The lack of insulin and equipment in Gaza poses a mortal risk, leading to serious health complications.
Gaza – On another day of Israel’s genocidal war on Gaza, 20-year-old Hamza al-Ghazali, who lives in the Zeitoun neighborhood south of Gaza City, set out again in search of an insulin pen. It wasn’t the first time he had shuttled between pharmacies and medical centers for a single dose. The effort has become part of his daily routine since the war broke out in October 2023 and Israel’s strict restrictions on the entry of medicine and medical supplies into the Gaza Strip.
Hamza knows that delaying insulin injections can be life-threatening. Type 1 diabetes requires strict daily treatment and constant monitoring. But in the conditions of war and blockade, managing the disease has become a daily, risky struggle.
Hamza recalled that his health was more stable before the war. He used to get insulin pens for 25-35 shekels (about 3000-4200 HUF) each. „I started to know all the pharmacies, and they knew me because I always took insulin,” he says.
But with the war, things changed drastically. The price of a single insulin pen rose to 75–100 shekels (about 9,000–12,000 HUF). Since Hamza needs six to seven pens a month, he was forced to try to use each pen for as long as possible.
Fight for survival
The suffering of diabetics has been exacerbated by cross-border restrictions, which have led to severe shortages of insulin, blood glucose meters and test strips. Hamza notes that this has created an unstable healthcare situation: sometimes expired medicines or those stored in inappropriate conditions are released onto the market, raising the risk of reduced efficacy or uncertain quality.
A year ago, when the Israeli food blockade caused famine in northern Gaza, Hamza was forced to eat whatever he could find. His biggest challenge was finding a balance between the insulin he had available and the scarce food. If he ate without insulin, his blood sugar would rise dangerously; if he ate less out of fear, it would lead to severe, fatal hypoglycemia (low blood sugar).
„I was afraid for myself during the shelling in northern Gaza,” Hamza said. „We were under siege. If the house had been bombed, I might have survived under the rubble, but I would have died from low blood sugar.” The first thing he took with him on every evacuation was his „diabetic bag.”.
Lack of funds
The lack of test strips means Hamza can no longer check his blood sugar levels daily, relying instead on his physical symptoms. A blood glucose meter costs 250-300 shekels (about 30,000-36,000 HUF), but the real problem is the lack of test strips. Without them, the device is useless, forcing some patients to constantly buy new devices. Hamza estimates that in some areas, more than 80 percent of diabetics are unable to regularly test their blood sugar, which he calls a „medical disaster,” as treatment becomes a daily guesswork.
According to the Palestinian Ministry of Health, 70,000 to 80,000 diabetics in the Gaza Strip are at risk due to severe shortages of supplies, the collapse of medical monitoring services, and inadequate nutrition.
Dr. Adli al-Ghouti, an endocrinologist and diabetes expert, says that around 2,500 children in Gaza are living with type 1 diabetes, and their condition is extremely critical. The doctor warns that the deterioration of insulin quality, the use of expired supplies and improper storage (especially due to power outages) can give a false sense of security. Blood levels can remain uncontrolled, leading to diabetic ketoacidosis, a life-threatening emergency.
„Administering expired insulin can cause significant harm to the body while only suggesting temporary improvement,” said Dr. al-Ghouti.
Diabetes in Gaza is no longer an easy condition to manage. Between insulin shortages, lack of testing kits, rising prices, and deteriorating nutrition, every aspect of treatment has become a daily struggle for survival.
