Gaza: Maternal and child health suffer under a decimated system

As the last hospital providing maternity care in Khan Younis, Nasser Hospital and its medical team is handling 25 to 30 deliveries a day. In addition to the destruction or closures of once-functioning hospitals, the decimation of infrastructure has created severe obstacles for pregnant women trying to reach medical facilities. Pregnant women are often forced to navigate unsafe routes amid the fighting and without safe transportation—often delaying access to health care and putting them at higher risk of complications. 

“She was close to death before we reached the hospital”

"I rode on a donkey-pulled cart to Nasser Hospital alone, as my husband couldn't afford to join due to financial constraints,” says Najwa*, an expectant mother in Gaza.

"Some women are delivering prematurely, often with postpartum complications exacerbated by their living conditions,” says MSF nursing team supervisor Mohamad*, who works in the MSF neonatal intensive care unit (NICU) of Nasser Hospital. Once women give birth, they must quickly return to unsanitary conditions, often in tents, where lack of food and constant stress put them and their newborns at further risk.

“The main health risks for pregnant women are blood-pressure related complications such as eclampsia, hemorrhage, and sepsis—which can become deadly if not treated in time,” says MSF emergency unit health advisor Mercè Rocaspana. “In contexts like Gaza, where the health system has been decimated and has collapsed, late access to care is posing a health risk to pregnant women and their children, with tragic—even lethal [consequences].”

When Hanin* first sought care for her malnourished daughter in Khan Younis in southern Gaza, the clock began ticking on her chances of survival. “My child was in a critical condition. They referred [us] to the hospital but there was no means of transportation,” explains Hanin. Finally, Hanin and her daughter reached the MSF inpatient therapeutic feeding center on a cart. Hanin describes her daughter’s state: “She was resting her head towards me and not moving. She was close to death before we reached the hospital.”

Nasser Hospital is the last tertiary hospital providing maternal and pediatric care in Khan Younis. In February, after several weeks of intense fighting with Palestinian armed groups in Khan Younis, Israeli forces stormed the facility, which had been under siege, and MSF teams were forced to flee the hospital. MSF teams returned to the hospital in June, and together with the Ministry of Health and other actors, reopened the maternity and pediatric wards, including an inpatient therapeutic center, and started providing support to the pediatric intensive care and neonatal intensive care units.

Skyrocketing needs despite dwindling supplies

The needs of Palestinian women and children are skyrocketing, yet MSF teams at Nasser hospital are witnessing a shortage of vital supplies, jeopardizing the provision and quality of care. Due to the lack of other functioning health care centers, Nasser is facing an overwhelming increase in patients every day. Between June 29 and July 5, the pediatric emergency department alone recorded more than 2,600 consultations, meaning staff attended to more than 300 children each day. As more and more children are admitted for inpatient care, they are being forced to share beds, as pediatric services are pushed beyond their capacity.

“We are seeing malnourished children—an issue never seen in Gaza before,” says MSF project medical referent Joanne Perry, a member of the team working in Nasser Hospital. “People are living in tents with minimal access to clean water and abysmal sanitation. Bombing has devastated the sewage and water systems, resulting in diarrhea, dehydration, hepatitis A, and skin infections among children.”

In addition to maternity and malnutrition care, MSF teams at Nasser are supporting the NICU, which is equipped with 29 beds and incubators for high-risk newborns. 

"There's no [...] diapers, or suitable clothing for my baby. Living in a tent exposes them to extreme conditions without even a proper bed,” says Khadra*, who gave birth in Nasser Hospital's maternity ward.

As the sole functional maternity in the south of Gaza, Nasser Hospital will continue to face challenges with capacity. Reopening the maternity and pediatric wards is one step forward to providing care, but an immediate and sustained ceasefire in Gaza, alongside unhindered humanitarian aid is the only solution to alleviate the suffering of people trapped in the Gaza Strip, including pregnant women and children. 

*Names have been changed for privacy