The Perils of Motherhood in Gaza
Amidst the chaos of Gaza's relentless airstrikes, Rajaa Musleh, 50, finds refuge at Al-Shifa hospital, the city's largest medical facility With shortages pushing women and hospitals to their limits, the lack of reproductive supplies intensifies the crisis Mothers endure the horrors of war, desperately seeking protection from Israel's brutal campaign
Rajaa Musleh, aged 50, is seeking refuge at Al-Shifa hospital in Gaza, the largest medical facility in the region. The hospital is currently overwhelmed by patients and displaced individuals, all desperately seeking safety from Israel's relentless airstrikes.
The Gaza representative of US healthcare NGO MedGlobal escaped her residence on the northern coast of the strip and relocated to Al-Shifa. This action was prompted by the Israeli military's declaration of war against Hamas as a response to their deadly October 7 terrorist attack. As a precautionary measure, civilians were urged to evacuate the area in anticipation of a ground operation.
According to the United Nations' humanitarian office OCHA, over 1.4 million individuals have been displaced within Gaza. Numerous civilians have been compelled to seek refuge in overcrowded camps or overwhelmed hospitals, enduring unhygienic living conditions.
The Al-Shifa hospital complex is bursting with people, with numerous women and girls resorting to sleeping on the hospital floors and outside. They are lacking essential physical and mental healthcare, adequate water supply, and privacy.
Two Palestinian women look at the massive destruction following Israeli airstrikes on Gaza City's al-Rimal district, on October 10.
Mahmud Hams/AFP/Getty Images
Gaza's expectant mothers fear for their unborn children as they face the daunting prospect of giving birth in a war-torn region. "Hospitals and streets are overwhelmed with women," Musleh expressed. "Personally, I am limited to using the bathroom only twice a day due to the overwhelming crowds."
Luck is found in those who are able to use a bathroom, despite having to share it with a large number of people ranging from 40 to 60.
Among the many women in Gaza, Musleh is one of a sea of faces confronting a dire health crisis due to Israel's complete blockade of the strip. This blockade has severely limited access to crucial reproductive supplies such as pregnancy, postpartum, and menstruation products, as well as basic necessities like drinking water and food. As a result, mothers are left grappling with the stark reality that they have no means to protect themselves or their children from Israel's relentless bombardment, which has indiscriminately targeted residential areas, hospitals, and schools.
According to data from the Palestinian Ministry of Health in Ramallah, sourced from the Hamas-controlled enclave, the number of casualties from Israel's airstrikes stands at a minimum of 9,155 individuals. The health ministry reports that a large majority, 73%, of these casualties comprises women, children, and the elderly.
Various human rights organizations argue that Israel's extensive bombings in civilian areas, evacuation mandates, and complete blockade of the territory are tantamount to war crimes. In response, Israel asserts that its aim is to target Hamas operatives in Gaza, highlighting that the militant group deliberately embeds its assets among civilian populations and utilizes civilians as human shields.
Shortages push women and hospitals treating them to the brink
Reham Ahmed Al-Sadi, with the hope of welcoming a baby girl, is currently nine months pregnant and getting ready to deliver her second child amidst the challenging circumstances of a war-torn area, all while striving to ensure the safety and well-being of her family.
Relaying messages from the Palestinian Medical Relief Society to CNN, the 28-year-old expressed her profound fear and apprehension regarding the entire process of giving birth amidst the ongoing conflict: "The war has shattered my happiness surrounding my pregnancy." She further elaborated on her concerns, encompassing tasks such as preparing essential items for the baby and postpartum care, ensuring safe transportation to the hospital during labor, and subsequently departing the hospital in a secure manner following childbirth.
Dr. Tanya Haj-Hassan, a pediatric intensive care physician affiliated with Médecins Sans Frontières (MSF), or Doctors Without Borders, expressed concern over the extensive lack of water, food, and medication in Gaza, resulting in a devastating "onslaught of human suffering" within local hospitals. According to Dr. Haj-Hassan's interview with CNN, medical staff within the region are depleting their stocks of vital resources such as gauze for wound care and external fixators needed for orthopedic surgeries. As a result, they have been compelled to provide treatment to wounded survivors without anesthesia or pain relief.
The Rafah border crossing, the only passage for Palestinians and aid between Gaza and Egypt, remained closed during the initial weeks of the war. However, it has recently been partially opened to facilitate the passage of a small number of aid trucks, as well as a limited number of injured Palestinians and foreign nationals out of Gaza.
As a result of the ongoing bombardment and a lack of vital fuel supplies, almost half of Gaza's hospitals are now inactive, according to the Palestinian health ministry's report on Wednesday.
During periods of intense stress, women face a higher risk of miscarriage or premature birth, putting the baby's survival in danger, Haj-Hassan highlighted. Reduced power availability becomes a life-threatening situation for patients dependent on vital medical equipment like ventilators and dialysis machines.
Moreover, premature infants rely on incubators, breathing machines, and infusion pumps for their recovery, all of which are electricity-dependent, explained Haj-Hassan. Without access to these essential resources, the chances of survival for premature babies decrease significantly.
Pregnant patients are being compelled to undergo emergency C-sections without anesthesia, as reported by the humanitarian agency CARE International on Monday. CARE has revealed that women are being discharged within a mere three hours after giving birth due to hospitals lacking capacity. Hiba Tibi, the country director of CARE West Bank and Gaza, stated that food shortages are endangering the health of 283,000 children under the age of five and pregnant or lactating women.
At a UN-run school in Rafah, in the southern region, women from displaced families, primarily from northern Gaza, skillfully prepare traditional unleavened bread over an open fire. The severe food shortages in the Palestinian enclave have been worsened by Israel's total blockade.
According to Haj-Hassan, a few of her Gaza colleagues have a mere 33 milliliters (approximately 1.12 oz) of drinking water available each day. This meager amount severely affects the ability of mothers to breastfeed or provide formula to their infants.
Amal, a pregnant woman who was forced to leave her home in Gaza City and relocate to Khan Younis in the southern part of the strip, is anxiously anticipating the circumstances surrounding her upcoming delivery.
She expresses her worries, "What will happen if I require a C-section? How will the birth take place without the presence of generators at the hospital? What if the limited power supply shuts down? The situation becomes even more perilous as there is a shortage of anesthetic. The healthcare facilities at hospitals are inadequate, and there is a lack of proper sanitation," said Amal, who requested CNN to withhold her real name due to security concerns.
Her immediate priority was the well-being of her child. Due to the scarcity of water, she had to resort to boiling limited water supplies using either wood or old gas in order to make it safe for drinking.
"It's considered a stroke of luck if you manage to obtain a bucket full of water," Amal commented. "Mothers are resorting to feeding their infants with powdered adult milk that they boil. Alternatively, they grind up biscuits and mix them with water to create a makeshift meal for their babies."
Haj-Hassan mentioned that there is currently a surge in cases of diarrheal disease and respiratory tract infections, specifically pneumonia. These conditions are arising due to people seeking shelter in close proximity to one another.
Eman Bashir, a 32-year-old woman, expressed that a majority of the children she is aware of, including her own, are experiencing symptoms of diarrhea and vomiting. Eman, who is also residing in Khan Younis, had to relocate from the northern region due to the evacuation order issued by the Israeli army.
She added that she had heard of some women giving birth in schools because "most hospitals are not operational."
Lack of reproductive supplies poses ripple effects
The shortage of contraceptive products, as highlighted by the International Planned Parenthood Federation (IPPF) on Monday, is having an impact on various areas of women's health, including sexual health and menstruation. Heather Barr, the associate director of the women's rights division at Human Rights Watch (HRW), stated to CNN that one of the outcomes of insufficient access to contraceptive supplies is unintended pregnancies.
Barr cautioned that rates of sexual violence are prone to rise during crisis situations due to the sense of impunity present.
According to Bashir, a 32-year-old mother, women require essential hygiene products like sanitary towels and painkillers. She revealed that women experience immense discomfort, sleeping on bare floors without mattresses.
"Many pharmacies have halted operations," Bashir noted, expressing concern. "Even the medication commonly used by women to manage their menstrual cycles is now insufficient.
"We find ourselves reverting to ancient practices, where women resort to using fabric as makeshift sanitary protection during their periods. In this current predicament, women are unable to evade the inevitability of their monthly menstrual cycles."
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Amal, a displaced resident in Khan Younis, mentioned that she is aware of many women who use birth control pills to either halt or minimize menstrual bleeding. Those who do not use these pills resort to "traditional methods, such as washing clothes."
According to several relief workers interviewed by CNN, women in displacement camps face increased risks of infections due to inadequate access to clean and safe toilets, limited running water, and lack of privacy. These infections include thrush, hepatitis B, and toxic shock syndrome.
Nesma ElFar, MotherBeing's commercial director, revealed that the Cairo-based health platform has partnered with NGO Together For Tomorrow to deliver over 400,000 donations of sanitary products. These include pads, reusable panties, wipes, and diapers to the people in Gaza. ElFar shared with CNN that she has received confirmation of the products' arrival at the Rafah crossing, but is uncertain about when the aid will be distributed in Gaza.
Under fire, under death, under ethnic cleansing, under injustice
Palestinian mothers are balancing their own health care needs with caregiving responsibilities for their children, many of whom are affected by the psychological trauma of war.
According to Haj-Hassan, the bombardment by Israel has led to the separation of families and heightened the fear of death among children. She shared with CNN a disturbing incident relayed by one of her colleagues in Gaza, where a girl ran in front of a car approximately two weeks ago, expressing her desire to die. Haj-Hassan further explained that medical professionals refer to children in Gaza who have lost their families due to the war as "wounded children with no surviving family."
The city of Khan Younis in southern Gaza witnessed Israeli strikes on October 15, causing distressing scenes of children crying. Palestinian mothers who spoke to CNN expressed their helplessness in shielding their children from the unrelenting bombardment by Israel.
Ahmad Hasaballah/Getty Images
So many aspects of motherhood, once routine, are now a matter of life or death.
Every day, women in Palestine, particularly in Gaza, suffer the loss of their husbands, fathers, and brothers. Musleh, a 50-year-old woman seeking refuge in Al-Shifa, highlighted the dire circumstances they face. She expressed that they endure constant bombardments, the looming threat of death, and the oppressive reality of ethnic cleansing and injustice. Musleh lamented the world's silence in witnessing these atrocities unfolding before their eyes.
CNNs Nourhan Mohamed, Kareem El Damanhoury, Magdy Samaan, Aya Elamroussi, Nouran Salahieh, Sahar Akbarzai, Richard Roth, Abeer Salman, Mohammed Abdelbary and Rob Picheta contributed reporting.
