Khan Yunis and Rafah, Gaza Strip, Palestine – In a small apartment in Khan Yunis, surrounded by a war-torn landscape as far as the eye can see, Abeer Al-Awadi counts the minutes until the war ends. The long-awaited ceasefire.

Her daughter Hanaa’s life depends on it.

The 15-year-old girl lets out a sharp scream when Abeer lifts the blanket protecting her face. Even the slightest glimmer of light causes excruciating pain in the teenager’s sensitive, puffy eyes, leaving Abeer no choice but to respond to her daughter’s agonizing pleas to be covered again.

Under the blanket lies a face bearing the relentless signs of cancer. A red lump protrudes from her left eye, her head appears shrunken, and her weak arms barely move. Her weak voice and constant screaming tell us about the pain she has endured since her diagnosis three months ago.

Abeer prays that Rafah crossingWhich Gaza shares with Egypt and was Closed by Israel Since its ground operation in the far south of the enclave in May, it will begin as soon as the ceasefire goes into effect early Sunday. “I don’t know how long Hana will live,” she said.

to Thousands of wounded Palestinians In Gaza and patients like Hana, the ceasefire agreed to by the Israeli government on Saturday after much political tension is more than just a diplomatic milestone; It’s a matter of survival. The Rafah crossing is expected to be opened as part of the deal, allowing Palestinians in Gaza to leave for medical treatment.

The war has devastated the Gaza Strip’s healthcare sector, depleting human resources, equipment, infrastructure and medical staff who have braved the Israeli attacks and have little left to offer their patients.

“There is none of that Health care sector in Gaza “These critical conditions can provide: no medicine, no specialists, no operations or procedures, and no proper equipment,” Dr. Muhammad Abu Salamiya, director of Al-Shifa Medical Complex and head of the treatment abroad department, told Al Jazeera. For many, the only chance of survival is treatment abroad.

The ceasefire is scheduled to facilitate the exit of Palestinians from Gaza who need medical treatment through the Rafah border crossing. “The details of where patients will go to receive treatment are still unclear. The 5,300 Gazans who have left for treatment since October 2023 have headed to Arab and European countries, in addition to the United States. Abu Salamiya noted that it is still unclear which countries are Where these cases will go.

Death sentence

For Abeer, who also has two sons, the Rafah crossing is her family’s only hope of holding on to Hana. “Hanaa’s diagnosis felt like a death sentence for our family,” Abeer said, her voice breaking as tears streamed down her face. “But to see her condition deteriorate daily, without us or anyone in Gaza offering her anything, is another level of suffering.”

The family’s ordeal began when Hana’a’s eyes swelled, prompting her to visit an ophthalmologist who immediately referred her to Nasser Hospital in Khan Yunis. There, tests confirmed the shocking news: Hanaa had cancer and multiple tumors in her head.

Abeer recounted how her once active daughter, despite being born with cerebral atrophy and a speech impediment, flourished with keen hearing, clear vision and a desire to live. But since her diagnosis, Hana has completely lost her sight, and her hearing is rapidly deteriorating. A huge tumor in her throat means she is unable to eat, and she now relies on a feeding tube connected to her stomach.

For three months, Hanaa has not received any cancer treatment due to a lack of medical supplies in Gaza. “All she gets is painkillers to help her sleep,” Abeer said. “If it had not been for this war and siege, Hana would have begun treatment and recovered. Instead, her condition worsened, robbing her of her senses and leaving her motionless.

Patients die every day

According to Abu Salmiya, there are 20,000 sick and wounded Palestinians in Gaza in need of treatment, including 12,000 in poor condition. “Nearly 6,000 people injured by the war need urgent treatment in facilities abroad,” he added. “Among these, nearly 4,000 are amputees, and more than 2,000 have suffered serious injuries to their spine and spinal cord, leaving them paralyzed and paralyzed.” “.

In a speech at a UN Security Council meeting on January 3, Dr. Rick Pepperkorn, the World Health Organization’s representative in the West Bank and Gaza Strip, said that more than a quarter of the 105,000 civilians had been injured during 15 months of Israeli bombing. From Gaza they face “life-changing injuries.” UN High Commissioner for Human Rights Volker Türk described hospitals as “battlefields,” citing World Health Organization figures indicating 654 attacks on health care facilities, resulting in 886 deaths and 1,349 injuries.

According to the organization, more than 1,000 healthcare workers have been killed since October 2023, increasing pressure on the exhausted healthcare system, with only 16 of Gaza’s 36 hospitals partially functioning, and only 1,800 beds available.

“We are losing patients with conditions that we could have easily dealt with had it not been for the war. We have lost nearly 25 percent of our dialysis patients. Children with heart disease die every day in incubators because we cannot operate on them,” Abu Salamiya noted. Up to 20 patients with curable diseases die every day in front of helpless staff.

The official added that, given these critical circumstances, exiting the Strip was an “arduous and useless process,” especially since the closure of the Rafah crossing. “Israeli restrictions on Kerem Shalom [Kerem Shalom] border crossing [between Gaza and Israel] This meant that many were not allowed to leave even though they had the green light to do so. For example, infants will be allowed to go, but without their mothers, he explained. Only 490 medical cases have been allowed to leave the areas since May. Abu Salamiya commented: “Out of 12,000 critical cases, 490 are nothing.”

According to Abu Salamiya, the ceasefire must be accompanied by the flow of resources and the ease of exit of patients. He said: “We urgently need plastic and burn surgeons, and orthopedic reconstructive consultants, in addition to consultants in neurosurgery, vascular surgery, pediatric surgery, thoracic surgery, maxillofacial surgery, and cardiac surgery.”

He also called on the World Health Organization, the Palestinian Authority and Egypt to “ensure the safe and timely departure of medical cases to receive treatment in hospitals around the world, taking into account that most of them have lost their travel documents amid war and displacement,” the official called. .

Desperate hopes in Nasser Hospital

At Nasser Hospital in Khan Yunis, 14-year-old Raghad Al-Farra lay on a hospital bed, barely able to speak. Her dream of surviving her injuries and living a normal life depends on receiving treatment outside Gaza.

Raghad was seriously injured on July 22, 2024, when an Israeli airstrike hit her family’s home. “The pain never ends,” she said, her words slow and strained. Raghad spent most of the past six months in the hospital, moving between the neurological, orthopedic, and abdominal care departments.

Her mother, Shadia Al-Farra, recounted the day their house was bombed. Shadia and her three daughters, including Raghad, were upstairs, while her husband and their youngest child were downstairs. “The walls have collapsed around us,” she said. The strike also destroyed a nearby house, killing its occupants.

Raghad’s injuries were serious. Doctors diagnosed her with two spinal fractures, complex fractures in her right leg, and severe internal bleeding. She underwent emergency surgery to remove the spleen and parts of her lungs, but her condition remains critical. “She still suffers from severe fibrosis and other abdominal complications that require treatment that is not available in Gaza,” her mother said.

In late August, Nasser Hospital doctors prepared a file for Raghad’s transfer abroad, and submitted it to the Israeli authorities through the World Health Organization in mid-September. But approval was not granted, and Raghad’s condition continues to deteriorate. She struggles to breathe, move or eat, and recently had her tonsils removed to address further complications.

Shadia fears her daughter is running out of time. “If the Rafah crossing is not opened soon, Raghad will not survive. Her life depends on specialized care that Gaza cannot provide,” she said.

The risks are high for patients and their families, who have suffered enormously during the 15-month war. “Our children are dying before our eyes,” Shadia said. “We are helpless because our medical system is exhausted. A ceasefire and the reopening of the Rafah crossing is our only hope.

This piece was published in collaboration with For example.