Dehumanizing Human Beings in Gaza: The

Devastating Impact of war on Palestinian Health

BIO
Riccardo Lo Verde has been a Political and Press assistant at the EU delegation to Israel
during the Israel-Hamas war conducting field research on the Israeli-Palestinian conflict.
He has a Bachelor’s Degree in Diplomatic Science from the University of Bologna and a
Master’s Degree in International Security obtained at the Université Catholique de Lille in
2023 with a thesis on the Russian Foreign Policy in the context of the war in Ukraine.

Introduction

Each individual’s health is influenced by a complex interplay of biological and social factors that
shape its personal growth. When political stability is highly compromised within a society, as in the
case of a war, the resulting disruption negatively affects the relation between health and individual
well-being. This relationship is evident in Gaza, where Palestinians have adopted a subjectively
natural yet objectively unnatural recognition of the difficult social conditions they are living in, as
new generations were born amid ongoing violence and conflict. In this context the right to health,
an inclusive right that extends beyond timely medical care to encompass determinants of health
such as access to clean water and adequate nutrition, has been progressively eroded. Since Israel's
blockade of Gaza in 2007, followed by four Israeli military operations in 2008/09, 2012, 2014, and
2021, the population of Gaza has faced a deterioration of living conditions with repeated exposure
to conflict, the impossibility of leaving Gaza for many, and the systematic destruction of critical
infrastructure which destabilised the determinants of health.
However, the ongoing conflict, which began on October 7, 2023, represents a point of no return
compared to the previous situation as the Israeli military operation has affected all segments of
Palestinian society.
As reported in the OCHA Bulletin of November 2024, one year after the war began, the death toll
has reached 40,717, with 13,319 of those being children, representing 32.5% of the total. At the
beginning of the war, Gaza had 36 hospitals, but only 17 now remain partially operational,
struggling under immense pressure to meet the overwhelming demand for medical care (OCHA,
2024). In this context, deaths occur not only from direct violence but also from indirect violence,
including the spread of infectious diseases, which often proliferate in deteriorating healthcare
conditions. This is particularly devastating in a situation where nearly 2 million people have been
displaced and are living in overcrowded makeshift camps with a density of almost 40,000 people
per square kilometer (IPC, 2024). The fact that residents in Gaza now have access to only 4.74 liters
of water per person per day further exposes them to serious health risks (OXFAM, 2024).Without
significant and sustained improvements in aid access, civilian protection, and humanitarian security,
Gaza faces the imminent threat of catastrophic famine. Such an outcome could result in an even
more devastating loss of life for Palestinians, potentially leading to a full-scale humanitarian
disaster.
The Deterioration of Gaza's Healthcare Infrastructure: A
Historical Analysis of a System on the Verge of Collapse

The Gaza Strip is one of the world’s most densely inhabited areas with almost 2.3 million people
living in a 365-square-kilometre territory. During the last years, its healthcare system has witnessed
a dramatic crisis exacerbated by episodes of political violence such as the Israeli blockade's
imposition in 2007, Palestinian political intra division and five major Israeli military operations in
2008, 2012, 2014, 2021 and 2023. Over time, in this region of the world, the right to health has
increasingly become antithetical to the idea of a right that guarantees a standard of living adequate
for human well-being as written in Universal Declaration of Human Rights. In this context, a
significant number of hospitals and primary healthcare centers have been destroyed or damaged,
with 34 hospitals and 104 PHC centers affected between 2008 and 2021 by Israeli military
operations (WHO 2009; MAP 2014; WHO 2014; ReliefWeb 2021). As of 2023, the healthcare
system was already on the verge of collapse, with just 36 hospitals in operation and a total of 3,412
hospital beds available for a population exceeding 2 million people (Soni, 2024). However, if we
consider the situation of Palestinians in Gaza as traumatic in the years ex ante October 7, 2023, the
events following can be seen as a form of structural violence, aimed at undermining Palestinian
human dignity. Since the Israel-Hamas war began in October 2023, 19 hospitals became non-
functional reducing the number of operational hospitals to just 17 (OCHA, 2024). Additionally, the
number of available beds in Gaza’s operating hospitals and field hospitals has dropped to fewer
than 1,500, which is insufficient to accommodate the needs of over two million people facing war
( Euro-Med, 2024). Cities with similar population sizes, such as Paris, with approximately 2.1
million residents, has around 10,000 hospital beds available (INSEE, 2024). A disparity made even
more concerning by the fact that 1,047 health workers died (OCHA, 2024). The destruction or
dismantling of key societal segments in Gaza has undermined the very fabric of society that support
everyday life and human dignity. The systemic reduction of these societal segments such as
healthcare, education, and humanitarian aid institutions forces Palestinians to cope with not just
physical devastation, but also to endure the long-term psychological trauma of living in a society
that has lost its foundational supports. An emblematic example of the dismantling of key societal
segments can be seen in the new legislation passed by the Israeli parliament in late October 2024,
which barred UNRWA from operating within Israeli-controlled territories and prohibited
coordination between Israeli officials and UNRWA staff. UNRWA provides health services to over
1.2 million Palestinian refugees through 22 centers, and this decision may severely disrupt its ability
to procure supplies, ensure staff mobility, and coordinate access to high-risk areas. This will further
exacerbate the humanitarian crisis in Gaza, threatening the lives of refugees who depend on
UNRWA for essential services.

Malnutrition and Health: The result of Food Insecurity, Scarce Water, and Disease

Modern societies rely heavily on interconnected systems such as transportation networks,

communication grids, water supply and energy systems. We consider these systems "invisible" in
the sense that they are taken for granted until they fail. War poses a significant threat to these
interdependent systems, as failures in one part of these complex networks can trigger cascading
effects, leading to widespread and catastrophic consequences. This dynamic is reflected in the
conflict in Gaza where nearly 60% of buildings and 68% of roads are destroyed, resulting in the
collapse of food, health, and water systems. As a result, nearly 2 million people are facing severe
food insecurity, including an estimated 60,000 children aged 6 to 59 months projected to suffer
from acute malnutrition between September 2024 and August 2025 (IPC, 2024). The destruction of
health infrastructure and lack of access to safe water have further exacerbated disease outbreaks
with over 25% of Gaza’s population affected by preventable illnesses (OXFAM, 2024). On a global
scale, every day, nearly 4,000 people die from diseases caused by inadequate access to safe drinking
water, sanitation, and hygiene (WASH) with over 1,000 of these deaths occurring among children
under the age of five (UNICEF, 2023). Deprivation in WASH traps individuals and communities in
conditions of vulnerability, inequality, and deprivation reducing them to a state of survival. As
written by Amartya Sen in Development as Freedom, access to clean water and sanitation is a basic
capability vital for health, nutrition, and dignity, enabling individuals to live lives they value. Its
limitation represents a form of “ unfreedom," trapping marginalized communities in cycles of
poverty and vulnerability (Sen, 1999). The water situation in Gaza is a critical example: 97% of the
Gaza aquifer, the primary source of drinking water, is contaminated and unsafe for consumption
due to seawater intrusion and sewage contamination (EcoPeace Middle East, 2024). Before the
2023 Israel-Hamas war, Gaza relied on groundwater (81%), desalination (6%), and water purchased
from Israel's Mekorot company (12%). Palestinians had 82.7 litres per person per day which was
below the WHO recommended daily quantity of 100 litres per person. However, after the war, 88%
of the wells and 70% of wastewater pumps were severely impacted and water production fell by
84%. Most alarmingly, people in Gaza now have access to just 4.74 litres of water per person per
day for all purposes, including drinking, cooking, and washing, representing a dramatic 94%
reduction in water availability (OXFAM, 2024). In comparison, the average European uses 144
litres of water per person per day (Ferguson, 2024). If the conflict continues, with escalating
destruction of critical infrastructure and the rapid spread of communicable diseases, Gaza could
face a catastrophic famine. This scenario occurs when an area has at least 20% of households facing
an extreme lack of food, 30% of children suffering from acute malnutrition, and a death rate of two
adults or four children per 10,000 people each day. The entire Gaza Strip is at risk of this possible
event (IPC, 2024).

Disease Outbreaks and Public Health Risks: The Surge in

Communicable and Non-Communicable Diseases in Gaza

When discussing infectious diseases, we refer to illnesses caused by infectious

agents like bacteria, viruses, parasites, fungi, and their toxic byproducts. Many
are communicable, meaning they can spread between people or animals.
Transmission can occur directly through blood or bodily fluids, indirectly via
contaminated food, water, air, or surfaces, or through vectors like mosquitoes.
Examples include measles, malaria, chlamydia, and polio (Australian Institute
of Health and Welfare, 2024). The history of armed conflicts has revealed that
communicable diseases can cause death rates equal or beyond those from
direct violence (Goniewicz et al. 2021). The crisis in Gaza is no exception and
has created a perfect storm for communicable disease due to the destruction
of water and sanitation infrastructure with internally displaced people living in
tents or shelters with limited access to safe drinking water and streets full of
untreated wastewater and sewage (OCHA,2024). In this context, since October
2023, 40,000 cases of hepatitis A have been recorded in Gaza, a significant
increase from just 85 cases before the conflict. In addition, WHO has reported
nearly a million cases of acute respiratory infections, over half a million of
acute diarrhea, and more than 100,000 cases of jaundice (WHO, 2024). Polio
remains a major concern in Gaza, with the cVDPV2 variant detected in sewage
samples in June and the first confirmed case in a 10-month-old baby reported
in August. However, a vaccination campaign successfully reached 94% of the
target population, although 10,000 children in hard-to-reach areas remain
unvaccinated and at risk (Sah, 2024). On the other hand, when addressing
Non-Communicable Diseases (NCDs) we refer to chronic conditions that are not
caused by infectious agents but instead result from a combination of genetic,
environmental, and lifestyle factors. These include diabetes, cardiovascular
diseases, cancer, and chronic respiratory diseases (WHO, 2023). In Gaza, the
conflict has severely worsened the situation for NCD patients, with essential
medications like insulin and cancer treatments in critically short supply, and
350,000 people with chronic illnesses having little or no access to necessary
medical procedures such as dialysis (Ashour et al. 2024). As of December 3,
2024, an estimated 14,000 patients in Gaza require urgent medical evacuation,
but only 352 have been successfully evacuated since the Rafah Crossing
closure on May 7, 2024 (OCHA, 2024). This low percentage highlights
significant challenges within the referral system, including delays in obtaining
permits from Israeli authorities leaving critical patients without timely access to
life-saving care.

The impact of the war on Child and Maternal Mental Health: A

Crisis of Trauma and Dramatic Loss

Involving children in armed conflict is not only a profoundly inhumane act, but a conscious effort
aimed at transforming them into mere statistics of violence, reducing their humanity to a tragic
arithmetic of casualties. This is a phenomenon of de-humanization in paradox to the idea that a
child, for the full and harmonious development of his or her personality, should grow up in an
atmosphere of happiness, love and understanding as written in the UN Convention on the Rights of
the Child. In Gaza, nearly all of the 1.2 million children require mental health and psychosocial
support (UNICEF, 2023). Even prior to the Israel-Hamas war, Gaza faced a mental health crisis
among children. A 2018 survey by Save the Children found that 95% of Palestinian children in
Gaza experienced mental health issues like depression, hyperactivity, and aggression (Save the
Children Canada, 2018). By 2022, the situation had worsened, with an alarming increase in children
expressing fear, anxiety, sadness, and grief (Save the Children, 2022).
However, the Israel-Hamas war dramatically worsened this situation. One year after the war's
escalation, the death toll for children in Gaza has reached 13,319, with an average of 70 children
injured daily since the conflict began (OCHA, 2024; UNICEF, 2024).
This devastating loss and the ongoing injuries have caused immense psychological harm. The
trauma of losing family members and living in constant fear has significantly damaged children’s
physical, cognitive, and emotional development, leaving many without the support they need for
recovery.
However, the impact of armed conflict on children cannot be considered in isolation from women,
their primary caregivers. Women often face significant physical and psychosocial challenges during
war, which directly affect their ability to care for children. This is particularly critical for pregnant
women in armed conflicts, who endure severe psychological trauma and face dangerous conditions,
such as home deliveries, induced deliveries, or births in precarious circumstances, including at
military checkpoints.
As reported in the WHO Bulletin of November 2024, around 50,000 women are currently pregnant,
with approximately 5,500 expected to give birth in the coming month (WHO, 2024). Each day,
around 183 women give birth in Gaza, but the availability of midwives, doctors, and postpartum
care is extremely limited. Many women have been forced to deliver without medical assistance,
with some even undergoing C-sections without anesthesia. In this context, the lack of proper care
and the constant fear for their own safety and that of their newborns has significantly worsened their
mental and physical health, leading to higher risks of complications such as premature births and
stillbirths, as well as a rise in postpartum depression (ICR, 2024).
Ensuring Protection: The Role of International Law in Safeguarding the Right to
Health in Conflict Zones

The right to health can be understood as an a-temporal and inclusive right

inherent in the life of every individual. It persists across time as it embodies an
intrinsic notion of a-temporality, and it extends not only to timely and
appropriate healthcare but also to the underlying determinants of health. It
serves as a means of liberating individuals from conditions of insecurity, as it
ensures the opportunity to lead a healthy life with adequate standard of living
necessary for well-being. Article 25 of the Universal Declaration of Human
Rights (UDHR) and Article 12 of the International Covenant on Economic,
Social, and Cultural Rights (ICESCR) form the cornerstone of this principle.
Article 25 emphasizes the right to access not only medical care but also other
basic needs like food, housing, and social services (United Nations, 1948).
Similarly, Article 12 of the ICESCR ensures the right to the highest attainable
standard of physical and mental health, encompassing the provision of
essential health services and factors like sanitation, housing, and nutrition
(United Nations, 1966).
In addition, the Fourth Geneva Convention mandates the occupying power to
"ensure and maintain" the health system and prevent the spread of disease.
Consequently, Israel, as an occupying power in Gaza, has clear obligations to
ensure the provision of health services for Gazans. Furthermore, the Geneva
Conventions protect health workers and facilities, prohibiting attacks on
medical infrastructure and personnel. These protections are codified in Article
18 of the Fourth Geneva Convention and Protocol I, Article 12 of the Additional
Protocols (ICRC, 1949; 1977). In this context, intentional attacks on healthcare
can constitute war crimes under the Rome Statute of the International Criminal
Court (ICC, 1998) despite IHL allows for exceptions when healthcare facilities
are used for military purposes. However, decisions involving these exceptions
must follow the principle of proportionality, which requires balancing military
advantage against the potential harm to civilians. While International
Humanitarian Law (IHL) provides some guidelines, the current framework offers
limited clarity on how healthcare infrastructure should be adequately protected
during armed conflicts. This ambiguity has led to calls for amending the
Geneva Conventions to unequivocally prohibit attacks on healthcare facilities,
regardless of military considerations.

Conclusion

After 12 months of conflict in Gaza, the situation has reached an

unprecedented level of devastation, with widespread destruction, immense
humanitarian suffering, and severe economic collapse. As reported by the
Integrated Food Security Phase Classification (IPC), the Gaza Strip faces the
imminent threat of catastrophic famine. To address this situation, immediate
actions are required. First, there must be an immediate and lasting
humanitarian ceasefire among all parties to the conflict, ensuring the
protection of civilians and the unconditional release of all civilian hostages by
Hamas and other armed groups. Urgent medical cases in Gaza must be allowed
safe access to critical healthcare, with injured or sick children evacuated
alongside family members. Preventing and managing acute malnutrition is also
essential, including scaling up feeding programs and improving infant and child
nutrition practices such as breastfeeding support. Furthermore, humanitarian
access must be granted to deliver lifesaving multi-sectoral assistance,
addressing acute food insecurity and malnutrition with sufficient and high-
quality aid. This aid should extend beyond household food assistance to include
the restoration of health services, WASH, and non-food items. Long-term
recovery will also require rehabilitating critical infrastructure, restoring market
systems, local food production and essential services like electricity and
telecommunications. Ultimately, the ongoing conflict has caused cumulative
trauma, where repeated exposure to destruction has eroded the collective
sense of security. As a result, it will be crucial to implement psychological
support programs, particularly for the most vulnerable populations such as
children, women and elderly people.

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