Suffocation Under the 'Dual-Use' Label: Gaza's Medical Oxygen Supply System on the Brink of Collapse

Of the 34 oxygen production stations in the Gaza Strip, only 12 remain operational, and of the 30 devices used to fill oxygen cylinders, just 4 still work—this is the warning issued by Gaza's Ministry of Health on August 15. According to Al Jazeera, the data lays bare the humanitarian cost of Israel's controls on "dual-use" items: oxygen cylinders, supporting equipment, and generators are barred from entering Gaza through closed crossings, while the import of related spare parts and specialty lubricants is likewise restricted.

Israel's regulation of "dual-use" goods is an internationally accepted practice designed to prevent technologies with both civilian and military potential from flowing into military use. When it is extended to oxygen cylinders—a medical gas used primarily in hospitals and home care—what is being restricted is no longer military potential, but the survival of patients themselves. In a densely populated, besieged enclave whose medical system has been battered repeatedly, the consequences of this extension fall immediately on every patient in need of oxygen.

Fourteen-year-old Abdulaziz is one such patient. Since birth he has suffered from congenital heart disease, pulmonary hypoplasia, hydrocephalus, and autism. Before the war, he traveled regularly to Israeli hospitals for specialized treatment; now that life line has been severed, and he is left to depend on a Gazan medical system devastated by the war. According to Al Jazeera, Abdulaziz's father, Ali Humaida, said his family's monthly expenses for his son's medications, diapers, and transportation have climbed to roughly 950 to 1,100 shekels (about 315 to 365 U.S. dollars)—double the pre-war level.

In a displacement camp in az-Zuwayda in central Gaza, Ali stares at the pressure gauge on the oxygen cylinder in the corner, watching the needle slowly drop. "The cylinder just ran out in the middle of the night," he recalled to Al Jazeera. "Every minute turned into a nightmare. We fanned him with our hands and pieces of cardboard, watching his face turn blue, afraid he would lose consciousness or slip into a coma right before our eyes while we were completely helpless."

"With every passing minute, the oxygen is running out," Ali said. "I kept asking myself: how much is left in the cylinder? Can it last until morning? If it runs out, where do I go to find another one?"

Citing United Nations estimates, Al Jazeera reports that roughly 350,000 people in Gaza suffer from chronic illnesses, whose treatment has been severely disrupted by the war. Mohammad Abu Salmiya, director of Gaza's al-Shifa medical complex, told Al Jazeera that Gaza is facing shortages of half of its essential medicines and more than 80 percent of its laboratory supplies, and estimated that some 21,000 patients and wounded require treatment abroad—including more than 4,000 cancer patients and more than 10,000 wounded in need of advanced surgical care.

Under the extreme strain on medical resources, Gaza's Ministry of Health and multiple hospitals have halted external oxygen cylinder refills for patients being treated at home or in displacement tents entirely, in order to reserve what oxygen remains for critical departments such as intensive care units, neonatal incubators, and operating theaters. According to Al Jazeera, frontline medical staff described the decision as a forced response to a catastrophic reality, rather than an administrative choice.

Citing the analysis of Ghada Hassouna, a doctor at Al-Aqsa Martyrs Hospital in Deir el-Balah, Al Jazeera reported that patients experiencing sharp drops in oxygen saturation develop symptoms such as rapid breathing, elevated heart rate, and cyanosis, or bluish discoloration of the skin; sustained oxygen deprivation damages vital organs including the brain and heart. For young patients like Abdulaziz, any drop in blood oxygen levels risks severe or permanent neurological damage.

"I am not asking for the impossible; I just want my son to breathe freely," Ali told Al Jazeera.