministry’s statement, 12 hospitals and 32 health centers have already been forced to stop functioning. “And we fear that more will stop because of the Israeli attacks and the lack of fuel,” it added.
But keeping the doors of the Gaza Strip’s remaining hospitals open does not in itself mean that these facilities will be able to treat the wounded pouring into them, the statement said, saying that many medicines and medical supplies in the hospitals have already run out are.
There are 24 kidney dialysis machines for about 300 patients at Al Aqsa Martyrs Hospital (Ashraf Amra/Al Jazeera)
Abu Zaher said that without fuel, patients in operating rooms, intensive care units, babies kept alive in incubators and others dependent on life-saving machines are all at risk.
“Patients are being stacked outside the operating rooms because we don’t have enough beds,” he said. Meanwhile, others recovering from operations have been moved to the outdoor tents – “a kind of field hospital,” he explained.
But Abu Zaher also stressed that recovery for treated patients is not guaranteed as the crowded environment and lack of medical facilities can lead to serious infections.
“Disease outbreaks are inevitable,” he said. “There will be a humanitarian disaster after the war is over.”
Hajj Salah al-Din Ahmed Suleiman Abu Iyadeh, 61, a dialysis patient, says if the war continues for a long time, patients like him will suffer immensely (Ashraf Amra/Al Jazeera)
‘Exhausted from this reality’
Manar Shreir from Gaza City’s Zeitoun neighborhood used to go to Al-Quds Hospital for kidney dialysis.
She and her family fled the intense Israeli bombardment of the city and made their way to Deir el-Balah in the central Gaza Strip, where her sister lives, after the Israeli army ordered 1.1 million Palestinians from the north to evacuate to the south .
So does Al-Quds Hospital receive alerts of the Israeli army to evacuate, indicating it could be targeted, the Palestinian Red Crescent said. The hospital’s director responded to the Israeli army, saying that a large-scale evacuation would only be possible if Israel provided buses to transport the 12,000 people seeking shelter in Al-Quds – including patients – to the southern Gaza Strip and to provide a safe place there. . The Israeli official allegedly hung up.
But even those like Shreir, who have managed to reach the south, are struggling to get treatment.
“My sister’s house (in Deir el-Balah) is close to Al Aqsa Martyrs Hospital, but I still have to queue for hours since early morning, waiting for my turn,” Shreir said as she sat up in a hospital bed with a red blanket around her legs.
Manar Shreir has been on dialysis since 2015 and was forced to flee her home in Gaza City (Ashraf Amra/Al Jazeera)
Shreir has been on dialysis since 2015 and goes to the hospital three times a week for four-hour sessions. Now she is lucky if she can receive dialysis twice a week, up to two and a half hours per session.
“It’s a huge difference,” she said. “The session is barely enough to get the toxins and built-up fluids out of my blood. I have to watch what I eat and drink, and I hardly let water pass my lips because I don’t want to have shortness of breath or swelling.”
After her last treatment, Shreir was on her way back to her sister’s house when Israeli airstrikes hit the street parallel to the one she was on.
“It’s terrifying,” she said. “Even when you’re in the hospital, you’re scared. Windows have been shattered before, the destruction is all around you, not to mention the horrific sound of the bombs. Things aren’t much better inside, with bodies of dead people piled up, blood on the floor and people missing limbs.
“We are exhausted from this reality. Enough crime, enough war.”
Hospitals in Gaza are operating at maximum capacity and the territory’s healthcare system has collapsed, the Health Ministry says (Ashraf Amra/Al Jazeera)
‘Not enough’
Hajj Salah al-Din Ahmed Suleiman Abu Iyadeh, 61, a displaced patient from Gaza City who is undergoing dialysis at Al Aqsa Martyrs Hospital, said that without regular treatment, patients will suffer from severe fatigue and swelling.
“Two and a half hours of dialysis, once or twice a week, is not enough,” he said.
“These are toxins in the body that should not remain. At the moment we are making do, but if this war continues there will be serious problems due to the capacity and enormous pressure the hospital is under.”
According to the Health Ministry, Israeli airstrikes killed 5,791 Palestinians in 18 days, including 2,360 children and 1,292 women. More than 16,000 others have been injured.
According to the Ministry of Health, about 1,500 people are trapped under the rubble, including 830 children.
Before October 7, hospitals in the Gaza Strip provided 13,000 dialysis sessions per month for patients with kidney failure (Ashraf Amra/Al Jazeera)
Al Aqsa Martyrs’ Hospital alone has received 2,850 wounded people and the bodies of nearly 1,000 Palestinians, Abu Zaher said.
“Most of the victims are men, women and children who died in their own homes after an Israeli airstrike hit their building,” he said.
The hospital staff is under constant, enormous pressure due to the overwhelming health situation and personal circumstances.
“Some of our employees have received news that their families were targeted or killed in Israeli airstrikes,” he said. “No hospital in the world works like this.”