Wars do not end with the last shell fired, nor are their chapters closed by the signing of a ceasefire agreement. In Gaza, the period after the genocide is not a moment of respite, but the beginning of another, harsher battle. It is a battle of exhausted bodies facing illnesses with no clear names and no precise diagnoses, yet claiming lives in silence.
More than one hundred days after the war of extermination came to a halt, its health consequences are gradually emerging within a medical sector barely able to remain standing. The system is besieged by severe shortages of medicines, the collapse of infrastructure, and the occupation’s continued obstruction of medical supplies, at a time when cases of mysterious diseases with acute and long-lasting symptoms are rapidly increasing.
Emergency Rooms
In the admissions ward of Al Shifa Medical Complex, west of Gaza City, a man known as Abu Muhammad lies on a hospital bed beside his five children.
According to doctors, the illness began with the father before spreading to the rest of the family one by one. The symptoms are similar but vary in severity: extreme fatigue, persistent coughing, high fever, and repeated vomiting. “It is like a new epidemic,” says one staff member in the ward. “It is spreading faster than we can understand it.”
In another corner of the same department, a young man in his twenties lies showing symptoms of chronic illnesses that do not match his age. His frail body and laboured breathing suggest that the war not only scarred buildings, but penetrated the cells of human bodies as well.
During field visits to several hospitals and medical points across Gaza’s governorates, Arab21 observed a sharp rise in the number of patients, particularly those suffering from flu-like symptoms, but with greater severity and longer duration.
A doctor working in a field hospital, who requested anonymity, said that the number of daily cases affected by what he described as an “unexplained epidemic” ranges between 350 and 400 cases per day. Before the war, flu-related visits did not exceed ten cases a day.
The director of Al Shifa Medical Complex, Dr Mohammed Abu Salmiya, does not speak in reassuring terms. Instead, he places his finger directly on the wound. He told Arab21 that the health situation in Gaza, more than 100 days after the cessation of the war, is worse than it was during the bombardment itself. He explained that the sector is suffering from a severe shortage of medical equipment, laboratory testing devices, and even basic supplies.
He added that the catastrophic humanitarian conditions endured by more than one and a half million displaced people living in tents have created an ideal environment for the spread of viruses and epidemics. He pointed to the monitoring of new variants of the coronavirus, alongside other viruses whose symptoms persist for more than two weeks. These cases are accompanied by extreme exhaustion, vomiting, coughing, and dangerously high fevers, in addition to severe pneumonia that has claimed the lives of patients from different age groups, including young people with no prior medical history.
“In the past, coronavirus infections lasted no more than five days,” Abu Salmiya said. “Today we are talking about infections extending beyond 14 days.” He warned that this development is a serious indicator of viral mutation in the absence of adequate healthcare.
He confirmed that emergency departments are under unprecedented pressure, particularly from patients with chronic illnesses, who have become the most vulnerable to complications. This is due to overcrowding in shelters, the absence of hygiene, water contamination, and the mixing of drinking water with sewage.
According to Abu Salmiya, the most dangerous challenge facing doctors is the absence of essential laboratory tests and the scarcity of imaging devices, forcing medical teams to rely solely on clinical examination. “This places the physician before extremely difficult choices and may lead to diagnostic errors that we cannot afford to make,” he said.
The danger does not stop at viral infections. Abu Salmiya noted that weakened immunity resulting from malnutrition, the spread of epidemics in displacement camps, and environmental pollution caused by rubble and substances released from cement during debris removal have all exacerbated respiratory diseases, particularly among asthma patients.
He issued a stark warning through Arab21: “If this reality continues without the entry of necessary vaccinations and medicines, more epidemics will sweep across the Gaza Strip, and we will face new numbers of deaths or severe health complications.”
For his part, Professor Abdulraouf Ali Al Manaama, Dean of the Faculty of Health Sciences at the Islamic University of Gaza, offered a more scientific reading of the situation, though no less alarming.
He told Arab21 that the emergence of unfamiliar diseases in areas exposed to severe environmental and health shocks, such as war, is scientifically possible, “but this does not necessarily mean the appearance of entirely new viruses previously unknown”.
He explained that multiple factors contribute to the emergence of unusual disease patterns, most notably the collapse of water and sewage systems, the transmission of zoonotic diseases from animals to humans, and the spread of known infectious diseases due to displacement, overcrowding, and poor hygiene. These include cholera and hepatitis A, both of which have seen increased incidence in conflict zones.
Mutations
Al Manaama noted that war does not directly create new viruses, but it accelerates the spread of pathogens and increases the likelihood of viral mutations. This is especially true amid weakened community immunity resulting from famine, chronic stress, and the absence of health services. “Mutations are always occurring,” he said, “but they become more likely in environments like this.”
The epidemiology expert also pointed out that exposure to chemicals produced by explosions and burning materials does not cause viruses, but it leads to serious health disorders. These conditions may be misinterpreted as mysterious diseases, particularly in the absence of diagnostic tools.
He concluded with a clear warning: “The absence of diagnosis does not mean the absence of disease. The lack of laboratories, the absence of technologies such as PCR and genetic sequencing, and the weakness of epidemiological surveillance systems all allow diseases to spread in the shadows. The worst case scenario is not the emergence of new diseases, but the expansion of existing epidemics within a population that is already medically exhausted.”
