Gaza’s last hospitals face closure due to Israeli evacuation orders: ‘He’s on a ventilator. If they force us to leave, it’s a death sentence’

When Nader al-Farrani holds the limp hand of his 17-year-old nephew Azeddine, he’s not just praying for a miracle. He’s also fearing the Israeli army’s next move. Azeddine has been in a coma since a missile struck a tent near his displaced family’s shelter in the Al-Mawasi area during the Eid al-Adha, or Festival of the Lamb, earlier this month. He is one of many patients fighting for their lives at the Nasser Medical Complex, the largest hospital still operating in southern Gaza but which is now on the verge of closure.

“We can’t even think about moving him. He’s on a ventilator. If they force us to leave, it’s a death sentence,” says Al-Farrani, whose family was displaced from Rafah, in the south of the Strip, in early May.

Nasser Hospital, located in Khan Younis, has become the last hospital in the southern part of Gaza with an operational intensive care unit (ICU) following the collapse of medical services in Rafah and repeated attacks on medical facilities across the territory.

But this medical center is now surrounded by so-called “red zones,” areas where Israel has ordered all residents to leave due to the imminent launch of major military operations. Medical staff, humanitarian organizations, and patients’ families warn that these increasingly frequent evacuation orders and road closures are isolating the hospital from the population it is meant to serve.

In February, Israeli soldiers stormed Nasser Hospital. During the military operation, several patients died after their oxygen and electricity supplies were cut off, and medical staff were arrested. In recent weeks, the Israeli military has also issued new evacuation orders for the areas surrounding Nasser Hospital and has reduced the so-called safe zone to an area barely larger than the perimeter of the medical center.

According to the NGO Doctors Without Borders (MSF), which remains present in the Strip, access to Nasser Hospital has become increasingly difficult due to airstrikes, fighting, and the new red zones. The population displacements decreed by Israel “have forced MSF to adjust its operations in Nasser and move part of its burns and orthopedic services to the field hospital in Deir el-Balah” in the center of the Strip, Pascal Cuttat, MSF’s emergency coordinator in Gaza, said in a statement a week ago. The NGO now only provides maternity and pediatric services inside Nasser Hospital, which it describes as “the only hope left for Palestinians in southern Gaza.”

This is not an isolated case, and other international humanitarian organizations have also reduced their presence at the hospital and have set up camps further north. “If the hospital is attacked again, they don’t want to be trapped,” says Ayman al-Astal, the hospital’s deputy director.

Lack of morphine

Palestinian medical personnel who continue to work at the hospital point out that Nasser is currently the only facility receiving critically ill patients, and that Israel’s expansion of the red zones could lead to its closure.

“It’s not a threat. It would be a death sentence for dozens of patients,” said Dr. Abdelrabbu al-Atrash, head of the intensive care unit. He explained that the medical center is surrounded from the east, west, and north, and the only access is from the south, but it remains a very dangerous road. “We fear that in a matter of days it will be completely inaccessible,” he predicted.

According to Al-Atrash, the 47 patients currently in intensive care cannot be transferred. “Most are on ventilators. Many have brain trauma. There is no alternative center to take them to,” he emphasizes. “If they attack this hospital, the entire healthcare system will collapse,” the doctor insists.

There’s no morphine. We’re using sedatives that numb the mind, but they don’t relieve the pain"

Abdelrabbu al-Atrash, head of the Nasser Hospital ICU

Meanwhile, the medical center is struggling to maintain basic operations. Water and electricity are scarce, and supplies of antibiotics, morphine, and intravenous nutrition are about to run out. Doctors are already sedating patients with basic tranquilizers. “There’s no morphine. We’re using sedatives that numb the mind, but they don’t relieve the pain,” says Al-Atrash.

Nasser Hospital is also treating dozens of patients displaced from Rafah hospitals, all of which were closed following the Israeli military operations in May. Despite not being included in the latest evacuation order issued last week, medical staff fear the hospital could be next. “We’ve seen this pattern before. Once they surround a hospital, it’s only a matter of time,” explains Al-Astal.

The hospital’s deputy director also warns that ambulance access has become nearly impossible. “There are no safe roads left,” he says. “Even getting to the hospital is a risk for our staff. Many have had to leave their homes because of the shelling and have no stable place to stay.”

In a nearby bed, 19-year-old Mohammad Abu Hadaid, who was shot in the abdomen by Israeli tank fire near western Rafah in late May, lies weak but conscious. When his doctors mention the possibility of evacuation, he raises a trembling hand and whispers, “Please, I don’t want to die. There’s nowhere else to go. Outside this hospital, death awaits us.”

Doctors echo that fear. “If we are forced to evacuate again, these patients will die,” says Al-Atrash. “They can’t be transferred. There is no plan B.”

A strangled health system

The nearby Al Amal Hospital, run by the Palestinian Red Crescent, is also under threat. Although it was not included in the latest evacuation order, all access roads have been declared dangerous combat zones.

Spokesperson Raed al-Nims said that coordination with the Israeli army is now required, even for the simplest movements. “We had to move the ambulances to Al-Mawasi for safety reasons. Transporting patients is almost impossible,” he explained.

Al Amal, like Nasser, is operating at reduced capacity. The possibility of establishing a new field hospital in the area has been raised, but doctors warn that this will not be enough. “Field hospitals cannot replace operating rooms, intensive care units, or pediatric wards,” says Al-Astal. “And if you can’t reach them, they’re useless.”

We are witnessing the slow strangulation of the healthcare system in Gaza. And we are about to breathe our last"

Ayman al-Astal, deputy director of Nasser Hospital

The World Health Organization and the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) report that only 17 of Gaza’s 36 hospitals remain partially operational. And nearly all are in danger due to bombing, fuel shortages, or the proximity of military activity. Since October 2023, Israeli attacks on Gaza have claimed the lives of at least 55,000 Palestinians and injured more than twice that number.

The tendency to overcrowd hospitals has been constant throughout the war. In northern Gaza, Al Awda, Kamal Adwan, and the Indonesian Hospital were forced to close after suffering direct attacks and military raids. Now, the same pattern is being repeated in the south.

“We are witnessing the slow strangulation of the healthcare system in Gaza,” Al-Astal said. “And we are about to breathe our last.”

In the intensive care unit at Nasser Hospital, Al-Farrani sighs helplessly and insists, looking at his nephew Azeddine: “His life depends on those machines. If they stop, he stops.”

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