In Gaza's collapsing hospitals, mothers watch their babies fight for life amid the ruins of a post-genocide medical system

In the dim corridors of Gaza's Nasser Medical Complex, Samah Ahmed collapsed in tears as doctors told her that her newborn son might not survive.

She crumples against the hospital corridor wall, her skeletal frame shaking with sobs. At 30 years old and weighing less than 50 kilogrammes, Samah can barely stand without gripping her husband's arm.

Through the neonatal intensive care unit window at Nasser Medical Complex, her eight-day-old son Muhammad lies fighting for breath, one of three infants crowded into a single incubator designed for one.

The doctor's words, a Palestinian medical euphemism meaning the staff can do nothing more, echo through the packed hallway where other mothers sit slumped on the floor, their faces etched with the same desperate grief.

A medical worker passes carrying a small, wrapped body toward the morgue. Samah's husband, Tariq, raises his hands in prayer, his face a mask of anguish.

Nearly one in five babies in Gaza are now born prematurely, according to UNICEF, as the enclave’s devastated health system leaves expectant mothers without adequate medical care, nutrition, or safe delivery conditions. 

Around 130 babies are born each day, and more than a quarter arrive by Cesarean section, procedures that often take place without anaesthesia or sterilised equipment; the UN estimates that more than 20,000 children have died as a result.

Officials in Nasser Medical Complex say that 60 percent of all deliveries now occur prematurely, triple the pre-genocide rate. The hospital has recorded 2,000 premature births in recent months, overwhelming a neonatal intensive care unit (NICU) designed for eight incubators that now holds 15, caring for 36 premature infants simultaneously.

Medical staff report daily deaths as overcrowding forces them to place two or three babies in single incubators, life-saving medications run out, and malnourished mothers deliver increasingly fragile newborns.

Samah delivered Muhammad via emergency C-section at 31 weeks on October 4, after haemorrhaging forced doctors to warn they might need to remove her uterus. The bleeding stopped, but Muhammad was born weighing just 1.9 kilogrammes. With no incubator space, he went home to the family's displacement tent in al-Mawasi.

"Everything that happened to me is because of the war," Samah tells The New Arab.

"My son should have been placed in an incubator from birth, but the shortage denied me that. He should have returned to a clean home with a proper environment, but we went back to a tent in an area unfit for adults, let alone premature babies."

Samah survived on almost nothing but daqqa, roasted, ground wheat mixed with spices, for five months of her pregnancy. Her weight plummeted to 46 kilogrammes, and she could barely walk.

Three years earlier, before the war, she had delivered her daughter Ayla without complications after a full-term pregnancy.

When Muhammad's skin turned yellow after a week, Samah rushed him to the hospital. With the NICU full, staff placed him in a regular pediatric room crowded with children suffering respiratory and blood problems.

Within two days, he had contracted an infection. His condition deteriorated rapidly. He stopped breastfeeding, and his tiny body rejected the formula.

"The displacement was torture," Samah says, her university degree in English translation now as useless as the normalcy it represents.

"Preparing food, carrying firewood and water, washing clothes and dishes, every detail of daily life without any means, it exhausted me and made me unable even to maintain my pregnancy. I'm paying the price now, and my baby is paying it too."

Inside the NICU, nurse Adi Al-Agha moves between incubators, checking vitals and adjusting tubes. He holds a master's degree in intensive care nursing and an advanced diploma in neonatology. In his eight years working in this unit, he has never seen anything like the current crisis.

"We've never had these numbers, never seen health conditions deteriorate this badly," Adi tells The New Arab, while manually assisting a premature infant's breathing, as two other babies lie beside the first in the same incubator.

"We're experiencing the worst period because of the war and its consequences — worsening conditions for pregnant women and newborns, and leaving a lack of supplies for premature babies."

Asaad Al-Nawajha, a paediatrician and neonatologist with 20 years of experience, says the caseload has increased more than 200 percent.

The unit's capacity has been exceeded by a factor of four. Each nurse now cares for eight premature infants when medical standards dictate one nurse per critically ill baby, or at most four per nurse under normal circumstances.

"We're forced to put two or three premature babies in some incubators because there's no space, despite the enormous health risks and violation of medical standards," Asaad explains.

"Sometimes we lack essential medications like surfactant, which improves breathing and lung development in premature babies. When it's unavailable, the baby's condition deteriorates, sometimes to death, especially since they're already struggling with underdeveloped organs, particularly the lungs."

The shortage extends beyond space and staff. Critical medications disappear from shelves. Equipment breaks down without spare parts. The hospital lacks even basic supplies – chlorine for sterilisation, IV fluids, beds, mattresses, and blankets for the maternity wards.

Ahmed Al-Farra, the director of the maternity and children's hospital at Nasser Medical Complex, reveals that 60 percent of medications needed for the NICU are completely out of stock.

The regular pediatric wards are even more overwhelmed, sometimes holding 130 patients when designed for 40, with children lying on floors in hallways and doorways.

"The situation is catastrophic and unprecedented," Ahmed says.

"The severe overcrowding forces doctors to transfer newborns who need incubators to regular pediatric wards, and sometimes there's no space. We're forced to choose between one baby and another when we have to decide who gets the ventilator; we choose the one with a better chance of survival. That's why we record daily deaths among these newborns."

The surge in premature births stems directly from the war's assault on maternal health. Pregnant women face repeated displacement, malnutrition, contaminated water, lack of prenatal vitamins and medications to prevent premature labour, psychological trauma, and extreme physical exertion.

Many cannot reach health facilities for regular checkups. When they do, medical staff often lack the resources to monitor high-risk pregnancies properly.

Ahmed says international and UN organisations have made promises, but nothing has changed days after the ceasefire took effect. He insists that the health system cannot withstand further delays.

"The crossings must open completely and allow everything the hospitals and health sector need," he says.

"Everything is urgent and necessary, laboratory testing materials, IV solutions, NICU incubators, antibiotics, maternity ward beds, and sterilisation chlorine. The list of urgent needs with zero inventory is endless."

Back in the corridor, Samah scrolls through photos on her phone from Muhammad's first days, images of her holding him in the tent, breastfeeding him, both seeming to have survived the worst.

Then came the jaundice, the infection, the crisis. She looks up at the NICU window, where, behind glass, her son struggles for each breath.

"For me, the war hasn't ended," she says. "The catastrophe continues. I suffered through the pregnancy in ways no human can imagine, and only waiting for my baby kept me going. But now I don't know what fate awaits him except the painful words the doctors tell me."

Her husband helps her stand. They wait for another chance to see their son, joining the cluster of parents whose eyes never leave the NICU windows, whose hands never stop praying, whose children Gaza's war is slowly, methodically, stealing away.

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

This piece is published in collaboration with Egab