Gauze is basic. It is literally the thing you wrap around a wound to stop infections. At Al-Shifa Hospital in Gaza City, months after a declared ceasefire, medical teams are rationing it like it is a rare spice. That tells you everything you need to know about how health care is working there.

Why one roll of gauze matters

Gauze is simple but essential. Without it, wounds stay wet, bacteria set up camp, and infections spread. With limited gauze and dwindling antibiotics, treatable problems turn into amputations and deaths. Nahreen Ahmed, a pulmonary specialist who has worked at Al-Shifa, put it bluntly: the lack of gauze was where many avoidable problems began.

Living conditions make recovery impossible

  • Many patients leave hospitals for tents, not sterile homes.
  • Winter flooding ruined tents and made wounds more likely to infect.
  • Limited antibiotics multiply the risk of simple infections becoming catastrophic.

Hospitals under pressure, staff under attack

Hospitals are supposed to be protected under international law, but Gaza's health system has been hit hard. According to international agencies, only 14 of Gaza's 36 hospitals are functioning. By last summer, more than 1,700 health care workers had been killed and about 220 were detained. The damage to staff and infrastructure is a major reason routine care is essentially unavailable.

Casualties did not stop with a ceasefire

When a ceasefire was announced in October, people hoped things would stabilize. Instead, violence continued, though often in smaller, intense incidents. Between that ceasefire and mid-February, more than 600 people were killed, pushing the official death toll above 72,000. Movement in and out of Gaza has also been tightly controlled. Even when crossings were partly reopened, only a tiny fraction of the people in urgent need of medical exit were allowed to leave, while still more people were permitted back in.

Foreign doctors can enter, supplies cannot

Foreign medical teams have been allowed into Gaza intermittently. But the entry rules for equipment have been unpredictable and strict. Many volunteers said Israel would let people in but deny or confiscate critical medical items. That led some doctors to hide supplies in their luggage or risk smuggling them in on their person.

How people got supplies in

  • Early in the response, many medical workers traveled through Egypt and the Rafah crossing with instruments and supplies.
  • Once the Israeli military took control of the Rafah area, workers had to travel a longer, more controlled route through Jordan, the Allenby Bridge, and then into Israel before reaching Gaza.
  • At checkpoints like Kerem Shalom and Allenby, enforcement varied. Some items passed, some were seized, and some travelers say they hid medicines in personal items to get them through.

Surgeons and aid workers described creative, risky steps to deliver care equipment. One volunteer bought tens of thousands of dollars of instruments and implants. Another said he spread medications throughout his luggage and hid antibiotics on his person. Some of those items were confiscated at checkpoints; some made it through. These are not heroic adventure stories. They are emergency improvisations because formal supply channels are failing.

Official response and contested motives

Medical teams and volunteers say the restrictions are effectively interfering with health care delivery. Israeli authorities, including the agency coordinating crossings, say equipment controls are for security and order and that items not pre-approved are confiscated. They reject claims of deliberate attempts to harm medical services.

Al-Shifa today: functional but hollow

Al-Shifa has not returned to its pre-war state. Some wards and services are back, such as a pediatric intensive care unit, but much of the complex remains damaged. Dust coats wards. There is no CT scanner. Personal protective equipment is scarce. Staff salvage anything usable and celebrate small wins when they find a usable box of gauze.

Work and wounds

International volunteers have been doing a mix of direct care, training, and advising. They move between emergency rooms and ICUs as needed. Many senior Palestinian doctors are gone, either killed, imprisoned, or evacuated. That leaves junior residents to make agonizing triage decisions and to carry the emotional burden of constant loss.

The human cost is visible at every turn

Doctors described traumatic scenes and long shadows of grief. Patients arrive with severe wounds from gunshots, artillery, and shrapnel. One emergency doctor recalls treating a 17-year-old with a severed femoral artery who did not survive. In another case, a 14-year-old girl with an abdominal shrapnel wound required blood and a splenectomy; doctors saved her life but she returned to a tent and remained malnourished. Stories like these repeat across hospital corridors.

Invisible damage: lungs and minds

Beyond immediate injuries, the widespread rubble and dust will have long-term health effects. Doctors warn of chronic respiratory problems for survivors. The emotional toll is also severe. Staff have time between attacks to process trauma, and those quiet moments bring intense emotional strain.

What this means going forward

For now, Gaza’s hospitals keep treating urgent cases with far fewer resources than they need. The declared ceasefire reduced but did not end violent incidents. Movement of people and medical supplies remains tightly controlled and unpredictable. Patients who could survive with basic wound care and antibiotics face worse outcomes because those basics are missing.

At the same time, Gaza’s people and medical teams keep trying to provide care and support for one another. They are exhausted, grieving, and operating with too little. When a roll of gauze becomes a small victory, it is a clear sign that the system is still broken and that recovery from this scale of damage will take far more than a temporary lull in fighting.

Final note

The crisis in Gaza is not only about immediate casualties. It is about the slow, preventable losses caused by lack of supplies, restricted movement, and damaged health systems. Until those gaps are closed, hospitals like Al-Shifa will remain places where every simple supply matters in ways most of us rarely think about.