Credit, BBC/Yousef al-Mashhawari
In an isolation ward at Nasser Hospital in Gaza, Raseel, a 6-year-old girl with serious injuries, cries as she lies on a bed.
Raseel is in constant pain. She suffered a serious fracture in her right leg, has infected wounds on her legs and hand, and has shrapnel lodged in her brain.
Raseel urgently needs a skin graft to help close the wounds. First, they need to start healing. But the infections do not respond to the antibiotics available in Gaza.
With no other alternative, doctors have to reopen and clean Raseel's wounds repeatedly. The procedure has been performed more than 20 times.
Beside his daughter's bed, her father, Mahmoud al-Balawi, leans in to kiss her.
"Don't cry," says al-Balawi, with tears in his eyes.
Raseel was sleeping with her family in a tent in the al-Mawasi camp, which houses displaced Palestinians near Khan Younis, in the Gaza Strip, when an airstrike from an Israeli helicopter hit the site on 7/30, according to witnesses.
His 9-year-old sister Rateel and a 20-year-old cousin died. Raseel's mother and brother were seriously injured. The Israel Defense Forces (IDF) claim to have no records of an attack at that time or location.
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Raseel has been admitted to Nasser Hospital for two months. According to Awni al-Jaafarawi, a doctor from the humanitarian organization Doctors Without Borders (MSF) who is monitoring her treatment, the girl's wounds are infected by bacteria resistant to several medications.
Antimicrobial resistance (AMR) occurs when bacteria, viruses, fungi and parasites undergo changes over time and no longer respond to the medications used to combat them.
The World Health Organization (WHO) considers the problem one of the biggest threats to global public health.
Antibiotic-resistant infections are more difficult and more expensive to treat and can cause serious illness, sepsis and even death.
"The girl [Raseel] will have to remain hospitalized for longer and will therefore contract other infections, which will make her recovery even more difficult," says al-Jaafarawi.
But Raseel isn't the only patient whose wounds don't respond to antibiotics.
According to al-Jaafarawi, Gaza hospitals record high rates of infections resistant to these drugs.
“Currently, we try to keep many of these patients in isolation because the bacteria they carry can affect the functioning of the health facility in the long term, which requires special measures,” says al-Jaafarawi.
Credit, BBC/Mahmoud al-Mashharawi
What al-Jaafarawi observes in hospitals is reinforced by a new study, shared with the BBC World Service, which finds widespread bacterial resistance to key antibiotics in Gaza.
According to the researchers, the study, carried out over ten years, between 2015 and 2025, analyzed almost 80 thousand bacterial samples collected in 11 hospitals, being the largest analysis on antimicrobial resistance ever carried out in Gaza.
The research was led by scientists from Gaza, with the support of a multidisciplinary team of researchers from the Fleming Initiative, Imperial College London, in the United Kingdom, and the American University of Beirut, in Lebanon.
The study has not yet undergone peer review, a process in which independent experts evaluate the scientific quality of research, and its results are preliminary.
The study's authors state that the situation in Gaza has created conditions ripe for the transmission of infections.
"During conflicts, it is common for water supply and sanitation systems to be destroyed. These services are essential to prevent infections and prevent the spread of resistant bacteria among the population", says Aula Abbara, a doctor at the Fleming Initiative, at Imperial College London.
"The consequences for patients are serious. For example, infections that could normally be treated can worsen and become impossible to combat," says Abbara. "In the most serious cases, they can cause sepsis and even death."
For those injured in Gaza, one of the consequences is the increase in the number of people who need to undergo amputations when infections reach the bones.
"In the coming years, we will see the number of amputations increase daily, even if the war ends," says MSF's al-Jaafarawi.
The doctor states that he continues to treat people injured in Israeli attacks every week, despite the ceasefire brokered by the United States and agreed between Israel and Hamas in October 2025.
According to the Hamas-run Gaza Ministry of Health, 1,421 Palestinians have died since the ceasefire began in October 2025.
The IDF disputes the figures released by the ministry. In a note to the BBC, they stated that they "regret any harm caused to civilians and work to reduce it as much as possible."
The war in the Gaza Strip began after the attack led by Hamas against Israel, on October 7, 2023, which left around 1,200 dead and 251 people taken hostage.
Since the start of the war, more than 74,000 Palestinians have died in Gaza, according to the local Ministry of Health.
One of the main factors contributing to the spread of infections is the lack of access to clean water and adequate sanitation services.
According to the UN, Israel has destroyed or damaged almost 90% of Gaza's water supply and sanitation infrastructure, including desalination plants, pipes and sewage systems.
According to a UN report released in July, more than 80% of families in Gaza do not have safe access to water, and up to 70% are unable to obtain even the six liters per person per day that the organization considers the minimum essential for drinking and cooking.
The Coordination of Government Activities in the Territories (Cogat), the Israeli body responsible for administering Gaza's borders, disputes these data. In response to the BBC, he stated that the volume of water supplied to the territory exceeds the minimum limit established by the UN for humanitarian emergency situations.
Although some public taps still work, most Gaza residents have to fetch water from distribution points.
Salem Abu Nahla, 42, is among those who face daily difficulties getting enough water.
He previously owned a supermarket and a butcher's shop, but his house was bombed. Since then, Abu Nahla, his wife and three children have had to leave the place where they lived six times. Today, the family lives in al-Mawasi camp.
To fetch water, Abu Nahla has to walk about 1 km, a difficult journey for him since he suffered a back injury in an accident involving a humanitarian aid truck.
Abu Nahla says that he sometimes witnesses arguments and fights at distribution points, where people form queues and wait for the water truck to arrive.
On some occasions, the vehicle does not even arrive.
Back in the field, Abu Nahla pours water into a container so the woman can wash the dishes.
"That's enough. We don't have much water. Maybe we won't get any more water today and we'll have to go get it again," he tells his wife.
In addition to the damage caused to the sanitation system and the lack of drinking water, garbage collection has practically stopped in Gaza.
As a result, garbage, human waste and puddles of contaminated water accumulate near the overcrowded camps, where Palestinians who have had to leave their homes live.
These camps face a serious infestation of rats and weasels.
At times, it is possible to see large numbers of these animals circulating between the tents and entering the shelters where people live.
A survey released in April by the Site Management Cluster, the group responsible for managing many of Gaza's camps, cited by UN agencies, found that rodents or other pests were frequently seen in 81% of sites housing displaced families, affecting around 1.45 million people.
There are numerous records of people bitten by rats or weasels while sleeping.
In addition to causing infections, these attacks can cause serious injuries.
Basel al-Dahnoun had to have his right leg amputated below the knee after being attacked by weasels while he slept, according to his daughter Rana.
Rana, 14, says she woke up one night and found the mats the family was sleeping on covered in blood. His father was seriously injured.
She rushed her father to the hospital, but due to a lack of medical supplies, the team was unable to treat the wound or even bandage it.
Humanitarian organizations and health professionals from different regions of Gaza told the BBC that there is a serious shortage of basic medicines and medical equipment.
Ultimately, doctors had to amputate al-Dahnoun's leg just below the knee.
Rana hopes that his father, who is over 60 and faces other health problems, can get on with his life.
“God willing, may he recover,” says Rana.
Cogat says it allows medicines to enter Gaza without restrictions, including antibiotics.
Back at Nasser Hospital, Raseel's condition is serious.
In addition to the infection and the need for a skin graft, the girl faces other challenges.
According to doctors, it is still not possible to safely remove the shrapnel lodged in his brain. Raseel is unable to walk and has started having seizures.
There is also the challenge of helping children like her adapt to a life profoundly transformed by serious injuries and the loss of those close to them.
UN experts estimate that virtually all children in Gaza need urgent psychological and psychosocial support.
"It's not just about the injuries suffered by the child, but the fact that his entire life has changed," says MSF's al-Jaafarawi.
For al-Balawi, Raseel's father, the most important thing is that his daughter survives.
"I'm afraid of what might happen to my daughter if she stays here in Gaza," says al-Balawi. "If she stays here, she might die."
According to the Gaza Ministry of Health, around 5,600 children are awaiting transfer to receive medical treatment outside the territory.
To obtain care outside of Gaza it is necessary to obtain a medical referral from the Ministry of Health, acceptance from a country willing to receive the patient and a security authorization from Israel.
But there was good news for Raseel.
After weeks of waiting for authorization from Israeli authorities, she and her father finally got permission to travel to Egypt at the end of September, with support from the WHO, to seek urgent medical treatment.
Her father says that his daughter was taken to a hospital on the outskirts of Cairo, but is still awaiting transfer to a better-structured unit in the Egyptian capital.
He hopes Raseel can finally get the treatment she needs.
During her stay at Nasser Hospital, Raseel received a doll from a cousin, who named it Rateel, in honor of her sister.
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