Palestinians with disabilities face a double crisis in Gaza as Israel's genocide and displacement push their limits of survival

At the UK screening of Voice Notes from Palestine, the emotional weight of the film was almost unbearable. The 12-minute documentary offers a glimpse into the lives of students with disabilities from the Islamic University of Gaza, trying to survive Israel’s onslaught.

There is a moment in the film when the streets are chaotic, filled with families fleeing with whatever they can carry, and Shireen Salama, a 38-year-old media and communications graduate who is blind, describes her worst fear.

"The thing that scared me the most was that I would lose my mother’s hand and get lost in the crowd," she says.

It is in that moment that the realisation hits: how terrifying it must be to face an already frightening situation like displacement, without sight, mobility, or the ability to protect oneself.

The story then turns to Abdulrahman Al-Gharbawi, a 27-year-old graphic design and web development graduate with cerebral palsy and lower-limb disability.

After being trapped with his family for 13 days – surrounded by Israeli forces, surviving on only dates and lemons, with no bedding in the winter cold – they were finally able to flee. Across demolished streets, his mother carried his wheelchair, and his cousin carried him.

"My cousin carried me over the rubble, over the electricity cables and dead bodies," he says.

Abdulrahman has been displaced nine times since then. He lost both his walker and wheelchair and is now effectively housebound in an almost completely destroyed home.

"We live crammed into two rooms under terrible conditions," he says. "My condition has worsened a lot due to the lack of clean drinking water and healthy food, and I bathe using a bucket and a plastic container."

For anyone in Gaza, forced expulsion, relentless bombardment, and starvation are deeply traumatic. But for disabled Palestinians, it is a double assault – inaccessible evacuation alerts, unsafe routes, lost assistive devices, no specialist care, reduced access to food and essentials, and deteriorating health.

Some cannot even flee, while others might become separated from caregivers. This is survival against the odds.

Collapsed rehabilitation system

Before the war, 58,000 people in Gaza lived with a disability. As of July 2024, the World Health Organisation (WHO) estimated that 22,500 more had acquired a life-changing injury, including limb amputations, spinal cord damage, traumatic brain injuries, and major burns, putting even more at risk of death or further harm.

Gaza’s borders remain sealed, there are no safe evacuation zones, and Israeli forces have damaged or destroyed at least 94% of all hospitals in the Gaza Strip. So, how do people with disabilities flee, find safety, or get the medical care they need?

Dr Itab Shuayb, a professor of inclusive design, senior researcher, and director for the Disability Hub at the Centre for Lebanese Studies, co-investigator in the Disability Under Siege network at the University of Birmingham, and associate producer on the film, highlights the UN’s failure to enforce its articles adopted by the Committee on the Rights of Persons with Disabilities in 2006.

"It’s so sad. Articles 11 and 25 specifically mandate the protection, safety, and healthcare of persons with disabilities – especially in situations of risk like armed conflict and humanitarian emergencies," she says.

She adds, "Yet, people with disabilities are the most vulnerable – and the most overlooked. Their needs are rarely included in emergency preparedness plans."

Dr Itab also notes: "Documenting these harsh realities is essential – not just for enforcing international laws but for holding the occupying power accountable."

Despite UN Committee statements expressing concern for the safety of disabled people, it still begs the question: why does the UN lack the power and authority to enforce its international laws?

Gaza’s decimated healthcare system – crippled by mass casualties, damaged infrastructure, displaced, detained or killed medical staff, and severe supply shortages – is making life infinitely worse for disabled people and thousands of newly disabled individuals.

"Tragically, much of the rehabilitation workforce in Gaza is now displaced," says the WHO, with an estimated 20% of Gaza’s physiotherapy workforce killed.

Furthermore, the Israeli blockade of medical aid since it broke the ceasefire on 18 March has worsened the situation further. The WHO warns of "vast, unmet rehabilitation needs."

The backlog of people needing care now and waiting for assistive devices is enormous.

"About 70% of people with disabilities have been delayed in accessing rehabilitation services for three months or more," says Loai Abu Saif, Disability Inclusion Programme Lead at Medical Aid for Palestinians (MAP).

"If these restrictions continue, the conditions will be challenging and will continue to put their lives at risk of death," he adds.

According to UNICEF, around 10,000 children are living with hearing loss – about 5,000 of those with severe impairments caused by war injuries and under-resourced medical services.

The Atfaluna Society for Deaf Children found that 95% of people with disabilities reported no access to medical care, and 83% had lost essential assistive devices. Its school for deaf and disabled children was attacked by Israeli forces in March 2024.

With this in mind, it's hard to comprehend how these atrocities are an act of self-defence.

Gaza’s health ministry has stated that around 1,500 people have lost their eyesight since the start of the war, with 4,000 others at risk of losing it due to the collapse of ophthalmic services.

Dr Tanya Haj-Hassan, a paediatric intensive care doctor recently back from Gaza, has witnessed this firsthand.

"Many people are losing their vision, their hearing. I treated several children who had lost theirs. A paramedic who we know desperately needed a hearing aid, and it was impossible to get one inside Gaza," she says.

British physiotherapist Rachael Moses, who spent a month this year working with hospital rehabilitation teams at Nasser Medical Complex, Khan Younis with MAP, affirms this.

"There are thousands of assistive devices on the border – wheelchairs and crutches and even batteries to power hearing aids – but they aren’t allowed in," she says.

The consequences are grave. For those with hearing loss, deafness, speech impairments, or learning difficulties, they cannot call out to rescue teams if an airstrike hits their area or hear calls to evacuate.

Meanwhile, conditions like cerebral palsy, Parkinson’s disease, strokes, multiple sclerosis, asthma, and diabetes – part of any population – are going untreated, causing disabling effects.

"These conditions are manageable with the right pharmacology," says Rachael. "But the denial of medications is just another form of weaponisation."

People with disabilities are “disproportionately affected by secondary effects of war," she notes. "That includes everything from health, hygiene, dignity, and sexual violence."

The repercussions can be deadly as families struggle to evacuate members who are less mobile. "Families with members who can’t be carried easily, or with cognitive impairments or dementia, are having to stay put, even if evacuation orders come."

Faced with insufficient supplies, the remaining surgeons, physiotherapists, and occupational therapists are forced into makeshift solutions to fill critical gaps.

"The Doctors Without Borders (Médecins Sans Frontières) physiotherapy team hired a carpenter to make wooden crutches and a tailor to make pressure dressings for burns from Lycra because we have none getting in," says Rachael.

Occupational therapists are making bespoke devices to support hand function in the early stages of rehabilitation.

“If you lose your hand function, the rest of your limb is pretty much unfunctional," she says.

But for patients needing more complex postoperative rehabilitation, the outcomes are poorer.

"The children I’ve seen very, very rarely have just one single limb loss. They’ll have burns, extensive shrapnel injury, or peripheral nerve injury too – secondary injuries that can be just as disfiguring and life-changing. Gunshot wounds, not just blasts, cause some amputations," she says.

"Complex injuries require speech and language therapy, nutritional support, occupational therapy, and psychological care – and that’s not possible,” she adds. “There is just no infrastructure.”

The result? "A lot of people die from complications," she says.

Dr Haj-Hassan recalls the case of a girl who lost much of her pelvis.

"She needed several reconstructive surgeries to have a decent quality of life. She died,” she says.

To treat burns, she explains that usually multiple surgical procedures are needed for long-term recovery. “[Otherwise] they can cause disfiguring and lasting disabilities from contractures that severely compromise functions like eating, talking, blinking, and using your hands and feet.”

"This kind of intense therapy is impossible. The Israeli military has destroyed the rehabilitation centres that existed in Gaza,” she says.

The destruction of the Rehabilitation and Prosthetic Limbs Hospital has left thousands of amputees without care. Gaza’s only cancer hospital was demolished, and no medical facilities now operate in North Gaza.

Compounded fears

All four disabled students who contributed to Voice Notes from Palestine fear getting injured or acquiring another disability.

"Things are incredibly hard even for healthy people – so it’s beyond impossible for someone like me with special needs,” says Abdulrahman, who hopes to continue his Master’s studies in the UK.

“Moving around in unfamiliar places is very difficult, if not impossible,” says Shireen, who lost her white cane and sunglasses.

Her family, displaced twice within Gaza, where her grandparents settled after they were expelled from their land by the newly formed Israel in 1948, faces countless hardships.

Displacement orders dropped on leaflets are inaccessible to visually impaired people, and “the streets are completely destroyed and pockmarked by rockets,” she says, making evacuation for people like her nearly impossible.

Now her hopes are simple: a full meal, something she hasn’t had in 18 months, clean drinking water, or a bath – “to relieve the fatigue, pain, loss, and suffering.” Beyond that, she hopes to study abroad.

Israel’s destruction of all infrastructure has left people with no access to essential services: 89% of Gaza’s water, sanitation, and hygiene systems have been damaged or destroyed, including water desalination and sewage treatment plants. Electricity is scarce, and most people must travel long distances to charge their phones.

"Our lives revolve around walking, and I can’t walk long distances,” says one student with a short stature disability, who has been displaced around 30 times, and wishes to remain anonymous.

Now living in a tent, she describes her environment as “suffocating and uncomfortable,” with scarce access to water and other essential needs.

"We feel dizzy and suffer from malnutrition. There’s no food or clothing, and we are in urgent need of medicine,” she adds. “Before this, we lived in safety and security.”

Life without the internet, mobility, or privacy is the new reality for many.

“The house is now filled with displaced people other than my family,” says Shireen, who also lives in a partially bombed building lacking basic necessities like electricity or water.

"Despite the harsh conditions, I try to maintain independence," says Imad Ahmad Qudaih, a 22-year-old blind graduate in English Language Translation. After being forcibly displaced more than 10 times, he now lives in a tent in the overcrowded Al-Mawasi area.

"Most of the tools and services we once relied on are now gone," he says, referring to the laptop, speaking software, and Braille notetaker he lost beneath the rubble.

"Those devices were vital for my education and independence. I now rely on family support and adjust as best I can."

This stands in sharp contrast to the everyday joys the students shared at the start of the film – making coffee, gathering with loved ones, using mobility aids, and attending classes.

Despite the challenges of life under 18 years of Israeli military siege, compounded by insufficient services and neglect of disability rights by Hamas authorities, their lives were relatively stable. Their ambitions were driven by learning and hope.

The Islamic University of Gaza, where many of them held scholarships and realised their dreams, offered rare opportunities through its Disability and Inclusion Centre.

"Braille books, voice recorders, and inclusive academic programs gave people like me visibility and purpose," says Imad.

Their university – one of Gaza’s largest – was bombed and destroyed in the first week of Israel’s response to the 7 October attack, instantly cutting off 16,000 students from their education and their futures.

A few months later, filmmaker Amal Al-Agroobi was invited to bring their stories to the screen.

With help from surviving professors, she contacted students from a course led by Dr Iain Overton and Dr Nazmi Al-Masri on storytelling through social media.

Funded by the Global Challenges Research Fund and in partnership with the University of Birmingham and Disabilities Under Siege Network Plus, the film premiered at the United Nations Humanitarian Disarmament forum in October 2024.

"As a filmmaker, I was just hoping I could do their stories justice," says Amal, who is passionate about Arab-centred stories.

Collecting footage came with challenges. "I couldn’t be my regular director-self and push for better shots or angles. These were people in a war zone, with limited internet access and being bombed all the time. Every day was a risk; we could lose them at any minute."

That fear, devastatingly, became reality when one of the students, Aya, was killed. The film is dedicated to her.

"It was very difficult because I developed a relationship with the students, their lives, and their difficulties – I grew attached to them," says Amal.

"Everybody wants to improve and be a better version of themselves – these students are no different," says Dr Itab.

Ultimately, the film shines a light not only on the suffering of disabled people in Gaza – how they’re disproportionately affected by the occupation, military aggression, and systematic erasure of infrastructure, services, and dignity – but also on their determination to survive, to speak, to be heard, and to demand peace.

Yanar Alkayat is a health and fitness editor for the national press and a registered Yoga Therapist

Follow her on Instagram: @yanarfitness