Between the tent and the cancer ward: Gaza's patients wait for a treatment that may never come

Karima Abu Al-Saud lies motionless on an iron bed inside the Gaza Cancer Centre at Nasser Medical Complex in Khan Younis, receiving the second of three chemotherapy doses she takes over three days every 21 days, since her cancer diagnosis in October 2025.

The 60-year-old mother of eight, four sons and four daughters, breathes with great difficulty, her frail body barely moving as she turns her face from side to side, hoping to ease the pain that keeps intensifying.

Her voice fades to nothing under the weight of the pain until her movements, her gaze, and her head settle in one position, as though she were breathing her last, only her index finger occasionally lifting, a gesture toward God, asking for relief, as if to say she has no one left but Him.

Time passes slowly under the medical protocol prescribed for Karima, while a nurse checks on her periodically in the patients' hall to make sure the chemotherapy dose is being administered properly through to the end.

In front of this scene stands her eldest daughter, 36-year-old Mayada, herself a mother of three, watching her mother's every movement.

With each groan from her mother, the daughter winces, turns away to hide her tears, then returns to hold her mother's hands, offering words and prayers.

Gaza's 'compound hell' 

Mayada describes her mother's condition: cancer in the bone of the lower spine's left side, which later spread to the lungs, after her chance for treatment abroad was delayed since diagnosis, despite having received a referral for treatment outside Gaza.

She has accompanied her mother since the diagnosis, through every treatment available, unable to imagine losing her given the disease's progression and the lack of both adequate local treatment and permission to leave for care abroad.

"My mother's life is a compound hell," Mayada tells The New Arab.

"Unprecedented weakness and wasting, constant pain throughout her body, complete loss of appetite, inability to move, sometimes total loss of movement so she cannot walk, and screaming from pain that never stops, without us being able to ease it. Even strong painkillers don't work," she adds. 

"My mother takes a dose over three days every 21 days," she adds. "After each dose, she remains in near-total physical collapse for at least two weeks, as if absent from the world except for her breathing. Just as she begins to recover, for a week or less, the next dose comes due."

Mayada lives in a tent after being displaced from Rafah in May 2024, like her mother and the rest of the family, who are also displaced in tents in Al-Mawasi, Khan Younis. They live in conditions that the healthy could barely endure, she says, let alone a cancer patient who needs proper medical, environmental, and living conditions and specialised care.

Mayada describes interrupted access to the medicines and painkillers her mother needs, unavailable in hospitals or commercial pharmacies.

"Medicine shortage has been a constant crisis since her diagnosis," she says.

"Some days a type is available; other days it isn't, so she survives on incomplete medication, which worsens her condition. Our only hope of not losing my mother is getting her treatment outside Gaza, at specialised cancer centres, so she might survive longer and not be denied her right to treatment and life," she explains. 

"Staying in Gaza means a pre-written death sentence for my mother. The doctor treating her case from the beginning was shocked to learn that she had not left Gaza for treatment, especially since her case is classified as extremely urgent. He recommended urgent transfer, as her condition keeps deteriorating and there is no local capacity for precise diagnosis and treatment."

Karima spoke to ​​​​​​The New Arab before receiving her chemotherapy dose, while still able to talk, despite severe hearing loss.

She affirmed her right to life, whether through treatment available in Gaza or permission to travel abroad for it.

"Our home was destroyed, we were displaced to Al-Mawasi, we live in worn-out tents, we've lost everything we own, and on top of all this, we're denied treatment," Karima says.

"At the height of my grief and weakness, have mercy on me; do whatever it takes to save my life."

Crying, in her most sorrowful moment, she adds: "I hope God extends my life so I can perform Hajj, that's my most important dream. I also dream of marrying off my youngest son Ali, who is over 26, but our financial situation doesn't currently allow it."

Karima receives chemotherapy, like other cancer patients, at the Gaza Cancer Centre in Khan Younis, a structure made of agricultural greenhouse arches and iron poles, covered in nylon and cloth, its interior and exterior divided by sheet metal, wood, and fabric, its floor made of tiles meant for gardens and streets.

But the space is designated only for diagnosis and treatment, with no wards for patients to stay overnight. The centre's administration has had to allocate part of two rooms inside Nasser Medical Complex's wards, in two separate buildings, for male and female cancer patients who need to stay overnight.

'I fear I won't see tomorrow' 

In the men's internal medicine ward at Nasser Medical Complex, 33-year-old Basel Abu Al-Aynayn was admitted with lung cancer after his condition deteriorated and he could barely breathe, having also lost the ability to move.

He has spent more than a week seeking relief and doesn't know when he'll leave, since his health doesn't allow him to be discharged.

Basel is accustomed to coming to the hospital periodically, staying a week or more whenever his health deteriorates, living his life moving between a worn-out tent he's been displaced to since May 2024, in wretched living and medical conditions, and the hospital, whose corridors he now knows by heart.

The young man lies in bed, an oxygen tube never leaving his nose, whether in hospital or in the tent, to preserve his ability to breathe and stay alive, especially since he went without treatment from the start of the war until early this year, as it was completely unavailable in Gaza.

His face and wasted body make him look far older than his years. His journey with cancer began in 2021, when he received chemotherapy inside Gaza before being transferred to Al-Muttala Hospital (Augusta Victoria) in Jerusalem, where he received seven doses, the last in September before the war. A new dose was scheduled for October, but the war prevented it.

Basel, who worked as a taxi driver and stopped working entirely before the war, groans more than he speaks, barely able to move his weak body, helped by his brother, his wife, and relatives who come to check on him.

"Since I resumed treatment at the start of this year, there's been no improvement in my health. It's only deteriorated further, and I now spend more time in the hospital than in my tent," he tells The New Arab.

"I often lose the ability to breathe and can't be without the oxygen cylinder, and sometimes I go days unable to walk. I was supposed to leave for treatment outside Gaza before the Israeli army entered Rafah in May 2024 and occupied the Rafah crossing," he adds.

"I called the World Health Organization and was told to prepare to travel, and afterwards I was told at least twice more to prepare to travel, but it never happened."

Basel considers staying in Gaza "a sentence of quick death, not slow," his health having deteriorated unprecedentedly. Holding back tears, he adds: "I am dying daily, and I fear I won't see tomorrow."

The young man falls silent for a long time before his only daughter, four-year-old Sawsan, rushes into his arms, telling him in innocent words: "Baba, don't cry. I swear you'll live with us, my love, Baba. Please don't cry."

He wipes away his tears and kisses his only daughter, while relatives around him try to soften the scene with words of hope, wishes for healing, blessings, and wishes for a long life.

A nurse arriving to give Basel his available prescribed medicine breaks the grief filling the room, offering him more hope that he might travel soon.

He responds with an angry question: "Why does Israel prevent patients from travelling? Why must I wait three years, and my turn still hasn't come? The world is obligated to intervene to stop us from dying," he adds.

"Before the war, I was scheduled to begin radiation therapy, unavailable in Gaza, and was set to travel to Al-Muttala Hospital in Jerusalem to receive it, but that still hasn't happened."

'Nothing left but prayers' 

In Al-Mawasi, Sharifa Abu Muammar believes that her 21-year-old son Yasser could die at any moment. She doesn't know if he has weeks, days or hours left with him.

The grieving mother stands over her son, who has a blood disorder, elevated haemoglobin, and adrenal insufficiency, causing developmental and neurological delay and spinal curvature.

She listens to Yasser scream at the top of his voice from pain that has robbed him of his mental capacity. She watches him breathe through a special tube, and he is unable to control his bladder or bowels due to his deteriorating condition.

Sharifa says through tears: "This is the first time I've felt my son is in truly grave danger. His health has deteriorated unprecedentedly amid limited treatment and no chance of treatment abroad. My son also has a physical disability and crawls to meet his needs."

The 51-year-old adds, still in pain, as her son continues to groan, "He used to live a life suited to his disability, in appropriate housing conditions before the war, displacement, and the destruction of our home east of Khan Younis, but things have worsened amid Israel's war. Yasser's illness also deteriorated at the same time, and any semblance of normal life vanished in the tents we're displaced in."

Her son's screams, "Ah, ah, ah," interrupt her, and she responds: "I swear I don't know what to do for you... my heart is breaking for him. His whole body is covered in sores and turning bluer by the day," she says.

"There's nothing left for us now but prayers."

Gaza's cancer drug shortage

Zaher al-Wahaidi, director of the health information centre at Gaza's Ministry of Health, describes the situation as “compounded and complicated”.

Early in the war, the Israeli army destroyed the Turkish-Palestinian Friendship Hospital, Gaza's only specialist oncology hospital.

He says Gaza now has 11,500 cancer patients, including 4,000 waiting for medical evacuation abroad. At least 1,500 cancer patients have been killed, he says, with two deaths recorded each day due to patients being denied treatment abroad and the lack of alternative medicines in Gaza.

Cancer care has also been reduced to less than 10 percent of its pre-war capacity, according to Zaher. Three temporary centres now operate across northern, central and southern Gaza, each occupying only a room or small section of an existing government hospital.

Before Israel's genocide, cancer patients had a dedicated hospital with specialist services.

He compares the limited cancer care now available with the services once provided by the destroyed specialist hospital. The Turkish-Palestinian Friendship Hospital had 180 beds and departments for diagnosis, treatment, surgery, palliative care, nutrition and psychological support. Most of these services are now either extremely limited or unavailable.

The computerised systems used for oncology care also collapsed at the start of the war. This included computers, an integrated information system and cloud servers. As a result, accurate and detailed patient data, including diagnoses and treatment plans, were lost.

"Of eight mammogram machines designated for early cancer detection, only two remain functional now," Zaher says.

"There is no MRI machine or CT scanner at all, and only a limited number of new X-ray machines, since the war destroyed all the equipment that was available at the oncology hospital, and we haven't been able to repair a single device."

He adds that Israel has not allowed medical equipment or devices to enter Gaza since the start of its war on the besieged enclave.

Medical supplies, laboratory materials, and medicines have been allowed in only very limited quantities and not in accordance with declared local needs.

Israeli occupation forces also destroyed all the equipment inside the Turkish-Palestinian Friendship Hospital. During its incursions into Gaza, the hospital was turned into a command, control and detention centre, leaving none of its former facilities or equipment intact, Zaher shares. 

He says cancer patients now face several major problems: shortages of treatment protocols and painkillers, the lack of centres providing complete cancer care, fragmented medical services and being denied travel abroad for treatment, adding that 61 percent of cancer medicines and treatments are at zero stock.

This means patients are missing 61 percent of their medication needs, either completely or partially. Some receive a treatment once but cannot complete the course, while others receive it only intermittently.

"About 46 percent of the essential medicines list, comprising 593 drugs, is at zero stock," Zaher tells The New Arab.

"This includes emergency, surgical, intensive care, primary care, and chronic disease medications, for cancer, heart disease, diabetes, and blood pressure, with the percentage varying between different medicines, and the percentage of cancer medications at zero stock is among the highest."

Zaher describes the situation facing cancer patients as "a death sentence upon them". He says the most urgent need is to allow patients to travel abroad for treatment, giving them a chance of survival. Until that happens, he says chemotherapy must be allowed into Gaza without the current restrictions, along with other cancer medicines, medical supplies, equipment, laboratory materials and screening and diagnostic devices.

"Without that, we will continue counting cancer deaths daily," he says, adding that the figures only include recorded cases, while many others have never reached hospitals or received the medical examinations they needed because of the collapse of Gaza's health system.

Mohamed Solaimane is a Gaza-based journalist with bylines in regional and international outlets, focusing on humanitarian and environmental issues

This story was published in collaboration with Egab