As the Israeli genocidal war on the Gaza Strip grinds into its 21st consecutive month, Gaza's health sector is collapsing under the combined weight of fuel shortages, infrastructure failure, and the killing and arrest of medical personnel.
The Ministry of Health in Gaza has issued an urgent appeal, warning that "the coming hours could be the final moments for the health system," as power outages and critical supply blockades push hospitals past breaking point.
The situation has escalated dramatically since 2 March, when Israel cut off the regular flow of fuel following the breakdown of the first phase of a ceasefire agreement with Hamas.
Since then, fuel deliveries have become sporadic and minimal, just enough to power a single hospital for several hours, according to the health ministry.
On fumes
The largest functioning hospital in southern Gaza, the Nasser Medical Complex, receives 4,500 litres of fuel a day, barely enough to keep generators running around the clock, according to Atef al-Hout, the hospital's director.
In Gaza City, Al-Shifa hospital faces intermittent blackouts in its most essential wards. The ministry's director general, Munir al-Borsh, paints a grim picture, saying, "The remnants of the health system are running on a few hours of fuel. We don't know when everything will go dark."
Power outages threaten to shut down incubators, oxygen stations, dialysis units, and life-saving ventilators. "No one can imagine the number of patients who depend on these machines […] Already, patients have begun dying due to power failures and the unavailability of essential medications and staff," Al-Borsh told The New Arab.
With Israeli restrictions on fuel, medicine, and medical equipment intensifying since October 2023, Gaza's humanitarian crisis is spiralling.
The World Health Organisation (WHO) and local health officials now warn of "a silent weapon"—fuel deprivation—being wielded to paralyse hospitals and pressure the population.
Entire teams of doctors wiped out
Beyond the fuel and supply shortages, Israel's military campaign has devastated Gaza's medical workforce.
Over 450 healthcare workers, doctors, nurses, paramedics, drivers, and service personnel, have been killed since the war began, according to the Health Ministry. Another 360 have been arrested in raids on hospitals, including the Al-Shifa and Nasser complexes.
During the past two weeks, the Israeli army killed at least eight medical professionals, among them Marwan Sultan, director of the Indonesian Hospital, and Ahmed Qandil, a surgeon at the Baptist Hospital in Gaza City.
Al-Borsh described the human toll on Gaza's hospitals, saying, "We have lost seasoned physicians whose experience cannot be replaced. Some of the detainees' fates remain unknown. And now we face dangerous gaps in critical specialities like neurosurgery, intensive care, and anesthesiology."
With some departments running at just 30 per cent staffing, routine surgeries are being delayed indefinitely. "We cancel dozens of operations each day, not because we don't want to operate, but because we simply can't," Al-Borsh said.
Patients dying
At Nasser Hospital in Khan Younis, Atef al-Hout described an unbearable scene, saying, "We have over 600 patients in beds. Fifty critically wounded individuals lie in the emergency room, waiting for space. Nine are intensive care cases stranded in the hallway."
The hospital has only 25 dialysis machines for more than 250 patients. "We're working with impossible numbers," he said.
In one harrowing case, 8-year-old Ahlam Shurrab lies unconscious in the intensive care unit, her small chest rising and falling rhythmically under the aid of a mechanical ventilator.
She had suffered severe injuries during an Israeli airstrike in Khan Younis that killed most of her extended family. Her survival now hinges entirely on the fragile hospital power supply, which is dependent on rapidly dwindling fuel reserves.
Beside her, her mother, Widad, sits on a plastic chair she hasn't left in three days, her hand resting gently on Ahlam's bandaged arm.
"The doctors told me the electricity could cut off at any moment. If that happens, she’ll die, and I won't be able to save her," the mother lamented.
Doctors have warned Widad that without consistent electricity to power the life-support machines, Ahlam's chances are slim.
Backup generators are operating only intermittently, and the hospital has already had to transfer or turn away other critical patients. "I can't sleep; I can't even close my eyes. Every beep from the monitor makes my heart jump," she said.
At al-Shifa, hospital director Mohammed Abu Salmiya warned that their generators could go silent within 24 hours.
"We've cut consumption to the bone. There's nothing left to reduce. And yet we're out of time," he told TNA.
Meanwhile, injured residents are increasingly turned away due to overcrowding and a lack of staff.
Alaa al-Nafar, 29, wounded by shrapnel in his chest, was refused admission at Al-Shifa. "There are no beds, no doctors, no equipment," he complained to TNA.
Alaa was left lying on the floor, awaiting transfer to a smaller clinic in Rafah. "Am I going to die on the ground without even finding a bed?" he asked.
A systemic assault on health
The Ministry of Health said in a press statement that Israel's blockade has intensified in recent months to include not just fuel but all vital supplies: anaesthesia drugs, surgical kits, blood bags, and diagnostic tools.
Spare parts for broken machines are no longer available, leaving 50 per cent of medical equipment unusable. Over 70 per cent of the essential medicine list is now depleted.
"This is not just a war with bombs. It's a war that uses starvation, fuel deprivation, and medical collapse as weapons. The blockade has become more deadly than the missiles," al-Borsh said.
The consequences ripple beyond hospitals. Ambulance services have ground to a halt, with many now relying on donkey carts or volunteers carrying the wounded by hand. "After every mission, we shut off the engine to save fuel […] Many times we can’t even respond; not because we don't care, but because the ambulance won't start," paramedic Ibrahim Abu Ali told TNA.
Blood banks, too, are collapsing. More than 10,000 blood units were distributed last month, but only 3,500 remain available.
"Patients die because there's no blood, and we can't get more in," said Mohammed Alian, an emergency physician based in Khan Younis.
In a press statement, the ministry renewed its appeal to the international community, urging the WHO and humanitarian organisations to intervene.
It stressed that Gaza's hospitals "cannot continue to function under these siege conditions" and that staff are under extreme psychological and physical duress.
"The daily reality is that patients are placed on the edge of death. Only urgent international action—fuel entry, medicine supply, and protection of facilities and personnel—can avert total collapse," the ministry said.
But even as please mount, the bombs fall. In Gaza's darkened hospitals, candles flicker beside surgical tables. Some patients die before reaching a doctor; others gasp for air as ventilators power down.
"We're no longer counting injuries. We're counting the minutes before everything goes dark. This is not just a humanitarian catastrophe, it is a crime unfolding in front of the entire world," Al-Borsh concluded.