For months, 70-year-old Bassam Musleh searched pharmacies and clinics across the occupied West Bank for the heart and blood pressure medication that keeps him alive.
Public facilities had no supplies, private pharmacies were too expensive, and the retired man, who lives with a pacemaker, feared his condition would worsen. Relief finally came this week when a mobile clinic in the village of Iktaba handed him the medicine he had been unable to find for six months.
Musleh's struggle reflects a broader healthcare crisis unfolding across the West Bank, where hundreds of thousands of Palestinians are facing worsening shortages of medicines, medical staff and essential services.
A report released Thursday by Physicians for Human Rights Israel (PHRI) warned that Israeli policies have pushed the territory's healthcare system to the brink of collapse, leaving vulnerable patients increasingly dependent on humanitarian organizations.
The report says the crisis has deepened since the war between Israel and Hamas in Gaza began nearly three years ago. Israel has withheld billions of dollars in tax and customs revenues it collects on behalf of the Palestinian Authority (PA), depriving the Palestinian government of a major source of funding used to pay healthcare workers, purchase medicines and operate hospitals, clinics and pharmacies.
According to the report, roughly 75% of public health facilities have reduced services and now operate only once or twice a week because of financial shortages. Hospitals have delayed surgeries, pharmacies regularly run out of essential medicines and many healthcare workers have gone unpaid for months.
"If this continues, it is patients, not institutions, who will pay the price," said Milena Ansari, director of PHRI's Occupied Palestinian Territory Department and author of the report.
The Palestinian Authority depends heavily on Israel to collect taxes on imported goods because Palestinians do not control their own borders. Human rights organizations have long accused Israel of using those revenues as political leverage.
Israeli Finance Minister Bezalel Smotrich halted the monthly transfer of clearance revenues last year. According to the International Crisis Group, Israel had withheld at least $2.5 billion from the Palestinian Authority between 2023 and June this year.
Smotrich's office and the office of Israeli Prime Minister Benjamin Netanyahu did not respond to repeated requests for comment from The Associated Press.
Palestinian Health Minister Majed Abu Ramadan said the financial crisis has severely weakened the healthcare system. Many unpaid medical workers have stopped reporting to work, increasing patient backlogs and forcing delays in routine surgeries. Earlier this year, doctors launched strikes while several primary healthcare centers temporarily shut their doors.
Health officials say cancer patients, people with kidney and heart disease, displaced families and older adults have been among those hit hardest.
The growing demand has placed enormous pressure on humanitarian organizations attempting to fill the gaps.
At PHRI's mobile clinic in Iktaba, hundreds of patients waited for treatment throughout the day.
Among them was 64-year-old Mohammed Sarris, who said he had gone weeks without the eye drops needed to treat diabetes-related irritation.
Forced from his home in the Nur Shams refugee camp last year, Sarris lost easier access to healthcare previously provided by the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA).
Living on a modest government pension, he often stretches his medication to make enough money for food.
"It's degrading. All of this has affected us a lot," Sarris said.
PHRI said patient numbers at its mobile clinics have doubled over the past two years, climbing from about 250 daily visitors to roughly 500.
Roland Friedrich, UNRWA's director in the West Bank, said the agency has also experienced a sharp rise in patient demand.
While UNRWA is attempting to expand healthcare services, he said financial constraints and Israeli restrictions on importing medicines have limited its ability to respond.
Humanitarian organizations have also faced additional operational obstacles.
Earlier this year, Israel revoked the operating licenses of more than three dozen humanitarian organizations, including Doctors Without Borders, widely known by its French acronym MSF.
As a result, MSF said it reduced the number of mobile clinics operating in the South Hebron Hills from 12 to six after losing the ability to coordinate movements with the Israeli military.
Joan Tubau, the organization's head of mission for Gaza and the occupied West Bank, said the cuts have affected healthcare access for more than 40,000 people.
Medical shortages have been compounded by tighter Israeli movement restrictions throughout the West Bank.
Over recent years, Israeli forces have expanded the number of checkpoints, barriers and roadblocks, frequently isolating towns and communities and making travel to hospitals increasingly difficult.
Medical Aid for Palestinians (MAP) said those delays have had deadly consequences.
Deputy advocacy director Aseel Baidoun said at least two women gave birth inside ambulances in July after closed checkpoints prevented them from reaching hospitals in time. One baby was stillborn.
She added that three other patients died this year while attempting to reach medical care, including two infants and a 30-year-old woman who suffered a fatal heart attack after an ambulance was stopped at a checkpoint near Sinjil, outside Ramallah.
The Israeli military has denied blocking civilians from receiving medical treatment, saying there is no policy intended to delay healthcare or medical evacuations.
Responding to questions about the stillborn infant delivered near Nablus, the military said the ambulance had not completed the required coordination before reaching the checkpoint. It said soldiers carried out a security inspection that lasted only a few minutes.
Healthcare workers say the prolonged crisis is taking a psychological toll as well.
"People here feel suffocated by everything they're going through," said Dr. Leen Ibrahim of Medical Aid for Palestinians.
Back at the mobile clinic in Iktaba, patients waited for hours in long lines, many visibly exhausted and emotional.
"The line is so long," 65-year-old Asala Wawi said through tears while waiting for an eye examination. "I'm tired."
