Three years into Israel’s genocide in Gaza, people living with chronic illnesses are struggling to access the medicines, tests and routine treatment they need to stay alive. For patients with diabetes, heart disease, kidney failure and cancer, shortages of essential drugs, medical equipment and fuel have turned the management of everyday conditions into a daily struggle for survival.
Across Gaza, disrupted medical care means patients are increasingly unable to monitor their conditions, attend follow-up appointments or complete essential treatment.
The consequences can be life-threatening: uncontrolled blood sugar, untreated heart problems, interrupted dialysis and cancer patients left uncertain about whether their disease is progressing.
The World Health Organisation says noncommunicable diseases, which accounted for the largest burden of disease in Gaza before the war, are now being underdiagnosed and undertreated because of limited access to diagnostic tests and treatment services.
According to 2026 figures, more than 18,500 people with injuries or chronic illnesses were in need of treatment unavailable inside Gaza and were awaiting medical evacuation.
'Diabetes has become a ghost'
Khalil al-Turk, 59, displaced from northern Gaza, once understood his illness well. Before the genocide, diabetes was something he could measure and manage: a tablet in the morning, an HbA1c test every three months, and regular medical follow-up.
Today, he says, diabetes has become "a ghost I cannot see."
"There are no glucose testing strips, and the insulin that is available is either constantly running out or spoils because there is no proper refrigeration. Sometimes I feel extremely dizzy, and I don’t know whether my blood sugar is too high or too low."
In those moments, even the decision to eat becomes frightening. "I eat a date and risk pushing my sugar higher, or I avoid eating because I’m afraid I might die."
Then came a small wound on his foot. Two months ago, Khalil developed a wound that, he says, did not receive the follow-up care it needed. It eventually developed into a deep infection threatening his foot.
Diabetes is not simply a temporary rise in blood glucose. Persistently high blood sugar can damage blood vessels, nerves, kidneys, eyes and the heart, making regular monitoring an essential part of treatment rather than a medical luxury.
In stable conditions, doctors can detect deteriorating blood-sugar control or the early signs of complications before they develop into a crisis. But when laboratory tests, monitoring equipment and follow-up appointments disappear, patients may not realise that their illness is no longer under control until their bodies begin sending far more serious warning signs.
'I don’t know how many attacks my heart has endured'
In Deir al-Balah, Aisha Juha, 62, lives with high blood pressure and heart disease. She used to attend a cardiology clinic every two months and took her blood-pressure medication regularly.
Now, she says, everything has changed. "For a year and a half, I have not stood in front of a single blood-pressure monitor," Aisha shares.
Her medication is no longer consistent either. "The medicine available at medical points changes from one week to another depending on whatever aid happens to arrive. Sometimes they give me an alternative; other times they simply tell me, ‘You’ll have to manage somehow.’"
Then came a night when she felt a heavy pressure in her chest and numbness spreading through her left arm. She knew the symptoms could be serious, but she could not find an ambulance or reach a nearby hospital equipped with an ECG machine.
"I took a patience pill, so to speak, and waited until morning. I don’t know how many attacks, or small heart events, my heart has gone through without any of them ever being recorded in a medical file," she says.
High blood pressure and heart disease require long-term monitoring and treatment. In Gaza, however, care for chronic conditions remains constrained by shortages of medication and equipment, as well as difficulties in reaching healthcare facilities.
The problem is not simply the absence of medication. It is also the absence of medical information.
Four hours became two
For Yousef Hammad, 41, a dialysis patient from Khan Younis, routine healthcare isn't an occasional visit to the doctor. It means staying alive. Under normal circumstances, he says, each dialysis session lasted four hours, three times a week.
"Today, a session lasts only two hours, twice a week — or sometimes just once, if we are lucky and there is enough diesel and treated water," Yousef tells The New Arab.
He describes reaching a dialysis machine as though competing for the chance to breathe. "I arrive at the machine competing with hundreds of other patients, our bodies full of toxins and fluid that are suffocating us," he adds.
The World Health Organisation says dialysis services in Gaza remain under intense pressure, with shortages of dialysis machines and essential medicines. Gaza’s Ministry of Health has estimated that as many as 1,100 patients require regular dialysis to stay alive.
For someone with kidney failure, treatment cannot simply be postponed until "conditions improve." When the kidneys stop functioning, they can no longer remove waste products and excess fluid from the body. In end-stage kidney failure, patients depend on dialysis or a kidney transplant to survive.
"A delay of just one day means I cannot sleep lying down because my lungs fill with fluid," Yousef says. "We are not waiting to recover. We are simply waiting to leave the dialysis session able to breathe."
When epilepsy medication runs out
For the mother of eight-year-old Karim, epilepsy was not an emergency before the genocide. Her son had lived with well-controlled epilepsy for years, and regular medication helped keep his seizures under control.
But when supplies of his medication began disappearing from pharmacies, she was unable to obtain it for three consecutive days.
Then the seizures began.
She says Karim suffered repeated, prolonged convulsions, and that she watched him struggling to breathe without knowing what to do.
The family tried replacing his medication with another drug they managed to find, but she says the seizures became worse.
With chronic illnesses, an "alternative medication" is not always a simple substitution that families can safely make on their own.
Some anti-epileptic drugs require careful selection, precise dosing and medical follow-up, because uncontrolled changes can result in a loss of seizure control.
Epilepsy also reveals something fundamental about routine healthcare: patients do not need doctors only when a seizure occurs. They need medical care to prevent that seizure from happening in the first place.
The cancer Khadija cannot see
Khadija Ahmed, 52, a breast cancer patient, has been displaced twice. Before Israel's war on the besieged enclave, she underwent surgery and was expected to begin adjuvant radiotherapy and chemotherapy at the Turkish-Palestinian Friendship Hospital.
Then the treatment plan stopped. She says the closure of the hospital, the destruction of medical equipment and the interruption of patients’ ability to leave Gaza for treatment brought everything to a halt.
Today, she can no longer undergo the tests that were meant to help her and her doctors monitor her condition.
"I cannot get tumour-marker tests. I don’t know whether the cancer has returned or whether it is spreading through my body," she tells The New Arab.
Sometimes, she feels pain in her bones. "I ask myself: is this simply exhaustion from displacement, or has the cancer reached my bones without me knowing?" she adds.
This is one of the less visible faces of war: not only living with illness, but living with medical uncertainty.
The World Health Organisation has confirmed that cancer patients in Gaza continue to face serious difficulties accessing treatment because of shortages of medicines, equipment and specialised services.
From chronic illness to emergency
Modern medicine does not treat chronic illnesses as conditions that patients can simply “put up with” indefinitely.
Diabetes requires monitoring, follow-up and treatment.
High blood pressure requires regular checks and medication adjustments when necessary.
Heart disease requires assessment and continuing care.
Kidney failure requires regular dialysis.
Epilepsy requires medication and medical follow-up to prevent or reduce seizures.
Cancer requires completion of a treatment plan and continued monitoring for response to treatment or recurrence.
When this system functions, patients may appear to be "well." But that apparent stability does not mean their illness has disappeared. It means the healthcare system is doing its job: keeping the disease under control.
When that system collapses, diseases that once remained silent can return as medical emergencies.
That is what makes routine healthcare part of the humanitarian response to war — not a secondary concern that can simply be postponed until the fighting stops.
According to the World Health Organisation, only 19 of Gaza’s 36 hospitals were functioning in September 2026, even partially, and none was operating at full capacity. Severe shortages of essential medicines, diagnostic tools, medical equipment and fuel persisted.
The care that disappeared
Nearly three years into the war, the problem may be more than just patients losing access to hospitals.
They have also lost the daily rhythm that once separated chronic illness from medical crisis: the scheduled blood test, the doctor’s appointment, the blood-pressure reading, the dialysis session, the prescription refill, the scan that reassured a patient that what was happening inside their body was still being watched.
When these seemingly small details disappear, chronic diseases do not.
They accumulate quietly, until some eventually emerge as emergencies that may be far more difficult to treat.
In Gaza, many patients are no longer waiting to be cured of their illnesses. They are simply waiting for their bodies to keep holding on.
Images of war tend to show injuries, explosions and destroyed hospitals. But another war is unfolding inside bodies we cannot see: people whose blood sugar rises without their knowing it, hearts functioning without medical monitoring, kidneys waiting for the next dialysis session, children waiting for medication that will prevent another seizure, and cancer patients waiting for a test that might finally tell them what is happening inside their bodies.
These illnesses may not appear in photographs of war. But every day, their patients continue to pay its price.
Dr Haya Hijazi is a gynaecologist and obstetrician from Gaza
