When armed Hamas terrorists invaded her home on Oct. 7, Karina Engelbert was still recovering from a double mastectomy and breast reconstruction surgery that had gone terribly awry. She was weak and easily fatigued, and a buildup of painful scar tissue on her chest caused tightness, limiting her mobility.
The militants kidnapped Ms. Engelbert, 51, and her entire family, including her husband, Ronen Engel, 54, and their daughters, 18-year-old Mika and 11-year-old Yuval, snatching them from the safe room inside their home on the Nir Oz kibbutz and taking them to the Gaza Strip, where they have been held for over 40 days.
“The last I heard from my sister was on that black sabbath at 9:30 in the morning, and she spoke very quietly, and she said, ‘They’re inside the house,’” Ms. Engelbert’s brother Diego Engelbert said in an interview.
He has not received any information about his sister’s condition, and she has not been visited by the International Red Cross, he said.
“We don’t know if she’s getting any medical treatment, if anyone is taking care of her, if she is getting any pain relief or any of the medication she needs to keep the cancer from coming back,” Mr. Engelbert said.
Ms. Engelbert is one of about 240 hostages abducted from Israel, many of whom need urgent medical attention.
They range in age from infants to octogenarians, and include a Thai foreign worker who was nine months pregnant on Oct. 7 and may have given birth in captivity. There are many kibbutz members in their mid-80s who were taking medications for chronic conditions like high blood pressure, and younger adults who have both psychiatric conditions and medical conditions that can be fatal if left untreated.
And then there were those who sustained potentially life-threatening injuries in the raid itself, which killed an estimated 1,200 people, most of them civilians.
Ms. Engelbert is one of three women abducted who had breast cancer. Another was 65-year-old Yehudit Waiss, whose body was discovered by Israeli soldiers as they closed in on a hospital in Gaza last week. Israeli officials say she and Noa Marciano, a 19-year-old female soldier, were murdered by their captors. And a few days ago, Hamas said that an 86-year-old kibbutznik, Arye Zalmanovich, had died after suffering a heart attack during the Israeli bombings of Gaza.
Most elderly captives depend on medications to manage high blood pressure, diabetes and heart disease, according to Hagai Levine, an Israeli physician who has been working with the families of the hostages.
Among the roughly 40 children being held, most of whom are girls, there is a 4-year-old boy whose growth is delayed and who takes a nutritional supplement because he is underweight, and the boy’s 10-month-old brother. A photo of the two redheads in the arms of their mother when they were abducted has been widely circulated.
Some hostages now being held by Hamas were shot, beaten or otherwise wounded during the attack.
Hersh Goldberg-Polin, a 23-year-old American citizen, lost a hand to a grenade, gunfire or both, his family says. The redheaded children’s father, Yarden Bibas, was beaten on the head with a hammer, videos circulated by the militants show. Guy Iluz, 26, was shot, according to his mother, Doris Liber, who traveled from Israel to Capitol Hill to plead for help.
“They all need medical attention,” Dr. Levine said in an interview. “They are being held underground, without enough food and water, and with unceasing trauma, for more than 40 days. Even a minor injury could trigger an infection that could become life-threatening.”
Families of the hostages have demanded that the International Committee of the Red Cross, or I.C.R.C., be allowed to visit their relatives and tend to the wounded and the sick, as guaranteed under the provisions of the Geneva Convention. So far, that has not happened.
Red Cross officials say that the organization has been advocating on behalf of the hostages in Gaza, speaking both directly with Hamas and with other parties that may have influence on Hamas. So far, however, the Red Cross has been unable to visit them to check on their health or deliver medications, a spokeswoman said.
“The I.C.R.C. cannot force its way in to where hostages are held,” said Alyona Synenko, a Jerusalem-based spokeswoman for the organization. “We can only visit them when agreements, including safe access, are in place.”
Relatives of the hostages have campaigned relentlessly for their release, traveling around the world to meet with foreign officials, speaking with the media, addressing the United Nations, writing guest essays in newspapers and holding daily demonstrations in the newly named Hostages Square in front of the Tel Aviv Museum.
On Saturday, families of hostages and thousands of their supporters concluded a five-day march to Jerusalem, where they plan to press the government to obtain the release of the captives. Many are furious with the Israeli government — and with Prime Minister Benjamin Netanyahu in particular — both about the failures that led to the Hamas incursion and the lack of support and regular communication with relatives about the status of hostage negotiations.
“We want the government to do everything possible to bring the hostages back — that has to be the top priority,” Tomer Keshet, Mr. Bibas’s cousin, said in an interview. “Yarden is wounded, and the baby isn’t even standing yet, he is barely crawling.”
“We are so worried that the children were separated from their parents, that they are frightened, that they don’t have the right things to eat, and that that could have long-term repercussions,” Mr. Keshet said. “They are being held underground, hungry, not knowing what’s going on, hearing bombing and fighting and shouting in a language they don’t understand. We don’t know what condition they are in, or what condition they will be in when they come back, after this emotional trauma.”
Although physicians generally refrain from discussing their patients’ medical conditions out of respect for privacy, several personal physicians of the hostages spoke out publicly last week to draw attention to their plight and stress the urgency of their situation.
“In some cases, children were taken moments after watching their parents being brutally murdered,” said Dr. Zion Hagai, chairman of the Israel Medical Association. “They are not only forced to live with this trauma but to experience it in a strange, dark and scary place.”
Speakers highlighted the cases of several particularly vulnerable hostages, among them Raz Ben Ami, 57, from the Be’eri kibbutz, who was being treated for neurosarcoidosis, a serious and rare disease that affects the brain, spinal cord or peripheral nerves, causing hearing and vision loss, confusion, agitation and other effects.
Dr. Arnon Elizur spoke of a youngpatient, Yagil Yaakov, who has a life-threatening peanut allergy and could die in minutes if he were exposed to even trace amounts of peanut powder. Islamic Jihad, another militant group in the Gaza Strip, recently published a video of the boy, looking pale and thin, with dark shadows under his eyes.
“I can’t imagine what is going through his mind when he is served food,” Dr. Elizur said. “Can he be certain it doesn’t contain trace amounts of peanuts? Every meal for him is like playing Russian roulette.”
The son of anotherhostage, Haim Peri, said that his fatherhad advanced heart disease.
“He is an artist, a peace activist and a man who always fought for human rights,” said the son, Noam Peri. “He is a brave man, but at age 80, he is not a healthy man, and requires daily medications. He will not survive captivity for long.”