Israel's military incursion of the southern Gazan city of Rafah and chokehold on key border crossings have pushed the Palestinian enclave's hospitals to the brink of collapse.
Souad Zohair, 73, has been kept alive by kidney dialysis three days a week at a hospital in Rafah, but that's shut now by Israel's latest offensive.
Her daughter brought her up the dangerous coastal road to the last hospital left in the Gaza Strip that still has functioning dialysis machines.
In a crowded room, her blood was trickling through tubes from her hand into the machine. Today, she'll live.
"This is the only remaining hospital (for dialysis) serving the entire Gaza Strip, serving around 1,000 remaining patients with kidney failure," said Dr. Saeed Khattab, head of the kidney department at Al Aqsa Martyrs hospital in Deir al-Balah in central Gaza.
There are 19 machines here. Staff are keeping them running round the clock, 200 sessions a day, with barely enough time to sterilize them between patients, Khattab said. It's not enough.
Zohair's treatment is supposed to last four hours, but in Gaza's brutal medical arithmetic, she can have the machine for just two. No one can say when she will get it again.
"She will soon get tired, tomorrow or the day after, and I don't know how we will bring her here or where to go," said her daughter Umm Bilal Zohair.
"How will we come here if she gets tired at night? There are no ambulances, the area is dangerous, no ambulances will come to us and there's nothing."
Collapse
Israel's assault around Rafah on the southern edge of the Gaza Strip is finally bringing what was left of the enclave's medical system to its knees, doctors say.
Tanks are massed on the outskirts of the city and a huge population of sick and injured is running out of places to go and safe ways to get there.
Fighting has directly shut down some of the main medical facilities that had served half of Gaza's 2.3 million people who have been sheltering in Rafah.
The two checkpoints into southern Gaza have also been shut, blocking the arrival of basic supplies such as fuel, though Israel says it reopened its Kerem Shalom crossing Wednesday and is trying to get aid through.
Rafah's main Najjar hospital, where Zohair was a dialysis patient, abruptly shut as the fighting came close. The Emirati maternity hospital where 85 babies per day were being born stopped receiving patients.
Closing the sole checkpoint to Egypt means patients needing emergency care can no longer be evacuated out of the Gaza Strip. Volunteer foreign medics can no longer get in, or go home.
Israel says any disruption to aid from its latest assault should be brief, and additional field hospitals will be provided near the coast in an area it says is safe.
Meanwhile, the sick and wounded are crowding into Al Aqsa hospital in Deir al-Balah.
"There used to be medical aid coming in, and now there is no medical aid," said Ali Abu Khurma, a Jordanian laparoscopic surgeon volunteering at Al Aqsa. Basic supplies were missing, like sterile gauze and surgical gowns.
"There are no beds for the patients. The patients are all over the hospital; in the corridors, in the halls, there are beds everywhere. Some have one or two patients on them. In the reception, there are patients on the floor," he told Reuters as the sound of a patient howling in pain could be heard from behind a door to a nearby ward.
"The entire medical sector has collapsed."