Opinion: The one thing Israel hasn’t managed to take from us in three years is hope

It is three years since the start of the genocide in Gaza. Three years of sustained and brutal onslaught by the Israeli army, which has killed more than 74,000 Palestinians, injured more than 175,000, razed much of Gaza to the ground and left almost the entire population displaced.The so-called ceasefire agreed a year ago is not a real ceasefire. The Israeli occupation force continues its attacks and has killed more than 1,400 people since it came into effect. Meanwhile the humanitarian situation is catastrophic. Only 25 per cent of what is needed is getting into Gaza. Almost everyone is struggling to access enough food and water. The health system is dire. Living conditions are extremely crowded and dangerous.New images released by Google Maps show the devastation in Gaza Winter is approaching and will make conditions even harder. Much of the population is living in tents or makeshift shelters, which will do little to protect from heavy rains, strong winds and low temperatures. Communicable diseases are expected to rise, increasing pressure on the already hugely overstretched health system. READ MOREWomen and girls have been hardest hit in this genocide. Access to essential services such as maternity healthcare and safe spaces has been severely disrupted. Thousands of women whose husbands have been killed, detained or have gone missing now carry the sole responsibility of protecting and providing for their families.I was the director of Al-Awda hospital in Jabalia in northern Gaza during most of the genocide. Before then, I lived with family, including my wife, five children, sister and elderly mother in the northern Gaza Strip, and life was nice. At that time, I was MEAL (monitoring, evaluation, accountability and learning) manager with the Al-Awda Health and Community Association, one of the largest healthcare providers in Gaza. My wife worked in the Ministry of Health. We had a house. Our children went to school. We were eating good food every day.That all changed after October 7th, 2023. Within 10 days, the occupation forces bombed my house. My family moved to live with my sister on the northern Gaza Strip. But her house and then all my relatives’ houses were destroyed. In the search for safety, my family moved south to Rafah, and I decided to stay with my colleagues in the hospital. I did not see my family for 15 months. They and other family members were displaced 16 times during this period. After the start of the war six of the Al-Awda Health and Community Association managers moved to Al-Awda hospital in the north, including me. Those 15 months were horrendous as the staff of Al-Awda hospital found themselves under regular and sustained attack by the Israelis. Thirty-four people were killed in the immediate area of the hospital during that period, including three of my colleagues – who were killed inside Al-Awda on November 21st, 2023, by a shell – and one patient carer. Three more were killed in December by a sniper when the hospital was under siege: one nurse and two cleaners. On December 18th, 2023, 12 people were arrested from the hospital including our director. Much of the hospital was destroyed. I took on the role of director at that point.During severe shelling and bombing in May 2024 we were ordered to evacuate. But I, along with 13 other staff members, refused to move. There were no ambulances to evacuate the injured patients, so we stayed to care for them.The worst period was the 106 days from October 5th, 2024, to the ceasefire on January 19th, 2025, when the Israelis did not allow supplies into the hospital including fuel, medication and medical supplies.We had only one general surgeon in the hospital for those 106 days, and he was the only surgeon available to do all surgeries in the north. We lost many patients due to the lack of specialist doctors, medication and medical supplies. There was no vascular surgeon, no orthopaedic surgeon. Because of this we had to amputate limbs, some from children, as a last resort.The lack of fuel meant we had to stop many of our life-saving interventions. We were working in a horrible situation but were putting all our efforts into helping our people.A shortage of oxygen was a big issue. We had one patient to whom we gave manual oxygen for three days using an ambu bag to provide ventilation. As a team, we did this in half-hour shifts, but still we did not succeed in saving the patient.Yet we showed that our humanity was stronger than all the armies. On May 29th, 2025, we were finally forced to evacuate the hospital. The army attacked the upper floors and this went on from 1pm to 8pm.Since August 2026, I am the director of PNGO, the Palestine Non-Government Organisations network, supporting humanitarian relief and advocating for international action. What is needed now is a real and permanent ceasefire, one that truly protects Palestinians.Border crossings must be fully reopened and the continuous free flow of aid, including fuel, medical supplies and heavy machinery, into Gaza must be allowed without impediment. There must be full accountability and justice for all atrocities that have been committed, with alleged breaches of international humanitarian law, war crimes and crimes against humanity fully investigated and prosecuted.Third states must uphold their obligations under international humanitarian law, including taking measures to prevent genocide as per the Genocide Convention. All forms of support that aids or assists Israel’s unlawful occupation, as per the advisory opinion issued by the International Court of Justice, must be prevented.There must be accountability for what has happened. Robust sanctions, including travel bans and asset freezes, must be imposed on senior Israeli government officials linked to violations of international humanitarian law.And all arms sales and transfers to the Israeli government where there is a clear risk they could be used to commit or facilitate violations of international humanitarian law must be ended. I am one of the lucky ones. I have survived the last three years. And so has my family.We have very little. But the one thing the Israelis can’t take away from us is hope. That is what keeps us going. We look forward to the day when we can all live in peace.Dr Mohammed Salha is director of PNGO, the Palestinian NGOs network, which is a partner of ActionAid