[Salon] 'Every Day, We're Forced to Choose Who Gets Treatment': Malnutrition Cases Outpace Gaza's Health System




'Every Day, We're Forced to Choose Who Gets Treatment': Malnutrition Cases Outpace Gaza's Health System - Palestinians - Haaretz.com

Nagham ZbeedatAug 24, 2025 
Palestinian doctor Ahmed Basal examines a child for malnutrition at Al-Rantisi Hospital in Gaza City, earlier this month.

Abu Walid was walking back home with his 13-year-old daughter Reem after visiting his brother's house when she began to complain of fatigue. Step after step, her voice grew weaker until she suddenly collapsed on the road, unconscious for hours. 

Terrified, the father of six carried her to the nearest hospital. Doctors ran tests, and the results came back clear: Reem had no illness. Instead, Abu Walid was told what he had feared but never imagined would touch his daughter so soon: She was suffering from malnutrition.

"We don't have enough doctors," Abu Walid says. "Some have been killed, others were detained by the Israeli army and some have left Gaza. The number of doctors remaining is far too few – they are barely able to cope with the wounded and injured from the bombings. Cases of malnutrition are not being prioritized."

Soon after, Reem's twin brother Karim was also diagnosed with malnutrition. Both children now struggle with constant fatigue and weakness, their growth stunted by a lack of proper food. But Abu Walid's family is far from unique. 

Doctors say cases of malnutrition have surged in recent months, with more and more children arriving dehydrated, underweight and too weak to carry out daily activities, like fetching water, bringing food from charity kitchens and NGOs, or even playing with other kids.

We ask 'Is the patient awake? Can they swallow?' If yes, we give them oral medicine and save the IV drugs for those who can't. Some patients risk their lives by swallowing when they can't, just to save the IV for others. 

Rawan, a 24-year-old pharmacist
A malnourished Palestinian child getting a check-up from a medical NGO in a makeshift clinic in Al-Mawasi last week.

A malnourished Palestinian child getting a check-up from a medical NGO in a makeshift clinic in Al-Mawasi last week.Credit: AFP

On Friday, The United Nations' expert body on food security released a report which found that over half a million people in the Gaza Strip are suffering from famine. In July, the amount of children admitted to hospitals due to acute malnutrition increased 275 percent, compared to the first six months of the year, according to the UN Office for the Coordination of Humanitarian Affairs. Yet being admitted to a hospital and receiving treatment is far from guaranteed. 

Seven-year-old Baraa, who suffers from the congenital brain condition Dandy-Walker Syndrome, was displaced from northern Gaza and now lives in a tent on the Gaza Citybeach. His condition has worsened without protection from the weather, and without access to medications necessary to keep him alive. 

Several organizations and hospitals have turned down Baraa. "They refused to accept him, because he is over five years old," says Mohammad Shabaan, Baraa's uncle, "age became the condition for treatment, even though his case is a matter of life and death." According to the uncle, the organizations and hospitals are prioritizing younger children, denying assistance, supplements or food supplies from kids over five, who are rejected or put on a waiting list.

Seven-year-old Baraa in Gaza City this week.

Seven-year-old Baraa in Gaza City this week.Credit: Mohammed Shabaan

Baraa cannot see, move, chew or control his muscles. "Before the war, Baraa weighed about 14 or 15 kilos," Shaaban explains. "Now, because of malnutrition and the lack of medicine, he weighs only 8 or 9."

Once known for its resilient healthcare system despite years of blockade, Gaza's hospitals have been overwhelmed, under-equipped and unable to meet even the most basic medical needs since December 2024. Power outages cut lifesaving machines mid-operation. Shelves in pharmacies stand empty. Patients line the corridors, waiting for care that may never come.

Healthcare workers – pharmacists, doctors, and nurses – are struggling to keep the system alive. Many have not received regular salaries in months, yet continue to volunteer. "Every day, we are forced to choose who receives treatment and who must wait," one pharmacist who volunteers in Al-Aqsa Hospital in Deir al-Balah told Haaretz. "This is not medicine. This is survival."

Beds standing in water after Nasser Hospital's field ER was flooded with sewage water last week in Khan Yunis.

Beds standing in water after Nasser Hospital's field ER was flooded with sewage water last week in Khan Yunis.Credit: Hussam Al-Masri/Reuters

As blockade intensifies, malnutrition rises 

Speaking to Haaretz from France, Dr. Jean-François Corty, the president of Médecins du Monde, describes the medical system as being "on the verge of collapse." The humanitarian NGO has operated in Gaza for more than 20 years, providing primary care consultations, runs malnutrition and mental health programs, and offers sexual and reproductive health services across Gaza. Médecins du Monde shut down its services in Rafah in July and may soon have to suspend operations in Gaza City due to the IDF's impending takeover.

To keep up with patient demands, the NGO recruited volunteers inside Gaza to assist doctors and nurses, since bureaucratic complications imposed by Israel limit the entry of foreign healthcare workers into the Strip. The NGO has also struggled to obtain medications and supplies, as it has only received authorization to bring four aid trucks into Gaza throughout 22 months of war, according to Corty.

Between July 2024 and April 2025, the organization conducted a large-scale survey on a cohort of around 15,000 children treated in its centers. The results, according to the French doctor, clearly demonstrate "a strong link between the rise in malnutrition and the intensity of the blockade."

Children waiting to receive food from a charity kitchen in Khan Yunis earlier today.

Children waiting to receive food from a charity kitchen in Khan Yunis earlier today.Credit: Hatem Khaled/Reuters

He explains that before October 2023, the rate of malnutrition among children aged six months to five years in Gaza was relatively low, "something like 0.5 to 0.8 percent." But after the escalation of the war and tightening of restrictions, the numbers skyrocketed. "In October and November, when the blockade was the strongest, we showed that the malnutrition rate was around 20 percent – not only for children, but also for pregnant women and mothers who were breastfeeding," he says.

During a short cease-fire in early 2025, when food deliveries briefly increased, the rate of malnutrition dropped by 2 to 3 percent. "But by April, as restrictions tightened again, it went back up to around 20 percent," he noted. The latest data from June showed malnutrition affecting "about 15 percent of children and 20 percent of pregnant women" in their patient cohort.

Even minor infections like diarrhea can kill a child who is malnourished. And because of insecurity, vaccination campaigns cannot reach most children, so they are more exposed to illnesses like meningitis.

Dr. Jean-François Corty

Despite Israel's rejection of famine statistics from the Strip and its insistence that reports of starvation are part of Hamas propaganda, for the doctor, the conclusion is unavoidable: "Malnutrition in Gaza is not caused by bad weather or natural disaster. All the capacity for producing food and clean water has been destroyed. Humanitarian aid is strictly limited. This malnutrition is deliberate – it is created by Israeli authorities as a weapon."

Hamada Al-Kilani, 18, who was shot in the abdomen by an Israeli tank, receiving treatment at Gaza City's Shifa Hospital last week, where doctors say he is also showing signs of malnutrition.

Hamada Al-Kilani, 18, who was shot in the abdomen by an Israeli tank, receiving treatment at Gaza City's Shifa Hospital last week, where doctors say he is also showing signs of malnutrition.Credit: Abdel Kareem Hana/AP 

He describes the consequences as devastating. "When you have malnutrition, you are more sensitive to every small disease. Even minor infections like diarrhea can kill a child who is malnourished. And because of insecurity, vaccination campaigns cannot reach most children, so they are more exposed to illnesses like meningitis," he says. "The more malnutrition spreads, the more children will die."

Pregnant women and breastfeeding mothers face similar dangers. "They are extremely vulnerable, and we already know that some have begun to die from malnutrition," he warns. 

Corty says that the staff themselves are suffering from dual responsibilities: to care for their patients, and to "secure their own families and their own lives." Some of them survive on one single lunch a day, while others don't eat anything at all. "Even if we try to help them by sending money, it's hard to find food," he says.

Patients waiting in a maternity clinic at Nasser Hospital in Khan Yunis on Sunday. Pregnant women are "extremely vulnerable" to developing malnutrition, says Dr. Jean-François Corty.

Patients waiting in a maternity clinic at Nasser Hospital in Khan Yunis on Sunday. Pregnant women are "extremely vulnerable" to developing malnutrition, says Dr. Jean-François Corty.Credit: AFP

'It's catastrophic'

Among those trying to keep Gaza's fragile healthcare system alive is Rawan, a 24-year-old pharmacist from Deir al-Balah, who graduated during the war. After completing her six-month training, she chose to volunteer for another six months at Al-Aqsa and Nasser hospitals – institutions that have been stretched to their limits since the war began.

Inside the hospital, Rawan says, the situation is unbearable on every level. "The wards are full of displaced families, and many of them are sick themselves," she explains. "The hospital is small, so patients lie in the corridors. Rooms meant for one or two now hold four, and the rest are outside. Amputees are given space in rooms." Rawan adds that while there are no cases that qualify as "minor injuries," others with "less severe wounds are left in the hallways."

Hygiene has collapsed. "It's not because we're not clean. Before the war, the hospital shone," she says. "But now there's blood everywhere, no cleaning supplies and too many people. The cleaners are doing their best, but the situation is bigger than all of us."

An injured boy lying on the floor as he waits for treatment at Al-Shifa Hospital in Gaza City last month.

An injured boy lying on the floor as he waits for treatment at Al-Shifa Hospital in Gaza City last month.Credit: Jehad Alshrafi/AP 

And then there is the shortage of medicine. "It's catastrophic," Rawan says bluntly. "We try to substitute drugs, combine alternatives and do whatever we can, but it's not enough."

The worst shortage is in IV medications, like paracetamol, metronidazole and omeprazole. Most patients can't swallow pills, so they need IV, but it's nearly impossible to provide, according to Rawan. "We end up calling the wards: Is the patient awake? Can they swallow? If yes, we give them oral medicine and save the IV drugs for those who can't. Some patients even risk their lives by swallowing when they can't, just to save the IV for others. The situation is truly disastrous."

Yet, the hardest part of working inside a hospital is not the endless hours or the shortage of medicine, but the constant fear of the unknown, according to Rawan.

An orderly resting in an operation room at Nasser Medical Complex in Khan Yunis earlier this month.

An orderly resting in an operation room at Nasser Medical Complex in Khan Yunis earlier this month.Credit: AFP

"The worst thing that could happen for someone who works at the hospital is the disconnection from what is happening outside," she says. "You live with the fear of something happening to your family, or the fear of suddenly seeing someone close to you brought into the emergency room, killed or injured, without even knowing they had been hurt."

She found herself in that exact situation last year. "I went back home after a shift, exhausted and tired – all I wanted to do was sleep – but I got a phone call that my brother-in-law was injured by a bullet to his head."

Her brother-in-law was displaced to Rafah at that time, thus she couldn't reach him physically, but she reached out to his medical staff. "I asked them about his condition, but he didn't make it. He died and I'm devastated that I wasn't there to help even if it was just mixing medicine for him."



This archive was generated by a fusion of Pipermail (Mailman edition) and MHonArc.