Khan Younis and Rafah, Gaza Strip, Palestine – In a small apartment in Khan Younis, surrounded by scenes of fighting, Abir Awadi is counting the hours until a much-anticipated ceasefire.

Her daughter Hana's life depends on it.

Whenever Abir lifted the blanket from her face, the 15-year-old let out a piercing cry. Even the faintest dim light caused excruciating pain in the girl's sensitive, swollen eyes, leaving Abir no choice but to heed her daughter's anguished pleas and cover her eyes again.

Underneath the blanket was a face wracked by cancer. A red lump bulged over her left eye, her head appeared shrunken, and her weak arms could barely move. Her weak voice and constant cries spoke of the pain she has endured since her diagnosis three months ago.

Abir prayed that the Rafah crossing that Gaza shares with Egypt could be opened as soon as a ceasefire came into effect early Sunday. The Rafah crossing, which Gaza shares with Egypt, has been blocked by Israel since a ground operation in May in the enclave's southernmost region. "I don't know how long Hana has to live," she said.

For thousands of injured Palestinians in Gaza and sick people like Hana, the Israeli cabinet's agreement to a ceasefire on Saturday in the wake of political tensions is more than just a diplomatic milestone; it's a matter of survival. As part of the deal, the Rafah crossing is expected to be opened, allowing Palestinians in Gaza to leave for medical treatment.

The territory’s health-care sector has been devastated by the war, with human resources, equipment and infrastructure depleted, and medical staff braving Israeli attacks and barely able to serve patients.

“Gaza’s health care sector cannot provide these critical conditions: no medicines, no specialists, no surgeries or procedures, no proper equipment,” said Dr. Mohammed Abu Salmiya, director of the Shifa Medical Center and head of the Overseas Treatment Department told Al Jazeera, adding that for many, the only chance of survival is to travel abroad for treatment.

The ceasefire is intended to facilitate the evacuation of Gaza Palestinians in need of medical care through the Rafah crossing. "Details of where patients will go for treatment remain unclear. Since October 2023, 5,300 Gazans have traveled to Arab and European countries, as well as the United States, for treatment. It is unclear to which countries these cases will flow." Abu· Salmia pointed out.

death penalty

For Abir, who also has two sons, the Rafah crossing is the family's only hope of keeping her hanna. "Hannah's diagnosis was like a death sentence for our family," Abir said, her voice cracking and tears streaming down her face. "But watching her condition worsen day by day, with no help from us or anyone in Gaza, is another level of torture."

The family's ordeal began when Hana's eyes swelled and she visited an ophthalmologist, who immediately transferred her to Nasser Hospital in Khan Younis. There, tests confirmed the devastating news: Hana had cancer, multiple tumors on her head.

Abir tells of her once energetic daughter, who despite being born with brain atrophy and a speech impediment, had keen hearing, clear eyesight and a zest for life. But since her diagnosis, Hana has become completely blind and her hearing has rapidly deteriorated. The massive tumor in her throat also means she is unable to eat and now relies on a feeding tube connected to her stomach.

Due to a lack of medical supplies in Gaza, Hana has not received cancer treatment for three months. "All she got was painkillers to help her sleep," Abir said. "Without this war and blockade, Hana could have started treatment and recovered. Instead, her condition worsened, she lost consciousness and became motionless."

Patients die every day

Abu Salmiya said that there are 20,000 Palestinian sick and wounded people in Gaza who need treatment, of which 12,000 are in critical condition. "Nearly 6,000 war casualties require emergency treatment in institutions abroad. These include approximately 4,000 amputees, and more than 2,000 cases of severe injuries to the spine and spinal cord, leading to paralysis and paralysis," he said.

Dr. Rik Peeperkorn, the World Health Organization (WHO) representative for the West Bank and Gaza, speaking at a United Nations Security Council meeting on January 3, said that during the 15 months of Israeli attacks, 105,000 More than a quarter of civilians injured in Gaza face "life-changing injuries". UN High Commissioner for Human Rights Volker Turk described hospitals as "battlefields" and cited WHO data saying there had been 654 attacks on medical facilities, resulting in 886 deaths and 1,349 injuries.

According to the organization, more than 1,000 health care workers have lost their lives since October 2023, putting further pressure on an overwhelmed health system, with only 16 of Gaza's 36 hospitals partially operational and only 100 beds available. 1800 sheets.

"We are losing patients who, without the war, we could have dealt with so easily. We are losing almost 25% of our dialysis patients. Babies with heart disease are dying in incubators every day because we cannot treat them Surgery. Up to 20 patients with curable diseases die every day in front of helpless staff,” Abu Salmiya noted.

The official added that in these critical circumstances, leaving the territory is "a tedious and futile process", especially since the closure of the Rafah crossing. “Israeli restrictions on the Kerem Shalom crossing (between Gaza and Israel) mean that many people are not allowed to leave, even though they have permission. For example, babies will be allowed to leave, But without their mother," he explained. Since May, only 490 medical personnel have been allowed to leave the country. “Out of 12,000 critical situations, 490 is nothing,” Abu Salmiya commented.

Abu Salmiya said the ceasefire must be accompanied by an influx of resources and easier travel for patients. "We urgently need orthopedic surgeons, burn surgeons, bone repair consultants, and consultants in neurosurgery, vascular surgery, pediatric surgery, thoracic surgery, maxillofacial surgery and cardiac surgery," he said.

The official also called on the World Health Organization, the Palestinian Authority and Egypt to "ensure that medical cases leave the world safely and promptly for hospital treatment, bearing in mind that most people have lost their travel documents amid war and displacement." .

Desperate Hope at Nasser Hospital

At Nasser Hospital in Khan Younis, 14-year-old Raghd al-Farra lay in his bed, barely able to speak. Whether she can survive her injuries and live a normal life depends on receiving treatment outside Gaza.

On July 22, 2024, an Israeli airstrike hit Raghad's home and she was seriously injured. "The pain never ends," she said, her voice slow and tense. Raghad has spent much of the past six months in the hospital, bouncing between neurological, skeletal and abdominal care units.

Her mother, Shadia al-Farra, recounted the day their home was bombed. Sadia and her three daughters, including Raghad, live upstairs, while her husband and youngest child live downstairs. “The walls fell down around us,” she said. The attack also destroyed a neighboring house, killing its occupant.

Raghad's injuries were serious. Doctors diagnosed her with two spinal fractures, a complex fracture of her right leg and massive internal bleeding. She underwent emergency surgery to remove her spleen and part of her lungs, but her condition remains critical. "She still suffers from severe fibrosis and other abdominal complications and needs treatment that is not available in Gaza," her mother said.

In late August, doctors at Nasser Hospital prepared a document for Raghad's transfer abroad, which was submitted to the Israeli authorities through the WHO in mid-September. However, approval had not yet been granted and Raghad's condition continued to worsen. She has difficulty breathing, moving or eating and recently had her tonsils removed to address further complications.

Sadia worries that her daughter's time is running out. "If Rafah is not opened soon, Raghad will not survive. Her life depends on specialized care that is not available in Gaza," she said.

For patients and their families who have suffered greatly during the 15-month war, the stakes are high. "Our children are dying right in front of our eyes," Sathya said. "There is nothing we can do because our health system is overwhelmed. A ceasefire and the reopening of Rafah are our only hope."

This article was published in partnership with Egab.