Humanitarian Crises

“Israel, as the occupying power, has the obligation to ensure the needs of people are met in Gaza.” As he prepared to leave Gaza, the Red Cross’s Patrick Griffiths is hopeful the Rafah crossing’s “opening” will give Palestinians a chance to heal, but says more must be done.

Sudanese military officials say they’ve broken through a siege by the Rapid Support Forces (RSF) paramilitary group of the South Kordofan capital of Kadugli. It’s the military’s second major advance in the Kordofan region in less than a week.

The Rafah border crossing between Gaza and Egypt has finally reopened after months of closure as a result of Israel’s devastating war on the Gaza Strip.

Hopes were running high that the freedom of movement would ease the dire humanitarian crisis created by this war.

But Israel has set strict conditions on who can leave the Strip and who can enter.

Now, only a small number of people are allowed to move in both directions – mainly for medical evacuations.

But much-needed humanitarian aid and construction materials are still barred from entering the Strip, which is in ruins.

Will this reopening ease the suffering of Palestinians after two years of war?

Presenter: Maleen Saeed

Guests:

Hussein Haridy – Former Egyptian assistant foreign minister

Mosab Nasser – CEO of FAJR Global, an organisation that provides medical care, surgical missions and emergency evacuations

Akiva Eldar – Political analyst and contributor to Haaretz newspaper

The long-awaited re-opening of Gaza’s Rafah crossing has been deemed too late for many seeking treatments, in life-or-death conditions. Al Jazeera’s Hind Khoudary spoke to a mother who had lost her sick child while waiting for the crossing to open.

Gaza City – With what remains of her wounded forearms, Nebal al-Hessi scrolls on her phone to follow news updates on the reopening of the Rafah land crossing from her family’s tent in an-Nazla, Jabalia in the northern Gaza Strip.

Nebal’s hands were amputated in an Israeli artillery attack on the home where she had taken shelter with her husband and her daughter in the Bureij refugee camp in central Gaza, on October 7, 2024.

More than a year later, the 25-year-old mother is one of thousands of wounded people placing their hopes on the reopening of the Rafah crossing between Gaza and Egypt as they seek access to adequate medical treatment outside the besieged Palestinian territory.

“It’s been a year and five months since I got injured … Every day, I think about tomorrow, that I might travel, but I don’t know,” Nebal tells Al Jazeera in a quiet voice.

Recalling the attack, Nebal says she was sitting on her bed holding her baby daughter Rita, trying to communicate with her family in northern Gaza, when the shell hit suddenly.

“I was trying to catch an internet signal to call my family … my daughter was in my lap… suddenly the shell hit. Then there was dust; I don’t remember anything else,” Nebal says.

“It was the shell fragments that amputated my hands,” she recounts.

‘Life is completely paralysed’

Nebal was taken to the hospital with severe injuries, including complete amputation of both upper limbs up to the elbows, internal bleeding, and a leg injury. She underwent two abdominal surgeries.

She spent about 40 days in the hospital before beginning a new stage of suffering in displacement tents, without the most basic long-term care.

Today, Nebal, an English translation graduate and mother to two-year-old Rita, relies almost entirely on her family for the simplest daily tasks.

“I can’t eat or drink on my own … even getting dressed, my mother, sister, and sister-in-law mainly help me,” she says sorrowfully.

“Even going to the bathroom requires help. I need things in front of me because I cannot bring them myself.”

Nebal talks about the pain of motherhood left suspended, as her daughter grows up before her eyes without her being able to hold her or care for her.

“My little daughter wants me to change her, feed her, give her milk, hold her in my arms like other mothers… she asks me, and I can’t,” Nebal says with sorrow.

“My life is completely paralysed.”

Doctors tell Nebal that she urgently needs to travel to continue treatment and have prosthetic limbs fitted, emphasising that she needs advanced prosthetics to regain a degree of independence, not just cosmetic appearance.

“Doctors tell me that I need a state or an institution to adopt my case so I can gradually return to living my normal life,” she adds.

With Palestinian authorities announcing arrangements to open the Rafah crossing today for batches of wounded people and medical patients, Nebal, like many others, lives in a state of anticipation mixed with fear.

According to Gaza’s Ministry of Health, thousands of wounded still require specialised treatment unavailable inside the Strip, while the scheduling of names depends on medical lists and complex approvals, amid the absence of a clear timetable or publicly announced priority criteria.

Nebal says she received repeated calls over the past months from medical organisations informing her that she would be among the first on the travel lists.

“They contacted me more than once, told me to prepare… they gave me hope,” she adds. “But this time, no one has contacted me yet.”

Today, Nebal fears her case might be overlooked again, or that the crossing’s opening could be merely a formality, disregarding the urgent needs of patients like her.

“I die a little every day because of my current situation … not figuratively. I’ve been like this for a year and four months, and my daughter is growing up in front of me while I am helpless,” she says.

Uncertain future

Nada Arhouma, a 16-year-old girl whose life has been completely altered by a single injury, is also hoping the crossing opens as soon as possible.

Nada, who was displaced with her family from Jabalia refugee camp in northern Gaza amid Israel’s two-year genocidal war on Gaza, was hit in the face by shrapnel while inside a displacement tent in Sheikh Radwan, Gaza City.

The incident caused the complete loss of one eye, in addition to fractures in her facial bones, orbital damage, and severe tissue tearing.

Her father, Abdul Rahman Arhouma, 49, says that her health deteriorated over time despite treatment attempts in Gaza.

“She entered the ICU at al-Shifa Hospital, then was transferred to Nasser Hospital. She stayed there for about two and a half months. They tried multiple times to graft her eye, but each operation failed, and the disfigurement worsened,” he says.

According to her father, Nada underwent three surgical attempts using tissue from her hand and other facial areas, but all failed, further complicating her medical and psychological condition.

“My daughter bleeds from her eye every day, and she has pus and discharge,” he says. “I am standing helpless, unable to do anything.”

Today, Nada needs constant assistance to walk and suffers from persistent dizziness and balance weakness. Her vision in the healthy eye is also affected.

“Even going to the bathroom, my sisters help me. I can’t walk alone,” Nada tells Al Jazeera in a soft voice.

Nada has an official medical referral and urgently needs to travel for reconstructive surgery and the implantation of a prosthetic eye. But her ability to get the treatments remains uncertain pending the reopening of Rafah – as is the case for other patients and wounded individuals.

“Since I’ve been in the hospital, I hear every week: next week the crossing will open. Honestly, I feel they are lying. I’m not optimistic,” Nada says.

Her father told Al Jazeera that the continuing wait for the Rafah crossing to reopen was “disappointing”.

“Unfortunately, we didn’t understand anything. All the reports came from Israeli sources, and it seemed Rafah looked like a gate for prisoners, not for travel,” he says.

“Our situation is difficult, and it’s clear we face a long wait to secure my daughter’s right to treatment.”

Pilot reopening

Sunday was the first pilot reopening day at Rafah, amid ambiguity and a lack of clarity about the mechanism, particularly regarding the number of patients and wounded who would be allowed to travel.

According to Gaza’s Ministry of Health, thousands of patients and wounded people require urgent medical transfers outside the Strip, amid the collapse of the healthcare system and lack of resources.

The World Health Organization has repeatedly confirmed that Gaza’s health system is “on the brink of collapse”, and that delays in travelling for critical cases threaten their lives.

Meanwhile, Israel has said it will only allow those whose names it has approved in advance to cross, without any clear announcement on daily numbers or approved criteria, leaving families of patients in constant anticipation and frustration.

For Nada’s family, this “experimental opening” means little so far.

“We can’t plan, neither to stay nor to leave,” her father says. “The decision is not in our hands. One lives in a whirlpool, unable to decide what happens. Even the Ministry of Health has not disclosed anything.”

‘Devastating’ struggle to access treatment

Raed Hamad, 52 and a father of four, is also desperate to leave Gaza in order to seek treatments and medication that are not available in the war-ravaged territory.

Hamad was undergoing kidney cancer treatment a year before the war started. He underwent kidney removal after tumour detection to prevent its spread. But the outbreak of the war in October 2023 halted his treatment protocol, significantly affecting his health.

Hamad lives in the remains of his destroyed home in Khan Younis, amid the devastation left by the war, under deteriorating humanitarian conditions.

He describes his current struggle to access treatment during the war, alongside other cancer patients he meets in the hospital’s oncology department, as “devastating.”

“The war has made it almost impossible to obtain medicines and medical supplies. Cancer treatments and known treatment protocols are unavailable,” he says.

“Food, its nature, and the harsh crises we’ve endured during the war—all of this has greatly affected my health.”

Raed’s weight dropped from 92kg (203lb) to 65kg (143lb) due to complications from the disease, lack of treatment, and malnutrition.

“I continue my treatment whenever I can at my own expense,” he says. “Every time I go to the hospital, I cannot find my treatment and see that capabilities in Gaza are extremely limited. My immunity is low, and every day I face new hardships.

“I need to complete my protocol, undergo nuclear scans, and obtain some essential medications to continue my treatment.”

Israel says it will reopen the Rafah crossing on Sunday after nearly two years — but only for restricted, tightly controlled movement of people. Humanitarian aid remains barred. Al Jazeera’s Hani Mahmoud reports from Rafah as Israel retains full security control.

Deir el-Balah and Khan Younis, Gaza – For the past two years, Khitam Hameed has clung to the hope of a single sliver of news that could fundamentally change the fate of her entire family.

The reopening of the Rafah crossing, shut and controlled by Israel as part of its genocidal war on Gaza in spite of a ceasefire agreement, would allow her family to travel and reunite with her husband outside Gaza.

But for this family, the reopening is not just about freedom of movement. It represents both a chance for reunion after a long separation, and an opportunity to secure treatment for their son, whose life, schooling, and normal childhood have all been destroyed by the two-year Israel-Palestine war.

With the United States pushing a deeply intransigent Israel to progress to phase two of the ceasefire that began on October 10, the reopening of the Rafah crossing was directly tied by the far-right government to the recovery of the remains of the final Israeli captive, and only partially for pedestrian use under strict military supervision.

On Monday, the retrieval of the last Israeli captive’s body appeared to open that locked door, with thousands in urgent need of treatment or family reunification in a state of anxious anticipation.

From her family’s displacement site in the Nuseirat refugee camp near Deir el-Balah in central Gaza, Khitam, 50, a mother of six, sits trying to organise her thoughts as news circulates about Rafah.

Next to her is her 14-year-old son, Yousef, unable to walk, suffering from a rare genetic disorder called Ehlers-Danlos Syndrome (EDS), a painful condition primarily affecting his bone development, with potential cardiac complications.

“Yousef has been undergoing treatment for this syndrome since he was very young … he has had around 16 surgeries,” Khitam tells Al Jazeera.

“We got used to hospitals, but before the war, there was some monitoring and a little hope.”

Since long before October 2023, the Rafah crossing between Gaza and Egypt has been a lifeline for Palestinians, not only as a natural exit and entry point, but also as a symbol of connection with the outside world.

Before the war, the crossing was heavily used by patients seeking medical treatment, families visiting relatives abroad, and the movement of goods and supplies that helped ease Gaza’s economic pressure under Israeli blockade.

Its closure, beginning in May 2024 after Israeli forces took control, marked a dramatic turning point in the humanitarian crisis.

The shutdown affected not just the movement of people, but also significantly reduced the flow of medical aid and essential supplies, impacting thousands of patients waiting for treatment outside Gaza, including children and the wounded, amid a severe shortage of health services and medical equipment.

‘Opening the crossing shouldn’t be a miracle’

Before the war, Khitam and her family monitored Yousef’s condition regularly, and he could walk and move.

But the war halted everything. Hospitals were routinely bombed by Israel, and most ceased functioning. Medics were killed by the hundreds, medications ran out, and medical checkups became nearly impossible.

“Since the war, Yousef’s condition has deteriorated. His legs are weaker, walking is harder, he uses crutches,” Khitam pauses before continuing: “He falls often… and my heart is in my throat every time.”

The mother no longer knows the full extent of her son’s health. “I don’t know if he has heart complications, or if his spine has worsened … we are living with him with no answers.”

The war also separated the family. Weeks before the conflict erupted, Khitam’s 52-year-old husband, Hatim, had left Gaza for Egypt, as an initial step to secure a chance for the family to migrate and access advanced medical care for Yousef.

“Since then, I’ve been alone. Six children, one with a special medical condition, war, displacement, hunger,” Khitam says, her voice exhausted.

“Being displaced alone is so difficult. You don’t know where to go, how to protect your children, how to provide food or safety. The constant anxiety and fear have affected everyone, but Yousef suffers the most.”

“No school, no play, no outings, no treatment … even psychologically, he is exhausted. A child his age should be living his life, not caught between war and illness.”

But, she adds, “just the idea of travelling eases us a bit psychologically. It feels like a door might open” for treatment outside of the besieged enclave.

She still fears how the crossing will operate, even as hope keeps her going.

“Even if the crossing opens, not everyone can leave, and not every case will be approved,” she adds. “Opening the crossing shouldn’t be a miracle… it’s a right.”

Yousef’s story intersects with those of hundreds of families of sick children in Gaza, for whom Rafah is not just a crossing, but a lifeline.

‘The family started a new battle against time’

Local estimates indicate that more than 22,000 patients and injured people, including about 5,200 children, are unable to travel for treatment due to the Israeli closure, with thousands more waiting for approved medical transfers that cannot be executed.

Among them is Hur Qeshta, a newborn girl only 15 days old, born with a large, unusual tumour in her neck, affecting breathing and swallowing.

She requires urgent surgery outside Gaza, according to doctors at Nasser Hospital in Khan Younis, in southern Gaza.

Her mother, Doaa Qeshta, 32 and a mother of five, tells Al Jazeera, “From the first moment she was born, the family started a new battle against time to ensure she could urgently travel for treatment.”

Hur was delivered via Caesarean section and now lies in the Nasser Hospital neonatal ICU, on oxygen and fed via a tube from her abdomen.

“She can’t breastfeed, everything is through a tube, and the mass is growing rapidly … all within 15 days,” says her mother.

Doctors confirmed that surgery inside Gaza is currently impossible due to a lack of facilities.

Doaa links her daughter’s condition to the circumstances during her pregnancy, including displacement in a tent in al-Mawasi, exposure to nearby shelling, smoke, gunpowder, hunger, and lack of nutrition.

“I was pregnant during famine … no food, no vitamins, no safety,” she recalls. “Shelling was nearby, 300 metres (980 feet) away… the tent shook; we thought we were dead.”

“Opening the crossing means saving my daughter’s life,” she says. “I’ve registered the whole family as companions … the most important thing is Hur goes, gets treatment, and survives.”

Of the reopening of the Rafah crossing, Doaa says, “We hear news and live on hope, but we are really in a limbo… we don’t know what’s happening or when. We just pray this is true.”

‘Our lives and futures hang on a hope’

The effects of Rafah’s closure go beyond medical access, affecting an entire generation of youth whose education has been halted at a closed gate.

Among those affected is Rana Bana, a 20-year-old from the Daraj neighbourhood in Gaza City.

She graduated from high school in 2023 with a 98 percent average in the science track, with a focus on pharmacy. Within a single year, she received multiple opportunities abroad, but none materialised due to Rafah’s closure.

“In 2024, I was accepted for a scholarship in Egypt, ready to leave, but the crossing closed. A year later, I got a scholarship to Turkiye, did the online interviews, was accepted, and since then I’ve been stuck,” Rana tells Al Jazeera.

Her Turkish scholarship includes 220 students from Gaza, all from different disciplines, most with high academic grades.

Over the past two years, Rana tried not to stagnate, taking Turkish language courses and exploring alternatives like local universities. But she would hold back each time she heard news of Rafah possibly reopening.

“Every time there’s news the crossing might open, I tell myself, ‘Let me wait a bit’… but it turns out to be just talk, and my hopes are dashed,” she adds. “A lot of our time and life has been wasted waiting … our lives and futures hang on a hope.”

Rana is displaced with her family of eight. They returned briefly to northern Gaza during the first ceasefire, found their home intact, but fled again after fighting resumed, and are now settled in Deir el-Balah.

“My biggest fear is leaving and not being able to come back,” she says. “Before, they [her family] were 100 percent supportive. Now there’s fear because the travel process is unclear, and they don’t know how many will be allowed or registered to travel.”

Many Palestinians fear leaving Rafah would be a one-way ticket as part of an openly touted Israeli plan to permanently expel the population from Gaza.

“We students and youth are the most affected group during the war,” Rana says. “Our years have gone by silently, our studies destroyed by war, and no one talks about us. All we want is education — not travel for tourism or anything else.”