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Sickness Can Be ‘Death Sentence’ in Gaza as War Fuels Disease 

A Palestinian woman reacts at the site following Israeli strikes on a tent camp sheltering displaced people, amid the Israel-Hamas conflict, at the Al-Mawasi area in Khan Younis, in the southern Gaza Strip, September 10, 2024. (Reuters)
A Palestinian woman reacts at the site following Israeli strikes on a tent camp sheltering displaced people, amid the Israel-Hamas conflict, at the Al-Mawasi area in Khan Younis, in the southern Gaza Strip, September 10, 2024. (Reuters)
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Sickness Can Be ‘Death Sentence’ in Gaza as War Fuels Disease 

A Palestinian woman reacts at the site following Israeli strikes on a tent camp sheltering displaced people, amid the Israel-Hamas conflict, at the Al-Mawasi area in Khan Younis, in the southern Gaza Strip, September 10, 2024. (Reuters)
A Palestinian woman reacts at the site following Israeli strikes on a tent camp sheltering displaced people, amid the Israel-Hamas conflict, at the Al-Mawasi area in Khan Younis, in the southern Gaza Strip, September 10, 2024. (Reuters)

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 one-year-old baby boy was found to be partially paralyzed 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, 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 program 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."

The conflict was triggered when Hamas-led fighters attacked southern Israel on Oct. 7, killing 1,200 people and taking more than 250 hostages, according to Israeli tallies.

Since then, more than 40,800 Palestinians have been killed by Israel's offensive in the enclave, according to the Gaza health ministry, with around 92,000 wounded.

But 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.

"Things that will stick to the child until they die."

SPECIALISTS KILLED

At least 490 healthcare workers have been killed since the conflict erupted, according to Gaza's health ministry. A Reuters investigation found that 55 highly qualified specialist doctors were among those killed.

With each specialist killed, Gaza has lost a source of knowledge and human connections, a devastating blow on top of the destruction of most of the Strip's hospitals.

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.

Eighty-two percent of children aged between 6 and 23 months have limited access to quality food, according to a report by the Global Network Against Food Crises, and more than 90% of children under 5-years-old suffer from infectious diseases.

Meanwhile, 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 $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.

"There is delayed suffering, delayed sadness, there are diseases that are being delayed," she said. "There is an entire journey of suffering that is being delayed until the end of the war," she said.

CANCER 'DEATH SENTENCE'

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 tumor 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.

Now, having also suffered several strokes, she is bedridden, unable to leave her tent by the sea in Al-Mawasi, which Israel had declared a safe zone. 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 a phone interview with the Thomson Reuters Foundation. "Now I do not know what do. We do not have the most basic things."

Her children try to help as much as they can and sometimes bring her seawater for her to wash with but the salty liquid offers no respite. 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 center was destroyed earlier this year, he said, and 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."

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Features

Four Iranian Narratives on the Collapse of the ‘Resistance’ in Syria  

Iran's General Qassem Soleimani makes a phone call near the historic Citadel of Aleppo, winter 2016. (Fars)
Iran's General Qassem Soleimani makes a phone call near the historic Citadel of Aleppo, winter 2016. (Fars)
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Four Iranian Narratives on the Collapse of the ‘Resistance’ in Syria  

Iran's General Qassem Soleimani makes a phone call near the historic Citadel of Aleppo, winter 2016. (Fars)
Iran's General Qassem Soleimani makes a phone call near the historic Citadel of Aleppo, winter 2016. (Fars)

One hundred and ninety-two days separated the last meeting between Iran’s Supreme Leader Ali Khamenei and Syria’s ousted President Bashar al-Assad in Tehran from the moment the Syrian regime fell to the opposition in December 2024.

That interval was no footnote in the Syrian war. It became a sharp mirror inside Tehran, reflecting the magnitude of the wager Iran’s leadership had placed on Assad, and the limits of its ability to anticipate the trajectory of the conflict and shifts in the regional balance of power.

At that meeting, Khamenei laid out the essence of his “Syrian doctrine” amid changing realities across the “Axis of Resistance.” Syria, he argued, was no ordinary state but one with a “special place” because its identity, in his view, stemmed from its role in this axis.

Since “resistance is Syria’s defining identity and must be preserved,” he addressed Assad not as a political ally but as a partner in that identity. He praised Assad for once saying that “the cost of resistance is lower than the cost of compromise” and that “whenever we retreat, the other side advances.” Thus, Khamenei reaffirmed his full - if belated – gamble on the regime’s survival, even as signs of collapse were unmistakable on the ground.

Less than seven months later, the regime would fall. Assad’s collapse would yield several Iranian narratives: the Supreme Leader’s, the Revolutionary Guard’s, the diplomatic narrative, and a fourth voiced from within the system itself, one that raised blunt questions about the price of Iran’s Syrian gamble.

Khamenei’s narrative

In his first speech after Assad’s fall, Khamenei offered a hard-edged explanation: the event, he said, was the product of a “joint American-Zionist plot,” aided by neighboring states. He spoke of factors that he claimed prevented Iran from providing the necessary support, including Israeli and US strikes inside Syria and the closure of air and land corridors to Iranian supplies.

He concluded that the decisive flaw lay within Syria itself, where the “spirit of resistance” had eroded in state institutions.

He stressed that the regime’s fall did not mean the fall of the idea of “resistance,” predicting that “patriotic Syrian youth” would one day revive it in a new form.

This narrative rejects the notion of strategic defeat: for Khamenei, what happened is not the end of the struggle, but a harsh phase in a longer one.

Revolutionary Guard’s narrative

The Islamic Revolutionary Guard Corps (IRGC) adopted a language closer to national security logic than pure ideology, though it drew from the same lexicon. In 2013, cleric Mehdi Taeb, head of the IRGC’s Ammar Headquarters think tank, framed the equation starkly: “Syria is our 35th province... If the enemy attacks Syria or Khuzestan, our priority is to keep Syria.”

With that shocking sentence, Syria was elevated to the level of Iranian strategic geography, sometimes above parts of Iran itself.

Late General Qassem Soleimani, then commander of the Quds Force, became the chief architect of this approach: confronting threats abroad by building multinational militia networks and using the “protection of shrines” as a mobilizing slogan that fused ideology with national security calculations.

A month after Assad’s fall, at a memorial for Soleimani, Khamenei reaffirmed this school of thought, linking the defense of shrines in Damascus and Iraq to the defense of “Iran as a sanctuary,” aiming to bind various fronts into a single cross-border security-sectarian struggle.

After the Syrian regime’s collapse, this narrative preserved its core: success or failure is not defined by who sits in Damascus, but by whether the IRGC’s influence networks remain intact and whether Iran still has access to Syrian depth.

Full withdrawal would amount, in this logic, to admitting that the “35th province” had slipped from the map, so the IRGC will continue to search for any possible foothold.

Diplomatic narrative

Iran’s diplomatic apparatus sought to tell a softer story. Weeks before the fall, Khamenei dispatched his adviser Ali Larijani to Damascus and Beirut with reassuring messages for Assad and other allies, publicly asserting that events in Syria and Lebanon “directly concern Iran’s national security.”

Days later, Foreign Minister Abbas Araghchi visited Damascus just six days before the collapse, even posing with shawarma in a downtown restaurant to signal “normalcy” and dismiss talk of impending downfall as “psychological warfare.”

It was the peak of the gap between diplomatic messaging and a disintegrating reality.

Afterward, the Foreign Ministry adopted a defensive formula: Iran had “responded to the request of an allied government”, but “cannot decide on behalf of peoples.” Thus, responsibility was shifted toward Syrian internal failures and the external “conspiracy” often invoked by Khamenei.

This narrative treats Syria as one file among many, not an existential arena as seen by the IRGC and the Leader.

‘Open account’ narrative

The fourth narrative emerged, unexpectedly, from within the establishment itself. For the first time, semi-public acknowledgments surfaced that the economic return on Iran’s Syrian adventure was nearly nil and that the political-security “investment” had resulted in something resembling a net loss.

In 2020, former member of the Iranian parliamentary national security and foreign policy committee, Heshmatollah Falahatpisheh revealed that Tehran had spent “$20-30 billion” in Syria, insisting: “This is the people’s money and must be recovered.”

Five years later, he returned with a more bitter charge: Syria’s debts to Iran were effectively settled through “land without oil, cow farms without cows, and empty promises.”

This view is no outlier. Over a decade, Iranian protest slogans increasingly linked “Gaza, Lebanon, Syria” with bread, fuel, and economic hardship at home.

With Assad gone, critics more easily argue that Iran spent tens of billions and paid a human cost among its fighters and proxies, only to end up with almost no influence in Damascus.

For decision-makers, this narrative becomes domestic pressure against any large-scale return to Syria.

Four scenarios for Tehran

Taken together, these narratives reveal a deep contradiction: the IRGC and Khamenei refuse to concede that Iran “lost Syria,” treating the episode as one phase in a longer struggle. Meanwhile, the diplomatic and economic narratives acknowledge, implicitly, that the previous intervention model is no longer sustainable.

Four broad scenarios emerge. The first is a return through proxies, closest to the IRGC’s logic: Iran would rebuild influence from the ground up through militias - old or newly recruited - to pressure any future authority in Damascus.

The second is regional repositioning without Syria, in which Iran shifts resources to arenas where it still holds leverage, including Lebanon, Iraq, Yemen and Gaza, while limiting its role in Syria to preventing hostile entrenchment.

The third is a “gray” re-entry: a gradual, negotiated, non-confrontational return through localized deals or modest economic and security projects, allowing Tehran to claim continued presence without the cost of backing a single ruler.

The fourth is institutionalizing the loss: Iran accepts Syria’s departure from its strategic depth, but repackages the outcome within a narrative of “conspiracy and steadfastness,” using it to tighten internal control while maintaining symbolic presence through shrine rhetoric and minimal diplomacy.

Across all scenarios, one fact remains. Syria, which was once described as more vital than Khuzestan and the “distinct identity of resistance”, is no longer what it was before December 8, 2024 when the regime collapsed.

Tehran can invoke time, the IRGC can search for openings, diplomats can polish their statements, and critics can lament “land without oil.” But one question looms over every debate in Iran: Can Tehran afford a second Syrian-sized gamble after emerging from the first still trying to convince itself that the “resistance factor” remains standing, even as its Syrian pillar has broken?

Features

A Year After Assad’s Fall, Families of Missing Detainees Languish without Answers 

Amina Beqai holds a photo of her husband, who went missing after he was arrested by security forces under the rule of ousted President Bashar al-Assad, in Damascus, Syria, November 23, 2025. (Reuters)
Amina Beqai holds a photo of her husband, who went missing after he was arrested by security forces under the rule of ousted President Bashar al-Assad, in Damascus, Syria, November 23, 2025. (Reuters)
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A Year After Assad’s Fall, Families of Missing Detainees Languish without Answers 

Amina Beqai holds a photo of her husband, who went missing after he was arrested by security forces under the rule of ousted President Bashar al-Assad, in Damascus, Syria, November 23, 2025. (Reuters)
Amina Beqai holds a photo of her husband, who went missing after he was arrested by security forces under the rule of ousted President Bashar al-Assad, in Damascus, Syria, November 23, 2025. (Reuters)

A year after dictator Bashar al-Assad's ouster in Syria, little has changed in Amina Beqai's desperate quest. She types her missing husband's name yet again into an internet search box, hoping for answers to a 13-year-old question. In vain.

Beqai has nowhere else to turn.

A National Commission for Missing Persons established in May has been gathering evidence of enforced disappearances under Assad, but has yet to offer families any clues on the estimated 150,000 people who vanished in his notorious prisons.

They include Beqai's husband Mahmoud, arrested by Syria's security forces at their home near Damascus on April 17, 2012, and her brother Ahmed, detained in August that year.

Assad's overthrow initially stirred hope that prison records could tell families if, when and how their loved ones died. Mass graves dug by Assad's forces across Syria could be exhumed. Victims could be properly buried.

None of that has transpired.

"It's been a year. They didn't do anything ... Is it thinkable that they didn't even get the documents for these men? Showing us the truth is what we want," Beqai told Reuters.

FADING HOPES

As opposition fighters swept through Syrian towns last year on the way to capturing Damascus, they rushed first to the jails, flinging doors open to free thousands of bewildered prisoners.

On December 8, 2024, hours after Assad fled to Russia, the fighters freed dozens of prisoners from Sednaya, dubbed "the human slaughterhouse" by Amnesty International for the industrial-scale torture and executions undertaken there.

The emerging detainees did not include Beqai's loved ones.

"When the prisons were open, and they didn't come back – that was the shock. That was when the hope ended, it really died," Beqai said. But she demands to know how, when and where her husband and brother may have died.

With no updates from the national commission, Beqai said she had become "obsessed" with her online hunt, scouring pictures of dead detainees and scans of prison documents published by Syrian news outlets who entered jails and security branches after Assad's fall.

"All there is left to do is sit and search," she said.

Such documents have revealed crucial information.

Sarah al-Khattab last saw her husband heading into a police station in Syria's south on February 9, 2019 to reconcile with Assad's government after years holed up with insurgents.

She has had no news of him since.

A spreadsheet of dead Sednaya prisoners seen by Reuters after Assad's fall included his name, Ali Mohsen al-Baridi, dating his death as October 22, 2019 from "stopped pulse and breathing" with orders that the body not be given to his family.

Reuters passed its finding to the Syrian Justice and Accountability Center, an advocacy group working with families of the missing, who informed Khattab.

COMMISSION SEEKS HELP, OVERSIGHT

The national commission was established by new President Ahmed al-Sharaa. The commission's media adviser, Zeina Shahla, told Reuters its mandate includes any missing Syrian, no matter the circumstances.

"When it comes to the pain of the families, maybe we really are being slow. But this file needs progress to come carefully, in a way that is scientific and systemic and not rushed," she said.

Next year, the commission hopes to launch a database of all the missing using documents from prisons and other locations. Exhuming mass graves requires more technical expertise and probably won't happen until 2027, Shahla said.

The commission has met with Syrian advocacy groups and some families. In November, it signed a cooperation agreement with the Geneva-based International Committee of the Red Cross and the International Commission on Missing Persons, which have global expertise on the issue.

Syria's commission hopes that will lead to more training for its personnel and access to equipment in short supply in Syria, including DNA testing labs for exhumed remains.

"We welcome any kind of cooperation and support we can receive, as long as the issue remains under (our commission's) authority,” Shahla said.

RELATIVES, ACTIVISTS DEMAND BETTER

The government's approach has upset organizations who developed expertise on enforced disappearances while in exile during the Assad era, six rights groups told Reuters.

Many were excited to apply that knowledge on the ground with Assad gone, but say the government's centralized approach has excluded them, slowed progress and left families in limbo.

"When you have as many as a quarter of a million people missing, you can't do that. You break up the work," said Ahmad Helmi, a Syrian activist who leads Ta'afi, an initiative focused on missing detainees and prison survivors.

Activists also accuse the commission of "monopolizing" detention-related documents.

In September, Syrian authorities briefly detained Amer Matar, an activist who founded a virtual museum to preserve detainees' experiences, accusing him of illegally accessing official documents for personal purposes.

In November, the commission urged families not to believe any detention-related documents shared on unofficial online platforms, like the ones Beqai has been searching, and threatened legal action against those outlets.

"The commission wants to monopolize the file, but it lacks the tools, the competence and the transparency. It demands the trust of families but delivers no results," Matar said.

Shahla said the commission is "the central, official body authorized to reveal the fate" of missing people and that families needed one place to go to for accurate answers.

Agnes Callamard, head of Amnesty International, said the commission should issue regular updates about its progress and consider granting financial aid to relatives of missing people.

"The most important thing ... the national commission can do at the moment is ensuring that families feel they are being heard and being supported," she told Reuters.

As Syria marks a year since Assad's downfall, many people remain exhausted by the same burden that plagued them under his rule: the lack of closure.

Alia Darraji last saw her son Yazan on November 1, 2014, as he left home to meet friends near Damascus. He never returned.

In the last year, the elderly woman has spent time in "truth tents" - sit-ins demanding information on disappeared Syrians that were unthinkable under Assad. While solidarity has helped, it hasn't given her what her heart aches for.

"We were hoping to find their bodies, to bury them, or to find out where they are," Darraji said.

Features

‘It’s All Over’: How Iran Abandoned Assad to His Fate Days Before Fall

Iran was a staunch backer of Bashar al-Assad but quickly withdrew its forces once as opposition forces took over Syria. (AFP)
Iran was a staunch backer of Bashar al-Assad but quickly withdrew its forces once as opposition forces took over Syria. (AFP)
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‘It’s All Over’: How Iran Abandoned Assad to His Fate Days Before Fall

Iran was a staunch backer of Bashar al-Assad but quickly withdrew its forces once as opposition forces took over Syria. (AFP)
Iran was a staunch backer of Bashar al-Assad but quickly withdrew its forces once as opposition forces took over Syria. (AFP)

As city after city fell to a lightning opposition offensive in Syria last December, Iranian forces and diplomats supporting Bashar al-Assad saw the writing on the wall, abandoning the longtime ruler days before his ousting, sources told AFP.

During Syria's civil war, which erupted in 2011 following the government's brutal repression of pro-democracy protests, Iran was one of Damascus's biggest backers, sending Assad military advisers and forces from its Revolutionary Guards.

Iranian and allied regional fighters -- mainly from Lebanon's Hezbollah, but also from Iraq and Afghanistan -- had held key locations and helped prop up Assad, only to melt away in the face of opposition forces' headlong rush towards the capital.

Syrian officers and soldiers served under the Iranian Guards, whose influence grew during the conflict as Assad's power waned.

A former Syrian officer assigned to one of the Guards' security headquarters in Damascus said that on December 5 last year, his Iranian superior summoned him to an operations center in the Mazzeh district the following day to discuss an "important matter".

The former officer, requesting anonymity due to fears for his safety, said his superior, known as Hajj Abu Ibrahim, made a bombshell announcement to around 20 Syrian officers and soldiers gathered for the meeting.

"From today, there will be no more Iranian Revolutionary Guards in Syria. We're leaving," they were told.

"It's all over. From today, we are no longer responsible for you."

He said they were ordered to burn or otherwise destroy sensitive documents and remove hard drives from computers.

- Border bottleneck -

The announcement came as the opposition forces were making huge gains, but it still took the Syrian soldiers by surprise, he said.

"We knew things hadn't been going well, but not to that extent."

They received one month's salary in advance and went home.

Two days later the opposition forces captured Damascus without a fight after Assad fled to Russia.

Two Syrian employees of Iran's consulate in Damascus, requesting anonymity for security reasons, also described a hasty Iranian exit.

The consulate was empty by the evening of December 5 as Iranian diplomats scarpered across the border to Beirut, they told AFP.

Several Syrian employees "who held Iranian nationality left with them, accompanied by senior Revolutionary Guards officers", according to one of the former employees.

At Jdeidet Yabus, Syria's main border crossing with Lebanon, taxi drivers and former staff reported a massive bottleneck on December 5 and 6, with an eight-hour wait to clear the frontier.

Both of the former consulate employees said the Iranians told their Syrian personnel to stay home and paid them three months' salary.

The embassy, consulate and all Iranian security positions were deserted by the morning of December 6, they said.

- Russian base -

During the war, forces under Iranian command were concentrated in sensitive areas inside Damascus and its suburbs, particularly the Sayyida Zeinab area, home to an important Shiite shrine, and around Damascus airport, as well as near the Lebanese and Iraqi borders.

Parts of the northern city of Aleppo and locations elsewhere in the province were also major staging areas for personnel and fighters.

At a site that used to be a key military base for Iranian forces south of Aleppo, Colonel Mohammad Dibo said that when the city fell early in the opposition campaign, "Iran stopped fighting".

Iranian forces "had to withdraw suddenly after the quick collapse" of Assad's military, said Dibo, who took part in the opposition offensive and now serves in Syria's new army.

On the heavily damaged walls of the abandoned base, an AFP journalist saw Iranian and Hezbollah slogans, and a painting of a sword tearing through an Israeli flag.

Tehran's foe Israel had launched hundreds of strikes on Syria over the course of the war, mainly saying it was targeting Assad's army and Iran-backed groups.

The former Syrian army officer who requested anonymity said that on December 5, a senior Iranian military official known as Hajj Jawad and several Iranian soldiers and officers were evacuated to Russia's Hmeimim base on the Mediterranean coast, then flown back to Tehran.

At the abandoned site near Aleppo, Dibo said that after the city's fall, "some 4,000 Iranian military personnel were evacuated via Russia's Hmeimim base" where they had taken refuge.

Others fled overland through Iraq or Lebanon, he said.

Their exit was so rushed that "when we entered their bases" in Aleppo province, "we found passports and identity documents belonging to Iranian officers who didn't even have time to retrieve them."