The elderly man sits in a wheelchair mounted on a donkey-drawn cart, with an oxygen cylinder and a small fan beside him as he makes his way from his tent in the Al-Mawasi area to the dialysis centre.

“Since January 2024 until now, I have been undergoing dialysis sessions three times a week,” he said. “I suffer a lot because of transportation as I travel in a cart pulled by a donkey under the scorching sun, and thank God, what can we do? I have no other choice.”

Near-daily ordeal

Access to the hospital has become part of his daily struggle, given the destruction of infrastructure, the lack of transportation and the continued difficult humanitarian conditions in the Strip since the Israel-Hamas war erupted in 2023.

Even with the October 2025 ceasefire, Gaza’s health system is still operating at limited capacity, according to the World Health Organization (WHO).

Israeli attacks and widespread damage to health facilities, along with restrictions on the entry of medical supplies, continue to impede the provision of healthcare at a time when patients with chronic diseases need regular, uninterrupted treatment, WHO said.

Mr. Hajji’s suffering reflects the reality for hundreds of kidney failure patients in the Gaza Strip, where obstacles facing health facilities have increased pressure on dialysis services, according to WHO and other UN agencies.

Harsh test of survival

For Mr. Hajji, challenges remain travelling to and from the centre, where the treatment itself becomes a harsh test of survival.

During the journey, his grandson, Saif, has to stop repeatedly to re-attach the wheelchair to the trolley due to the unpaved roads.

“There is great suffering along the way due to the heat of the sun and the rough roads,” his grandson said. “We have to stop every fifty metres to adjust the position of my grandfather’s wheelchair, and we arrive at the hospital exhausted and in immediate need of oxygen.”

Limited resources

After a difficult trip, his grandson helps him transfer from his wheelchair to a bed at the dialysis centre in the Nasser Medical Complex, where patients line up waiting their turn at the available machines while the medical staff try to cope with increasing numbers and limited resources.

The elder Mr. Hajji then begins his dialysis session as a health worker monitors his condition during the treatment, which lasts between three and five hours. 

“It is very difficult, especially with the high temperatures, so I had to bring a fan with me, and I also need to fill the oxygen cylinder daily,” Mr. Hajji explained.

Lack of equipment

The lack of equipment exacerbates the suffering of patients, said Hamza Abu Raya, one of the centre’s employees.

“We are under a lot of pressure on the dialysis machines, many of which are worn out,” he said. “We also suffer from a shortage of treatment supplies, including bicarbonate, in addition to the unavailability of the drug Eprex for a long time, which increases the suffering of patients.”

Shortages of fuel, spare parts and medical supplies are common, according to the latest reports from the UN Office for the Coordination of Humanitarian Affairs (OCHA). They are compounded by reports warning of the continued spread of infectious diseases and the increasing pressure on existing health facilities.

Meanwhile, health partners continue to operate services to the maximum extent possible.

Another journey home

After the treatment session, Mr. Hajji is returned to his wheelchair.

He then waits outside the hospital gate.

He will take the same donkey-led cart back to his tent, in preparation for yet another journey that is repeated three times every week.

Aysen Slack, 65 and from Eastbourne, chose to pay privately for the pills once she heard about them.

She said fampridine was “working well for me” but came at a “significant expense and I could not keep doing that forever” so she had to stop.

Slack said it was “great news” the drug was coming to the NHS and she “would definitely like to try” again.

“My mobility has decreased a lot and even in my flat I have to use sticks now,” she said, “it would make a huge difference to my life if I were able to improve my walking.”

More than 120,000 people live with MS in England. However, only around 5,000 people a year will be eligible – based on the extent of their walking difficulties.

Patients will try the medicine for up to a month and only those showing “clear benefit” will be able to continue taking it.

Prof Frankie Swords, the NHS national medical director, said: “Walking difficulties can have a huge impact on the freedom and independence of people with MS, so this signal-boosting pill could be life-changing for thousands of patients.

“Even a modest improvement could mean getting around the house more easily, going out with greater confidence and living more independently.”

Ceri Smith, from the MS Society, said they were “delighted” by the news as the drug could be “life-changing” for many, allowing people to “live more independently or stay in employment”.

A German palliative care doctor has been sentenced to life imprisonment for killing 15 of his patients.

A court in Berlin found the 41-year-old man, named only as Johannes M. in line with German privacy rules, guilty of murdering 12 women and 3 men between September 2021 and July 2024.

The authorities believe these killings could be just the tip of the iceberg. Prosecutors are currently investigating dozens of other incidents involving the doctor.

His victims were between the ages of 25 and 94. The court heard how they were all critically ill, but that their deaths were not imminent.

Prosecutors said that during home visits, the doctor administered a lethal combination of various medicines without his patients’ consent.

On several occasions, they said he set fires to cover his tracks.

In July 2024, shortly before his arrest, prosecutors said the doctor killed two patients in a single day – a 75-year-old man at his home in central Berlin and, a few hours later, a 76-year-old woman in a neighbouring district.

They said the doctor tried to set fire to the woman’s house, but failed.

For much of the trial, which has gone on for about a year, the doctor said nothing. But last month, he confessed to having “killed people,” twelve of his severely ill patients.

He told the court he had convinced himself that he was doing the right thing, sparing them “suffering and infirmity”.

“Throughout it all, I thought this was the best thing for everyone,” he said.

He said he apologised for all the suffering he had caused.

The authorities suspect him of having killed further patients. Prosecutors are currently investigating 76 other cases.

German media say if the further cases are proven, and he is found guilty, it would be one of the largest incidences of serial murder in Germany’s history.

The doctor told the court that he would “get involved much earlier in the forthcoming proceedings.”

Earlier in the trial, relatives of the victims told the court they still couldn’t believe it.

The mother of the youngest victim, a 25-year-old woman who died in 2021, was in tears. “She never said she didn’t want to live anymore,” she said.

The son of a 72-year-old woman who died in 2024, said his mother had had plans to go to the Baltic Sea with her sister. “My mother wanted to keep on living,” he said.

The court ruled that the doctor’s guilt was particularly serious. It ordered that the doctor be put in preventive detention, following his prison sentence. It also imposed a lifetime ban on him practising medicine.

Artificial intelligence will be used on the NHS app to determine which service is most appropriate for patients in England, the health service has announced.

A new triage tool will ask patients a series of questions, and will use the responses to direct them to a GP appointment, pharmacy, A&E, community service or offer self-care advice.

NHS England said the update would reach more than 200,000 patients in the next 12 months and be available to all app users by April 2028 as part of a “major overhaul” of its technology.

The rollout has been largely welcomed, but some health bodies urged the NHS to prioritise patient safety, confidentiality and inclusion as it grows more reliant on AI.

An initial trial of the tool at Wealden Ridge Medical Partnership in Sussex saw a 29% reduction in the number of people queuing on the phone for an appointment.

Dr Ragu Rajan, who works at the practice, said integrating the tool “means our patients can tell us what they need, when they need it, and be directed to the right care first time.

“It hasn’t replaced our judgement – it’s given us back the time to use it.”

Sir Jim Mackey, chief executive of NHS England, said the tool would “help get patients to the best service for their needs first time… so that clinicians can make sure those most in need of a GP appointment can get one sooner”.

It comes as part of a £10bn investment, allocated by the government in 2025, to overhaul the NHS’s technology, digital and data systems.

There will also be an England-wide rollout of AI tools that record conversations between patients and NHS staff to generate real-time transcriptions and clinical summaries.

It will start with hospital appointments not requiring an overnight stay at four NHS trusts in and around London – St George’s, Epsom and St Helier, Croydon, and Kingston and Richmond.

Alder Hey Children’s NHS Foundation Trust in Liverpool and Manchester University NHS Foundation Trust are also expanding their AI notetaking programmes.

A trial led by Great Ormond Street Hospital for Children and carried out across nine NHS sites in London found NHS staff spent almost 25% more of their time interacting with patients when using the notetaking technology.

The Royal College of Nursing’s chief nursing officer, Prof Lynn Woolsey, said the rollout could mark “an important step in upgrading technology in the NHS” and “ease the administrative burden on nursing staff”.

But she also emphasised that patient safety and confidentiality must be at the “heart of any AI triage system, with a guarantee that a health professional will be the one making decisions at key points in that process”.

Pritesh Mistry, fellow at the King’s Fund think-tank, said the announcement “could help turbo-charge improvements in how [the] NHS uses modern technology to deliver better care for patients”.

“People should find it easier to have support at the right time and in a way that best suits them, digitally or physically,” she added.

“And this means the NHS will need to keep a strong focus on ensuring that people are not digitally excluded as clinical services become increasingly reliant on technology.”

Conservative shadow health secretary Stuart Andrew said: “Any innovation that improves patient care and helps the NHS work more effectively should be welcomed. But new technology must be introduced with a fully-funded plan that delivers value for taxpayers.”

The desperation of patients haunts Gaza’s hospitals – their exterior walls eaten away by gunfire and Israeli strikes, the health-care system inside them still unrepaired.

Eight months after the ceasefire deal instructed that “full aid” be sent into the Gaza Strip, aid workers say the continued lack of essential medicines and equipment has meant doctors are rationing or loaning each other essential life-saving drugs, or turning patients away from chemotherapy or dialysis appointments.

“The fact that the medical evacuation list is thousands long is a sign that people in Gaza don’t have access to what they should have – which Israel, as the occupying power under international humanitarian law, has an obligation to allow them access to,” said Pat Griffiths, spokesman for the International Committee of the Red Cross (ICRC) in Jerusalem.

Shortages, he said, run from basic consumables like gauze dressings and painkillers, all the way up to advanced medical equipment.

“There is no doubt in my mind that people in Gaza are dying because they can’t receive the care they need – and that there are preventable deaths happening because of the limits on what can be brought in, in terms of healthcare.”

Asked about the reports of critical shortages, Cogat said in a statement that 17,000 tons of medicines and medical aid had entered Gaza since the ceasefire, including wheelchairs, cancer medications, insulin pens, anaesthetics, X-ray machines, CT scanners, dialysis machines and medical consumables.

“Despite claims to the contrary,” it said, “Israel has approved every request for medicines submitted by international aid organisations.”

In response, one humanitarian official involved, speaking to me anonymously, said that Israeli authorities often used anecdotal examples to mask shortages of key medicines and equipment, and that aid supplies continued to be restricted.

“You don’t count medical aid in terms of trucks and pallets; that’s not a denominator we use,” said the WHO’s Reinhilde Van de Weerdt. “We talk about the needs patients have, and the needs that are met.”

“If medical supply is unrestricted, you don’t have these discussions about what is given versus what is needed,” she said. “We need certain buffer stock levels of medical supplies, [and] you can’t run a hospital hoping the generator doesn’t break down.”

According to initial information from the Lebanese authorities, at least 86 people, including healthcare workers, have been injured in the strikes on Jabal Amel Hospital. 

The attacks “caused significant damage…to the emergency department and intensive care unit”, said World Health Organization (WHO) representative in Lebanon, Dr Abdinasir Abubakar.

Speaking from Beirut on Tuesday, Dr Abubakar explained that Jabal Amel is one of the few hospitals currently operating in the south.

Deadly pattern 

In just three months, WHO has verified almost 190 attacks on healthcare, which have killed 128 healthcare workers and injured 332 others. The past week alone has seen 11 attacks.

“These attacks kill and maim, they also deprive people of the health services they need,” the WHO representative said.  

Healthcare in Tyre district has suffered the worst impacts of hostilities between Hezbollah fighters and Israel in the last few days; two out of three hospitals, Jabal Amel and Hiram – which was attacked last Sunday – are damaged, while the third hospital is “overwhelmed as it’s dealing with the influx of increased numbers of injured patients”, Dr Abubakar said. 

Access to essential services is “critically constrained,” he insisted, especially in southern Lebanon, where patients face up to 48-hour delays to reach the nearest referral facilities. 

A matter of life and death 

“Six hospitals have not yet resumed maternity delivery services and are currently providing only emergency room care,” Dr Abubakar stressed. “For pregnant women and newborns, delays in care can mean the difference between life and death.”

The WHO representative also flagged the challenging health situation in shelters, hosting some 130,000 people who have fled the fighting. Displacement is on the rise following the most recent Israeli evacuation orders. The escalating violence and warnings of Israeli strikes on Beirut’s southern suburbs, home to hundreds of thousands of civilians, prompted a Security Council meeting on Monday.

The UN health agency has been monitoring infectious diseases within shelters and host communities, reporting “an increased trend of acute watery diarrhoea”. 

“We are in the summer season and now the risk of cholera may be increasing,” Dr Abubakar warned.

With humanitarian needs outpacing the response, the WHO representative insisted on the need to sustain funding for essential health services.

“We also need the attacks on healthcare to stop, and we need active protection for healthcare,” he said, reiterating calls for a sustained ceasefire and durable peace.

Since the start of the current escalation in fighting between Israel and Hezbollah fighters on 2 March, more than almost 3,400 people have been killed in Lebanon and nearly 10,400 people have been injured, most of them civilians. 

“These have been among the deadliest months for Lebanon since the start of the conflict in October 2023,” Dr Abubakar insisted.

A US-brokered ceasefire between Lebanon and Israel took effect on 17 April but has never been fully observed by either side. It was nominally extended twice, most recently on 16 May for a 45-day period.