Amid Destroyed Health System, Gaza Sees Severe Outbreak of Autoimmune Disorder
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Struggle and Solidarity: Writing Toward Palestinian Liberation
The residents of Gaza City are not only corralled by Israel’s siege and bombing, but also by infections from overflowing sewage, the pathogens seeping from contaminated water puddles, the immunity-threatening diseases emerging from overcrowded displacement camps, and the toxic residues of unexploded ordnance. As a result of Israel’s campaign of genocide, Gaza’s fragile health care system is experiencing an unprecedented outbreak of Guillain-Barré syndrome, or GBS.
GBS is a rare autoimmune neurological disorder in which the body’s immune system attacks the peripheral nerves — many of which are responsible for initiating muscle movement, while others transmit sensations of pain, touch, and temperature. This, in turn, leads to a progressive loss of sensation that typically begins in the legs and moves upward. In severe cases, GBS can deteriorate into complete paralysis, along with difficulty in breathing, swallowing, and seeing. Such complications can be life-threatening. Globally, it affects a small percentage of the population — about 1 to 2 cases per 100,000 people — and occurs across all ages and genders, with a slight predominance in males.
Guillain-Barré syndrome’s root cause is not yet fully understood, but there is strong evidence linking it to Campylobacter jejuni bacteria and certain enteroviruses. Once diagnosed, the condition requires urgent medical intervention and supportive care — often including intensive care unit monitoring, mechanical ventilation, plasmapheresis, and optimal intravenous immunoglobulin (IVIG) therapy. These measures are crucial to halt further complications and prevent progression toward paralysis and respiratory distress.
Yet in Gaza, the ongoing genocide has reshaped every medical protocol. Agreed-upon standards, medical guidelines, and even humanitarian charters have been brutally upended. The catastrophic collapse of Gaza’s health care system, the severe shortage of medications, and the scarcity of medics have allowed both the number of cases and the severity of GBS to worsen unchecked. According to numbers from the Ministry of Health shared with Truthout, between June 1 and October 17, 2025, 130 cases of Guillain-Barré syndrome were recorded in the Gaza Strip, with 20 recorded deaths. The majority of those diagnosed were males: 80 compared to 50 females.
The findings showed that individuals older than 17 were at higher risk of developing GBS compared to those under 15 — not to mention its intertwined impact with acute flaccid paralysis and polio in children. Up to 90 percent of Gaza’s water, sanitation, and hygiene infrastructure is destroyed, according to the UN Office for the Coordination of Humanitarian Affairs. Together with widespread malnutrition and an immunocompromised population, this has created a fertile storm for cases of GBS to spiral out of control.
“Before the genocide broke out, 1 in every 100,000 individuals contracted GBS … now, we record one or two cases every day.”
Dr. Ahmed Al-Farra is head of the pediatric department at Al-Nasser Hospital Medical Complex, where he directly supervises cases of Guillain-Barré syndrome. “Many of the admitted cases were children,” he told Truthout. “Their parents had awoken them early to fetch water from humanitarian trucks, only to discover their children could no longer walk. At first, some families thought their children were pretending — refusing to walk out of mischief or tiredness. Yet soon after, when the child tried to stand, they fell. That’s what spurred them to seek medical care.”
Dr. Al-Farra said the hospital faced challenges in detecting the first diagnosed case of GBS, given Gaza’s ill-equipped health care system.
“The first case of GBS was recorded only after we sent stool biopsies to laboratories in Jordan and the Palestinian Territories occupied in 1948,” he said. “Out of 15 samples, nine tested positive for campylobacter jejuni. In other analyses, enteroviruses were detected, highly indicating acute flaccid myelitis — a condition very similar to acute flaccid paralysis. Yet, to improve diagnosis and follow-up for GBS or acute flaccid paralysis, we require tools like nerve conduction studies, muscle conduction tests, cerebrospinal fluid protein analysis, and MRI scans — all of which are nonexistent in Gaza.”
Dr. Al-Farra was shocked by the sudden spike in the number of cases. “Before the genocide broke out, 1 in every 100,000 individuals contracted GBS,” he said. “On average, we used to document a single case per year. Doctors who detected it early were even recognized by the Ministry of Health for their early detection of polio or AFP [acute flaccid paralysis]. Yet now, we record one or two cases every day.”
He noted that it typically takes about a week for symptoms to progress to breathing difficulties.
“But here in Gaza,” he said, “it takes only 48 hours.”
“To enhance survival, patients urgently need mechanical ventilators,” Dr. Al-Farra continued. “But Gaza’s few remaining functioning hospitals suffer severe shortages, overwhelmed by the flood of genocide-related injuries.”
When I asked him about the triage dilemma during emergencies — between those suffering from GBS and those injured by Israeli missiles — he replied quietly, “Every day is a test of priority, as ventilators are insufficient. The grim reality here is far too complex. Both are in desperate need of care. Both are hanging in balance. Both deserve the chance to survive. We are doing what we can to help them survive.”
He sighed before adding, “Most of the cases that wasted away could have been saved if GBS treatment — IVIG [intravenous immunoglobulin] — had been available.”
Guillain-Barré syndrome is not contagious, but it is preventable if optimal treatment is delivered urgently through IVIG. Yet, in a cracking voice, Dr. Al-Farra pointed out that the humanitarian crisis has also crushed the medical sector.
“The Israeli forces impose severe restrictions on the entry of medications, especially IVIG,” he said. “And even when it’s available, it requires special storage and transport conditions. It’s also very expensive. So, we are forced to carry out plasmapheresis, but not in its standard way — we clear the plasma from antibodies only partially.”
In a determined voice, he added, “We managed to deliver IVIG to some cases, yet the therapeutic response was not as expected. Patients are not improving as they did before the genocide.”
He continued, “So we reached out to our fellow pediatric neurologist colleagues in Harvard, Amsterdam, and Britain to inquire. They said it’s a natural outcome — due to Gaza’s multiple risk factors that have intensified the severity of GBS.”
For Wadeaa Abu al-Saoud — a correspondent journalist, father, and husband whose wife was among the very first diagnosed cases of GBS at Al-Ahli Baptist Hospital — his story of survival was not only punctuated by pain and uncertainty, but also by the unbearable burdens that kept him away from his wife when she needed him most.
“Since the genocide was unleashed, I asked her to evacuate south, and I would stay in Gaza City to share people’s suffering. Gaza needs me the most,” he told Truthout. “She replied in a shaken voice, ‘I won’t leave you alone. Either we live together, or we die together.’”
In a desperate tone, he continued, “Since that day, she has lived through all forms of fear, hunger, and displacement. She fled death from shelter to shelter, clutching our children and keeping our promise sacred. She hasn’t seen me for months — unless, by chance, she catches one of my live-streamed reports, if she’s lucky enough to find an internet connection.”
“But now,” he said softly, “she’s bedridden, and I stand helpless before her.”
Abu al-Saoud was separated from his family for their safety, as Israel considers journalists among its targets.
“Her symptoms first appeared when the famine struck the enclave,” he recalled. “She told me during a call that she felt dizzy, then suddenly collapsed. I tried to reassure her that it was just the effects of malnutrition.”
“Later, she called again, saying, ‘I’m so exhausted and in pain.’ She was admitted to the hospital but discharged the same day, as they thought it was only a complication of malnutrition. Yet the next day, she felt paralysis in her legs — completely motionless. I carried her to Al-Ahli Arab Baptist Hospital, and that’s when she was diagnosed with GBS and referred to Al-Shifa Hospital.”
“Back then, I learned how devastating GBS can be,” Abu al-Saoud said. “But I lied to my wife, telling her it was only a vitamin deficiency — until I slowly prepared her for the truth.”
Abu al-Saoud appeared in a video on his Instagram account, sharing his wife’s condition and pleading with authorities to provide IVIG for Guillain-Barré syndrome patients in Gaza. His plea was answered by Jordan’s Royal Hashemite Court, an intermediary between the Jordanian king and the state’s institutions, which facilitated a small amount of IVIG to meet his wife’s urgent need and help a few other patients.
“I kept telling myself that if I were killed, my wife would raise our children properly. But now she’s dying before me, and I might be killed at any moment. That belief shatters me every day.”
“Her condition improved, yet I couldn’t stay consistently by her side. That period coincided with the systematic killing of Anas al-Sharif and the Al Jazeera crew. Tremendous burdens weighed on my shoulders — I couldn’t balance between my oath to journalism and the one I made to my wife,” Abu al-Saoud said.
“My wife’s condition kept fluctuating, from slight recovery to decline. We were forced to separate — I was covering the news, while she remained in the hospital, and our children were in another shelter,” he said. “I kept telling myself that if I were killed, my wife would raise our children properly. But now she’s dying before me, and I might be killed at any moment. That belief shatters me every day.”
He paused before adding softly, “Nowadays, she’s getting better. Once the borders open, I will evacuate her so she can resume her medical treatment abroad.”
Guillain-Barré syndrome could be a manageable disease anywhere with proper treatment — but not in Gaza. To halt its silent spread, urgent, sustained, and integrated long-term action is needed: to restore nutrition, ensure the chlorination of drinking water, raise awareness about hygiene to stave off infectious diseases, and provide what has become sacred in Gaza — ICU beds, ventilators, and life-saving medications — before another preventable disease claims lives that could have been saved.