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Dialysis Patients Struggle to Get Treatment in Blockaded Gaza. Officials Say Hundreds Have Died 

Mohamed Attiya, 54, receives dialysis treatment at Shifa hospital in Gaza City, Monday, April 14, 2025.(AP)
Mohamed Attiya, 54, receives dialysis treatment at Shifa hospital in Gaza City, Monday, April 14, 2025.(AP)
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Dialysis Patients Struggle to Get Treatment in Blockaded Gaza. Officials Say Hundreds Have Died 

Mohamed Attiya, 54, receives dialysis treatment at Shifa hospital in Gaza City, Monday, April 14, 2025.(AP)
Mohamed Attiya, 54, receives dialysis treatment at Shifa hospital in Gaza City, Monday, April 14, 2025.(AP)

Twice a week, Mohamed Attiya’s wheelchair rattles over Gaza’s scarred roads so he can visit the machine that is keeping him alive.

The 54-year-old makes the journey from a temporary shelter west of Gaza City to Shifa Hospital in the city’s north. There, he receives dialysis for the kidney failure he was diagnosed with nearly 15 years ago. But the treatment, limited by the war's destruction and lack of supplies, is not enough to remove all the waste products from his blood.

“It just brings you back from death,” the father of six said.

Many others like him have not made it. They are some of Gaza’s quieter deaths from the war, with no explosion, no debris. But the toll is striking: Over 400 patients, representing around 40% of all dialysis cases in the territory, have died during the 18-month conflict because of lack of proper treatment, according to Gaza's Health Ministry.

That includes 11 patients who have died since the beginning of March, when Israel sealed the territory's 2 million Palestinians off from all imports, including food, medical supplies and fuel. Israeli officials say the aim is to pressure Hamas to release more hostages after Israel ended their ceasefire.

COGAT, the Israeli military body in charge of coordinating aid, declined to comment on the current blockade. It has said in the past that all medical aid is approved for entry when the crossings are open, and that around 45,400 tons of medical equipment have entered Gaza since the start of the war.

Hardships mount for Gaza patients

Attiya said he needs at least three dialysis sessions every week, at least four hours each time. Now, his two sessions last two or three hours at most.

Israel’s blockade, and its numerous evacuation orders across much of the territory, have challenged his ability to reach regular care.

He has been displaced at least six times since fleeing his home near the northern town of Beit Hanoun in the first weeks of the war. He first stayed in Rafah in the south, then the central city of Deir al-Balah. When the latest ceasefire took effect in January, he moved again to another school in western Gaza City.

Until recently, Attiya walked to the hospital for dialysis. But he says the limited treatment, and soaring prices for the mineral water he should be drinking, have left him in a wheelchair.

His family wheels him through a Gaza that many find difficult to recognize. Much of the territory has been destroyed.

“There is no transportation. Streets are damaged,” Attiya said. “Life is difficult and expensive.”

He said he now has hallucinations because of the high levels of toxins in his blood.

“The occupation does not care about the suffering or the sick,” he said, referring to Israel and its soldiers.

A health system gutted by war

Six of the seven dialysis centers in Gaza have been destroyed during the war, the World Health Organization said earlier this year, citing the territory’s Health Ministry. The territory had 182 dialysis machines before the war and now has 102. Twenty-seven of them are in northern Gaza, where hundreds of thousands of people rushed home during the two-month ceasefire.

“These equipment shortages are exacerbated by zero stock levels of kidney medications,” the WHO said.

Israel has raided hospitals on several occasions during the war, accusing Hamas of using them for military purposes. Hospital staff deny the allegations and say the raids have gutted the territory's health care system as it struggles to cope with mass casualties from the war.

The Health Ministry says over 51,000 Palestinians, mostly women and children, have been killed in Israel's offensive, without saying how many were civilians or combatants. Hamas-led fighters killed some 1,200 people, mostly civilians, and abducted 251 in the Oct. 7, 2023 attack that triggered the war.

Officials say hundreds of patients have died

At Shifa Hospital, the head of the nephrology and dialysis department, Dr. Ghazi al-Yazigi, said at least 417 patients with kidney failure have died in Gaza during the war because of lack of proper treatment.

That’s from among the 1,100 patients when the war began.

Like Attiya, hundreds of dialysis patients across Gaza are now forced to settle for fewer and shorter sessions each week.

“This leads to complications such as increased levels of toxins and fluid accumulation ... which could lead to death,” al-Yazigi said.

Mohamed Kamel of Gaza City is a new dialysis patient at the hospital after being diagnosed with kidney failure during the war and beginning treatment this year.

These days, “I feel no improvement after each session,” he said during one of his weekly visits.

The father of six children said he no longer has access to filtered water to drink, and even basic running water is scarce. Israel last month cut off the electricity supply to Gaza, affecting a desalination plant producing drinking water for part of the arid territory.

Kamel said he has missed many dialysis sessions. Last year, while sheltering in central Gaza, he missed one because of an Israeli bombing in the area. His condition deteriorated, and the next day he was taken by ambulance to Al-Aqsa Martyrs hospital.

“The displacement has had consequences,” Kamel said. “I am tired.”

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What Egypt’s Red Lines Mean for Sudan’s War

Egyptian President Abdel Fattah al-Sisi holds talks with Sudan’s army chief Abdel Fattah al-Burhan in Cairo on Thursday (Egyptian Presidency)
Egyptian President Abdel Fattah al-Sisi holds talks with Sudan’s army chief Abdel Fattah al-Burhan in Cairo on Thursday (Egyptian Presidency)
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What Egypt’s Red Lines Mean for Sudan’s War

Egyptian President Abdel Fattah al-Sisi holds talks with Sudan’s army chief Abdel Fattah al-Burhan in Cairo on Thursday (Egyptian Presidency)
Egyptian President Abdel Fattah al-Sisi holds talks with Sudan’s army chief Abdel Fattah al-Burhan in Cairo on Thursday (Egyptian Presidency)

In unusually blunt language, and following a visit by Sudan’s Sovereignty Council Chairman and army chief Abdel Fattah al-Burhan to Cairo, the Egyptian presidency issued a statement on the war in Sudan outlining three points it described as red lines.

It said Egypt would not allow any of them to be crossed or compromised, as they directly affect Egypt’s national security, which it said is inseparable from Sudan’s national security.

The reference to activating the joint defense agreement between the two countries was seen as a signal that Egypt could bring its military, political, and diplomatic weight to bear in support of the Sudanese army.

Joint defense agreement

In March 2021, Egypt signed a military cooperation agreement with Sudan that covers training, border security, and the confrontation of shared threats. That agreement followed a joint defense pact signed in 1976 during the presidencies of Sudan’s Gaafar Nimeiry and Egypt’s Anwar Sadat.

Articles One and Two of the pact stipulate that any attack on one party is considered an attack on the other, and require immediate consultation, including the use of armed force to repel aggression. The agreement also commits both sides to coordinating their defense and military policies on matters related to their national security.

After the fall of Nimeiry’s regime in the 1985 popular uprising, then Prime Minister Sadiq al-Mahdi informed the Egyptian leadership of his desire to cancel the joint defense agreement. Instead, the two sides signed what became known as the Brotherhood Charter in 1987. While it did not explicitly cancel the 1976 agreement, its mechanisms have not been discussed or activated since then.

Regional and international messages

Sudanese journalist Osman Mirghani, editor-in-chief of Al-Tayar newspaper, said the Egyptian statements amounted to regional and international messages linked to recent developments and what he described as serious security threats facing Sudan.

He pointed to the expansion of the Rapid Support Forces in the Darfur and Kordofan regions in a way that threatens shared Sudanese and Egyptian national security, warning of risks of geographic fragmentation that could endanger Sudan’s unity.

Speaking to Asharq Al-Awsat, Mirghani said Egypt was, for the first time, using direct and tough language and signaling the possibility of intervention under international law in Sudan’s conflict. He said this reflected the level of Egyptian concern over the situation in Sudan.

Mirghani added that the reference to red lines was a message directed at all parties, noting that there are many influential players in Sudan.

The red lines

The first red line cited by Cairo was the preservation of Sudan’s unity and territorial integrity, preventing any tampering with its resources or those of the Sudanese people, and rejecting the secession of any part of the country. Egypt reiterated its categorical refusal to the establishment or recognition of any parallel entities, saying such moves would undermine Sudan’s unity and territorial integrity.

The statement also stressed the need to preserve Sudanese state institutions and prevent any harm to them. Egypt affirmed its full right to take all necessary measures permitted under international law, including activating the joint defense agreement between the two brotherly countries, to ensure these red lines are not crossed.

Timing of the visit

Former Sudanese Foreign Minister Ali Youssef noted the timing of Burhan’s visit to Cairo, stating that it occurred after his trip to Saudi Arabia earlier this week and following a visit by Saudi Crown Prince Mohammed bin Salman to the United States.

Youssef said the trip was part of efforts to end the war in Sudan through the Quartet mechanism, which includes Saudi Arabia, the United Arab Emirates, Egypt, and the United States.

Speaking to Asharq Al-Awsat, Youssef said Burhan briefed Egyptian President Abdel Fattah al-Sisi on the outcomes of his Saudi visit and the latest developments in Sudan.

He stated that the visit did not follow the usual ceremonial protocol and was a result of developments in the war, noting that Egypt’s security is linked to Sudan’s security. He added that Egypt is part of the Quartet, which seeks to end a war that is approaching its third year.

Military implications

Sudanese military expert Al-Muatasim Abdel Qader said activating the joint agreement would imply Egyptian intervention in various forms, including supplying weapons and ammunition or direct military involvement.

He said the provisions of the agreement obligate each army to defend the other, adding that the red lines outlined by the Egyptian presidency represented a significant step and carried major implications for the Sudanese state.

In remarks to Asharq Al-Awsat, Abdel Qader described mutual protection between the two countries as a historically rooted matter, dating back to wars Egypt fought in the last century in which Sudanese armed forces took part.

Rapid Support Forces response

Basha Tabiq, an adviser to the commander of the Rapid Support Forces, said in posts on X that Egypt’s position amounted to blatant interference, bias toward one party, and a colonial mindset that views Sudan as a backyard.

Another source aligned with the RSF said accusations against Egypt of backing the Sudanese army have persisted since the early days of the war. The source pointed to the presence of Egyptian forces at Merowe air base in northern Sudan at the start of the conflict, when several Egyptian soldiers and officers were captured before later being handed over to Cairo.

The source also cited accusations by RSF leader Mohamed Hamdan Dagalo, known as Hemedti, who said in October 2024 that the Egyptian army had carried out air strikes against his forces and supplied the Sudanese army with drones and training.

He said Hemedti renewed those accusations last June, alleging that Cairo supported the Sudanese army with aircraft flown by Egyptian pilots that bombed areas under his forces’ control, and supplied weapons and aviation fuel. Hemedti described this as a blatant aggression against the Sudanese people.

The source, who requested anonymity, said Egypt has been intervening in the war from the outset and that activating the joint defense agreement would merely formalize an existing reality.

No time to spare

Sudanese ambassador Al-Sadiq al-Maqli said Egypt is working with Saudi Arabia and the international Quartet, in coordination with the United States, to give fresh momentum to efforts on Sudan.

He said Washington is currently using soft power rather than force, which he described as an option deferred until shuttle diplomacy by US President’s senior adviser Massad Boulos is exhausted.

Speaking to Asharq Al-Awsat, Maqli said the United States fully understands the influence of Saudi Arabia and Egypt and their ability to persuade and soften the stance of Sudan’s government, which has rejected the latest US initiative.

He said Burhan currently has no time to spare, as what is unfolding in Sudan represents the world’s worst humanitarian disaster, according to the international community.

Maqli noted that Egypt, represented by Foreign Minister Badr Abdelatty, has been almost fully dedicated to making the Quartet mechanism succeed, given that the continuation of the current situation in Sudan poses a threat to Egypt’s national security.

He described Burhan’s visits to Riyadh and Cairo as short but necessary steps toward accepting the Quartet initiative, saying the Saudi visit marked a qualitative shift in the Sudanese government’s official position.

He added that Sudan’s foreign ministry later expressed Port Sudan’s readiness to cooperate with President Donald Trump, his secretary of state, and Boulos in efforts to achieve peace in Sudan, predicting imminent developments that could lead to a major breakthrough in the crisis.

Features

Iraq Negotiates New Coalition Under US Pressure

Election workers count ballots as they close a polling station, during the parliamentary elections in Baghdad, Iraq, Nov. 11, 2025. (AP)
Election workers count ballots as they close a polling station, during the parliamentary elections in Baghdad, Iraq, Nov. 11, 2025. (AP)
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Iraq Negotiates New Coalition Under US Pressure

Election workers count ballots as they close a polling station, during the parliamentary elections in Baghdad, Iraq, Nov. 11, 2025. (AP)
Election workers count ballots as they close a polling station, during the parliamentary elections in Baghdad, Iraq, Nov. 11, 2025. (AP)

More than a month after Iraq's parliamentary elections, the country's top leaders remain locked in talks to form a government while facing pressure from Washington to exclude Tehran-backed armed groups.

Amid seismic changes in the Middle East, where new alliances are forming and old powers waning, Iraqi leaders face a daunting task: navigating relations with US-blacklisted pro-Iranian factions.

The US has held significant sway over Iraqi politics since leading the 2003 invasion that ousted long-time ruler Saddam Hussein.

But another specter also haunts Iraq's halls of power: Washington's arch-foe, Iran.

Iraq has long been caught between the two, with successive governments negotiating a delicate balance.

Now, after November's election, Washington has demanded the eventual government must exclude Iran-backed armed groups and instead move to dismantle them, Iraqi officials and diplomats told AFP.

A State Department spokesperson, speaking on condition of anonymity, said: "Iraqi leaders well know what is and is not compatible with a strong US-Iraq partnership".

Washington, the spokesperson said, "will continue to speak plainly to the urgency of dismantling Iran-backed militias".

But some of these groups have increased their presence in the new chamber and have joined the Coordination Framework, an alliance of Shiite parties with varying ties to Iran and which holds the majority.

For weeks, the Coordination Framework has been embroiled in talks to nominate the next prime minister.

"The US has put conditions that armed factions should not be part of the new government," a senior Iraqi official said. The factions must disarm and "sever ties with Iran's Revolutionary Guard," he added.

In recent tweets, the US special envoy to Iraq, Mark Savaya said that Iraqi leaders are at a "crossroads".

Their decision "will send a clear and unmistakable signal to the United States... that Iraq is ready to claim its rightful place as a stable and respected nation in the new Middle East.

"The alternative is equally clear: economic deterioration, political confusion, and international isolation," Savaya said.

The US has blacklisted as "terrorist organizations" several armed groups from within the pro-Iran Popular Mobilization Forces, a former paramilitary alliance now integrated into the armed forces.

They are also part of the Iran-backed so-called "Axis of Resistance" and have called for the withdrawal of US troops -- deployed in Iraq as part of an anti-ISIS coalition -- and launched attacks against them.

Most of these groups hold seats in parliament and have seen their political and financial clout increase.

The Asaib Ahl al-Haq faction, led by Qais al-Khazali, who is a key figure in the Coordination Framework, won 27 seats in the latest election, making it harder to exclude it from the government.

A potential compromise is to deny it a key portfolio, as in the current government.

"The US has turned a blind eye before, so they might after all engage with the government as a whole but not with ministries held by armed groups," a former Iraqi official said.

Other blacklisted groups are:

+ Kataeb Hezbollah, one of the most powerful armed groups, supports a parliamentary bloc (six seats).

+ Kataeb Sayyid al-Shuhada, Kataeb Imam Ali and Harakat Ansar Allah al-Awfiya.

+ The al-Nujaba movement is the only group that has steered clear of elections.

Iraq has its economic growth to worry about.

After decades of turmoil, it has only begun to regain a sense of normalcy in recent years.

Washington has already imposed sanctions on several Iraqi entities and banks, accusing them of helping Tehran evade sanctions.

But Iraqi leaders hope for greater foreign investments and support partnerships with US companies.

The most striking endorsement came from Khazali, an opponent of the US military presence who now argues that it would be in Baghdad's interest for major US companies to invest.

Since the Israel's war with Hamas in Gaza began in October 2023, Iraq has remained relatively unscathed by the turmoil engulfing the Middle East.

Iraqi armed groups did launch attacks on US troops and largely unsuccessful ones on Israel. Washington responded with heavy strikes, and the attacks have long since halted.

Iraq remained the only close regional ally of Iran to stay out of Israel's crosshairs.

So far, the US has acted as a buffer, helping to prevent an Israeli attack, but Iraqis have been warned of strikes against the armed groups, multiple sources said.

But as the presence of American forces dwindles, fears are growing.

Features

Bethlehem Camp's 'Lifeline' Football Field Faces Israeli Demolition

Displaced Palestinian youths take part in a training session at the Aida Refugee Camp's football pitch, next to the separation wall outside Bethlehem in the occupied West Bank, on December 16, 2025, a few weeks after an Israeli military decision to demolish the field. (AFP)
Displaced Palestinian youths take part in a training session at the Aida Refugee Camp's football pitch, next to the separation wall outside Bethlehem in the occupied West Bank, on December 16, 2025, a few weeks after an Israeli military decision to demolish the field. (AFP)
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Bethlehem Camp's 'Lifeline' Football Field Faces Israeli Demolition

Displaced Palestinian youths take part in a training session at the Aida Refugee Camp's football pitch, next to the separation wall outside Bethlehem in the occupied West Bank, on December 16, 2025, a few weeks after an Israeli military decision to demolish the field. (AFP)
Displaced Palestinian youths take part in a training session at the Aida Refugee Camp's football pitch, next to the separation wall outside Bethlehem in the occupied West Bank, on December 16, 2025, a few weeks after an Israeli military decision to demolish the field. (AFP)

Earlier this month a group of Palestinian boys turned out to train at their local football pitch in the shadow of the wall separating Israel from the West Bank's Aida refugee camp -- and found a note at the gate.

The children took the ominous message from Israeli authorities to Muhannad Abu Srour, sports director at the Aida Youth Center in the camp near Bethlehem, and the news was not good.

"We were shocked to discover that it was a decision to demolish Aida camp's football field," Abu Srour told AFP, adding that more than 500 children regularly train on the field roughly half the size of a regulation soccer pitch.

"The football field is the only open space we have. If the field is taken away, the children's dream is taken away," Abu Srour said.

The planned destruction of the Aida field is one of many points of contention in the occupied West Bank, but it is a particularly painful one for young Palestinians yearning for a better future.

One of the older members, 18-year-old Abdallah al-Ansurur, hopes to make it into the national Palestinian team, and, like many other youth at Aida camp, took his first steps in the game on the pitch flanked by the eight-meter concrete Israeli wall.

"I started when I was about 13 years old. This field gave me a real opportunity to train," said Ansurur, who was born and raised in Aida camp, one of the smallest in the West Bank.

Ansurur, who trains to be a goalkeeper, calls the astroturf-covered piece of land a "lifeline".

"Without this field, I wouldn't have had this chance. If it didn't exist, we'd be playing in the streets -- or not playing at all," he said.

Israel has occupied the West Bank since 1967 and frequently demolishes Palestinian homes or infrastructure, arguing they were built without permits.

AFP was shown the note from COGAT, the Israeli defense ministry body in charge of Palestinian civilian affairs, which says the field was not authorized.

But Anton Salman, who was mayor of adjacent Bethlehem when the field was built in 2021, told AFP the construction was legal.

Salman said his municipality leased the land from the Armenian Church authorities to whom it belongs, before allowing Aida camp's popular committee to manage it for the benefit of residents.

Saeed al-Azzeh, head of the popular committee, confirmed the information, calling the space, "the only breathing space" for camp residents.

"Today, more than 7,000 people live on the same piece of land. Streets are narrow, alleys are cramped -- there is nowhere else," Azzeh said, referring to the camp.

Like other Palestinian refugee camps, Aida was built to accommodate some of the hundreds of thousands of people who either fled their homes or were forced out during the creation of Israel in 1948.

With time, tents gave way to concrete buildings, with the football field representing one of the few open spaces in the camp's dense patchwork.

Abu Srour is proud of what came out of the field, with youth sports delegations able to travel abroad to play, a welcome escape from the West Bank's myriad restrictions.

This is because checkpoints, a fixture of the West Bank since the start of Israel's occupation, have multiplied since the start of the war in Gaza.

Abu Srour mentioned that bringing a local team to Ramallah, a city 20 kilometers (12.5 miles) away as the crow flies, took six hours recently, instead of one hour in the past.

Restricted mobility is a major issue for most Palestinian athletes as it makes it nearly impossible for athletes of similar levels from different cities to train together.

Waseem Abu Sal, who was the first Palestinian boxer to participate in the Olympics, told AFP he frequently sparred with athletes of different levels or weight categories for lack of mobility.

Taking a short break from running a practice for 50 excited five- to 10-year-old boys, coach Mahmud Jandia told AFP he hoped the field would remain.

"Yes, the wall is there -- it feels like a prison -- but despite that, the most important thing is that the field remains and the children keep playing."

"If the field is demolished, all the children's dreams will be demolished with it."