Deir el-Balah, Gaza Strip – Hiba Musbah has already been through seven rounds of chemotherapy for the breast cancer that is plaguing her body. Next week will be the eighth.
But the ۳۶-year-old mother of three, from eastern Deir el-Balah, says her condition has continued to deteriorate as she waits to travel outside Gaza for further treatment.
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“I can no longer take care of my children as I used to. My son is the one who helps me,” she told Al Jazeera. Her husband Motaz, who has a heart condition, has had to take on more responsibility as her health has worsened, caring for their three children – Mohammed, ۱۳, Jaber, ۱۰, and Ahmad, eight.
Musbah first noticed lumps around her right breast in January ۲۰۲۴, a few months after the beginning of Israel’s genocidal war on Gaza. At the time, she initially ignored them because she was displaced and the war was intensifying. Her mother eventually insisted that she seek medical attention.
Doctors confirmed it was cancer, but despite needing urgent surgery, it took two months for Musbah to be operated on, with the delay caused by Israeli military attacks around the Nasser Hospital in Khan Younis, where she was being treated.
“The situation was difficult, with the bombardment and the tanks,” she said. “I delayed the operation because of the war. The last time, I nearly died from tank fire, so I postponed the operation.”
Her chemotherapy was initially also delayed for seven months because medicines were unavailable at Nasser Hospital.
Musbah’s experience reflects the reality facing hundreds of women with breast cancer in Gaza, where Israel’s war and blockade have severely weakened the health system’s ability to diagnose and treat the disease.
Shortages of medicines and medical equipment, broken diagnostic machines, the absence of radiotherapy and difficulties leaving the Gaza Strip for specialised care have turned the fight against cancer into another struggle amid Gaza’s deepening health and humanitarian crisis.
Surgery, chemotherapy and the cost of waiting
The lack of access to diagnostic equipment is now another source of anxiety for Musbah. She explains that she needs a new computerised tomography (CT) scan to assess how her condition has progressed, but has been unable to obtain one because the equipment is unavailable at public hospitals.
A private hospital has a scanner, she said, but the examination costs about ۱۵۰ shekels ($۴۸), which she cannot afford. The waiting time for an appointment can also exceed three months.
“I am now suffering from pain in my back and leg, and I have not had a scan for three months because the equipment is unavailable,” she said. “My doctor told me he was concerned that the disease might have spread through my body, but I still do not know.”
Musbah now struggles to walk and move one of her arms, and experiences pain in her shoulder, legs and eyes, as well as damage to her hair and nails during treatment.
“If I had received treatment early, things would not have reached this point. My condition has become much more difficult because my treatment was delayed,” she said. “Cancer patients also need good food, fruit, meat, fresh produce, but we cannot afford everything we need.”
According to Musbah, she has been waiting for around two years to leave Gaza for treatment after receiving a medical referral. But Israel, which controls all entry and exit from Gaza, has yet to give her security approval to travel.
“I want to travel, receive treatment and get better,” Musbah said. “I want to regain my health and return to the way I was before.”
Growing crisis
According to Gaza’s Ministry of Health, the Gaza Strip recorded about ۳۶۰ new breast cancer cases annually before the war, compared with ۲۵۰ in ۲۰۲۴ and around ۲۶۰ in ۲۰۲۵.
The ministry has warned that these figures may not reflect the true number of cases because screening and early-diagnosis services have largely collapsed, potentially leaving hundreds of patients undiagnosed.
In a statement on October ۱, the ministry said repeated breakdowns of mammography machines and shortages of laboratory supplies had severely restricted early detection in Gaza. Chemotherapy, hormonal and targeted therapies were also unavailable or critically scarce, while radiotherapy was completely unavailable.
The ministry said surgery for advanced tumours had also been halted because of a lack of specialised medical capabilities.
The shortage of diagnostic equipment adds another obstacle for women who suspect they may have cancer.
Dr Iman al-Haj Ahmad, an obstetrician and gynaecologist at Hikmat al-Jamei Health Centre in Deir el-Balah, understands these barriers both as a doctor helping women seek diagnosis and as a breast cancer patient herself, having been diagnosed in May ۲۰۲۵.
“I had to search until I found a place where I could get a mammogram,” al-Haj Ahmad said. “I kept thinking about ordinary women who don’t have the medical knowledge or connections that I have. If it was this difficult for me, how much harder must it be for them?”
Before the war, women could seek an initial examination at a primary healthcare centre and be referred to hospitals for mammography, ultrasound scans, and further tests.
Now, al-Haj Ahmad said, imaging services are limited, some cancer specialists have left Gaza, and tests needed to confirm a diagnosis are not always available through public health services. Some patients have to pay privately.
Al-Haj Ahmad waited about a month for surgery, eventually undergoing the operation at Nasser Hospital with a visiting Jordanian medical team while the hospital was operating under dangerous conditions.
Chemotherapy and severe food shortages later took a heavy toll on al-Haj Ahmad’s health. She said she lost about ۲۰kg (۴۴lb), her immune system weakened significantly, and doctors had to pause chemotherapy temporarily.
Al-Haj Ahmad is now receiving hormonal treatment while waiting to travel abroad for radiotherapy. Her referral for treatment abroad had been pending since September ۲۰۲۵.
Despite her own illness, she continues to examine women and refer suspected cases to the surgery department at Al-Aqsa Hospital. She also encourages women with a family history of breast cancer to be especially attentive to changes in their breasts.
“Early detection is especially important in Gaza because treatment options are so limited,” she said.
Pink October
It has been a year since the “ceasefire” began in Gaza, although Israeli attacks continue, bringing the death toll from the war up to more than ۷۴,۴۰۰ Palestinians.
October is the global Breast Cancer Awareness Month – also known as Pink October. Health workers in Gaza are participating in the international initiative, with staff at Hekr al-Jameh Health Centre in Deir el-Balah trying to reach women through healthcare visits and targeted awareness sessions.
It’s part of a Pink October campaign they’ve called “pink blooms from among the rubble”, which teaches women about breast cancer, demonstrates breast self-examination, and offers psychological support to those affected by the disease.
Sabreen al-Buhaisi, who supervises Hekr al-Jameh’s primary healthcare services, said the centre had screened between ۷۰۰ and ۸۰۰ women during the campaign. Seven or eight cases were referred to hospital surgical departments for further assessment.
But identifying women who may have cancer is only the first step. Al-Buhaisi said free mammography was available at a limited number of hospitals, where women face long waits for appointments. Private screening is too expensive for many families.
“The financial cost is very high for women. Our people cannot afford these expenses,” she said.
Still, al-Buhaisi urged women to continue examining their breasts despite the difficult circumstances the vast majority live in.
“Even displacement and living in the camps should not stop you from examining yourself,” she said. “Take five minutes of your time. It can make a big difference in your treatment journey.”
Amid these hardships, Musbah continues her fight against time.
She says she has repeatedly followed up on the travel arrangements, but remains unable to leave, with no clear explanation for the delay.
The evacuation process is coordinated between the World Health Organization and Gaza’s Ministry of Health, but they have to then submit patients’ files to Israel for security screening and approval.
“I have been waiting for two years,” Musbah said. “And I still haven’t travelled.”
