'We're dying in silence': Al-Shifa Hospital's chronic kidney disease patients fight to stay alive

In what remains of Gaza's Al-Shifa Hospital, patients with chronic kidney failure sit silently in plastic chairs or lie on rusted stretchers, waiting for their turn to use dialysis machines that may or may not work.

Dialysis is a lifeline for those whose kidneys no longer function. Without it, toxins build up in the blood, leading to heart failure, coma, and death. In war-torn Gaza, dialysis has become yet another casualty of the siege, and for many, hope is fading away quickly.

"I come here because I don't want to die, but sometimes I think it might be easier if I did," Hind Awadallah, a displaced mother from Jabalia refugee camp, now living in a tent in central Gaza, said to The New Arab. 

Awadallah has relied on dialysis since 2022, after years of undiagnosed high blood pressure. Before Israel's current war, she received four sessions per week. Now, she's fortunate to receive one or two and medical staff were forced to halve her treatment time from four hours to two, worsening her condition.

"Unfortunately, the machine stops every time there's a power cut," she said. Despite this, Awadallah praises the nurses for their efforts, but does wonder what those efforts could accomplish without essential resources.

'Powerless'

Once Gaza's largest and best-equipped medical facility, Al-Shifa Hospital has been reduced to a hollow shell following repeated Israeli raids and months of siege. Its labs are empty, and its operating theatres are dark.

The dialysis units, which once treated hundreds, now are broken, are working on reused filters and spare parts salvaged by volunteer engineers. 

Each dialysis machine, designed for one patient at a time, is now shared between three or more. Sessions are shortened. Hygiene is compromised. The water used to filter blood is often untreated or rationed.

"The infrastructure is gone. There is no power, no clean water, no medication," Ghazia-Yazji, head of the nephrology department at Al-Shifa, said to TNA. 

"We are doing our best to keep our patients alive, but most of the time, we’re just watching them die. And we're powerless," he said. 

"This is no longer a hospital," Sameh Nijim, another kidney patient in Gaza, said to TNA. "We come here to survive, but the truth is that it is a waiting room for the dying."

Nine-year-old Nour Siam, suffering from a congenital kidney disorder, was carried into the unit by her father on Sunday.

Her face was pale, her breathing shallow, her father Ahmed described to TNA. Diagnosed at age four, Nour requires clean water, strict nutrition, and regular dialysis. In Gaza, all three are now scarce.

"She should be in school, not here. She hasn't walked on her own in weeks," Siam said. "We are sheltering in a mosque, drinking chlorine-filled water and eating canned beans. When she gets dialysis, she vomits or shakes. She begs me not to take her, but if I do not, she will die."

Awadallah, Nijim and Siam are among 684 kidney patients in Gaza who rely on regular dialysis to survive, according to medical officials. 

"They are lucky enough to stay alive until now amid the current deterioration of the health sector," according to Ahmed Harb, a Palestinian man, who recently lost his mother, Fatima, to kidney disease. 

"Because of poverty and lack of transportation in Gaza, my mother missed three sessions," the 35-year-old young man said. "By the time we got to al-Shifa, she could not move."

His mother died two weeks ago. With no ambulances available, he had to carry her body home wrapped in a donated blanket. 

"She kept asking for water," Harb recalled. "But the doctor said she would retain it, that she would die shortly." 

Health system collapse

According to Gaza's Health Ministry, over 400 kidney patients have died since the war began, mostly due to interrupted care, contaminated water, and the collapse of medical services. Many died while going to hospitals or in overcrowded shelters. 

The situation in Gaza continues to highlight how basic medical needs of the people are unmet. "The health crisis in Gaza has reached catastrophic levels as Israel's ongoing genocidal war continues to target civilians, infrastructure, and medical facilities," Munir al-Batish, the director of the Health Ministry in Gaza, stressed to TNA. 

"Our hospitals are overwhelmed. The destruction of essential medical facilities and the systematic targeting of health infrastructure have left us unable to respond to the overwhelming number of casualties. The war has made basic healthcare nearly impossible to access," he said. 

"One of the most devastating consequences of the conflict has been the impact on those suffering from kidney disease, a critical issue in Gaza even before the escalation," he added. "Dialysis patients in Gaza are facing the brunt of this war. With hospitals and clinics destroyed or damaged, and vital medical supplies severely lacking, we cannot provide the care these patients desperately need."

Mustafa Ibrahim, a Gaza-based political analyst, described the deliberate targeting of medical facilities as part of a calculated strategy by Israel.

"Al-Shifa Hospital represented resilience," Ibrahim said. "Its destruction sends a clear message that Gaza is not meant to recover. The continued attacks on hospitals and clinics are an attempt to cripple Gaza's civilian infrastructure entirely."

"Dialysis patients are one example of how the war is targeting Gaza's most vulnerable. But they represent a broader reality of a society that is being systematically strangled. Without dialysis, these patients cannot survive," he added.

The dire shortage of medical supplies further complicates the situation. Despite efforts from international organisations such as the UN and the Red Crescent, Gaza's healthcare system is critically underfunded.

As Israel's war rages on, the lives of thousands of Gaza's residents depend on international solidarity and the will of the international community to end the siege and halt the attacks on medical facilities. 

Until then, kidney disease patients in Gaza, like many others, will continue to face unimaginable hardship, with their health system hanging by a thread.