When 23-year-old Noor Al-Ishi from North Gaza started experiencing daily night sweats and joint pain, she thought it was from carrying heavy buckets of water from the water distribution point to her tent and from long hours spent waiting in line for food. She and her family had been displaced to Rafah, in southern Gaza, soon after Israel’s genocide started in October 2023.
Noor visited a UNRWA clinic where she was prescribed painkillers for joint pain, but when a butterfly-shaped rash appeared on her face, she got scared and went to see an internal medicine doctor at the Al-Emirati Hospital.
The doctor suspected she had lupus, an autoimmune condition which causes the body’s immune system to attack healthy tissue and organs. A blood test confirmed the doctor’s suspicions. Noor’s doctor believed that her lupus was brought on by the severe stress and trauma of Israel’s war on Gaza.
“The doctor advised me to rest, not stress and to manage my emotions, as well as not to expose myself to too much sunlight,” Noor tells The New Arab. “He also said to drink clean water and healthy food, which is almost impossible in the conditions of war and displacement. Our tents were worn out and exposed to sunlight whether you are inside or outside them.”
Noor is one of several Gazans The New Arab spoke to who believe they developed lupus as a result of the extreme conditions they were exposed to during the genocide.
Nagham Hammaad was also told by the doctor who diagnosed her with lupus that it was most likely due to the extreme fear and stress of the genocide. She tells The New Arab that one of her main issues was extreme hair loss, a common symptom associated with lupus.
“I saw a dermatologist in Central Gaza and she gave me cortisone but there was no improvement in my hair loss, it just got worse,” she shares.
“I’ve been searching for a dermatologist but there aren’t many left in Gaza. They’ve either been martyred or they evacuated.”
Nagham was relying on minoxidil, a hair spray used to stimulate hair growth in those suffering from hair loss, however, it quickly became unavailable as did the cortisone, as the Israeli army’s blockade on Gaza resulted in a shortage of all types of medications and health products.
Noor too found her condition getting worse as her lupus medication started to run out. “When the ground invasion of Rafah happened, I tried to seek treatment from abroad, but it was impossible to get it into Gaza,” she says.
Immunosuppressants such as Plaquenil, a common treatment for lupus, were largely unavailable over the last 15 months in Gaza, which meant for the besieged territory’s lupus patients, their conditions only worsened.
The New Arab also spoke to Gazan doctors who said they had witnessed a rise in the number of patients developing lupus, but that it was hard to determine the exact number, as the Israeli army had destroyed most of Gaza’s health infrastructure.
It is believed that there were around 300 Gazans who had lupus before October 2023, a figure which Gaza’s only lupus support group, Firashat Amal, also known as Lupus in Palestine, confirmed with The New Arab.
Internal medicine specialist Dr Abdul Qadir Ahmed from north Gaza says he noticed an increase in the number of Gazans developing lupus which he too attributes to the genocide, due to the poor conditions of displacement, constant fear and panic, malnutrition, and the lack of safe drinking water.
Dr Ahmed was displaced to the south where he says he has encountered lupus patients whose conditions deteriorated after suffering from auditory and visual hallucinations due to nervous shocks from seeing martyrs and body parts thrown on the ground.
“There are especially high risks for elderly lupus patients or those with lupus who are suffering from heart and respiratory disorders,” Dr Ahmed tells The New Arab. “I’ve seen the deaths of heart patients and those with regurgitation of heart valves due to the unavailability of treatments, overcrowding of hospital beds and poor or unavailable medical services.”
One older lupus patient who was recently on the brink of death is Um Hassan Abo Hwaidy. Her daughter Zainab explains how the abysmal conditions of war and displacement led to her mother’s lupus deteriorating so much that her teeth fell out. Um Hassan, Zainab and the rest of the family were unable to leave north Gaza and the severe shortage of food only made Um Hassan’s condition deteriorate further.
“Three-quarters of her treatments were not available. My mother was meant to eat protein, meat, vegetables, fruit, milk and take nutritional supplements and unfortunately, there were none of those things,” says Zainab.
“When she was close to death she was admitted to the hospital and there was no doctor experienced in her condition. They were all trying out different things on her. Finally, we found the doctor who used to treat her before the war who specialised in lupus and cancer and he prescribed a treatment for 21 days. She started to improve, but now she can no longer walk.”
Firashat Amal founder, Islam Al Shanti, told The New Arab that she came across seven cases of Gazans who developed lupus during the war and that she feels that Gazans suffering from the condition have been largely neglected. She is Gaza’s first and maybe only lupus advocate and spent a portion of the war trying to source medication for other lupus patients, despite going without her own medication.
“I only respond to one type of treatment which I used to get from Israel via a charity, but unfortunately the charity stopped and I have not been able to get hold of it for a year and a half – it is only available in the UK, Germany and Qatar,” she shares.
As a ceasefire in Gaza finally came into place, lupus patients and doctors are now hopeful they will finally receive the treatment they so desperately need.
“There is hope that patients will improve with the daily entry of medical delegations into the Gaza Strip from all specialities, the availability of medicines again and the beginning of the return of the displaced to their homes,” says Dr Ahmed.
“There will not be a sudden noticeable improvement, as the disease is chronic and requires follow-up over long periods, and there are disasters that we are discovering daily with the entry of the ceasefire.”
Noor, Zainab and Zainab’s mother Um Hassan are hopeful too that lupus medications such as steroids and immunosuppressants will soon be within reach, bringing an end to what has been over fifteen months of pain, sickness and suffering.
“With the entry of the ceasefire food has become available. And some of my mother’s medications too, but not all of them,” ” says Zainab.
“I am happy now that the ceasefire has entered into force and medicines have entered the Gaza Strip,” says Noor.
“I have hope now of recovering from this disease.”
If you would like to donate to Zainab and Um Hassan’s fundraiser please click here. To donate to Islam Al Shanti’s fundraiser to raise money for her medication, please click here
Haya Ahmed is a doctor and freelance writer from Gaza
