Why thousands of Gaza’s injured remain trapped after ceasefire

More than 18,000 Palestinians in Gaza still need urgent medical evacuation for care unavailable inside the territory, the World Health Organization (WHO) has said.

Months after the ceasefire, medical evacuations remain paralysed not by active fighting, but by closed crossings, opaque approval processes, limited hospital capacity abroad, and the absence of a clear plan for what happens to patients after they receive treatment.

Even as security approvals from Israel improve, doctors and aid officials say time, evacuation routes, and political concerns are still dictating who is evacuated and who must wait.

Ismael Al Neder, 12, miraculously survived being shot in the head while trying to collect food with his four brothers at a Gaza Humanitarian Foundation (GHF) aid site in August, when famine conditions were first confirmed.

“We would separate. Some stay back, some risk it and go closer,” said Nafez Al Neder, 22, Ismael’s brother.

“They were shooting frantically. People on the way back were telling me he had been shot in the head,” Mr Al Neder told The Telegraph, adding that Ismael only survived because a man dropped his food rations and carried the 12-year-old to safety.

The bullet pierced the lining of Ismael’s brain and left bone fragments lodged in his frontal lobe.

Doctors managed to stop the internal bleeding and sutured his head, but he still requires surgery to repair the damaged membrane and remove the remaining fragments.

The injury has left Ismael in a precarious position.

“He can’t really eat or drink without throwing up. He’s constantly nauseous and has constant headaches,” Mr Al Neder said.

“Any small bump could cause internal bleeding again. Even the wind shaking the tent is dangerous for him,” he said, adding that they are sheltering on Gaza’s western coast by the beach.

With no access to scans, diagnostics, or ongoing monitoring, Mr Al Neder said: “The scariest part is the darkness – not knowing what’s happening inside his body.”