Under a tightening Israeli siege, Palestinian girl Rahaf Ayyad struggles with physical and emotional changes, as her mother fights for answers.

Once proud of her long, silky brown hair, Rahaf Ayyad now dreads combing it.

“Each time I use the comb, more of my hair falls out,” the  Palestinian girl says.

The hair loss is just one of several changes in her body in recent months by what her mother suspects are the result of the ongoing Israeli blockade and destruction of the Gaza Strip.

The 12-year-old has become severely underweight, and her growth has visibly stalled since she was forced to live in a makeshift tent in Zawaida, in the central Gaza Strip.

“Rahaf was a completely normal girl. I don’t even recall ever needing to take her to the hospital for any illness since she was born,” Shorouq Ayyad, Rahaf’s mother, tells Middle East Eye.

“Her condition began eight months ago after we were displaced to the al-Zawaida area.”

At first, her mother dismissed a pain her daughter began feeling in her legs and bones as simple fatigue.

“I didn’t think much of it, I thought it would pass,” she says.

But when the pain persisted longer than a week, the family sought help from Doctors Without Borders, who referred her to al-Aqsa Martyrs Hospital in Deir al-Balah.

“She was admitted for a week and received medication and treatment,” Shorouq says.

But when they returned to the tent, Rahaf’s health deteriorated, and her body began to swell.

“Pink spots appeared on her hands and feet. They told me it might be kidney-related, but the treatment they gave her was completely ineffective,” Shorouq says.

“When we returned to northern Gaza, the swelling worsened. Her face and eyes swelled dramatically, her skin began peeling, and spots started appearing on her scalp. Her hair started falling out in large amounts. I had more tests done, but none showed anything wrong.”

Unable to diagnose

Shorouq carried her daughter from one of Gaza’s few partially functioning hospitals to another.

But with medical supplies exhausted and staff either overwhelmed or missing, the doctors could do little more than speculate and they were unable to diagnose her condition.

“I kept telling them, ‘There’s no way my daughter is fine,’” Shorouq says. “But they replied, ‘We don’t know what her diagnosis is'.

“No-one could figure it out. Under normal circumstances, she would have been referred for treatment abroad, but now, they can’t even identify what’s wrong to make that referral.”

As of 27 April, hospitals across the Gaza Strip had been forced out of service by relentless Israeli bombardment, according to the Palestinian Ministry of Health in Gaza.

At least  1192 healthcare professionals have been killed in the bombings, inside prisons, or by targeted killings, including 96 doctors, while 1460 others have been injured.

Though the doctors failed to determine the cause of her daughter’s condition, Shorouq believes the harsh conditions of displacement are to blame.

“I’ve been relying on canned food to feed my children for the past 18 months. They have been drinking contaminated water because there is no alternative. Perhaps it’s also the polluted waste that has piled up next to our displacement tent, or the sewage in the streets, maybe all of that led to her condition,” she says.

Since October 2023, the Israeli war and blockade have left Gaza grappling with a severe environmental crisis.

Hundreds of thousands of tonnes of waste have accumulated across the Strip, including medical and household garbage, due to the destruction of waste management infrastructure and the suspension of collection services.

This waste has become a breeding ground for disease-carrying insects and rodents, leading to a surge in skin diseases such as scabies, chickenpox and ringworm.

As of mid-2024, more than 150,000 people in Gaza have developed skin diseases since the start of Israel’s war, according to the World Health Organisation.

The Israeli military destruction of about 85% of Gaza’s sewage treatment facilities has also caused untreated sewage to flood streets and residential areas. This has led to a significant increase in waterborne diseases, including hepatitis A and diarrhoea.

Israeli blockade

According to Shorouq, Rahaf never allowed her to trim her hair.

“She used to say, ‘Not my hair, I want it to grow all the way down’,” her mother recalls.

Now, as she watches it fall out in clumps, Rahaf turns to her and asks, “Mama, will my hair grow long again?”

Shorouq tries to comfort Rahaf by pretending it’s happening to everyone.

“I tell her, ‘Look, my hair is falling out too. All of our hair is falling out because of the war and the contaminated water’,” she says.

But the reality is harder to mask.

“I haven’t combed her hair in a month because it keeps falling out in the brush. I’m scared she’ll lose what’s left,” she adds. “She’s deeply affected, especially emotionally.”

On 7 May, with the Israeli blockade restricting both aid and commercial goods, Shorouq simply doesn’t have enough food to help improve her daughter’s condition.

“As you can see, we only have canned food. It lacks the necessary vitamins for her condition and may even harm her,” she said.

“On top of all the food restrictions we are facing due to the blockade, I try to give Rahaf a special diet.

“I cook for her without salt or frying oil so that her body doesn’t swell up again. She sometimes cries, begging me to add a bit of salt to her food, my heart breaks for her, but I can’t.”

Since 2 March, Israel has completely sealed off Gaza’s borders, blocking the entry of food, medicine and fuel into the impoverished Strip.

‘I don’t like seeing myself’

Rahaf now can no longer walk. Her growth has completely stalled, and her development has come to a halt.

“No one believes she’s 12 years old,” says her mother. “I have to help her get to the toilet. She spends all day lying on this mattress, watching her siblings play and telling me, ‘I’m tired of sitting’.”

Shorouq recalled one trip to the doctor when Rahaf broke down in tears in the street.

“Her legs stopped moving, her bones ached so badly, and suddenly her skin began to peel and bleed.”

Sometimes, she catches her daughter silently watching her siblings with a distant, longing look.

“I interrupt her thoughts and say, ‘What are you thinking about? God willing, you’ll get better soon. I’ll take you out, just the two of us, and we’ll buy all the sweets you want’.”

Sitting on an aid-provided mattress in a relative’s office, which serves as a temporary refuge from the tent until her condition improves, Rahaf seems more focused on her hair than anything else.

“I want my hair to grow back so I can comb it again,” she tells MEE. “I used to love looking in the mirror and taking pictures, but now I don’t like seeing myself. This isn’t me.”

Republished from MIDDLE EAST EYE, 7 May 2025