suwandi-tan
Inside the crowded displacement camps of the Gaza Strip, the delicate balance between life and death is increasingly measured by the falling needle of an oxygen gauge. As essential medical resources dwindle under the ongoing siege and conflict, families caring for chronically ill dependents face a desperate shortage of medical-grade oxygen, turning routine daily care into an agonizing struggle for survival.
In az-Zuwayda, located in the central Gaza Strip, Ali Humaida spends his days and nights anxiously observing the pressure meter on the oxygen cylinder standing in the corner of his shelter. His 14-year-old son, Abdulaziz, lies on a simple mattress on the ground, completely dependent on an uninterrupted flow of supplemental oxygen to support his severely compromised respiratory system.
For the Humaida family, any disruption in the gas supply can rapidly escalate into a catastrophic emergency. Ali recalled a harrowing night when their single canister was depleted unexpectedly before a replacement could be located. In their desperation, family members attempted to keep Abdulaziz breathing by fanning him with pieces of cardboard and their bare hands while watching his face turn blue from oxygen starvation, terrified that he would slip into a coma before their eyes.
The father’s persistent anxiety reflects a severe healthcare breakdown throughout the territory. According to data released by Gaza’s Ministry of Health on August 15, only 12 out of 34 oxygen-generation plants remain functional across the enclave. Compounding the crisis, merely four of the 30 specialized filling machines used to recharge portable cylinders are still operational, leaving the remaining equipment heavily overworked and prone to frequent mechanical breakdowns.
These sweeping operational deficits have created insurmountable hurdles for outpatients who require sustained oxygen therapy in home or camp settings. For families living in makeshift displacement tents, obtaining regular cylinder refills has transformed from a difficult logistical challenge into an almost impossible feat, leaving vulnerable patients on the brink of suffocation.
Abdulaziz’s survival is especially fragile due to a series of complex health conditions present since birth. Born with underdeveloped lung tissue and a congenital cardiac defect, he has faced extensive medical challenges his entire life. His health is further complicated by hydrocephalus—an excessive accumulation of cerebrospinal fluid in the brain—which required the surgical placement of a ventriculoperitoneal (VP) shunt to relieve pressure by draining fluid away from his skull.
In addition to his physiological conditions, the teenager lives with autism spectrum disorder, necessitating extensive daily assistance that has become nearly impossible to provide inside a displacement camp. Prior to the war, Abdulaziz received specialized treatment and regular monitoring at a medical facility in Israel. However, the conflict abruptly cut off his access to that cross-border care, leaving his family entirely dependent on Gaza’s crippled local healthcare network.
The ongoing hostilities have also imposed severe financial strains on the household. The scarcity of essential goods has inflated the cost of Abdulaziz's required medications, diapers, and necessary transportation to between 950 and 1,100 shekels ($315 to $365) per month—roughly double the family's pre-war expenditures.
Communicating his physical distress is an added hurdle for the teenager due to his autism. While Abdulaziz cannot verbally express pain the way other children do, his father notes that the suffering remains visible in his eyes. Ali emphasizes that he is not asking for the impossible, but merely wants the basic resources necessary for his son to breathe freely.
The clinical dangers of disrupted oxygen therapy are severe and immediate, according to Dr. Ghada Hassouna, a physician at al-Aqsa Martyr’s Hospital in Deir el-Balah. When a dependent patient experiences a sudden drop in blood oxygen saturation, the body exhibits rapid physiological distress, marked by abnormally rapid breathing, an accelerated heart rate, and cyanosis—a bluish discoloration of the skin caused by poor oxygenation.
Dr. Hassouna explained that prolonged oxygen deprivation inflicts heavy damage on vital organs, particularly the heart and brain. Brain cells are exceptionally sensitive to oxygen loss and deteriorate rapidly when deprived of supply. In patients with pre-existing neurological and physiological conditions like Abdulaziz, any significant drop in oxygen levels carries a heightened risk of causing permanent nerve damage.
Gaza’s Ministry of Health has stated that the widespread failure of oxygen-generating facilities is the direct result of systematic Israeli border policies. Authorities continue to block the entry of replacement parts, maintenance equipment, and specialized lubricants needed to service hospital backup generators and oxygen stations, while also preventing the import of new production plants to replace ruined infrastructure.
Furthermore, Israeli authorities categorize oxygen cylinders, associated medical devices, and electrical generators as "dual-use" items. This classification has effectively barred the entry of both new equipment and vital spare parts through closed and restricted crossing points.
At the same time, the harsh environmental conditions of forced displacement are intensifying the broader respiratory crisis. Hundreds of thousands of residents reside in open areas lacking proper ventilation, where they are continuously exposed to thick dust and toxic fumes from burning plastic waste and makeshift generators. This polluted environment has led to a sharp increase in respiratory illnesses, doubling the number of patients suffering from acute pneumonia and chronic obstructive pulmonary disease (COPD).
Confronted with collapsing resources and an inability to maintain production, the Ministry of Health and hospitals across the strip have completely suspended external cylinder-refilling services for home-care and tent patients. Health authorities were forced to enact this rationing measure to preserve remaining supplies exclusively for internal hospital bed networks, including intensive care units, operating rooms, and neonatal incubators.
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