The health system in the Gaza Strip has completely collapsed. The Israeli army has destroyed most of the hospitals in the Strip, forcing them out of service at a time when the number of dead and injured continue to grow.

In addition to war injuries, diseases and epidemics such as hepatitis A, smallpox, and infectious skin diseases are becoming more widespread. These conditions are an inevitable result of the lack of cleaning materials, clean water, personal hygiene, and hair care products, coupled with increased contact between people in very tight spaces and the spread of sewage and garbage in the alleys of displacement camps.

To mitigate the disaster at least to some extent, medical staff set up small medical points or hubs in tents in nearly every camp to treat the sick. After my family and I were displaced from Khan Younis to Rafah in October 2023, I worked at a medical point in Rafah for two months (roughly mid-December to mid-February 2024). At that time, the severity and spread of diseases were not as great as they are now.

The medical point where I volunteered was a tent made of plastic tarps and wood posts, run by doctors, nurses, and pharmacists. In the summer heat, the tent was very hot, making it hard to breathe. Diagnosis and treatment were done in the same tent, but we often lacked many necessary treatments, such as strong antibiotics and medications to treat thyroid gland conditions. All services we provided were free.

We saw approximately 400 to 500 patients daily, most of whom were children suffering from intestinal infections, colds, and malnutrition. We could help some patients, but for those suffering from chronic or serious illnesses, we had to apologize to the patients because we had little to offer them, especially those with endocrine disorders and diabetes.

My role as a nurse involved changing bandages, administering injections, and suturing wounds. It was very exhausting to deal with the number of injured people we received daily, especially with insufficient resources. We had to improvise, but we didn’t always succeed. Hospitals couldn’t handle simple injuries like wounds and common diseases because they were focused on those injured from the bombings. Emergency departments were always full of injured and deceased individuals.

After several weeks of working, I noticed the significant spread of infectious diseases like fungal infections and viral hepatitis. Hepatitis A is especially dangerous; if left untreated, patients die.

The story of my 15-year-old niece, Sondos, illustrates how conditions that might have been treatable under normal circumstances turn dramatically worse when hospitals are either destroyed or stretched beyond capacity. Sondos was suffering from a slight pain in her left knee shortly after the war began. She was displaced with her family several times and ended up in Rafah, and her physical and psychological condition worsened.

One day, her condition deteriorated and she was no longer able to walk at all, so I took her to the Gaza European Hospital. The doctor who examined her started doing some tests; she needed an MRI, but the only device was in Al-Shifa Hospital in the north of Gaza Strip, and the Israeli occupation forces bombed it when they stormed the hospital. We never received a definitive diagnosis, but the doctors told us that she would lose her leg unless she had surgery.

Unfortunately, there are thousands of injured people needing surgery and waiting their turn, and so she is unlikely to be operated on any time soon. In the meantime, Sondos’ condition is getting worse every day and the risk that she might lose her leg increases, too.

After the invasion of Rafah, I evacuated to Egypt in early April 2024 with some members of my family. Recently I contacted my colleague Enas to ask her how the medical points were doing. Enas works at a medical point in the camps in the middle of the Strip, and it had become terribly crowded after the displacement of people from Rafah.

The Israeli occupation forces destroyed all water lines and desalination plants, and the area no longer had empty space or potable water. She described the camp as a prison closed from all directions, filled with sewage, garbage, flies, strange insects, and even dogs. The rising temperatures worsened the situation.

I asked her about the types of diseases and injuries she was seeing. The number of patients had increased many times after the beginning of summer and the displacement of people from Rafah to Khan Younis, and most patients had skin diseases, which are often associated with other diseases.

Viral hepatitis was spreading rapidly due to the lack of potable water and the scarcity of bathing water. The cleanliness and water crisis, along with the shortage of cleaning materials, has become critical. Public bathrooms used by camp residents lacked basic sterilization, accelerating disease transmission.

The latest update from the Palestinian Ministry of Health reported the presence of the polio virus in sewage water. We are facing a new health disaster in the Gaza Strip at a time when the few semi-functioning hospitals are overwhelmed with the number of injured people who seek care.

We may soon witness the spread of new diseases among the displaced, and unless treatments are made available, many will die.

This article is co-published with Washington Report on Middle East Affairs.