GAZA CITY — At the Hassan Salama school in the Nasr neighbourhood of Gaza City, hundreds of displaced Palestinians live in tents pitched across a rubble-strewn courtyard. The school was bombed in August 2024 alongside the adjacent Nasr school; at least 30 people died in those strikes. What remains of the building now functions as an informal displacement camp with no managing organisation and no regular services of any kind.
Last month, a team of medics from a local private clinic offered free check-ups at the camp for a single day. The team saw at least 150 patients. The welcome they received from residents, many of whom had gone without any medical consultation for months, was immediate.
Patients presented with a wide range of conditions. Adults came with high blood pressure, diabetes, kidney disease, hepatitis and scabies. Children were seen for chickenpox, gastroenteritis, diarrhoea and respiratory infections. The medics provided basic assessments and prescriptions but no advanced treatment or follow-up care.
One patient — a 46-year-old man — illustrated the structural problem facing the camp's residents. A shrapnel injury to his foot left him dependent on crutches. He also had hypertension. The nearest functioning hospital, Al Rantisi, operates only partially and limits its services primarily to children and oncology patients, ruling it out for a hypertension consultation. Walking to another facility was not possible given his injury. Getting there by any form of transport would have cost him at least eight dollars — an amount that exceeds what most people in displacement camps can spare once they have covered food for the day.
That eight dollar figure captures the gap between formal healthcare infrastructure and the people furthest from it. Transportation costs, long distances and the physical and mental exhaustion of displacement combine to push many patients into delaying care even when their conditions are urgent. For a person managing a chronic disease who cannot afford transport, the delay is not a choice so much as a constraint.
No organisation runs the Hassan Salama camp, which means no systematic medical provision reaches it. The informal day clinic was arranged voluntarily by the private clinic's staff. Without similar outreach, residents have no consistent point of contact with the healthcare system.
Gaza's hospital network has been under severe strain since the start of the war. Al Shifa Hospital, the territory's largest medical complex, was raided in November 2023. The broader pattern of attacks on health facilities has drawn international scrutiny. In December 2024, Andrew Cayley, leading the International Criminal Court's investigation in Palestine, said Israeli claims about Hamas use of hospitals to justify military operations were "grossly exaggerated." Doctors Without Borders has described Israel's conduct toward medical infrastructure as showing "complete disregard for the protection and safety of medical and humanitarian" personnel and facilities.
Schools and other civilian structures across Gaza have been repurposed as improvised medical points, absorbing some demand that hospitals once handled. The U.N. has documented this shift. But improvised facilities operating without staff, supplies or sanitation cannot substitute for a functioning healthcare system, and displacement camps that host no organisation at all fall entirely outside even those makeshift arrangements.
Conditions in the camps deepen health risks independent of access to care. The absence of safe drinking water, inadequate sanitation and prolonged exposure to extreme heat or cold all worsen existing illness and accelerate the spread of infectious disease — the same infections that turned up in patients at Hassan Salama last month. Gastroenteritis and respiratory infections spread quickly in densely occupied spaces without clean water or waste disposal.
The Rafah crossing between Gaza and Egypt reopened partially in recent weeks, allowing a limited number of the most severely injured and ill Palestinians to be evacuated for treatment abroad. Health advocates have described the evacuations as necessary but insufficient, arguing that the priority must be rebuilding the healthcare system inside Gaza rather than routing individual patients out of it. The territory's health infrastructure was already under-resourced before the war; the damage since October 2023 has reduced it further.
For the 150 patients seen at Hassan Salama last month, the visit produced prescriptions and assessments they had been unable to obtain on their own. Whether they can fill those prescriptions — or afford a second appointment — depends on factors the visiting medics could not control.
