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Medication and food shortages, a destroyed healthcare system, plus extreme stress, create the conditions for slow death by the “silent killer.”
Al-Taher Pharmacy in Deir Al-Balah, central Gaza Strip, has only two boxes of high blood pressure medication available, and this was the only pharmacy where the author found this treatment. Photo: Refaat Ibrahim
As Israel wages a relentless war on the Gaza Strip, humanitarian crises deepen with each passing day. While scenes of bombardment and destruction dominate headlines, the suffering of hypertension patients battling the “silent killer” is largely overlooked. These individuals require continuous medical care, regular medication, and stable nutritional and psychological support.
These requirements are impossible to meet these days. An Israeli blockade prevents the entry of food and medicine, and Israeli bombs have destroyed the healthcare facilities. This leaves patients, particularly the elderly, vulnerable to a slow and silent death.
According to the Palestinian Central Bureau of Statistics, approximately 225,000 people in Gaza were afflicted with hypertension by April 2024, with the majority being elderly.
This chronic condition is among the most dangerous due to its severe complications, which include heart or kidney failure, strokes, and vision problems.
These complications require strict adherence to medication and a healthy lifestyle, both of which are nearly impossible under the ongoing blockade.
Dr. Fawzi Murtaja, who works at an UNRWA clinic in Gaza City, explains: “We deal daily with chronic hypertension cases, and many patients come to us after their condition has deteriorated due to the unavailability of medication. The absence of treatment doesn’t just elevate blood pressure; it increases the risk of heart disease, kidney failure, and strokes. Unfortunately, many patients reach us too late, when their condition has worsened, and medical intervention is of limited effectiveness.”
Before the war, hypertension patients received free medications from UNRWA centers and government hospitals. However, with the Israeli blockade and the halt of medicine imports, pharmacies face severe shortages of essential drugs, including Enalapril and Valsartan. Once provided free of charge, these medications are now sold at exorbitant prices. For instance, a pack of Enalapril, previously free, now costs $10, while Valsartan’s price has skyrocketed beyond the means of most patients. Some medications are sold per strip for over $40.
The limited medicines that reach Gaza are typically reserved for emergencies resulting from airstrikes, leaving chronic illness patients neglected. Worse still, some drugs are secretly sold on the black market by corrupt hospital or relief organization staff and then offered to patients at double or triple the cost, exacerbating patients’ suffering and eroding trust.
Al-Rashid Pharmacy in Khan Younis, southern Gaza Strip, has one type of high blood pressure medication available, with just two boxes in stock. Photo: Refaat Ibrahim
Treatment for hypertension relies not only on medication but also on a low-sodium, balanced diet rich in potassium, magnesium, fruits, and vegetables. However, the blockade has caused widespread famine, forcing residents to rely on nutrient-poor meals like bread and lentils, which fail to meet basic nutritional needs.
Like everyone in Gaza these days, hypertension patients suffer from severe malnutrition. A local doctor explains: “A hypertension patient who lacks medication, proper food and lives under constant threat is essentially under a death sentence.”
Patients’ bodies waste away as they struggle to survive amid extreme hunger and malnutrition.
Pharmacist Raed Qassem from Deir al-Balah in central Gaza states: “We see hypertension patients daily, suffering doubly due to the lack of food. Malnutrition exacerbates hypertension and weakens the body’s ability to cope with the disease, often leading to serious complications like heart disease and kidney failure. Many patients arrive visibly emaciated, needing balanced nutrition to support their health, but what reaches them is often insufficient for even their most basic nutritional needs.”
The psychological toll is no less significant than the lack of medicine and food. Patients live in tents without thermal insulation, swelteringly unbearable in summer and freezing in winter. They endure chronic fear and grief due to continuous bombardment and the loss of loved ones. The lack of a stable environment and adequate sleep make it impossible to regulate blood pressure.
Pharmacist Moataz Al-Barim from Khan Younis in southern Gaza explains: “The psychological aspect plays a significant role in hypertension and cannot be separated from patients’ overall health. We observe that many new cases go unrecorded in official health ministry records due to the war; people can’t always access medical facilities or register their conditions, making official figures far lower than the reality.”
Conditions increase the likelihood of younger individuals developing hypertension, he added. “And for existing patients, these conditions intensify the disease and accelerate complications, as controlling blood pressure becomes more challenging and health problems escalate rapidly.”
Israel deliberately prevents the entry of medical and humanitarian aid, imposing stringent restrictions on international organizations like UNRWA. This policy not only targets medicine but aims to strangle life itself. The occupation not only destroys Gaza’s healthcare system but also deprives Palestinians of the conditions for a dignified life, trapping patients in harsh and deadly circumstances.
The suffering of hypertension patients in Gaza (and other patients with chronic diseases) is no longer just a public health crisis; it has become an organized humanitarian crime, committed in full view of the world amid international silence.
Withholding medicine, starving civilians, and destroying healthcare infrastructure are not incidental collateral damage but rather calculated Israeli policies aimed at weakening Palestinian resilience through illness.
In times of war, images of the dead often dominate headlines. But death does not always come by a bullet; sometimes, it takes the form of the withholding of essential medication.
This article is co-published with Washington Report on Middle East Affairs.
