Standing in front of the almost bare shelves of his Nejma pharmacy in the town of Rafah, Hammam Ali reeled off all the illnesses for which he said there were no medicines in the Gaza strip. These include common conditions such as asthma, diabetes, hypertension and heart disease.
There were no antibiotics, he said, neither were there liquid medicines for young children and drugs to treat viral infections and high fevers. “Within a month after the start of the war on October 7, all essential drugs and their known alternatives became unavailable in Gaza,” said Ali.
He recounted how a man had come into his pharmacy the day before he spoke to the Financial Times, asking for epilepsy medication for his four children, but Ali had nothing to give him. The father was so distraught he “appeared to be about to lose his mind”, said the pharmacist who “felt helpless” every day as desperate people walked into his shop looking for medicine, but he could not supply it.
The health system in Gaza has nearly collapsed since the start of Israel’s offensive in the territory, aid agencies have warned. Only 14 out of 36 hospitals are still open. Those still functioning are overwhelmed and offer only a partial service, according to the World Health Organization.
Medical supplies, from anaesthesia to everyday basic drugs, are scarce. On average just over 100 trucks carrying humanitarian supplies enter Gaza every day compared with 500 before the war, said UN officials.
“Like other kinds of humanitarian supplies, medicines do not enter Gaza in sufficient quantities to meet the need,” said the International Committee of the Red Cross in Gaza.
“Hospitals are in constant need of supplies, like medicines used during surgery and drugs for burns. There is also a shortage of cancer therapies and antibiotics. Unfortunately, people with chronic conditions find it difficult to secure medicine,” added ICRC.
It said ICRC doctors on missions in the territory have heard from Palestinian colleagues that they have had to carry out amputations without anaesthesia.
Israel’s offensive has killed more than 27,000 people, according to Palestinian health officials. It has also forced more than 75 per cent of the 2.3mn population to flee their homes. The Jewish state launched its military campaign in response to Hamas-led attacks in southern Israel on October 7 that killed 1,200 people, according to government figures.
Rafah, on the border with Egypt, has been swollen with more than 1mn displaced people, many of them living in tents on streets that turn muddy when it rains. The lack of medicines had added to the misery of daily life in unsanitary conditions for people weakened by hunger, said aid officials.
The WHO warned in December that a “lethal combination of hunger and diseases” would lead to more deaths in Gaza. “Malnutrition increases the risk of children dying from illnesses like diarrhoea, pneumonia and measles, especially in a setting where they lack access to life-saving health services,” it said.
Raeda Awad, 50, displaced with dozens of relatives from the centre of Gaza and now living in a tent, complained that children in her family were constantly sick with coughs, stomach bugs and other ailments but there were no drugs. Herself a diabetic, she has had no access to insulin since she came to Rafah a month ago, she said.
“I was told I could use tablets until insulin became available,” said Awad. “But I have also run out of tablets and my son goes out every day trying to look for them, but to no avail.”
Alaa Mahmoud was displaced from Khan Younis, the southern city viewed by Israel as a Hamas stronghold, which has been the scene of fierce fighting for weeks. He has been struggling to find an inhaler for his asthmatic 70-year-old mother.
“She has already had several asthma attacks,” he said, including one that required taking her on a donkey cart under bombardment to hospital in Khan Younis. “Death surrounds us from every side, whether it is through shelling, diseases, hunger or the cold,” said Mahmoud.
Gaza is already experiencing soaring rates of infectious diseases, according to the WHO. These include diarrhoea, upper respiratory infections and “numerous cases of meningitis, skin rashes, scabies, lice and chickenpox”. There have also been outbreaks of Hepatitis A and jaundice because of unsanitary conditions.
In the absence of adequate medical treatment, some in Rafah are trying to get sick relatives out via the border crossing with Egypt. But this is a slow process requiring Israel’s agreement to the exit of patients and their accompanying family members.
Ghada Sakhr has been hoping to get her 20-year-old sister Hadeel out because they no longer have access to the kidney dialysis sessions she has needed three times a week since childhood. “She hasn’t had a session for 10 days and I am dying of worry we will lose her,” said Sakhr. “She is in a bad way and we have been trying to take her out, but it is difficult.”
Similarly, Mahmoud al-Belbesiy wants to take his mother out of Gaza for bone cancer treatment. She used to be able to go to a hospital in the West Bank, but since the start of the war, she has been trapped in Gaza with no access to medication.
“I took her five days ago to a hospital in Rafah because she was screaming with pain,” said al-Belbeisiy. “They could only give her painkillers but they told us the cancer had spread to her liver and digestive system. She has been on a list to leave since the start of the war, but nothing yet.”
