Ahmed al-Masri, a 47-year-old father of four, used to carry two vials of insulin with him everywhere. Now he carries a prayer rug. The insulin ran out three weeks ago. His blood sugar readings hit 500 mg/dL — three times the safe limit. He can barely see. One eye has already gone dark.
“I’m waiting for death,” he told me over a crackling phone line from Gaza City. “Either a bomb gets me or my kidneys shut down.”
Ahmed is not alone. Across the Gaza Strip, an estimated 40,000 people with Type 1 diabetes — the kind you cannot manage with diet or exercise — are being pushed toward coma, amputation, and death. War has done what Hamas and Israel could not agree on: it has choked off every supply line for insulin, test strips, glucose monitors, and trained doctors.
One Vial, Two Patients, No Options
At Al-Shifa Hospital, Dr. Samira Nasser has watched three patients die in the last seven days from diabetic ketoacidosis — a condition where the body, starved of insulin, starts eating its own fat and muscle. It is painful, preventable, and entirely caused by the blockade.
“I have 10 vials of insulin left for 200 patients,” she said. “We ration: half a dose per person, per day. That’s not enough to keep them alive. It’s just enough to delay death.”
“Half a dose per person, per day. That’s not enough to keep them alive. It’s just enough to delay death.” — Dr. Samira Nasser
The problem isn’t just insulin. Test strips are gone. Glucometers are dead batteries. Many patients are injecting blindly, guessing how much insulin they need, and sometimes injecting the wrong type altogether. Fast-acting insulin gets used for long-term control. The results are catastrophic: strokes, comas, amputations.
The War Economy of Insulin
Before the war, insulin cost about $5 a vial in Gaza. Now, on the black market, a single vial goes for $200 — if you can find it. The World Health Organization has tried to send supply trucks. Some get through. Most don’t. The Israeli military says it inspects all medical shipments for dual-use materials. Insulin, they say, is not a prohibited item. But the inspections take weeks. The insulin spoils.
“It’s a slow-motion execution,” said Dr. Rami al-Hindi, a nephrologist at the European Gaza Hospital. “You cannot treat acute war wounds if the patient’s blood sugar is 800. You cannot operate. Their wounds won’t heal. They get infections. They die.”
He estimates that at least 15 percent of all war-related deaths in Gaza are actually complications from untreated diabetes — not direct bomb blasts. That’s a number the IDF does not release. But it’s a number the dead cannot deny.
Children Pay the Highest Price
Fatima, 12, has been diabetic since she was six. Her mother, Leila, used to test her blood sugar before every meal. Now there are no test strips. Fatima’s feet are swelling. Her kidneys ache. The last ounce of insulin they had was given to her little brother, who was in a coma. He died anyway.
“I have to choose which child gets medicine,” Leila said. “There is no choice. Both die.”
UNICEF estimates that at least 2,000 children in Gaza have Type 1 diabetes. Without insulin, they have weeks, not months. The aid agencies have appealed for a medical corridor. The UN has passed resolutions. Nothing changes.
What a Ceasefire Would Mean
A ceasefire would not magically fix insulin supply lines. It would take days, even weeks, to get shipments moving. But it would stop the bombing that makes transport impossible. It would allow doctors to move between hospitals. It would let aid workers bring in cold-chain logistics — refrigerated vans that keep insulin from spoiling in Gaza’s 95-degree heat.
But ceasefire talks have stalled again. The U.S. is pushing for a deal. Qatar and Egypt are mediating. Hamas and Israel both say they want peace. But while they talk, diabetics die.
“Every day without a ceasefire is a death sentence for at least 10 diabetics I know personally.” — Dr. Rami al-Hindi
The international community has promised $2 billion in humanitarian aid. Only $600 million has arrived. The rest is caught in bureaucracy, inspections, and political games. Insulin is not a weapon. But in Gaza, it might as well be.
The Verdict
This is not a natural disaster. It is not an accident. The starvation of insulin is a policy choice. Blockades are designed to pressure Hamas. But they do not distinguish between fighters and children, between soldiers and diabetics. The math is simple: no insulin equals death. And death is piling up.
When the war ends — and it will end — we will count the buildings destroyed and the bombs dropped. But no one will count the vials of insulin that never arrived, the toes that went black, the parents who watched their children slip into comas. They should. Because in Gaza, the war is not just bombs. It is also a slow, quiet, preventable death by diabetes.
