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Gaza Patients Face Death Again as Rafah Crossing Stays Closed

Palestinian patients sit in wheelchairs in the courtyard of the Red Crescent Hospital in Khan Younis while waiting to leave for treatment (AFP)
Palestinian patients sit in wheelchairs in the courtyard of the Red Crescent Hospital in Khan Younis while waiting to leave for treatment (AFP)
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Gaza Patients Face Death Again as Rafah Crossing Stays Closed

Palestinian patients sit in wheelchairs in the courtyard of the Red Crescent Hospital in Khan Younis while waiting to leave for treatment (AFP)
Palestinian patients sit in wheelchairs in the courtyard of the Red Crescent Hospital in Khan Younis while waiting to leave for treatment (AFP)

Patients and wounded in Gaza are facing increasingly harsh conditions after Israeli authorities again closed the Rafah land crossing, which had been partially reopened for a short period under a ceasefire agreement following a prolonged shutdown that prevented tens of thousands from leaving for medical treatment.

The crossing’s reopening at the beginning of February had raised hopes among patients and the wounded that they would be able to travel abroad for treatment. However, Israeli restrictions on the number of people permitted to leave further complicated the situation.

Those hopes faded when the crossing was closed again following the start of the war with Iran on the 28th of last month.

Twelve-year-old Asmaa al-Shawish, who suffers from a rare disease known as Sanfilippo syndrome, has for years faced the threat of death as her health has recently deteriorated sharply, her mother told Asharq Al-Awsat.

Her mother said the girl had obtained a medical referral to receive treatment abroad in 2023, shortly before the war began, but did not manage to travel in time. She remained inside Gaza, and her condition has continued to worsen day by day.

She said her daughter is losing the ability to drink water and suffers from brain atrophy as well as enlargement of the liver and spleen. The child also experiences constant seizures and requires daily treatment in hospitals in an effort to keep her alive as long as possible. Her condition, she added, is deteriorating rapidly.

“When the Rafah crossing opened, we felt a little hope that we might be able to travel again,” she said. “But the large number of patients and wounded waiting like us delayed our departure until the occupation closed it again, leaving us to face our fate on our own.”

“Every time I see my daughter in this condition, I grieve over her harsh circumstances,” she added. “I see her taking her last breaths, and she could die at any moment.”

20,000 Patients

According to the Gaza Health Ministry, more than 20,000 patients and wounded people urgently need treatment abroad. Deaths are already being recorded among those waiting for the crossing to reopen regularly, as it operated before the war, so they can travel and save their lives.

The ministry said hospitals in the enclave lack the medical capabilities needed to save these patients amid the difficult conditions imposed by the Israeli blockade. It added that some medicines have completely run out, while others are close to being depleted.

According to the government media office, the total number of travelers and returnees during the period when the Rafah land crossing was partially open reached 1,148 out of the 3,400 expected to travel in both directions. This represents about 33% compliance with the agreement that was supposed to be implemented after the ceasefire.

Government sources from Hamas told Asharq Al-Awsat that there are “no promises to reopen the Rafah land crossing, even partially.”

Hazem Qassem, a spokesman for Hamas, said the continued closure of the Rafah crossing “under flimsy security pretexts and false claims” represents a “blatant and dangerous violation” of the ceasefire agreement and a retreat from commitments made to mediators, particularly Egypt.

He said the move is part of efforts to “tighten the blockade” imposed on the enclave, preventing tens of thousands of wounded people from traveling to receive what he described as their natural right to medical treatment.

Continued Killings

On the ground, Israel has continued its escalation, killing more Palestinians and striking multiple targets across the enclave.

The Israeli military said on Tuesday it had killed six Palestinians, three of whom it said had crossed the “yellow line” north of the enclave, and three armed Hamas members in tunnels in Rafah.

The number of Palestinian deaths since the ceasefire has risen to more than 656, including at least 20 killed since the start of the war with Iran. The cumulative toll since Oct. 7, 2023, has reached 72,134 deaths.

This coincided with Israeli airstrikes, artillery shelling and gunfire in several areas on both sides of the yellow line in the enclave. For the second consecutive day, bulldozers were seen demolishing what remained of homes east of Khan Younis, about 20 meters from Salah al-Din Road.

A warplane also struck a house whose residents had evacuated following an Israeli order in northern Khan Younis. Another strike hit a mobile phone charging point and an internet service station in an empty area next to tents housing displaced people southwest of Gaza City.

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Features

Trump’s Tough Test: Is Military Success Enough to End the War?

US President Donald Trump dances during a private celebration with the Republican majority in the House of Representatives in Florida on Monday (AFP)
US President Donald Trump dances during a private celebration with the Republican majority in the House of Representatives in Florida on Monday (AFP)
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Trump’s Tough Test: Is Military Success Enough to End the War?

US President Donald Trump dances during a private celebration with the Republican majority in the House of Representatives in Florida on Monday (AFP)
US President Donald Trump dances during a private celebration with the Republican majority in the House of Representatives in Florida on Monday (AFP)

On the eleventh day of the war, the conflict with Iran looks closer to a military decision than a political settlement. By most circulating estimates, the US and Israel have dealt heavy blows to Iran’s missile infrastructure, air defenses and military command structure, sharply reducing Tehran’s ability to strike its neighbors as it did in the opening days.

But the key question remains unanswered: is military success enough to end the war?

Here, the ambiguity of US President Donald Trump comes into view. He says the war “will end soon” and suggests he could talk to Iran. Yet he also insists Washington “has won in many ways, but not enough,” warning of tougher strikes if Tehran continues threatening shipping and energy flows.

The contradiction is not just rhetorical. It reveals a real dilemma: a battlefield achievement that still lacks the political formula to turn it into a stable endgame.

Iran, meanwhile, does not appear to be winning militarily. The appointment of Mojtaba Khamenei as a new supreme leader, widely read as a defiant signal, was followed by statements from senior officials pledging to continue the fight and rejecting negotiations.

The regime’s response to the strikes has not been compromise but tighter alignment with the Revolutionary Guards.

Tehran’s calculation is straightforward: political survival matters more than battlefield losses. If it prevents its adversaries from forcing total surrender, endurance itself can be seen as a form of victory.

Oil: Iran’s Most Powerful Card

As Iran loses conventional military tools, oil remains its most potent weapon. The Strait of Hormuz is not merely a shipping lane; it is a critical chokepoint for global energy markets. Any disruption there reverberates instantly through prices, shipping costs, insurance premiums and political nerves in Washington and Western capitals.

That is why markets have quickly become part of the war.

Iran knows it cannot match the United States and Israel in airpower or technology. What it can do is raise the economic and political price of the conflict, for both its adversaries and the world.

As oil prices climb, pressure builds inside the United States and Europe to end the war quickly. Not because Iran has prevailed militarily, but because it has turned energy into a strategic lever.

This is what makes the decision to stop the bombing so sensitive. If Washington halts the war simply because oil prices spike or political pressures grow, Tehran will draw a clear lesson: threatening energy flows ensures survival.

That would be more consequential than any short-term battlefield gain. It would mean Iran, even after losing much of its arsenal, still holds a deterrent capable of helping it rebuild its position later.

If, however, the US and Israel continue the pressure until Iran loses the ability to threaten shipping and disrupt energy markets, the regime would be stripped of its last major lever. Only then would halting the strikes resemble ending a war rather than freezing it.

The “Day After” Question

The central criticism aimed at Trump in Washington and abroad is simple: he lacks a coherent plan for the day after.

Who governs Iran? Who prevents chaos? Who signs ceasefire arrangements and nuclear restrictions? And who ensures the country does not slide into instability like that in Iraq or Syria?

The question is legitimate, but it may not match Trump’s own logic.

The US president does not appear interested in rebuilding Iran or managing a political transition there, as Washington attempted in earlier post-September 11 interventions. His approach seems simpler and harsher: destroy the regime’s ability to threaten US and regional interests.

What happens to power in Tehran afterward may not be a direct American responsibility.

In that sense, Washington does not seem intent on toppling the regime and then inheriting the burden of governing the country. The objective appears to be weakening it enough that it can no longer pose the same threat.

If the regime collapses internally, that would be an added bonus. If it survives but with far fewer capabilities, that too can be framed as a win.

This approach is less about nation-building and more about strategic punishment followed by withdrawal.

But such a method carries risks. There is no strong evidence that the regime is close to collapse despite visible fractures in its leadership. Nor is there an organized alternative ready to take its place.

Pushing Iran toward internal fragmentation or civil conflict could open the door to far wider instability, displacement and regional violence.

For that reason, the absence of a detailed day-after plan may not mean the administration lacks a goal. It may simply mean it has deliberately lowered its political ambitions.

The promise is not a new, stable and democratic Iran—only a weaker one.

Such a gamble will succeed only if Iran accepts the new reality, or proves unable to resist it. So far, Tehran shows little sign of doing so.

Three Possible Endings

The first scenario is a conditional ceasefire after the core strikes are completed. Operations would continue for days or weeks until Washington and Tel Aviv conclude that Iran’s missile, nuclear and military structures have been damaged enough. Indirect channels would then open to impose a ceasefire formula on US-Israeli terms.

This is the most rational outcome. It would allow Trump to claim victory without becoming trapped in a regime-change operation or the occupation of a large, complex country.

The second scenario is a longer war than Washington wants. That would happen if Mojtaba Khamenei rejects any settlement that looks like surrender and continues betting on exhausting markets and raising costs for the Gulf and the wider world.

Iran might not win militarily. But it could pursue a political objective: pushing the US to stop before turning its battlefield gains into a full strategic victory.

The third, and perhaps most likely, scenario is a victory without resolution.

The US and Israel would destroy a significant share of Iran’s capabilities and curb its ability to threaten shipping and its neighbors. Yet the regime survives – more hard-line and more tightly bound to the Revolutionary Guard, convinced that survival requires rebuilding deterrence later.

In that case, the conflict is not solved at its roots. It is merely postponed. What changes is the balance of power, not the conflict itself.

Will Trump Stop the Bombing Now?

The most realistic answer: not yet, but not indefinitely either.

Stopping now under pressure from oil markets and financial panic would allow Tehran to claim it succeeded in setting limits on Washington. Continuing indefinitely without a political horizon could turn military success into an open-ended drain.

Trump is therefore operating in the gray zone between those outcomes: seeking enough strikes to claim a decisive military victory while avoiding the burdens of the “day after” that previous US administrations accepted.

The risk is that this middle path produces only an incomplete victory.

Iran would be weaker but not politically defeated. The war would fade, but its deeper causes would remain.

The coming days will determine not only when the war ends, but also what its ending means: a settlement imposing new realities on Iran, or merely a pause from which the regime emerges wounded yet convinced that oil leverage saved it.

That is the real test facing Trump, not in the number of targets destroyed, but in the kind of ending he ultimately delivers.

Features

Iran Bets on Long War to Wear Down Trump’s US, Say Experts

Smoke rises after an air strike in central Tehran, Iran, 10 March 2026. (EPA)
Smoke rises after an air strike in central Tehran, Iran, 10 March 2026. (EPA)
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Iran Bets on Long War to Wear Down Trump’s US, Say Experts

Smoke rises after an air strike in central Tehran, Iran, 10 March 2026. (EPA)
Smoke rises after an air strike in central Tehran, Iran, 10 March 2026. (EPA)

Outgunned by the United States, Iran's rulers have been lashing out on multiple fronts -- but experts say what looks like a chaotic reaction is actually a time-tested strategy to outlast a stronger enemy in a fight to survive.

To some, Iran's response since US and Israeli strikes killed supreme leader Ali Khamenei on the war's first day look like those of a decapitated and directionless power.

Why is Iran targeting Gulf countries, Türkiye and Azerbaijan with air strikes? Why not seek those countries' support, or at least keep them neutral?

But various analysts see a well-honed strategy of asymmetric warfare in Iran's retaliatory offensive: resist the onslaught, and make the enemy pay a price so heavy they have to give up.

"Iran's strategy is to create pressure on Washington, DC by angering the Gulf and by creating upward trends in the price of oil, gas and other commodities," said Burcu Ozcelik, a Middle East security expert at Britain's Royal United Services Institute.

Although Iran's leadership was badly shaken by the strikes that killed Khamenei -- now replaced by his son Mojtaba as supreme leader -- and other top figures, the system is holding so far.

And Tehran is digging in for an all-or-nothing fight, against a United States that has less at stake.

- 'Exit ramp' -

Tehran has little chance of defeating the US military.

But it can hope to outlast the current campaign, which is limited to air strikes. US President Donald Trump will meanwhile have to think hard about the potential political costs before sending in ground troops.

"Tehran is trying to raise the cost of escalation until Washington starts looking for an exit ramp," said Ali Vaez, an Iran expert at the International Crisis Group.

It is a page straight out of the textbook on asymmetric warfare.

In a classic 1975 paper, "Why Big Nations Lose Small Wars", the late professor Andrew Mack unpacked the reasons for outcomes such as the US defeat in Vietnam.

He underlined how weaker powers can exploit the gradual diminishing of a stronger adversary's political capacity to wage war.

Since the Iranians "don't have unlimited supplies of missiles and drones, we see them trying to use their firepower carefully, to make the conflict last long enough that Trump eventually says, 'That's enough'", said Agnes Levallois, head of the Middle East-focused think tank iReMMo.

"The longer the conflict lasts, the more Tehran believes the strategic balance -- psychologically and politically -- begins to shift" in its favor, said Danny Citrinowicz, of Israel's Institute for National Security Studies.

And the Iranian toolkit goes deeper.

"Tehran, cognizant of its inability to win a conventional war against the US, relies on irregular tactics to drag out the war, primarily through economic coercion and cost asymmetry," said a briefing by the US research center Soufan.

That includes sowing chaos in the Middle East, bombing neighboring countries and sending global oil and gas prices skywards by effectively shutting the crucial Strait of Hormuz.

- War of attrition -

If Trump comes under enough pressure from Gulf allies and energy inflation, he may have to fold.

"Market impacts, Hormuz disruptions and oil prices are all variables that will weigh heavily on Washington's thinking," said analyst Emily Stromquist of US advisory firm Teneo.

The strategy relies on the assumption that Gulf countries will have more pull on Trump than key US ally Israel, which is gunning for regime change in Iran.

If the Islamic Republic survives, it may pay a heavy price.

"The regime in Iran will have to make some deep concessions" in any end-game, said Ozcelik.

The Gulf states "will want to have some influence" in any ceasefire agreement, and Iran's relations with the rest of the region will be badly damaged, she said.

But none of that likely matters to Tehran, said Citrinowicz.

"From Iran's perspective, the goal of this war is to maximize its gains and 'imprint' in the minds of its adversaries the costs of fighting Iran in the future," he said.

Features

What Safe Havens Remain for the Islamic Jihad?

The late Iranian Supreme Leader Ali Khamenei receives the late «Hamas» leader Ismail Haniyeh and the leader of the «Jihad» movement, Ziad al-Nakhala, in Tehran, July 2024 (AFP)
The late Iranian Supreme Leader Ali Khamenei receives the late «Hamas» leader Ismail Haniyeh and the leader of the «Jihad» movement, Ziad al-Nakhala, in Tehran, July 2024 (AFP)
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What Safe Havens Remain for the Islamic Jihad?

The late Iranian Supreme Leader Ali Khamenei receives the late «Hamas» leader Ismail Haniyeh and the leader of the «Jihad» movement, Ziad al-Nakhala, in Tehran, July 2024 (AFP)
The late Iranian Supreme Leader Ali Khamenei receives the late «Hamas» leader Ismail Haniyeh and the leader of the «Jihad» movement, Ziad al-Nakhala, in Tehran, July 2024 (AFP)

The US-Israeli war against Iran has reshaped the landscape for Palestinian factions aligned with Tehran, with the Palestinian Islamic Jihad among the most affected. The group has faced financial and security setbacks in both Syria and Lebanon, even as fighting continues in the Gaza Strip.

Sources in the movement told Asharq Al-Awsat that the regional security changes and the war against Iran have further complicated the organization’s remaining safe havens.

While Hamas maintains close ties with Tehran, Islamic Jihad’s relationship with Iran runs deeper. The connection dates back to the group’s founding in the 1980s by Fathi Shaqaqi.

For decades, Islamic Jihad maintained a military and human presence in both Syria and Lebanon, gaining additional protection as Iranian influence expanded in the two countries over the past ten years.

However, the assassination of Ismail Haniyeh, the head of Hamas’ political bureau, in Tehran in July 2024, followed by an attempted attack on Hamas leaders in Doha in September, served as a major warning to Palestinian faction leaders, particularly Islamic Jihad.

Three countries

According to sources in the group, Secretary-General Ziad al-Nakhalah has sharply reduced his visits to Iran, traveling there only three times since Haniyeh’s assassination. One visit involved a joint delegation from Islamic Jihad and Hamas and lasted several days, while the other two were brief.

Previously, Nakhalah and several senior figures — particularly Akram al-Ajouri, who oversees the group’s armed wing, the Al-Quds Brigades — considered Iran a key safe haven, along with other capitals, such as Beirut. In recent years, however, the group has also expanded its contacts with Qatar and strengthened ties with Egypt.

A source close to Nakhalah said the leader has recently been moving between Doha and Cairo, staying for extended periods, especially in Doha, where his deputy Mohammed al-Hindi is based almost permanently.

Hindi also travels between Qatar, Egypt and Türkiye, with his role in Egypt largely focused on Gaza-related discussions with Egyptian intelligence officials.

Sources declined to confirm whether Ajouri, who had been based in Beirut’s southern suburbs in recent years, has left the area because of security concerns.

Israel recently killed Adham al-Othman, a commander in the Al-Quds Brigades in Lebanon, in a strike on an apartment used by Hezbollah in Beirut’s southern suburbs. He was known to be close to Ajouri.

Pressure in Syria

Israel had already tightened pressure on the Islamic Jihad in Syria before the fall of Bashar al-Assad’s government. A November 2024 airstrike on a group facility in Damascus killed senior figures Abdul Aziz al-Minawi and Rasmi Abu Issa, along with other members.

After the regime’s collapse in December 2024, the pressure intensified. Syria’s new authorities arrested the Islamic Jihad’s representative in the country, Khaled Khaled, and his deputy Abu Ali Yasser in April 2025, holding them for several months.

Movement sources say many of its members in Syria were detained and later released, with interrogations focusing on their weapons and where they were stored.

Some Israeli strikes in recent months have also targeted senior operatives, including field commanders in the Al-Quds Brigades who had previously been wounded in Gaza and remained in Damascus for treatment.

Facing continued Israeli pressure, some Islamic Jihad activists have relocated from Syria to Lebanon or Türkiye. Others have joined Hezbollah fighters in southern Lebanon.

All of this comes as the Islamic Jihad faces a severe financial crisis. Iranian support has largely stopped, affecting salary payments for fighters and limiting the group’s operational budgets both inside Gaza and abroad.