Inside the Ramallah Hotel Sheltering Gaza’s Cancer Patients Amid the Israel-Palestine Conflict

Ramallah, occupied West Bank — For over 16 months, loss and grief have lingered in the corridors of the Retno Hotel.

On the evening of October 6, 2023, the family-run hotel was nearly full. A few of the 70 or so guests were Palestinian Americans, but most were from Gaza. Expecting to return home soon, they had packed only enough clothes for a week’s stay.

Among them were Ahmed Ayyash, a 72-year-old civil engineer from Gaza City, and his 62-year-old wife, Maha. Also staying were 44-year-old Shadia Abu Mrahil from Deir el-Balah and her 25-year-old son, Karam.

Like most of the guests from Gaza, they were regular visitors to the modest limestone building with its 45 double or triple-bedded rooms. It wasn’t the quiet north Ramallah street that drew them there, nor the small courtyard with its plastic tables and chairs, though on sunny days, guests would sometimes sip coffee under a canopy of bright pink bougainvillaeas.

They were there to receive medical treatment—for cancer, heart problems, and developmental disorders—that was unavailable in Gaza. Both Ahmed and Shadia have leukemia.

They would travel via the Beit Hanoon crossing, managed by the Israeli army and known to Israelis as Erez, from northern Gaza to Ramallah. They would stay at the hotel for a few days at a time, receive treatment, and then return home to Gaza. Relatives often accompanied them. Some had been doing this for years. For Ahmed and Maha, these trips also offered a chance to visit Al-Aqsa Mosque in occupied East Jerusalem and to eat kunafa with friends in Nablus, 50km (31 miles) away.

October 6, 2023, was a quiet Friday. Most businesses in Ramallah were closed, and many guests at the Retno Hotel took a break from their treatments. Ahmed went out to pray at a nearby mosque with Maha, his wife of 44 years. They had arrived in Ramallah the previous day and bought bread, cheese, chocolate, fruits, and vegetables for their stay. When they returned to the hotel that evening, they ate dinner in the dining hall, spoke with fellow guests, and then went to bed.

When they woke the next morning, everything had changed. Following the Hamas-led attack on southern Israel, Israel launched a massive bombardment of the Gaza Strip and cut off food, water, and electricity. The Palestinian American guests at the hotel fled. Those who stayed—hospital patients and their family members—waited anxiously for news from Gaza. Phone service was down, and many were unable to reach loved ones back home. Some crowded into the hotel owner’s office to watch the developments on TV, wondering what the rapidly escalating war would mean for their families and their treatments.

Ahmed stayed in his room, watching the news and scrolling through Telegram updates from journalists in Gaza. Guests who managed to contact loved ones during brief moments when phone service returned shared what they learned with others. Some never got through.

“Some of the guests lost their children in the first month of the war, and I heard news of the martyrdom of many members of my family, like the children of my cousin and his wife, my cousin and her husband … and their children, and some friends,” Ahmed recalled. “The bad news was constant.”

Clouded thoughts of the future

Since 2017, the Retno Hotel has housed patients and their family members from Gaza during their medical visits to Istishari Hospital, a 10-minute taxi ride away.

It is part of a network of accommodations—mostly hotels, but also lodgings like UNRWA facilities—housing Palestinians granted temporary permits by Israel to leave Gaza for medical treatment in the West Bank, occupied East Jerusalem, and the occupied West Bank. The Palestinian Authority’s (PA) Ministry of Health covers the treatment costs.

Over the years, Nawaf Hamed, the 66-year-old owner and manager of the Retno, has tried to keep the atmosphere cheerful. Common areas were often filled with music—from Western folk to classical Arabic. Guests would sometimes play instruments—a tabla, guitar, or qanun (a Middle Eastern string instrument)—that Nawaf kept in the lobby. “We would sing, and we [would] dance!” he reminisced wistfully. Those joyful nights stopped during COVID lockdowns and never quite returned.

When the war began, the permit system for patients from Gaza broke down. Those in Jerusalem hospitals had to flee to the occupied West Bank, where they scrambled to register with the PA and find a new hospital. None were able to return to Gaza.

“The people [were] very afraid of the future,” Nawaf recalled of his guests.

Today, 400 patients from Gaza are registered with the PA, with some staying in Ramallah, Hebron (60km/37 miles to the south), and Nablus and Jenin (less than 100km/62 miles to the north).

Over the months, more patients have moved into the Retno. Today, it is a temporary home to 33 adult and 14 child patients, along with 37 family members. Seven patients at the hotel have died of their illnesses since the war started. As others continue to fight their health battles, their family members have been killed, and their homes and former lives destroyed.

One November afternoon, Shadia sat on a light grey couch in the corner of the hotel lobby, a gathering spot for many guests. “What the war has done to my family, to my home, to my Gaza, kills me more every day than the cancer ever will,” she said, sighing.

As frail residents emerged from the elevator, they greeted one another before heading to the hospital in shared taxis. A shuttle bus would bring them back later in the day.

Karam—his hair styled and beard neatly groomed—sat beside his mother, hands clasped gently in his lap. Nearby, Ahmed, dressed in a blue sweater and green button-down shirt, slouched in his chair, while Maha smiled warmly at fellow residents passing by. Other guests stopped to ask the front desk attendant, a woman in her 30s, for fresh towels or to complain about noise from a neighboring room at night.

“Our feelings are [in Gaza], and it impacts every moment of our lives,” said an exhausted Shadia. “I am tired and sick already from the cancer treatment. And our thoughts of the future, of continuing day after day, are clouded not only by our own life-threatening illnesses but also by the total destruction that sweeps our homes, families, and communities in Gaza.”

They cry at night

Nawaf, a stout man often with reading glasses on a cord around his neck, spends his days running the family business while stopping to chat with guests.

When in his small office next to the lobby, Nawaf peers through the glass doors to see who is there and beckons them inside for coffee. He has arranged the black leather couches in a semicircle around a table to make the space more inviting. Guests come by to discuss their treatments or to watch the news on TV. On cold winter nights, they sit by the fireplace. Some stay late into the night talking, while others prefer silence.

One sunny afternoon, as Nawaf sipped Arabic coffee in the courtyard, Ahmed approached. He called out to the older man and shook his hand. “How are you, my friend?” he asked.

“Peace be upon you,” Ahmed replied with a faint smile before heading inside.

“May you have good health,” Nawaf called after him.

“That man was a great civil engineer in Gaza!” Nawaf declared, gesturing toward Ahmed as he disappeared through the entrance door.

As other guests walked by, Nawaf greeted them with a hearty “hello” and shook their hands.

Nawaf and his father, Nayef, began building the hotel in 2000 and opened it four years later. They ran the place together until Nayef passed away two years ago. Nawaf’s 11 siblings are all involved in the family business, as are his two daughters in their 20s and early 30s, who help with administrative tasks.

Most hotels in the occupied West Bank are nearly empty these days, with the war bringing tourism to a standstill and restricting travel. The Retno is a rare exception. But even with all its occupants, the hotel is under financial strain. Although the PA covers the patients’ accommodation costs, payments became erratic when Israel began withholding the PA’s tax revenues last April, says Nawaf. “Every week, we struggle to figure out how to pay the bills the next week,” he explained as he sat in the courtyard lined with potted citrus trees. “We don’t know what to do, how to spend money for breakfast. [Since June], the workers don’t have their [regular] salaries,” he said, referring to his 20 employees.

From the time breakfast is served, Nawaf tries to keep hotel operations running smoothly while listening to residents’ concerns, like complaints about a broken bulb or a toilet issue in their room.

Over time, he has seen some guests grow restless. Some become aggressive. Others worry that after 16 months of living in the hotel for free, the arrangement won’t last.

“Some of them don’t let us clean their rooms,” Nawaf explained. “They think we are going to use it as an excuse to kick them out.”

He has tried to ease the patients’ anxieties, occasionally bringing representatives from the PA or NGOs to offer psychosocial services or even theater sessions. “Usually, we don’t speak about politics,” he said. Sometimes he half-jokingly suggests to single male patients that they get married, saying they will be less lonely. “If nothing else, maybe the [PA] will distribute [wives] to them,” he added with a laugh.

Nawaf often tries to cheer up his guests with humor. On February 4, when the Israeli military arrived in the area of Ramallah where the hotel is located, he asked over the phone, “What do you think they want? Falafel or shawarma?”

But as the war continued, despair grew among Nawaf’s guests. “They are under stress because they always wait [for] sad news,” he reflected, his tone becoming somber. “Nobody speaks about happy things. They’re just crying.”

Nawaf leaned back in his chair and looked out at the empty street. “At night, in the corridors, you walk, it’s quiet, and all you hear is people crying,” he said slowly, taking a sip of his coffee. He sighed. “It’s a really difficult experience.”

Though he tries to stay positive, when the mood in the hotel becomes too heavy, “I sometimes go to my office, [and] I close the door just so I can laugh,” Nawaf explained. He doesn’t laugh at anything in particular; it’s just how he copes with the stress. Then, he might play some Mozart to try to unwind.

‘He’s everything in my life’

Shadia and Karam have done their best to make their shared room at the Retno feel like home. A small donated carpet, darkly colored with geometric patterns, sits in the middle of the 3-by-3-meter (10-foot-by-10-foot) room. On top of a dresser, an electric kettle waits—full of water—to prepare Arabic coffee. But it’s a long way from their home near the beach in Deir el-Balah. Just a year old before the war began, it had marble floors, chandeliers, and brand-new furnishings.

“Around our house were palm trees and olive trees,” recalled Shadia, sitting next to Karam on his bed. “The people next to us planted cabbage, peas, and cauliflower. When we looked outside, all we saw were green spaces and beauty.”

Now, at the Retno, shutters block the view of Ramallah’s limestone apartment buildings, empty lots, and back roads.

In Gaza, Karam spent time outdoors in the family garden and on the nearby beach.

An only child, he has always been close to his mother. “Her and my father, that’s all I have,” said Karam.

“I don’t feel like she’s only my mother,” he added softly. “She’s my friend and my brother. We hang out together. In Gaza, we went to the beach together. I spent more time with her than even my friends.”

Shadia looked at her son and smiled. She suffers from joint pain, nausea, fatigue, and dizziness, and often speaks anxiously, but she brightens when talking about her son.

“Karam is not only my son,” said Shadia. “He’s my father, my friend, my sister, my brother. He’s everything in my life, and I can’t imagine my life without Karam.”

In 2014, Shadia began experiencing intense pain in her back and joints. For years, doctors misdiagnosed her ailments, saying she had a bulging disk or even that she was imagining the pain. “The painkillers gave me temporary relief, but the pain always came back stronger,” she recalled.

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