No helium to operate MRI machines. No antibiotics to treat infected wounds.
No room in surgery for general medical conditions, and no new tyres for ambulances wrecked by driving through Gaza’s bombed streets.
This is the lot of the 19 hospitals still functioning – most only partially – in the devastated enclave where they serve a war zone with 2.1 million people that has received no significant medical aid for almost three months.
The severe depletion of life-saving medical items in Gaza comes as Israel’s offensive floods hospitals with casualties, their bodies torn and burned by bombs and often also crushed by the rubble of their collapsed homes.
“There are countless examples of lives that could have been saved but were lost because of shortages, or because they could not be evacuated for treatment abroad,” said Allam Nayef, head of intensive care and anaesthesiologist at a field hospital in Deir al-Balah, central Gaza run by the health ministry and MSF, the international medical charity.
Infection is a major risk. “Bacteria have become like monsters” in Gaza’s hospitals, he said.
One patient was injured so badly his feet had to be amputated, but 2½ months later Nayef found himself anaesthetising the same patient again: his wounds were infected and doctors could only save his life with a fresh amputation, this time above the knees.
Gaza’s hospitals have plunged further into crisis since Israel resumed its offensive on March 18th after breaking a two-month ceasefire. Local health authorities say more than 3,700 Palestinians have been killed and about 11,000 injured since then.
Israel has laid full siege to the territory since March 2nd, preventing all aid deliveries and pushing the population to the brink of famine. In recent days it has allowed limited humanitarian aid to enter, but UN officials have described this as a “drop in the ocean” compared with the need.
[ In pictures: Many in Gaza face malnutrition as blockade enters third monthOpens in new window ]
During the ceasefire, medical supplies had surged into the enclave, and the World Health Organisation built up stocks in warehouses and hospitals. But doctors say crucial items have now run out or become so depleted that their use is severely rationed.
Trauma doctors must resort to inadequate workarounds to try to save lives, while the lack of supplies is causing needless deaths and greater pain for those who survive.
“If someone needs 20 tablets of antibiotics, we give them four,” said Raafat al-Majdalawi, director general of the Al-Awda Health and Community Association, which operates two hospitals in the strip.
One of them, Al-Awda hospital, the last functioning medical facility in northern Gaza, was evacuated of all staff and patients on Thursday evening on orders from the Israeli military, according to the UK charity Medical Aid for Palestinians, citing hospital director Mohamed Salha.
The hospital had been encircled by Israeli troops and repeatedly shelled this month. “Inpatients still needed care,” Salha said. “However, the shelling continued and directly targeted the hospital, leaving us with no choice.”
In the hospitals still operating, doctors are severely limited in their ability to help patients.
“There is no scope to prescribe all that an injured patient needs,” said Taisir al-Tanna, a vascular surgeon at Al-Ahli hospital in North Gaza. “I am restricted by what can be found here.”
The hospital was forced to close for weeks after Israeli air strikes in mid-April destroyed the emergency ward.
It has since reopened, but Tanna, who carries out up to a dozen surgeries each day, said he lacked crucial materials such as artificial blood vessels to replace damaged arteries; correctly sized sutures for vascular repair; and specialised catheters to remove blood clots during surgical procedures.
This month Tanna operated on a 26-year-old bombing victim with a gash in his abdomen that severed a main artery supplying blood to the lower limbs.
No artificial blood vessels were available so he used a surgical plastic tube, known as a shunt, hoping that within 48 hours an artificial vessel could be found.
“We couldn’t get one, and a foot turned gangrenous, so we had to amputate it,” said Tanna.
In the absence of many kinds of antibiotics and disinfectants, and with the injured packed into overcrowded wards, post-operative infection is a major scourge, said Nayef.
One cause of infection, he said, was the use of external fixators — long pins piercing the skin attached to a metal frame outside the body that are used to hold broken bones together.
They carry a bigger risk of contamination than other methods of setting bones, but doctors have to rely on them because of a shortage of screws and plates used for internal fixation.
The lack of a functioning MRI machine has cost yet more lives, said Nayef. He and other doctors could not intervene to save the 20-year-old son of a colleague whose neck was wounded by shrapnel.
“He had a lentil-sized hole, and it appeared his spinal cord had been injured,” said Nayef. “We needed an MRI scan to assess the damage so we could treat him or try to evacuate him from Gaza.”
The injury affected an area in the spinal cord that controlled breathing, said Nayef. The man remained on a ventilator suffering lung infections until he died.
Nayef himself, like most Palestinians in Gaza, has been displaced multiple times. Until he moved to Deir al-Balah this month, he worked in the Gaza European hospital in Khan Younis, but it closed on May 13th after a series of Israeli strikes.
That meant the loss of another 25 emergency beds, Nayef said. Israel said it was targeting Mohammad Sinwar, the Hamas chief in Gaza, at the hospital. It has subsequently said Sinwar was killed.
The WHO said this month that 94 per cent of all hospitals in Gaza had been “damaged or destroyed”. Some 18 non-profits working in the strip, including Oxfam and Medical Aid for Palestinians, on Wednesday said the attacks on hospitals “violate international humanitarian law and are part of the systematic dismantling of Gaza’s already fragile health system”.
“All we do now is war medicine, to try to save a life or save a limb,” said Nayef. “There is no scope for scheduled operations and for most reconstructive surgery.
“If we get a mass casualty event, we have to start with those most likely to survive, and by the end we will have lost two or three of the others.”
Victoria Rose, a UK plastic surgeon volunteering at the Nasser Medical complex in Khan Younis, described the situation there as “absolutely dire” as doctors struggled to treat “more and more” casualties.
“We are running out of basic things like blades for scalpels, gloves, gauze and solutions to clean the skin with,” she said.
Patients’ recovery is being badly delayed by another factor: malnutrition.
Starvation is creeping through the enclave as food stocks dwindle.
Patients “don’t have the vital nutrients, vitamins and minerals that they need to heal”, said Rose.
Ahmad al-Farra, head of paediatrics at the same hospital, said this was the war’s most critical period. “There is starvation, fear, and people are being forced to evacuate from place to place,” he said.
“In two or three weeks, no vaccines will be available to give to any child. All the diseases that are preventable will come back.”– Copyright The Financial Times Limited 2025
