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Ali Jneina hardly talks any more. The eight-year-old cancer patient, who is glued to his iPad when not asleep, has lost the will to leave his room in Jerusalem’s Augusta Victoria Hospital.
He is embarrassed about losing his hair and about the weight he has gained because of chemotherapy. Most of all though, his mother says, Ali just wants to go home.
The little boy and 11 other patients in the children's cancer ward are from Gaza.
Because of the devastating Israeli war in the Palestinian territory, which has killed more than 32,000 people since it started on October 7, they do not know when they will be able to go back.
Ali's mother, Mai Jneina, is visibly exhausted as she sits by Ali's bed, trying to keep her son’s spirits up. She also has to find ways to communicate with her husband and the couple's two other children in Gaza.
“I don’t tell my husband about our son’s treatment. He just says he’s had enough and can’t stand it any more. So the pressure is all on me,” Mrs Jneina told The National. “I don’t know if I’ll recognise my husband when I see him. He’s lost a lot of weight, as have my children.”
Augusta Victoria and a few other hospitals in Jerusalem have historically welcomed the sickest Palestinians from the occupied West Bank and Gaza, who lack access to advanced medical care at home.
They have now become temporary homes for the Gazans who were receiving treatment before the war broke out.
It is a massive challenge for the hospital, which normally hosts the patients and their guardians only for the duration of treatment.
Despite the unexpected difficulties, Dr Fadi Mizyed, the hospital's CEO, says his staff will always prioritise patient well-being, particularly in this uniquely testing moment.
“They are not only fighting their disease now. They are fighting the war, the situation – they’re stressed the whole time, away from home,” he says.
“These are not the conditions in which a child should be treated. Two of the kids here have psychological problems now and are becoming less co-operative with staff."
It falls to Dr Khadra Hasan Salami to try to keep the children's treatment on course. She and her staff do their best to fill the ward with positive energy. Two Palestinian clowns even came to visit while The National was at the hospital.
But nothing works on Ali, whose eyes stay glued to his iPad as he sits surrounded by teddy bears, paper Ramadan lanterns and the scooter he will get to ride again when he is strong enough.
A nurse recounts a story that illustrates the horror of his situation. One day Ali was talking to his sister in Gaza. He told her that he ate meat that day, which made her cry because she was so hungry.
“I’m sure Ali feels guilty thinking about how he’s in a 'better’ situation,” Dr Salami explained.
“Ali has had anxiety attacks and is agitated. When he has a procedure now he loses his communication with us and gets angry.”
Most of the children on the ward are recovering from treatment. One is being actively treated and a few others are going into palliative care – a number of these children are likely to die so soon that they will never go back to Gaza.
It is a nightmare for the mothers, who make up the majority of the companions that Israeli authorities allow to accompany the patients. Many of their family homes have been bombed. Their other children have mostly been evacuated and are often living in tents. Some have lost family members.
Unlike Ali, Ameera Sabbagh, 11, dreads the prospect of going back to Gaza. Her mother, Eman Sabbagh, brought her to Augusta Victoria in September. They were supposed to stay for a month and a half. It has now been more than six months.
'Full of horror'
“When the war broke out we were terrified and full of horror,” Mrs Sabbagh told The National.
“At first Ameera was crying all the time. She wanted to see her siblings and her dad.”
Her treatment has gone well, and after a painful few months, she now walks around the ward with ease, chatting away.
“The hospital is beautiful and I’m friends with the doctors, nurses and the mothers of the patients,” says the little girl. “So I don’t want to go back to Gaza. It is destroyed and my family is staying in a tent – where would I go?”
It is a question that preoccupies the medical staff. Earlier in the month Israeli authorities set in motion a process to bring back to Gaza some cancer patients in another hospital who they deemed to be sufficiently recovered.
Dr Salami is desperate to keep her patients close.
“Many of our patients who are now in Gaza are in contact with us. Some have relapsed, some are living in terrible, unhygienic conditions and many are not able to get the nutrition they need,” she says.
“I lost a patient whose cancer I was in the process of curing very successfully. It’s extremely sad. Cancer treatment is not easy. You and your patient go through a special journey. At any point you might lose them.
"But to complete the journey and then lose them to a human cause is terrible,” she adds.
“He was a leukaemia patient. He presented in a very critical state. He was nine. We were trying to send medication to him, but we found out he was bombed. He and his family died. They were near Nuseirat refugee camp, I believe.”
Dr Salami says none of the staff will ever be the same again: “This has changed me a lot. I have to express myself honestly. I travel a lot to the US and Europe for conferences. I always hear about human rights, and that every child with cancer should live regardless of whether they are in the east or west.”
“After the war, we see that this mask has fallen. They are not doing the best they can to stop this from happening.”
