West Bank Hospitals Run Empty as Funding Dries Up

Hospitals across the occupied West Bank are running on empty because funding has dried up. Khaldoun Atwan walks into the oncology ward at Beit Jala Government Hospital every single day without knowing what roadblocks stand in his way. The checkpoint near Nabi Yunis in Halhul looks closed most of the time, forcing him to leave his car and take a taxi from Hebron just to get there.

"I found the mirror broken. I found the wiper broken," Atwan said about driving through territory where settlers are now active. He navigates a dizzying maze of gates that open and shut at Israel's whim. Sometimes he does not reach the hospital. Sometimes his patients do not make it. And sometimes the drugs they need sit empty on the shelf when they finally arrive.

Beit Jala is the only government hospital in the Bethlehem governorate, which holds about 320,000 people. Inside Atwan's tiny, bare office, he fights to keep up with cancer patients whose conditions have worsened due to missed appointments or a lack of essential chemotherapy drugs. Not even during the second Intifada was drug supply such a nightmare. Now it is unavoidable.

"Everything's short … whatever's available we give," Atwan said. "It's a disaster."

The Palestinian Authority's finances have collapsed over the last three years thanks to cuts in international aid and disruptions in Israel's transfer of tax receipts. Since October 2023, Israeli actions including widespread road closures, checkpoint delays, and settler pogroms against Palestinian communities have hammered the economy hard. As a result, the healthcare system is falling apart fast. Staff members receive just half their salaries, while the PA cannot afford essential medications.

An older cancer patient from Bethlehem stood at the hospital entrance with his son, weighing what to do next alongside others pacing nervously in the courtyard. "Every month they do their best, the doctors and the cleaning staff, but they aren't provided with anything," he said.

Ministry clinics now operate part-time. When a doctor is available, they see well over 100 patients a day. Even a simple checkup has become rushed and unaffordable. "If we want to go to the doctor for a checkup, we need 200 shekels [$65]," said an older cancer patient.

"It's not a story of there being no staff," Iyad Dari told reporters. He is an attending physician at the dialysis unit at Beit Jala. Getting paid only half their salaries means government employees work just two or three days a week because they do not have enough money to come in for full hours. The hospital ends up covering emergency cases only.

"At first, [patients] were [angry]. But now everyone understands: Everyone's suffering," Dari said.

This medical supplies crisis in Beit Jala and across the West Bank stems from Israel withholding tax revenues earmarked for the PA. Israeli Finance Minister Bezalel Smotrich spearheaded this action. Milena Ansari of Physicians for Human Rights Israel called it predictable. "This crisis is very predictable, and we saw it coming 100 percent," she said.

Before the war in Gaza began last October, Milena warned that Israel was already withholding tax revenue from the West Bank. This action emptied the Ministry of Health's accounts long before the fighting started. Yosef Ojra, a specialist at Beit Jala, says these missing funds have stopped payments to medical suppliers. Those vendors now refuse to deliver services. The public and private health sectors are scrambling to borrow supplies between themselves. This constant strain is breaking private clinics, pharmacies, and hospitals across the region.

Hisham Amle, an oncologist working at the hospital, calls shortages an old problem rather than a new crisis. However, he says ninety percent of essential items used to be available. Now even immunotherapies and biologics are missing. Cancer treatment relies on an unbroken chain of medication. "If the patient misses a session or two, he's lost all the treatment before it," he stated. Atwan, the lead oncology nurse, confirmed that drugs were present when he first took charge. He now lists every crucial medicine his patients need but cannot find. "There's not one single complete protocol I've got," he said.

Khuloud Dweib, the pharmacy director, noted a recent small victory. The ministry managed to get eight missing oncology drugs and four biologics. This stockpile should last between one and two months. Yet many other medicines remain out of stock entirely. Unlike Gaza, Israel does not block medicine from entering the West Bank, Ansari explained. The issue is strictly that the Palestinian Authority has no money to buy them. She emphasized that Israel holds the primary legal obligation as an occupying power. They must ensure adequate medical care for occupied populations regardless of local funding.

Access to care has become a nightmare due to checkpoints and gates multiplying across the southern West Bank. Beit Jala's hospital stands as the only public option for cancer and dialysis treatment in this area. Patients travel from Bethlehem, Hebron, parts of Jerusalem, and sometimes Jericho just to get help. Dari described a dialysis patient from Nahalin who had an appointment at seven or eight in the morning. His village was sealed tight that day. "He sat about four, five hours at the checkpoint," Dari said. The man then took a long detour through Jaba, Surif, Halhul and Hebron to reach the unit by four in the afternoon. A normal journey costs about 10 shekels. "A detour like this costs more than 100 shekels," Dari said. Some patients need dialysis four times a week.

The ministry's central supply warehouse sits in Nablus, Dweib pointed out. An hour-and-a-half drive can now take six to ten hours when closures hit the roads. Often, Atwan's patients require treatments split between his unit and Augusta Victoria Hospital in occupied East Jerusalem. Before the war, cancer patients from the West Bank routinely received permits to enter Jerusalem for specific procedures. Some treatments happen in Beit Jala while others are only available in East Jerusalem. There are no guarantees anymore that patients can reach Jerusalem safely. "I've got a cancer patient … He waited on a referral, and there's no treatment," Atwan said. "After all the running around it comes back he's security-rejected, too." He asked where such a man is supposed to go if denied a permit for Augusta Victoria.

Atwan recalled patients who became neutropenic because they missed treatment sessions. One was lucky not to end up with sepsis. "These are disasters," he said. He does not know exactly how many cancer patients he has lost due to incomplete treatments. Many poorer patients simply go home and die there when they cannot afford the wait. As crowds swell at front desks and people wait by the entrance, a nervous exhaustion percolates through the hospital's aged halls. "People are really tense.

Everyone's scared," Dari admitted. The fear is palpable in a place where half-salaries leave men like Atwan unable to cover their commute from Hebron or support daughters studying at university. "Let's not talk about our state of mind – we'll start crying, for God's sake," Atwan said flatly. Their morale has hit rock bottom, and they smile only because they have no other choice.

Mass unemployment is hitting hard now, with labor permits getting revoked one by one. This pushes more sick people toward public hospitals that simply do not have enough to give. "Hospitals will prioritise someone who will actually pay them," Ansari noted. The system has broken down for those without cash.

Ahmed, a Palestinian from Bethlehem holding a medical degree, checks with the pharmacist every couple of days for Humira. His sister suffers from Crohn's disease and needs that injection every two weeks. For three months straight, the pharmacists ran out of stock. Buying directly from the pharmaceutical company would cost about 2,000 shekels ($650) for just one or two shots. "We couldn't afford that," he said. They struggled until supply returned.

An elderly cancer patient in a village facing settler pogroms has cut back on his own medicine because it is not supplied regularly. A full course runs 20,000 shekels ($6,500). "I've started cutting back, not taking much," he added. Supply and staffing shortages mean surgery backlogs are piling up fast. Sayed Ayyad, 22, from al-Eizariya, fractured his ankle badly in an accident last month. With serious operations taking priority, he waited three weeks for a slot.

"They told me there's 60 people waiting for an operation," he said. One day they simply could not do the surgery because there were no medicines, no painkillers, and no anaesthetic. Nothing was available.

Khuloud Dweib heads the pharmacy department at Beit Jala and has to manage this worsening crisis while patients struggle with their health and finances. "There's no security," she said. They lack political safety, health security, or even financial stability. She thinks of cases like a young man with multiple sclerosis studying medicine in Egypt. The Health Ministry used to provide his medicine through private purchase until the company stopped supplying without payment. His mother came to see her recently. "I want to sell my house so I can get the injection for my son," she told Dweib. Her son is in Egypt, away from home, studying and has stopped seeing or walking.

"So, what can I tell you," Dweib said, fighting back tears. "God help people."

The medical staff fear that with their supplies being hollowed out, they could face a similar fate to colleagues in Gaza who have been kidnapped or killed. "We know that at any moment we could be targeted as medical staff, just because we're medical personnel providing services to people," Dweib said. They are father and mother figures within this society.

Nobody in the ageing hospital wards sees an end in sight. "The longer we stay, the worse the situation gets," Dari said. At three o'clock each afternoon, Atwan has to leave hoping he can reach Bab az-Zawiya in Hebron, where he waits for a shared taxi. "Maybe there'll be a checkpoint for me, maybe there won't be," he said. It is not so different from the conundrums his patients face. When a patient gets sick, it is their luck if the medicine is there. They have no future. I swear: We've got no future.