How Badly Are the Remaining Hostages Being Treated?
Fears grow over the deteriorating conditions of remaining hostages after the last three were released frail and malnourished
After announcing earlier this week that it would be delaying the release of additional hostages, Hamas committed on Thursday to releasing three Israeli hostages on Saturday in accordance with the ceasefire deal. That was after US President Donald Trump issued an ultimatum, warning that “all hell will break loose” if the group did not release the hostages, and Israeli Prime Minister Benjamin Netanyahu said that Israel would launch another powerful attack on Gaza if Hamas ignored its demands.
Hamas’ announcement on Thursday that it would be releasing hostages was a relief for Israelis. But the families of the hostages still held captive in Gaza are increasingly fearful after the release of three male hostages last weekend. The men were frail and malnourished and reported being tortured by their captors.
Reports are continuing to come out about the atrocities that the released hostages faced while in captivity. Speaking to Israeli news on Thursday, Shira Albag said that her daughter Liri Albag said she and the other women held hostage with her was forced to watch videos of male captives being tortured.
Seventy-six hostages are currently held in Gaza, more than 30 of whom are believed to be alive.
“It was amazing to see how malnourished, exhausted, and pale the hostages were—visibly frail,” Dr. Asnat Raziel, director of the Multidisciplinary Center for Obesity Treatment at Assuta Ramat HaHayal Hospital, told The Media Line. “Their appearance was heart-wrenching: emaciated bodies, sunken eyes, and a fragile demeanor that bore testimony to the hardships endured.”
The conditions of the three hostages released on Saturday was so shocking that the International Committee of the Red Cross (ICRC) felt compelled to issue a statement: “The ICRC is increasingly concerned about the conditions surrounding release operations. We strongly urge all parties, including the mediators, to take responsibility to ensure that future releases are dignified and private.”
Since the start of the ceasefire deal on January 19, Hamas has staged public ceremonies for the release during which the hostages have been made to thank their captors, and the group has forced the released hostages to walk through crowds of armed men on their way to the Red Cross handover. That has led to significant criticism of the ICRC for its apparent indifference toward this behavior.
ICRC public relations officer Sarah Davies told The Media Line that the organization can only facilitate the release and transfer of hostages based on agreements between the parties involved and mediators.
“This agreement dictates who, where, when, and how the releases will take place, and the ICRC steps in as the neutral humanitarian actor to facilitate this,” Davies said in an email. “We are not part of the negotiations for the agreement itself but engage constantly with parties to convey the ICRC’s view on how these release and transfer operations should happen in order to ensure the safety and dignity of all involved.”
Many aspects and parameters are outside of our control, and it is important that people know about the limitations we face in such operations.
Davies stressed that “many aspects and parameters are outside of our control, and it is important that people know about the limitations we face in such operations.”
She added that maintaining neutrality is critical to the organization’s ability to operate in complex and volatile environments.
“Challenges like large crowds limit the ICRC’s ability to fully manage the process,” she said. “Ensuring the safety and security of the handover operations is the responsibility of the parties to the agreement. Our priority is and always will be the safe and successful release and transfer back to relevant authorities and awaiting families and loved ones.”
Davies declined to comment on the health status of the released hostages, citing privacy concerns.
However, reports in foreign media suggest that Israeli officials were not as surprised as the public was by the hostages’ deteriorated condition.
This holiday season, give to:
Truth and understanding
The Media Line's intrepid correspondents are in Israel, Gaza, Lebanon, Syria and Pakistan providing first-person reporting.
They all said they cover it.
We see it.
We report with just one agenda: the truth.
According to CNN, Israeli intelligence had been aware for months that the hostages were in poor health. The report, which cited unnamed officials, added that many of the remaining Israeli hostages are expected to be in even worse condition than Ohad Ben-Ami, Or Levy, and Eliyahu Sharabi, the three hostages released on Saturday. In general, male hostages have reportedly been treated worse and kept in harsher conditions than female hostages, and at this point, nearly all of the living hostages still in Gaza are believed to be men.
Some analysts have speculated that Hamas halted the hostage release either to avoid retribution for the released hostages’ condition or to extract more concessions before the world fully grasps the extent of their mistreatment.
A report published by Israel’s N12 channel last weekend further underscored the dire situation. Idit Ohel, the mother of 24-year-old hostage Alon Ohel, said she learned from the released captives that her son had shrapnel wounds in his eye, shoulder, and arm. He was also reportedly kept in chains and given no more than a single pita a day to eat.
When hostages are freed, the ICRC deploys specialized teams that include medical personnel. But Davies said that the organization has not been granted access to visit those still in captivity.
Raziel emphasized that all captives worldwide should be monitored by the Red Cross, given the severe physical and psychological risks associated with prolonged captivity. She explained that extended deprivation often leads to severe muscle loss, weakened immune function, and, in some cases, organ damage.
Dr. Asnat Raziel, director of the Multidisciplinary Center for Obesity Treatment at Assuta Ramat HaHayal Hospital. (Talou Loren)
“The digestive system, after enduring long-term malnutrition, becomes highly sensitive, often reacting with gastrointestinal distress, impaired nutrient absorption, and digestive issues,” she said.
She also warned of significant musculoskeletal deterioration. “Rapid weight loss and extreme muscle depletion lead to profound weakness, impaired posture, and difficulty with movement,” she explained. “Physical therapy will play a crucial role in restoring muscle mass, improving mobility, and preventing further deterioration.”
One of the most critical concerns is refeeding syndrome, which Raziel described as “a life-threatening condition that can occur when a severely malnourished person suddenly begins consuming food in an unregulated manner.”
“After an extended period of starvation, the body enters a survival mode, primarily relying on fat and protein for energy instead of carbohydrates. When food, particularly carbohydrates, is reintroduced, the body undergoes a drastic metabolic shift,” she said.
This shift can trigger an insulin surge, which rapidly moves glucose into the cells, along with essential electrolytes like phosphorus, magnesium, and potassium—causing dangerously low electrolyte levels. Such imbalances can lead to severe complications affecting the heart, nervous system, and muscles.
“Imbalances in electrolyte levels may cause excessive fluid retention, leading to swelling and potential organ failure,” Raziel warned.
Symptoms of refeeding syndrome include irregular heartbeat, arrhythmia, heart failure, respiratory muscle weakness, confusion, extreme fatigue, seizures, and even coma.
Raziel noted that captivity also inflicts deep psychological trauma alongside the physical effects.
Community, prayers, meditation, and friends will also be an important part of their recovery.
“Mental health professionals explain that the coping process varies from person to person—some will require prolonged therapy, while others may find comfort in the warmth of their families and a gradual return to normalcy,” she said. “Community, prayers, meditation, and friends will also be an important part of their recovery.”
She added that some hostages will likely be diagnosed with post-traumatic stress disorder, anxiety, or depression. Psychological distress can also manifest in physical ailments, such as digestive problems, headaches, and chronic fatigue, she said.
To help hostages and their families navigate these challenges, a hotline to assist released hostages and their families was launched in Israel two months ago. The hotline is a project of the Kamim Fund—an organization devoted to supporting the hostages—and the NATAL Israel Trauma and Resiliency Center.
The one-of-a-kind hotline is specifically designed to assist freed hostages, and the families of those still in captivity and those who will soon be released. “People can call whenever they are in stress or distress and receive immediate support,” explained Eliezer Cohen, who manages the hotline.
Cohen told The Media Line that while call workers handle the initial response, they can refer individuals to additional help if needed, such as connecting them with a member of NATAL’s nationwide network of over 400 therapists.
NATAL was founded by Jude Yovel Recanati and Dr. Yossi Hadar, a physician who served during the Yom Kippur War and saw firsthand the soldiers suffering from “invisible” wounds. Hadar passed away just three months after the organization was established, leaving Recanati to carry forward his vision.
Many released hostages and their families feel isolated, even though Israeli society is largely empathetic toward their plight, Cohen said. “The helpline is meant for those moments when they just need to talk to someone,” he explained.
The helpline is meant for those moments when they just need to talk to someone.
Cohen emphasized that two key areas need to be addressed when working with freed hostages: first, restoring their sense that the world is a safe place, and second, helping them regain the belief that they have control over their own destiny. He noted that each hostage experiences captivity differently and will respond based on their personality and resilience.
Of course, trauma doesn’t affect only the hostages. Their families, friends, and loved ones also suffer—a phenomenon known as the circle of trauma.
“We are looking at family members—parents, cousins, people who stopped their lives to fight for the return of their loved ones,” Cohen said. “Some of them stopped working and even struggled to care for their homes because they were preoccupied with the crisis. There is a lot of stress involved, and they also went through trauma.”
Despite the hardships, Cohen offered words of reassurance. He stressed that even those hostages who endured the most severe trauma can find resilience.
“There is growth after trauma,” he said.
