indah-permata
At Al-Aqsa Martyrs Hospital in Deir el-Balah, central Gaza, the laboratory department has become a place where life-and-death decisions are made not with sophisticated equipment but with careful calculation. Bassem Hassan, who directs the lab, oversees a team whose test results give physicians the information they need to identify conditions ranging from kidney disease to diabetes. Without those results, doctors are left guessing at the most critical moments, and in a healthcare system already shattered by nearly three years of war, guessing can mean the difference between survival and death.
The ability to run those tests has been severely compromised by Israel’s ongoing military campaign and siege of the Gaza Strip, which has devastated medical infrastructure and cut off supplies of the materials laboratories need to function. According to the source article, all blood gas testing has been suspended — a category of testing that is especially vital for cardiac and intensive-care patients. Blood-collection tubes, which are essential for clinical chemistry tests, are in critically short supply, and the automated chemistry analysers that laboratories depend on for more than 60 percent of their testing have stopped operating altogether. Sterilisation equipment and the refrigerators used to store blood and plasma have also failed.
Faced with these constraints, Hassan explained to Al Jazeera that his team has resorted to triage at the laboratory level. Tests are now ordered according to the severity of each patient’s condition, with priority going to kidney, cancer and heart patients as well as those receiving intensive care. This is not a matter of convenience but of necessity: laboratory results determine correct medication dosages, allow doctors to monitor how patients are responding to treatment and underpin urgent medical decisions. When that information is missing, physicians lose a key piece of the diagnostic puzzle — one that can determine whether a patient lives or dies.
The scale of the collapse is stark. As the third anniversary of the war approaches, more than three-quarters of medical imaging equipment in the enclave is out of service. Laboratory testing materials are running at an 87 percent shortage, and there is a 74 percent deficit in the essential consumables required for laboratory and diagnostic testing. These figures, drawn from the source article, describe a system operating far below even its emergency capacity, with equipment breakdowns compounding the shortage of supplies.
Gaza’s ministry of health has warned that these shortages, combined with repeated equipment failures, put blood banks and laboratories at risk of shutting down entirely. The patients most exposed to that outcome are those with critical conditions: electrolyte imbalances, dangerously high potassium levels, impaired kidney function and heart disease. For these groups, timely laboratory results are not routine; they are the basis for treatment decisions that cannot safely be delayed or made on clinical judgment alone.
Marwan Al-Azaiza, head of cardiology at Al-Aqsa Martyrs Hospital, told Al Jazeera that the shortages in public hospitals have forced doctors into uncomfortable workarounds. When patients can afford the added cost, they are sometimes referred to private laboratories. In other cases, doctors fall back on clinical examinations, electrocardiograms and whatever indicators are available to them — a substitute that Al-Azaiza acknowledged is incomplete, since it cannot reliably confirm or rule out the diagnoses that tests would settle. Medical teams are also trying to coordinate with charities, health organisations and relief institutions in an effort to broaden care for Gaza’s population.
Imaging services have been hit just as hard as laboratory testing. Only five of Gaza’s 18 CT scanners remain operational, and those that still function are being run well beyond their intended capacity. The situation for magnetic resonance imaging is even more severe: the source article reports that no MRI services remain in Gaza after nine machines were destroyed in Israeli attacks. That means conditions requiring MRI for diagnosis or staging simply cannot be properly evaluated anywhere in the enclave.
Mohammed Abu Salmiya, director of al-Shifa Hospital in Gaza City, described to Al Jazeera how medical teams have been compelled to restrict laboratory tests, X-rays and CT scans to the most urgent cases only. In his words, this reality forces doctors to make difficult choices between patients — deciding who needs a test immediately and whose test can be postponed. He noted that while such an approach is unavoidable under current shortages, it leaves many other patients on waiting lists, with diagnostic tests delayed even when those tests are needed to identify their conditions or to monitor their treatment.
The human consequences of these delays are not abstract. Yousef al-Athamneh, a 57-year-old man from Deir el-Balah who suffers from kidney failure, requires dialysis three times a week. He told Al Jazeera that his greatest fear is the possibility that dialysis supplies will one day run out, or that a machine will break down while replacement parts remain unavailable, leaving him without the treatment that keeps him alive. He said that all patients are asking for is the most basic necessities of medical care, so that they can attend their dialysis sessions with the reassurance that they will receive treatment.
Al-Athamneh’s concerns reflect a broader anxiety across Gaza’s dialysis units, where shortages of bicarbonate, bloodlines, dialysis machines, intravenous fluids and other materials threaten the regularity of a treatment that cannot be interrupted without risking death. Every missed or shortened session places additional strain on already weakened patients, and the absence of reliable diagnostic testing makes it harder for doctors to detect complications before they become emergencies.
Taken together, the accounts from laboratory directors, cardiologists, hospital administrators and patients describe a health system straining against shortages that affect every stage of care — from the blood draw to the imaging suite to the dialysis chair. Doctors are being asked to practise medicine without the diagnostic tools that modern care depends on, and patients are being asked to wait for answers that may come too late. The source article makes clear that this is not a temporary disruption but a sustained crisis in which medical personnel must decide, every day, who receives the limited testing that remains available.
The implications extend beyond individual cases. When laboratory capacity falls to a fraction of normal and imaging equipment is destroyed, the health system loses its ability to detect disease early, adjust treatment precisely or track how patients are responding over time. Those losses compound one another: delayed diagnoses lead to sicker patients, sicker patients require more intensive care, and intensive care demands exactly the kind of laboratory and imaging support that is now missing. For Gaza’s doctors, the choices they face each shift are a direct result of a system that can no longer see clearly enough to treat its patients safely.
Comments (0)