In the quarantine ward inside Nasser Hospital in Gaza, six-year-old Rasil lies on her bed, crying.
Russell suffers from constant pain.
Her right leg is broken in more than one place, and her wounds are infected in both her legs and in her hand, while shrapnel is lodged in her brain.
She needs urgent surgery to patch the skin and seal her wounds.
However, before she can do that, her wounds must heal, but she does not respond to the ground-based antibiotics available inside the Gaza Strip.
This means that the only option for doctors is to constantly open the wounds to clean them. They have done this more than twenty times so far.
Beside her bed, Rasil’s father, Mahmoud Al-Balaawi, bends down to kiss her.
He says to her, “Don’t cry,” and his eyes fill with tears.
Rasil was sleeping with her family in the Al-Mawasi camp for displaced Palestinians near Khan Yunis when her tent was bombed by an Israeli helicopter on July 30, according to eyewitnesses.
Nine-year-old Rateel and her twenty-year-old cousin were killed in the raid. Her mother and her brother were injured. The Israeli army says it has no information about an attack on the place or when Russell's family was attacked.
Raseel has been in the hospital for two months, but her wounds are infected with multi-drug-resistant bacteria, according to Dr. Awni Al-Jaafrawi, a doctor with the charity Doctors Without Borders, who is treating her.
Antimicrobial resistance occurs when bacteria, viruses, fungi and parasites change constantly over time and no longer respond to antibiotics designed to kill them all.
This phenomenon is considered at the forefront of the risks threatening people around the world, according to the World Health Organization.
Antibiotic-resistant infections are often difficult and expensive to treat and can lead to serious illness, suppuration, and even death.
“The girl will have to stay in the hospital for a longer period, and therefore she will be vulnerable to contracting infections that will delay the recovery journey,” says Dr. Al-Jaafrawi.
But Russell's infections are not the only ones that refuse to respond to antibiotics.
Dr. Al-Jaafrawi says that he is noticing an increase in the rates of antibiotic-resistant infections in Gaza hospitals.
He added, "With many cases, we try to isolate them and quarantine them because the bacteria they carry may affect the facility for a long time, and they require special procedures."
What Dr. Al-Jaafrawi sees in hospitals is confirmed by a new study seen by the BBC, which reports an outbreak of bacteria resistant to basic antibiotics in Gaza.
The researchers say that the study, which was conducted over a period of ten years, between 2015 and 2025, and which was based on more than eighty thousand bacterial samples collected from eleven hospitals, is the largest study of this phenomenon conducted in Gaza.
The study, conducted by Gazan researchers and supported by a wide range of other researchers at the Fleming Initiative, Imperial College London, and the American University of Beirut, has not yet been peer-reviewed, so its results remain preliminary.
The study's authors say that the situation in Gaza provides ideal conditions for transmission.
“During conflicts there is a lot of destruction to water and sanitation facilities, all of which are important needs for the population to avoid infections and the transmission of these resistant bacteria,” says Dr. Ola Abara from the Fleming Initiative at Imperial College, London.
“The impact on patients is significant. For example, patients with treatable injuries can have their injuries deteriorate to become untreatable. In serious cases, it can lead to suppuration and even death.”
For the wounded in Gaza, this may result in more amputations when the infection spreads to the bones.
“Over the coming years, we will see the number of amputations increasing daily, even after the war stops,” says Dr. Al-Jaafrawi, adding that he still sees people wounded in Israeli attacks every week, despite a ceasefire agreement sought by the United States and approved in October of last year by both Israel and Hamas.
The Ministry of Health in Gaza, whose figures the United Nations considers reliable, says that 1,421 Palestinians have been killed since the start of the truce in October 2025.
The Israeli army disputes the numbers issued by the Ministry of Health. He told the BBC that he "regrets any harm caused to civilians, and seeks to minimize it to the greatest extent possible."
The Gaza War broke out following the Hamas-led attack on Israel on October 7, 2023, resulting in the killing of about 1,200 people and the taking of 251 people hostage. Since the outbreak of the war, more than 74,000 Palestinians have been killed in the Gaza Strip, according to the Ministry of Health.
People crowding in the water lines
One of the main contributors to the spread of infections is irregular access to clean water and a poor sanitation network.
According to the United Nations, Israel has destroyed or damaged approximately ninety percent of Gaza's water distribution and sanitation infrastructure, including desalination facilities, pipes, and sewage systems.
A United Nations report issued in July stated that more than eighty percent of families in Gaza do not have access to water on a regular basis, and that nearly seventy percent of Gazan families are unable to obtain the minimum quantity of water, which is six liters per person per day for drinking and cooking, as recommended by the United Nations.
But the Israeli Coordinator for Government Activities on Its Territory, which supervises the borders of the Gaza Strip, disputes this and told the BBC that the amount of water supplied to Gaza exceeds the humanitarian aid threshold set by the United Nations.
Some water taps are standing, but the majority of Gazans rely on distribution sites for water, some of which is transported by tankers.
Salem Abu Nahla, forty-two years old, is one of those who struggle to obtain enough water for his daily needs.
He owned a large store and a butcher shop, but his house was destroyed in the bombing. He has been displaced with his wife and three children six times now, and he currently resides in Al-Mawasi camp.
Salem has to walk a kilometer to fetch water, which he finds difficult since the injury he suffered in his back in an accident with a humanitarian aid truck.
He suffered a back injury due to a humanitarian aid truck accident.
Salem says he sees quarrels and fistfights at water distribution sites, where people line up and wait for the water tanker to arrive.
Sometimes it happens that the tanker does not come.
In the camp, he pours water into a viscous bowl to wash the dishes.
He tells her: “That's enough. We don't have enough water. We may not get any today, and we may have to carry water again.”
Pest of rats and weasels
In addition to damage to sewage systems and a shortage of fresh water, garbage collection has almost stopped.
As a result, garbage, human waste, and polluted swamps pile up near the crowded tent cities inhabited by Gazans displaced from their homes.
These tents have become places infested with rodents.
Sometimes huge numbers of these animals can be seen running between or even inside tents where people live.
In a survey conducted in April by the Site Management Group, which oversees a number of camps in Gaza, and seen by UN agencies, it was reported that rodents can be seen roaming in eighty-one percent of the sites where displaced families live, affecting the lives of approximately 1,450,000 people.
Numerous cases have been documented in which rodents bit people while they were sleeping.
These bites can cause serious infections and injuries.
Basil Al-Dahnoun underwent the amputation of his right leg below the knee after he was attacked at night by a weasel while he was sleeping.
His fourteen-year-old daughter, Rana, woke up to find blood staining the robes and rugs they were lying on while her father was seriously injured.
She took her father to the hospital, but due to the severe shortage of medical supplies, they were unable to treat him or even bandage his wound. Humanitarian agencies and medical personnel across Gaza have told the BBC that there are significant shortages of essential medicines and equipment.
Doctors ended up amputating Bassel's leg below the knee. Rana hopes that her father, who is over sixty, will be able to continue his life despite the other health problems he suffers from.
“I hope he recovers, God willing,” she says.
The Israeli government coordination body in the Palestinian territories, Cogat, says it allows medicines to enter the Gaza Strip without restrictions, including antibiotics.
The issue is that a person's life has changed radically
Returning to Nasser Hospital, Rasil’s medical condition deteriorated.
UN experts estimate that almost all of Gaza's children require mental health care and psychological support.
He desperately wants you to receive medical treatment outside the Gaza Strip, whose hospital facilities have been destroyed and dilapidated.
“I fear for my daughter. If she stays here in Gaza, she may die.”
The Palestinian authorities have approved the transfer of patients to receive treatment outside Gaza, but they are awaiting permission from the Israeli security authorities. Her family says it could take up to a year.
Nearly 5,600 children are awaiting approval from the Israeli authorities for their requests for treatment outside the Gaza Strip, according to the Ministry of Health.
Medical treatment outside the Gaza Strip requires a referral from the Ministry of Health, acceptance by the host country, and obtaining an Israeli security clearance.
But there is good news for Russell. After waiting weeks for approval from the Israeli authorities, Rasil and her father were later granted permission to travel to Egypt in late September, with support from the World Health Organization, to receive urgent medical treatment there.
Her father says that she was transferred to a hospital outside Cairo, but she is waiting to be transferred to another hospital in the capital that has better capabilities and equipment.
Her father hopes that Rasil will now be able to get the treatment she needs.
