Dialysis patients struggle to get treatment in blockaded Gaza. Officials say hundreds have died

DEIR AL-BALAH, Gaza Strip (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.

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.

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 militants killed some 1,200 people, mostly civilians, and abducted 251 in the Oct. 7, 2023 attack that triggered the war.

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.”

Magdy reported from Cairo. Associated Press writer Cara Anna contributed.

Follow coverage of the war at https://apnews.com/hub/israel-hamas-war

Fatima Radwan, 40, and Mohamed Attiya, 54, left, receive dialysis treatment at Shifa hospital in Gaza City, Monday, April 14, 2025.(AP Photo/(AP Photo/Jehad Alshrafi)

Mohamed Attiya, 54, waits for a dialysis session in a corridor at Shifa hospital in Gaza City, Monday, April 14, 2025.(AP Photo/(AP Photo/Jehad Alshrafi)

Mohamed Attiya, 54, second from left, receives dialysis treatment at Shifa hospital in Gaza City, Monday, April 14, 2025.(AP Photo/(AP Photo/Jehad Alshrafi)

Patients receive dialysis treatment at Shifa hospital in Gaza City, Monday, April 14, 2025.(AP Photo/(AP Photo/Jehad Alshrafi)

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

Patients receive dialysis treatment at Shifa hospital in Gaza City, Monday, April 14, 2025.(AP Photo/(AP Photo/Jehad Alshrafi)

Mohamed Attiya, 54, waits for a dialysis session next to his son, Wasem, at Shifa hospital in Gaza City, Monday, April 14, 2025.(AP Photo/(AP Photo/Jehad Alshrafi)

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

Wasem Attiya pushes his father, Mohamed, 54, in a wheelchair as they head to Shifa hospital in Gaza City for a dialysis session, Monday, April 14, 2025. (AP Photo/Jehad Alshrafi)

Wasem Attiya pushes his father, Mohamed, 54, in a wheelchair as they head to Shifa hospital in Gaza City for a dialysis session, Monday, April 14, 2025. (AP Photo/Jehad Alshrafi)

Mohamed Attiya, 54, right, and his son, Wasem, sit in front of their tent before heading to Shifa hospital for a dialysis session in Gaza City, Monday, April 14, 2025. (AP Photo/Jehad Alshrafi)

Wasem Attiya pushes his father, Mohamed, 54, in a wheelchair as they head to Shifa hospital in Gaza City for a dialysis session, Monday, April 14, 2025. (AP Photo/Jehad Alshrafi)

Iran's top judge hinted at fast trials and executions for those who were detained in nationwide protests against the country's theocracy, even as activists said Wednesday that the death toll rose to levels unseen in decades with at least 2,572 people killed so far.

Iran’s judiciary chief Gholamhossein Mohseni-Ejei made the comments about trials and executions in a video Tuesday, despite a warning from U.S. President Donald Trump that he would “take very strong action” if executions take place.

The U.S.-based Human Rights Activists News Agency said the number of dead climbed to at least 2,571 early Wednesday. The figure dwarfs the death toll from any other round of protest or unrest in Iran in decades and recalls the chaos surrounding the country’s 1979 Islamic Revolution.

After Trump was informed on the number of deaths, he warned Iran's leaders that he was terminating any negotiations and would “act accordingly.”

Details of the crackdown began emerging Tuesday as Iranians made phone calls abroad for the first time in days after authorities severed communications countrywide when the protests broke out.

Here is the latest:

Major Middle East governments were discouraging the Trump administration from waging a war with Iran, fearing “unprecedented consequences” in the volatile region, an Arab Gulf diplomat said Wednesday.

The Cairo-based diplomat, who was given anonymity because he wasn't authorized to speak to the media, said major governments in the region including Turkey, Egypt, Saudi Arabai and Pakistan have been “in constant contact” with the U.S. administration over a potential American strike on Iran that could explode into a “full-blown war.”

Such a war will “certainly” have dire repercussions “not only on the Middle East but also on the global economy," he said.

Samy Magdy contributed from Cairo.

Iranian state television said Wednesday’s mass funeral in Tehran would include 300 bodies of security force members and civilians. The funeral is expected to take place at Tehran University under heavy security.

The Human Rights Activists News Agency, which is tracking the death toll, said more than 2,550 people have been killed, 2,403 protesters and 147 government-affiliated.

Twelve children were killed, along with nine civilians it said were not taking part in protests. More than 18,100 people have been detained, the group said.

Gauging the demonstrations and the death toll from abroad has grown more difficult and The Associated Press has been unable to independently assess the toll given the communications being disrupted in the country.

Melanie Lidman contributed from Jerusalem.

Trump’s decision to impose a 25% tariff on countries that trade with Iran could impact India, an expert said, as New Delhi already faces existing 50% U.S. trade levies due its purchases of Russian oil.

Abhijit Mukhopadhyay, a senior economist at the Chintan Research Foundation in New Delhi, said the bigger risk is not India-Iran trade, but India’s access to the U.S. market as its exports to Iran are modest.

India mainly exports rice, tea, sugar, pharmaceuticals and electrical machinery to Iran, while importing dry fruits and chemical products. Textiles and garments, gems and jewelry and engineering goods are likely to be the most vulnerable sectors, he said.

Trump’s latest move also could affect India’s investments in Iran including the strategically important Chabahar port, which gives India a trade route to Afghanistan, Central Asia and Europe while bypassing Pakistan, Mukhopadhyay said.

Iran’s judiciary chief signals fast trials and executions for those detained in nationwide protests.

Gholamhossein Mohseni-Ejei made the comment in a video shared by Iranian state television on Wednesday.

He emphasized the need for swift action, saying delays would lessen the impact.

His remarks challenge Trump, who warned Iran about executions in an interview aired Tuesday.

Trump stated the U.S. would take strong action if Iran proceeded with executions. The situation highlights escalating tensions between the two countries over the handling of the protests.

Dozens of Pakistani students studying in Iran have returned home through a remote southwestern border crossing, a Pakistani immigration official said Wednesday.

Federal Investigation Agency spokesperson in Quetta city, Samina Raisani, said about 60 students crossed into Pakistan on Tuesday through Gabd border in Balochistan province with valid travel documents.

More students were expected to return through the same crossing later Wednesday, she said.

Mudassir Tipu, Pakistan’s ambassador to Iran, said Tuesday that Iranian universities had rescheduled exams and permitted international students to leave the country.

The satellite internet provider Starlink now offers free service in to people Iran who have access to the company's receivers, activists said Wednesday.

Mehdi Yahyanejad, a Los Angeles-based activist who helped get the units into Iran, told The Associated Press that the free service had started. Other activists also confirmed in messages online that the service was free.

Starlink has been the only way for Iranians to communicate with the outside world since authorities shut down the internet Thursday night as nationwide protests swelled and they began a bloody crackdown against demonstrators.

Starlink did not immediately acknowledge the decision.

This frame grab from videos taken between Jan. 9 and Jan. 11, 2026, and circulating on social media purportedly shows images from a morgue with dozens of bodies and mourners after crackdown on the outskirts of Iran's capital, in Kahrizak, Tehran Province. (UGC via AP)