IN Gaza, falling ill can be a death sentence. Cancer patients are waiting to die, polio has returned, and many of the doctors and nurses who might have offered help are dead while the hospitals they worked at have been reduced to rubble.
Doctors and health professionals say that even if the Israel-Hamas war were to stop tomorrow, it will take years to rebuild the healthcare sector and people will continue to die because preventable diseases are not being treated on time.
"People are dying on a daily basis because they cannot get the basic treatment they need," said Riham Jafari, advocacy and communications coordinator at rights group ActionAid Palestine.
Cancer patients "are waiting for their turn to die", she told the Thomson Reuters Foundation.
Last week, Israel and Hamas agreed on limited pauses in the fighting to allow children to be vaccinated against polio after a 1-year-old baby boy was found to be partially paralysed from the disease, the first case in the crowded strip in 25 years.
But even as crowds gathered in the southern cities of Rafah and Khan Younis for vaccinations on Sept 5, Israeli bombs continued to fall in other areas with Gaza health officials saying an Israeli strike killed five people at the Al-Aqsa Hospital in Deir Al-Balah.
"It will take long and so much effort in order to restore the level of care that we used to have in Gaza," said Mohammed Aghaalkurdi, medical programme lead at Medical Aid for Palestinians.
Every day he sees around 180 children with skin diseases that he "just cannot treat", he said.
"Due to vaccination campaign interruptions, lack of supplies, lack of hygiene items and infection prevention control material, it (healthcare) is just deteriorating."
Since Oct 7, more than 40,800 Palestinians have been killed by Israel's offensive in the enclave with around 92,000 wounded.
Beyond the death toll from the fighting and airstrikes, people are also succumbing to illnesses that could be cured in normal circumstances. As with the re-emergence of polio, children will bear the brunt of these long-term consequences, health experts say.
"We are talking about disabilities, we are talking about intellectual disabilities, mental health issues," said Aghaalkurdi.
Many people have become weak from a lack of food, as prices of basic commodities have more than quadrupled since the conflict began.
When they become ill, they are also too frightened to journey to the few remaining hospitals, Jafari said.
According to a report by the Global Network Against Food Crises, more than 90 per cent children under 5-years-old suffer from infectious diseases.
Skin diseases are rampant because of a lack of cleaning supplies and hygiene products, Jafari said. In markets, a bottle of shampoo can cost around US$50.
Israel has severely restricted the flow of food and aid into Gaza, and humanitarian agencies have warned of the risk of famine. Jafari expects a reckoning after the war ends.
Manal Ragheb Fakhri al-Masri, 42, is one of those facing that health reckoning.
Displaced seven times with her nine children, she has a heart condition and a benign tumour in her stomach and was supposed to leave Gaza for treatment earlier this year.
But then her husband was killed and she could not bear to leave her children. She has not had any medicine in five months and has not even been able to shower for two weeks.
"My husband used to take care of me and get medicine and feed his children," she said in phone interview. "Now I do not know what do. We do not have the most basic things."
Her children are also all suffering from red rashes but they have no creams to soothe their burning limbs.
Waseem Alzaanin, a general practitioner with the Palestine Red Crescent Society, said the lack of drugs, equipment and medical facilities is killing his cancer patients.
Gaza's only cancer centre was destroyed earlier this year, he said. Many of his stage-one cancer patients are now classified as stage-four.
"The most basic requirements are not present. We cannot do anything except give them painkillers and make them comfortable with what life they have left," he said.
"It is like a death sentence," he added. "Let us not kid ourselves. We have no medical system."
The writer is from Reuters