Gaza City - At al-Shifa Hospital, the largest hospital in Gaza, 50 babies lie crowded in 30 beds in the neonatal intensive care unit (NICU). Outside, the yard resembles a factory as massive generators roar and hum, turning fuel into electricity, supplying the babies with oxygen through ventilators.
Due to the electricity shortage in Gaza, the generators are the only lifeline for these newborn babies, but even this may be cut soon as Gaza's fuel reserves are expected to be depleted in a month, placing patients' lives at risk.
"Most of the babies are connected to mechanical ventilation. If the electricity is cut, most of these babies will die within a few seconds; we cannot support them," said Dr Allam Abu Hamida, director of al-Shifa's NICU.
"You see," Abu Hamida points to a monitor displaying the level of supplied oxygen, "The oxygen is supposed to be at 90 and above, but it's just 62."
Half of the babies in the NICU were born premature, some weighing only 700 or 800 grammes. They are all critical cases, some born with congenital defects, and all dependent on the generators to keep them alive.
|A baby lies underneath a broken oxygen hood held together by masking tape [Mersiha Gadzo/Al Jazeera]|
One baby lies in an incubator with his head under a broken oxygen hood donated years ago from Japan, now held together with masking tape. "We don't have spares, so we taped it together. It's broken from everywhere," Abu Hamida said.
"If the electricity is cut, the baby will get hypothermia and will die."
This is just another ordinary day at Gaza's al-Shifa hospital, where staff regularly make do with what they have.
Under the Israeli-Egyptian siege, hospitals in Gaza have been struggling for years to operate with a severe electricity shortage, but doctors now say the situation is reaching a breaking point for patients.
The crisis was exacerbated last month when Gaza's sole power plant shut down after it ran out of fuel provided by Turkey and Qatar. The Fatah-dominated Palestinian Authority decided to stop paying Israel for the electricity it supplies to Gaza after Gaza's Hamas leadership said it could no longer afford to pay the fuel taxes.
If this problem continues, the unit will collapse; it will be a catastrophe. We already have a shortage of staff, shortage of supplies, shortage of everything.
Israel announced last week that it would be reducing its electricity supply at the request of the Palestinian Authority. Since then four hospitals in the Gaza Strip have already closed, and surgeries have been postponed.
Patients who depend on electricity to survive - such as those in the Intensive Care Unit, operating rooms and those in need of dialysis - will be in a life-threatening situation if there is a complete power shutdown in Gaza. In al-Shifa Hospital, a power shutdown would result in the immediate death of 100 patients, and another 1,000 patients will be indirectly affected.
"If this problem continues, the unit will collapse; it will be a catastrophe," Abu Hamida said. "We already have a shortage of staff, shortage of supplies, shortage of everything."
According to Robert Piper, UN Coordinator for Humanitarian Aid and Development Activities in the Occupied Palestinian Territory, Gaza's fuel reserves will be depleted "by the end of June or early July at the latest."
"With power cuts of 16-20 hours a day, no one is spared the impact of the current energy crisis in Gaza," Piper wrote in an email to Al Jazeera.
"The UN is coordinating the distribution of fuel for generators at 180 key facilities, 32 of which are health facilities. This helps maintain essential services but cannot substitute for the grid.
The International Committee of the Red Cross (ICRC) warned this month that Gaza was on the brink of experiencing "a systemic collapse of an already battered infrastructure and economy."
The UN also recently warned of devastating consequences if the Gaza Strip runs out of fuel.
Hospitals in Gaza currently run on about four hours of electricity. The generators powering al-Shifa for the remaining 20 hours costs $3,000 - $4,000 daily for 2,000 litres of industrial fuel.
But even the generators operate at a risk of breaking down since they are designed to run only six to eight hours at a time.
"Our generators don't have big reservoirs for fuel, so they operate day by day," said Ayman al-Sahabani, spokesman for al-Shifa. "It adds more pressure and stress on our staff because we have to always be careful about how much we have left and decide when we need to talk to the Ministry of Health [for more]."
"Imagine what will it be like if there was another attack on Gaza. We're already at full capacity," al-Sahabani said.
A few days ago, the health minister arrived for a visit but got stuck in the elevator for seven minutes due to a problem with one of the generators, al-Sahabani explained.
"We're in the 21st century. We don't want to reach a point where we're losing patients because of a lack of electricity," al-Sahabani said.
The constant interruptions of electricity supply also mean that medical machines don't operate optimally.
|The hospital prioritises electricity for departments that need it most [Mohammed Salem/Reuters]|
In the NICU, a monitor next to a baby's incubator flashes the warning: "Leaking fresh gas".
"It's not leaking; the sensor just isn't functioning properly," Abu Hamida said, pressing buttons on the screen, attempting to fix it.
At al-Rantisi Pediatric Hospital in Gaza City, children with chronic kidney disease undergo hemodialysis three times a week for two to four-hour sessions in order to stay alive.
Their only other alternative to the machines would be to undergo a kidney transplant, but finding a compatible kidney is difficult.
In the past six years, there have been seven kidney transplants for Gaza patients; three in Gaza, two in Israel and two in Jordan, explained Dr Jomaa Waleed Younis.
"If there's no electricity, there's no life for them because their situation is very critical," Younis said.
|Yahia sometimes undergoes dialysis sessions for three hours instead of four, which affects his health [Mersiha Gadzo/Al Jazeera]|
For now, the hospital prioritises electricity for departments that need it most; once a department is done with its treatment, the electricity is passed onto the next department.
Najwan al-Samnai is worried about her eight-year-old Yahia. Due to the shortage, Yahia sometimes undergoes sessions for three hours instead of four, which affects his health.
"It affects his breathing, his blood pressure; he comes back home with more weight," al-Samnai said.
Mohamed el-Ron, head of al-Shifa's surgery department, spent two years working as a doctor in besieged Sarajevo during the war in Bosnia in the early 90s.
"During the war in Bosnia, I never felt as if we didn't have any hope," el-Ron said. "We were always hoping that we would reach an agreement soon and that the war would end.
"Here, we have nothing. People in Gaza have lost all hope. We're just waiting for the worst."