The international medical humanitarian organisation EMERGENCY, which is delivering primary health care in Gaza, is warning of approaching total collapse after almost two months without the entry of fuel, medical supplies or food.
As the International Court of Justice (ICJ) opens hearings into the legality of Israel’s aid blockade on Gaza, humanitarian groups on the ground warn that the Strip’s health system is nearing total breakdown.
EMERGENCY, which received the Right Livelihood Award in 2015, says aid has been blocked from entering Gaza for over 50 consecutive days, causing a cascading collapse in health services, supply chains and daily survival.
“It is the longest interruption of deliveries that, according to local staff, they ever experienced,” said Alessandro Migliorati, EMERGENCY’s Head of Logistics in Gaza. “We can speak in terms of weeks before most of the organisations would be forced to leave, to at least leave it to the Red Crescent, UN… let’s say big institutions to manage something.”
That pressure mounts by the day. In an interview with Right Livelihood, Migliorati recalled how a brief delay—a routine request to sign a contract—ended up saving two colleagues from walking into an airstrike.
“I stopped them to sign an extension of contract, just one or two minutes, and they went back home later,” he said. “Then I received a message saying, ‘Thank you, we are safe.’ A bomb had fallen 100 metres in front of them.”
Such moments underscore the daily uncertainty for staff and patients alike. With 60–65 per cent of Gaza declared a no-go area, nearly 2 million people have been displaced into the remaining parts of the Strip—most living in tents, with limited or no access to water, food or medicine. It is there that EMERGENCY operates two primary health clinics in Al-Qarara and Al-Mawasi.
With cars scarce and fuel unaffordable, even basic transportation has broken down.
“Now the simplest way to move is becoming by donkey cart,” said Migliorati. “The taxi, the bus, it’s a donkey carrying a cart where people sit. Imagine needing medical care and arriving by donkey.”
Children are particularly vulnerable.
“Scabies is almost, I wouldn’t say endemic because that needs scientific steps, but it’s super spread, it’s over-spread, it’s everywhere,” said Migliorati. “Persistent respiratory diseases that cannot be treated in hospitals—because they are completely saturated with trauma—are now coming to our clinics. Skin abrasions, burns, little traumas, day by day.”
Out of 67 primary health centres once active in Gaza, just nine are still functioning. EMERGENCY is among the few groups offering consistent treatment for chronic illness, infections, burns and reproductive health care. But supplies are critically low, and adapting to that reality has become part of daily operations. Their much-needed respirators and other essential medical equipment remain stuck in trucks, unable to reach clinics because it is extremely difficult to ensure safe and timely supply chain delivery.
“We are managing to sterilise all our tools… we built a grill and we are doing it with wood, which would be better to do with gas—but it’s not available,” Migliorati said.
As the person coordinating day-to-day operations on the ground, Migliorati says he now tracks every litre of fuel in terms of trips made between the clinics and the team’s base.
“We have to do it that precisely because we don’t know when we’re gonna get fuel again,” he noted.
Meanwhile, the humanitarian cost continues to grow. Malnutrition is widespread, with many families surviving on a diet of tubers and cereals alone.
“Everything else is missing,” Migliorati said.
EMERGENCY is staying, even if conditions worsen further.
“We are not going anywhere. Absolutely. Despite everything,” said Migliorati.
“Seeing how much our job is needed, and the resilience of the local population, the commitment we see every day, it gives us all the energy. In the middle of it all, you still see children playing at the beach. That kind of resilience is what stays with you. There is no other way if not going on.”
