Since Hamas attacked Israel on October 7th, 2023, Israel’s offensive retaliation has devastated the Palestinian people throughout the Palestinian territories, overwhelmingly in Gaza. With an estimated 43,391 killed as of November 2024, and an additional ~102,000 injured, Israel's bombardment of Gaza via air strikes has had detrimental effects on its population, infrastructure, landscape, and healthcare. As a result of Israel’s bombardment of the Gaza strip, key healthcare facilities have been destroyed, and critical medicine and supplies have been blocked from reaching the people of Gaza, exacerbating the horrors of war Gazans are facing every day. In particular, the increasing devastation of healthcare can be seen in the horrific effects it is having on women, particularly pre and post natal women and children, as well as menstruating women. 

According to the UN Women’s September 2024 report, 84% of health facility buildings in Gaza have been destroyed or damaged. The remaining 16% of healthcare infrastructure lacks critical medicines, emergency vehicles, life-saving equipment, electricity, and water. Aside from the clear problem of the absence of critical supplies and medicine, the lack of sanitation poses health risks of its own. According to the CDC, lack of WASH access (Water, Sanitation, and Hygiene) increases the likelihood of infection and diseases such as diarrhea, cholera and typhoid fever among a population. In a report on Gaza’s water infrastructure, BBC reported that according to Oxfam, a quarter of Gaza’s population had become ill due to waterborne diseases as of August 2024. Lama Abdul Samad, a water and sanitation expert at Oxfam, describes the situation as “a catastrophic health crisis unfolding in front of our eyes”. This lack of infrastructure and proper access to care has directly impacted the women and children health sector of Gaza in a devastating manner. 

Gazan women, particularly pregnant and post-natal women, as well as young children, are disproportionately affected by the destruction of the Palestinian healthcare system. UN Women reported that 162,000 women are at increased risk for non-communicable diseases such as cardiovascular disease, diabetes, and cancer. Additionally, 15,000 pregnant women are on the brink of famine. The malnutrition of pregnant women puts not only the women at risk, but the fetus as well. Fetal malnutrition is associated with a wide range of long term health issues, such as increased risk factors for later diseases, stunted physical and cognitive development, and increased cardiovascular mortality. In January 2024, a UNICEF remarks summary titled “Born Into Hell” described the hardships pregnant women in Gaza face and the impact on their children, outlining how “mothers face unimaginable challenges in accessing adequate medical care, nutrition, and protection before, during and after giving birth.”. This is not only applicable to health concerns, as the article further elaborates on how expecting mothers have been buried under rubble in the aftermath of airstrikes. One mother even described how “her baby stopped moving inside her.” and was still awaiting the proper treatment for her miscarriage when the UN report was published. Since October 7th 2023, the rate of miscarriage among Palestinian women in Gaza has increased three-fold. When a pregnancy does make it to term, it is estimated by the International Rescue Committee (IRC) that about 183 women are giving birth in Gaza each day without access to midwives, doctors, healthcare facilities, or pain medication during delivery. As of April 2024, the IRC received credible reports that some women are forced to undergo a cesarean section delivery without any medication or pain relief, posing an unimaginable trauma on the body and psyche. Additionally, the level of shock and trauma that comes from carrying a pregnancy during war under immense physical stress manifests itself in premature labor, which poses great risk to the mother and child, especially without proper medical attention. 

Not only is the burden of war’s effects on health care heavy during pregnancy, but non pregnant women and girls of all ages, even when not severely sick, are directly impacted by Gaza’s lack of sanitation and access to care. According to the United Nations, there are an estimated 700,000 women and girls in Gaza experiencing menstrual cycles who lack access to feminine care products, as well as basic hygiene infrastructure such as clean, running water, plumbing, and toilet paper. Women and girls have been attempting to supplement pads and tampons through torn pieces of fabric from tents and clothing. Not only does this open up this population to a higher risk of contracting urinary tract infections and reproductive health complications, but it also strips these women and girls of their dignity and privacy during their menstrual cycles. A spokesperson from UNICEF to NPR describes the psychological effects of poor healthcare for menstruating women and girls, stating that these challenges are “...exacerbating mental health issues.” In an article from early 2024 in the Guardian, 17-year old Mona described her experience of menstruating as a displaced Palesinian in Rafah. Describing the impact of her period and the air strikes on her health, Mona said, “I feel my mental health is deteriorating further due to the combination of the bombing and menstrual pain.” Mona’s description of the devastating effects on her mental health caused by monthly menstrual pain coupled with bombing demonstrates how multi-faceted the issue of healthcare for women in Gaza is. Access to resources and care directly impacts physical health which in turn impacts the quality of life and mental health of those living there. It is a vicious cycle that is perpetuated as the war carries on, with no improvements in care or aid. 

While the current ongoing war in Gaza and other Palestinian territories have exacerbated the Palestinian health crisis, the strangulation of Gaza’s healthcare sector and infrastructure did not begin with Israel’s response to the October 7th 2023 attacks carried out by Hamas. Focusing on the last two and a half decades, Israeli policy surrounding the movement of persons and goods has severely restricted the access Palestinians have to proper, life-saving care, as well as the assistance that can enter occupied territories, particularly Gaza. In June of 2007, in response to Hamas’ control of the Gaza Strip, Israel imposed a land, sea and air blockade on the Gaza Strip. The effects of the blockade can be seen in the restriction of supplies and aid into Gaza as well as the restriction on the movement of critically ill Palestinians seeking healthcare access outside the Gaza Strip. According to a UN report on the effects of 15 years of blockade, published in 2022, as of this report’s publication Israeli authorities only approved 64% of patients' requests to exit Gaza for specialized treatment in the West Bank by the date of their medical appointments. In late October 2024, the Israeli Parliament voted to ban UNRWA, the United Nations Relief and Works Agency for Palestinian Refugees from operating within Israeli territories. This bill is incredibly crucial to the developing discussion on healthcare access and services in Gaza and will serve to exacerbate the already devastating conditions, as UNRWA delivers the vast majority of what aid is able to reach Palestinians in Gaza. By increasing the barriers to healthcare access and proper medical services and supplies, this new Israeli bill is only adding to the suffering experienced by Gaza’s most vulnerable, including women. UNRWA has been a critical aspect of what relief efforts are making its way into Gaza. This new bill makes a frightening reality even more frightening for the women who rely on UNRWA care and resources for dignity in healthcare, treatment, and aid.