So many lives in Gaza still hang in the balance.

In different wards of Nasser Hospital lie two 10-year-old boys, one shot by Israeli fire and paralysed from the neck down, another with a brain tumour.

Now that a fragile ceasefire is in place, they are among some 15,000 patients who the World Health Organization (WHO) says are in need of urgent medical evacuations.

Ola Abu Said sits gently stroking the hair of her son, Amar. His family says he was in their tent in southern Gaza when he was hit by a stray bullet fired by an Israeli drone. It is lodged between two of his vertebrae, leaving him paralysed.

“He needs surgery urgently,” Ola says, “but it’s complicated. Doctors told us it could cause his death, a stroke or brain haemorrhage. He needs surgery in a well-equipped place.”

Right now, Gaza is anything but that. After two years of war, its hospitals have been left in a critical state.

Sitting by the bedside of her younger brother, Ahmed al-Jadd, his sister Shahd says her brother was a constant comfort to her through two years of war and displacement.

“He’s only 10 and, when our situation got so bad, he used to go out and sell water to help bring some money for us,” she says. A few months ago, he showed the first signs of ill health.

“Ahmad’s mouth started drooping to one side,” Shahd explains. “One time he kept telling me, ‘Shahd my head hurts’, and we just gave him paracetamol, but later, his right hand stopped moving.”

The one-time university student is desperate for her brother to travel abroad to have his tumour removed.

“We can’t lose him. We already lost our father, our home and our dreams,” Shahd says. “When the ceasefire happened it gave us a bit of a hope that maybe there was a 1% chance that Ahmed could travel and get treated.”

On Wednesday, the WHO co-ordinated the first medical convoy to exit Gaza since the fragile ceasefire began on 10 October. It took 41 patients and 145 carers to hospitals abroad via Israel’s Kerem Shalom crossing, with ambulances and buses taking the group on to Jordan. Some have stayed for care there.

The UN agency has called for numbers of medical evacuations to be rapidly increased to deal with the thousands of cases of sick and wounded. It wants to be able to bring out patients through Gaza’s Rafah border crossing with Egypt as it has done previously.

However, Israel has said it is keeping the crossing closed until Hamas “fulfils” its commitments under the terms of the Gaza ceasefire deal by returning the bodies of deceased hostages. Israel has kept the Gaza side of the Egyptian border closed since May 2024 when it took control during the war.

Speaking at a news conference on Thursday, the head of the WHO, Dr Tedros Adhanom Ghebreyesus, said “the most impactful measure” would be if Israel could allow Gazan patients to be treated in the occupied West Bank, including East Jerusalem, as happened before the war.

Top EU officials and foreign ministers of more than 20 countries – including the UK – have previously called for this, offering “financial contributions, provision of medical staff or equipment needed”.

“Hundreds of patients could be treated easily and efficiently in a short time if this route reopened to the East Jerusalem Hospital Network and the hospitals in the West Bank,” says Dr Fadi Atrash, CEO of the Augusta Victoria Hospital on the Mount of Olives.

“We can at least treat 50 patients per day for chemotherapy and radiation and even more than that. Other hospitals can do a lot of surgeries,” the doctor told me.

“Referring them to East Jerusalem is the shortest distance, the most efficient way, because we have the mechanism. We speak the same language, we’re the same culture, in many cases we have medical files for Gazan patients. They’ve been receiving treatment in East Jerusalem hospitals for more than a decade before the war.”

The BBC asked Cogat, the Israeli defence body which controls Gaza’s crossings, why the medical route was not being approved. Cogat said it was a decision by the political echelon and referred queries to the prime minister’s office, which did not offer further explanation.

After the Hamas-led attacks of 7 October 2023, Israel cited security reasons for not allowing Gazan patients in other Palestinian territories. It also pointed out that its main crossing point for people at Erez had been targeted by Hamas fighters during the assault.

The Hamas-run health ministry in Gaza says that in the year to August 2025, at least 740 people, including nearly 140 children, died while on waiting lists.

At Nasser hospital, the director of paediatrics and maternity, Dr Ahmed al-Farra, expresses his frustration.

“It’s the most difficult feeling for a doctor to be present, able to diagnose a condition but unable to carry out essential tests and lacking the necessary treatments,” Dr al-Farra says. “This has happened in so many cases, and unfortunately, there’s daily loss of life due to our lack of capabilities.”

Since the ceasefire, hope has run out for more of his patients.

In the past week in the hospital grounds, a funeral took place for Saadi Abu Taha, aged eight, who died from intestinal cancer.

A day later, three-year old Zain Tafesh and Luay Dweik, aged eight, died from hepatitis.

Without action, there are many more Gazans who will not have a chance to live in peace.