Gaza's Collapsing Health System Leaves Thousands Without Vital Care

On the dialysis ward at al-Shifa Hospital in Gaza City, the machines never stop. They run through the day and into the night, filtering blood for patients who will die without them. Ruwaa Muntasir Abdul Karim, fourteen years old, sits in one of the chairs with a medical tube running from her arm. She is small for her age, dwarfed by the rows of other patients arranged so close together that the room feels like a single organism of need. Her father Muntasir sits beside her, watching the vital signs on the monitor, watching his daughter's body do the work that her kidneys can no longer do.

Ruwaa was not always this way. She used to walk and play. Then came the surgeries, then the dialysis, and now her life is measured in sessions—three per week before, two per week now. Her weight has fallen from sixty-five kilograms to thirty-five. The only real solution, a kidney transplant, sits just out of reach. Her mother is a match. The tests are ready. But the transplant cannot happen in Gaza, and Israel, which controls all movement out of the territory, has not approved her exit for six months. So she waits, and the dialysis machines keep running.

The machines themselves are failing. According to the Palestinian Ministry of Health, half of Gaza's dialysis equipment has stopped working entirely due to a shortage of sodium bicarbonate, the chemical required to operate them. The number of hospitals equipped to treat kidney failure has collapsed from seven to four. One facility, the Noura al-Kaabi Dialysis Centre, was destroyed by Israeli forces during the war. At Al-Aqsa Hospital in central Gaza, the head of the kidney department, Osama Abu Rahma, oversees fifty-one dialysis machines. Twenty-five of them are completely out of service. He treats two hundred and forty patients, but he has been forced to reduce both how many sessions each person receives each week and how long each session lasts. The medical consequences are visible: general weakness, shortness of breath, heart and lung problems, dangerously high potassium levels in the blood. The numbers tell the story more starkly. Before the war, there were twelve hundred kidney failure patients in Gaza. Now there are about seven hundred. More than four hundred and seventy have died—not from the disease itself, but from missed dialysis sessions and lack of essential medications.

The collapse of Gaza's health system extends far beyond dialysis. The war has left more than forty-three thousand people with what the World Health Organization calls life-changing injuries. Thousands of these are severe limb injuries that resulted in amputations. Between five thousand and six thousand people have lost limbs. Most of them are still waiting for prosthetics. In Khan Younis, physiotherapist Aya al-Shaltouni works in a system where demand for wheelchairs, crutches, and prosthetic limbs vastly exceeds supply. Many patients wait for months and receive nothing. Without these tools, rehabilitation becomes nearly impossible. A patient cannot recover to any form of independent life if they cannot move. Zaki Jumaa Salem Abu Harb, a sixty-year-old farmer from northern Gaza, lost a leg in an Israeli attack in March 2025. For months he waited. Recently he received a prosthetic limb—a major development for him, but he is acutely aware that thousands of others, including children, are still waiting, some resorting to tree trunks or pieces of wood to move around.

Beneath the physical injuries lies a psychological catastrophe that the healthcare system is barely equipped to acknowledge. Hadeel, twenty-two years old, lives in a tent on the outskirts of al-Aqsa Hospital. She spends her days caring for her seven younger siblings, securing their needs, trying to maintain some version of life. At the beginning of the war, her family fled a bombing in chaos and panic. She remembers the sound of children and women screaming. She remembers her mother buried under rubble, only her fingers visible, neighbors pulling her out. That image never left her. While her mother recovered, Hadeel became the eldest daughter responsible for everything—grief and endurance mixed together, responsibilities that never stop. Some days she feels depressed. Other days she simply continues. She suffers from emotional exhaustion, from recurring memories of bombardment, from the loss of safety.

Her story is one among millions. According to Asil Abu Shaweesh, a twenty-seven-year-old psychologist working in central Gaza, the mental health crisis is widespread and will only deepen. The war, repeated displacement, loss of loved ones, destruction of homes—these are the conditions that create the need for psychological support. Abu Shaweesh has observed depression, anxiety, post-traumatic stress disorder, insomnia, and panic attacks across the population. Among children, the symptoms include bedwetting, aggressive behavior, difficulty concentrating, recurring nightmares, and excessive attachment to caregivers. The mental health workers themselves face constant psychological pressure, lack of safety, high demand, shortage of resources, and difficulty reaching patients. Yet they continue, stretched thin, because they know how essential their work is.

Gaza's healthcare system is not simply struggling. It is collapsing under the weight of a catastrophe that has no end in sight. Dialysis patients die waiting for machines that do not work. Amputees wait for prosthetics that do not arrive. Trauma survivors wait for psychological support that cannot be provided. The system was never designed to absorb this much damage, this much loss, this much need. What remains is a territory where the most basic medical care has become a luxury, and survival itself has become uncertain.