Gaza’s health set back in time for years to come

A ceasefire is indispensable if Gaza is to be given a chance to rebuild its health system, however, Israeli repression against healthcare infrastructure continues

March 02, 2024 by Peoples Health Dispatch
Palestine Red Crescen teams carry out an evacuation from Nasser Hospital after it went out of service (Photo: Palestine Red Crescent Society)

Even if a ceasefire were declared today, the Gaza Strip would still face thousands of excess deaths in the months that follow. However, the difference between a scenario in which Israel ends its attacks and one in which it continues to escalate them is enormous: over 3,000 people could die from traumatic injuries under a ceasefire scenario, while close to 69,000 could be killed in this way if the violence increases, according to data collected by the London School of Tropical Medicine and Johns Hopkins. 

More people would die from other immediate causes, ranging from malnutrition — if an adequate supply of aid to Gaza is not ensured — to infectious diseases and non-communicable conditions. If Israeli attacks were to continue at the same pace as over the past four and a half months, over 58,000 people could lose their lives to trauma or disease, and the number would rise to 66,700 in the event of an epidemic outbreak. Whatever the scenario, the report states, Gaza will be thrown far back in terms of health conditions. 

Rates of maternal and neonatal health, for example, could reach levels not seen in almost 25 years. The harm done to women’s and children’s health would permeate Palestinian society in various ways, starting from falling breastfeeding rates. In an escalation scenario, the number of children younger than 6 months who are breastfed could drop from 58% before October 7 to as low as 5-15%. At the same time, formula would remain either inaccessible due to the slow pace of aid delivery or unsafe to use in the context of the destruction of water and sanitation facilities. 

In the same scenario, children up to 5 years of age would continue to be the population group most at risk of malnutrition, perpetuating the disastrous trend observed over the past days, in which too many have already died of starvation in northern Gaza. If the attacks continue, up to 22% more children in Gaza could be exposed to severe malnutrition compared to pre-October 2023 levels. Hungry children are also more vulnerable to infectious diseases, as current data vividly illustrates: around 90% of young children in Gaza are affected by at least one communicable disease. 

Read more: Malnourishment could lead to even more deaths among children in Gaza

Miscarriages and deaths from postnatal bleeding would certainly increase further in a setting where the health system is unable to rebuild and is exposed to more bombardments. Maternal health experts are already providing devastating testimonies about the condition of delivery facilities in southern Gaza. The Al-Helal Al-Emirati maternity hospital in Rafah is reporting streams of ill pregnant women and babies pouring in, despite its extremely limited capacities. “We have to put four or five babies in one incubator… Most of them don’t survive,” pediatrician Ahmed Al Shaer reported to UN officers. 

Direct attacks on healthcare in Palestine between October 7, 2023, and today—which have broken records of attacks on healthcare in conflicts in the contemporary era—are not the only way health services in the occupied territories are being devastated. Equally damaging are the long-term intentions that Israel has to erase any chance for the reconstruction of the health system. 

In an open letter to leading medical associations, activists calling for health justice pointed out that Gaza’s only two medical schools were destroyed by Israeli attacks. This, “together with the targeted assassination of health experts, has left Gaza with no training capacity for healthcare workers in the near future and ensures that even if hospitals are rebuilt, the healthcare system will not recover.”  

A similar strategy is being applied in the West Bank. During a conversation coordinated by the People’s Health Movement, Dr. Jamileh Abuduhou and Mazen Rantisi from the Health Work Committees spoke about the impacts of the escalation of Israeli violence following October 7. While the character of Israeli repression against the health system has not changed significantly, the attacks have worsened in intensity. More and more roadblocks continue to emerge along roads in the West Bank, making it increasingly difficult for health workers to reach their workplaces on time or without being threatened by army or settler violence. 

Read more: Dehumanization of healthcare in the West Bank, a blueprint for ethnic cleansing

The roadblocks should not be confused with Israeli checkpoints, which are located in fixed positions. Both forms of Israeli presence restrict access to healthcare for Palestinians by delaying people on their way to hospital appointments or health workers traveling to a mobile clinic, and by exposing patients and medical staff to various types of violence. However, the emergence of scattered roadblocks renders it impossible to predict whether they will be able to reach their destination at all, implying a high risk of injury or death along the way.  

This, combined with a financial and administrative choke-hold that Israel has imposed on Palestinian organizations, including Health Work Committees, has led to shutdowns and closures of essential services. Health Work Committees were forced to shut down school programs that they were running in Jerusalem, as well as some of the clinics they operated in the Jordan Valley, ending the provision of care for some of the most disadvantaged populations in Palestine. 

Following attacks that the Israeli Occupying Forces conducted against Health Work Committees, including arresting several of its leading figures, the organization was also forced to significantly reduce the number of employees, which fell from 300 to about 100 in a short span of time. The organization was forced to sell some of the vehicles it owned to be able to pay suppliers, as other funding was cut short after Israeli authorities ramped up pressure on Health Work Committees. 

In this context, the organization is forced to spend most of the time on trying to resolve daily problems. “They try to suffocate our work, but we’re determined to continue,” said Abuduhou and Rantisi.

As health workers in Palestine are not giving up despite all the hardship, the signatories of the most recent call for health justice called upon those in other countries to denounce Israel’s actions for what they are – acts of intended genocide and weaponization of health. “Silence is complicity,” the organizations said.

People’s Health Dispatch is a fortnightly bulletin published by the People’s Health Movement and Peoples Dispatch. For more articles and to subscribe to People’s Health Dispatch, click here.