Baby Siwar returned from treatment in Jordan and returned to a hospital in Gaza.

A one-year-old Palestinian girl evacuated from Gaza with severe nutritional problems has returned to a Gaza hospital after returning from Jordan. Siwar Ashour, whose story the BBC has been covering for months, was repatriated to Gaza on December 3 after completing treatment in Amman.

She spent six months in a hospital there under a medical evacuation program run by the Kingdom of Jordan. Her grandmother, Sahar Ashour, said she became ill three days after her return.

“She started having diarrhea and vomiting and the situation just kept getting worse. The diarrhea wouldn’t go away,” she told a freelance journalist working for the BBC in Gaza. Israel has independently banned international journalists from entering the Gaza Strip since the war began nearly two years ago.

Siwar is receiving treatment at Al Aqsa Martyrs’ Hospital in central Gaza. Dr Khalil al-Dakran told the BBC: “He is receiving the necessary treatment but the situation is still not good.” The doctor said Siwar was suffering from a stomach infection. She has a deficient immune system, which makes it difficult for her to fight off bacteria. She also has difficulty absorbing nutrients. This means you need specialized baby formula.

Dr Dakran said the number of children being admitted to hospitals in Gaza, which was severely damaged by Israeli bombing and fighting with Hamas before the ceasefire took effect in October, was increasing. Poor sanitary conditions resulting from the destruction of key infrastructure have led to the spread of infection and disease.

“Since the ceasefire was announced, the number of children arriving at hospitals in Gaza has tripled their capacity. The situation at Al Aqsa Martyrs’ Hospital is no different from other hospitals in Gaza.

“There is a serious shortage of medicines and medical supplies, and there is a huge shortage of generators, which is the main artery that keeps hospitals going.”

The World Health Organization (WHO) described humanitarian aid in Gaza as “extraordinary, with current assistance covering only the most basic survival needs.”

Siwar fled to Jordan last June after the BBC reported his case and raised the issue directly with Jordanian authorities.

Jordan’s Minister of Communications, Dr. Mohammed al-Momani, said Siwar was among 45 children who returned to Gaza after completing treatment. According to the evacuation plan, all patients will be treated and then sent back.

I told Dr. Al Momani that it would be difficult for people to accept that under the current circumstances a child in such a vulnerable condition could be sent back to Gaza.

“We don’t turn patients away before they complete treatment. The first reason (reason for sending patients away) is so we can bring more patients from Gaza. We can’t take them all at once. We have to take them in batches. So far, we’ve brought in 18 batches.

“The second reason is that we do not want to contribute in any way to the displacement of Palestinians from their land and all patients are told that after treatment they are sent back so that other patients and other children can be brought in for treatment.”

Jordan also treated war wounded in field hospitals in the Gaza Strip and supplied aid via airlift and road convoys. The kingdom is home to more than 2 million Palestinian refugees who have fled the conflict with Israel since 1948, as well as 500,000 refugees from other countries, mostly Syrians.

Since last March, about 300 sick and injured children and 730 parents and guardians have been brought to Jordan in 2000 for treatment. Other countries in the region, including the United Arab Emirates and Türkiye, have treated thousands of sick civilians from Gaza.

During the ongoing conflict, the special powdered milk Siwar needed was either unavailable or in very short supply. Last March, Israel completely blocked aid to the Gaza Strip, but it was partially lifted after 11 weeks. Aid deliveries have surged since the ceasefire, but the United Nations and aid groups say there is not enough humanitarian supplies.

Jordanian authorities supplied Siwar’s family with 12 cans of the hypoallergenic Neocate preparation as they departed for Gaza. But her mother, Najwa, said Israeli officials confiscated much of what was given to them. Nine of the 12 cans were confiscated.

“They told us, ‘It’s forbidden to take more than this can,’” said Siwar’s mother, Najwa Ashour. “It’s therapeutic milk, but I took it even though they said it could cure me.”

She also said the family took the extra clothes they had received from Jordan. “They searched us from top to bottom. When they saw that we were wearing layers of clothes, they didn’t let us out and said, ‘You have to take off every single piece of clothing.’”

I asked the Israeli government why they confiscated the baby formula and clothes. They responded that there were limits to what they could retrieve for “security considerations.”

They said only minimal baggage was allowed and this was passed on to Jordanian authorities and returning families. “If your baggage exceeds the approved limit, you will be denied entry.”

WHO has appealed to more countries to provide medical evacuation for patients who cannot receive the treatment they need in Gaza.

It also called on the Israeli government to allow patients to be treated in occupied East Jerusalem and the West Bank, which is “the most time- and cost-effective route.” Israel stopped allowing such evacuations after an Oct. 7 Hamas-led attack on Israel killed about 1,200 people and kidnapped 251 others in the Gaza Strip.

Kogat, the Israeli aid chief, said procedures for Gaza residents to leave for third countries have been significantly eased.

Siwar’s family received Neocate milk formula after returning to Gaza. There have also been donations of money, including funds raised through online appeals. Jordanian representatives in Gaza also visited the family to offer assistance.

Ashours is trying to evacuate Siwar once again. The process began with the issuance of a permit by the Palestinian Health Authority. It will be managed by the WHO, which handles all evacuation requests from what the UN calls “the wasteland.”

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