In recent images, Jana Ayyad is seen curled into herself, her face hidden in her hands. At times, the frail eight-year-old weeps, calling for her father, who has been stranded outside Gaza since the conflict began nearly two years ago.
Jana is now fighting for her life. Her sole chance of survival is immediate medical evacuation from Gaza to receive care abroad.
Her health decline began with acute malnutrition, which later caused severe acidosis—a condition where bodily fluids become dangerously acidic due to the failure of the kidneys and lungs to maintain balance. Medical workers report they lack the necessary supplies to treat it. Over the past month, her body has swelled, a common sign of malnutrition and acidosis.
“The doctor told me clearly: ‘Your daughter’s condition is critical; she could be gone at any moment,’” said Nesma Ayyad, Jana’s mother. Two months earlier, her two-year-old sister, Joury, was hospitalized after her skin began peeling and bleeding. She passed away within weeks. Ayyad fears that without swift intervention, Jana will meet the same fate.
Israel controls all movement in and out of Gaza. Those requiring medical care abroad must first secure approval from Cogat, the Israeli military body overseeing humanitarian issues for Palestinians. Applicants must complete an Israeli security screening and find a country willing to accept them.
Officials stated they requested Jana’s transfer to Jordan two weeks ago but are still awaiting Israel’s decision. Her case was filed alongside those of 10 other critically ill children seeking evacuation, but so far only two have been approved, according to an official familiar with the process.
Cogat denied receiving a request for Jana’s evacuation in a statement.
Dr. Musab Farwana, one of Jana’s doctors at the Patients’ Friends Benevolent Society hospital in Gaza, said, “Jana’s health is worsening. With such limited resources, we are doing everything possible to sustain her until she can be evacuated. Without an immediate transfer, it’s likely she won’t survive.”
Jana’s situation, while dire, is far from isolated. She is among over 16,000 individuals awaiting medical treatment abroad, according to Gaza’s health ministry data from August.
Israel’s prolonged military campaign in Gaza has left more than 150,000 injured, while its widespread destruction of infrastructure has fueled disease in the densely populated area. A severe aid blockade has caused famine, according to experts, leaving healthcare workers without the tools to treat malnutrition and illness.
While the most urgent cases are referred for treatment abroad, doctors and officials say most requests face indefinite delays.
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