Gaza’s improvised medical points (MPs), makeshift clinics set up in tents and temporary shelters — some operated by the Hamas-run Health Ministry and others by nonprofits or voluntary teams — are struggling to provide even basic care amid severe shortages of medicines, equipment, and trained staff, a peer-reviewed study published Wednesday warned.

Published in PLOS Global Public Health — described on its website as “an open access forum for research that reaches across disciplines and regional boundaries” — the study highlights how these small units, established as substitutes for hospitals, have been degraded and overwhelmed throughout nearly two years of war.

Responding to the report, Israel said it continues to facilitate the entry of medical supplies into the Gaza Strip, while maintaining constant contact with aid groups.

The state of Gaza’s health sector has been at the center of international controversy throughout the ongoing conflict. Israel has repeatedly struck in and around medical facilities, operations that have drawn condemnation from humanitarian organizations and foreign governments alike.

Most recently, in August, the IDF carried out a tank shelling on Nasser Hospital in Khan Younis, killing at least 20 people, according to the Hamas-run Gaza Health Ministry, including rescue workers and journalists. Footage showed rescue personnel who had arrived at the site of an initial attack engulfed in smoke and debris when a second strike hit.

Israel insists that Hamas has systematically embedded itself inside Gaza’s hospitals, turning them into military hubs and thereby stripping them of the protections they are guaranteed under international law.

Documents from the Hamas Ministry of Interior and National Security, dating back to 2020 but declassified by the IDF last week and publicized by NGO Monitor, appeared to support this claim. The files detail how Hamas used hospitals to shelter operatives, host leadership meetings, and establish a secure communications infrastructure, while imposing restrictions on international aid groups to prevent exposure of its activities.

The PLOS study documented the reality of Gaza’s collapsing health system in stark detail.

Researchers surveyed 28 MPs throughout the Strip between October and December 2024, finding facilities crippled by shortages that left many unable to provide safe or reliable care. Essential drugs such as insulin, cancer treatments, and epilepsy medication were almost entirely absent, while antibiotics, psychiatric medicines, and even basic painkillers were rarely available.

Equipment was similarly scarce. Only a handful of MPs had oxygen supplies, and just two had functioning refrigerators to store vaccines or temperature-sensitive drugs. Trauma supplies, including suture kits and sterilization materials, were missing in many locations. In some cases, units operated without even basic sanitation, lacking soap, disinfectant, or sewage drainage.

“The severe shortage of critical medical equipment… severely limits the capacity of MPs to deliver adequate care, particularly for trauma and critical patients,” the authors wrote. “The absence of these supplies is likely contributing to preventable deaths.”

The article also painted a picture of an overburdened workforce. With a median of only seven personnel per MP, sites treated an average of 117 patients daily. Two-thirds of staff reported having received no training since joining, and many had no access to psychosocial support despite operating under constant stress. Salaries were irregular, and in some cases, nonexistent.

During the survey period, at least one health worker was killed in an IDF airstrike and several others were injured, while two facilities sustained direct damage.

Services provided were patchy and limited. Almost all sites offered general primary and pediatric care, but fewer than half provided trauma or maternity services. Mental health provision was “nearly absent,” despite widespread need. Vaccination campaigns, prenatal checkups, and nutrition programs were available only sporadically.

The findings coincided with a situation update released September 10 by the UN Office for the Coordination of Humanitarian Affairs (OCHA), which described Gaza’s health system as “overwhelmed by the influx of mass casualties” and critically short on blood.

On September 7, the Hamas-run Gaza Health Ministry issued an urgent appeal for blood donations after the Strip’s last delivery of 6,000 units — received on August 4 — was consumed within 20 days. Aid officials estimate that Gaza requires 350 units daily, but the number of donors has plummeted amid widespread hunger, disease, and displacement.

The United Nations Population Fund (UNFPA) also warned of “catastrophic consequences” for women and girls if fighting continues in the Strip. Four hospitals and 23 clinics offering obstetric and newborn care in Gaza City were described as being “at imminent risk of shutdown,” while southern facilities have already been stretched beyond capacity. More than 465 women gave birth outside hospitals in the first seven months of 2025, many without any medical support, according to UN data.

In an attempt to fill the gap, UNFPA and its partners opened a new field maternity hospital in August, equipped for cesarean sections and gynecological surgeries, and delivered six truckloads of reproductive health kits to support more than 200,000 sexual and reproductive health services.

Even these emergency measures remain vulnerable. On September 8, Medical Aid for Palestinians (MAP), a British charity providing medical services in the West Bank, Gaza, and Lebanon, reported that an MP it supported through its partner, the Gaza-based health organization Ard El Insan, was forced to shut down after sustaining damage from a nearby strike.

In response to the PLOS findings and broader criticism, the Defense Ministry’s Coordinator of Government Activities in the Territories (COGAT) agency said Israel has continued to facilitate the transfer of humanitarian aid into Gaza, including medical supplies and medicines. According to the agency, more than 3,500 tons of medical equipment have entered the Strip in recent weeks, with deliveries coordinated in advance and carried out in cooperation with international aid groups.

COGAT also said the IDF maintains regular contact with international organizations working in Gaza in order to support hospitals and field facilities, and pledged that Israel would continue to enable the entry of medical equipment in line with international law.

In a statement responding to a letter published earlier this year by the Israel Medical Association urging greater access to medical supplies, COGAT said it had supported international aid organizations in establishing 13 field hospitals in Gaza, equipped with essential supplies.

At the same time, COGAT stressed that measures are being taken to prevent Hamas from diverting humanitarian supplies for military use.

Critics, however, contend that more needs to be done in order to shield civilians from the wider impact of the war.

“What we are seeing in Gaza City is not collateral damage; it is the predictable and preventable result of deliberate Israeli policies and actions that harm civilians and healthcare in violation of international humanitarian law,” said Fikr Shalltoot, MAP’s Gaza director.

“The UK and other governments must not continue to stand by while civilians are bombed, starved, and systematically denied lifesaving aid,” she said.