The situation in Gaza is rapidly evolving into the worst humanitarian crisis in modern memory, and international health organizations have no long-term plan to address the region’s post-war needs.

More than three-quarters of Gaza’s 2.2 million residents, half of whom are children, are internally displaced, trapped in one of the world’s most densely populated areas and without access to food, water, or health care. Since October 7, when Hamas militants in Gaza invaded Israel, killing more than 1,000 civilians, Israel has heavily bombed the enclave, disrupting the flow of humanitarian aid and destroying civilian infrastructure. As a result, more than 30,000 Palestinians, mostly women and children, were killed, and more than 72,000 were injured in Gaza, according to the United Nations.

But these numbers only mark the beginning of a public health disaster. Those who survive the war will face lifelong health effects. Thousands of Palestinians will be living with missing limbs, weakened immune systems, mental illnesses, and other chronic illnesses. Meeting their health needs will be a decades-long undertaking, and no global aid organization has adequately planned for it.

The World Health Organization, World Food Programme, UNICEF, Palestine Red Crescent Society, CARE International, Mercy Corps, and Médecins Sans Frontières all have specific projects to address health needs in the Gaza Strip, according to information shared by the organizations. Lack of long-term planning. new scientist. Save the Children and the International Committee of the Red Cross did not respond to questions about long-term plans.

unprecedented humanitarian disaster

The lack of planning for health needs in the coming decades contributes to the enormity of the current humanitarian crisis. Most of Gaza’s residents live in crowded conditions without sewage treatment or garbage removal. On average, people can consume less than 1 liter of clean water per day. As a result, infectious diseases spread.

A survey conducted in a limited number of shelters in December and January found that at least 90% of children under 5 years of age have one or more infections, and 70% have experienced diarrhea within the past 2 weeks. “And it doesn’t take into account the hundreds of thousands of people who are not in refugee shelters,” he says. Margaret Harris At WHO.

Hunger is also widespread. Almost two-thirds of households have one meal a day, and a quarter of the population faces imminent hunger and extreme malnutrition. The situation is most dire in northern Gaza, where one in six children is malnourished, according to the study. The Gaza Ministry of Health reported on March 7 that 20 people had died, including: 15 children Some died from malnutrition and dehydration. Inadequate monitoring means these numbers could be even higher.

“The problem with child malnutrition is that it causes further disease,” says Tanya Hadji-Hassan of Médecins Sans Frontières. Malnourished children are more susceptible to infections, and the lining of their intestines wears down, making it difficult to absorb nutrients. “So they become even more malnourished, their immune system weakens, and it just creates this vicious cycle that snowballs into death,” she says.

Bombing left much of the territory in danger. By December, UNICEF 1000 children On average, more than 10 children per day have lost one or both legs since the conflict began. And there are few options for receiving treatment for these injuries. As of February 21, only 18 of Gaza’s 40 hospitals are still functioning, but with reduced capacity. “They don’t have drugs. They don’t have machines. They don’t have power. They might have a few doctors running emergency rooms. So there’s not really a functioning medical system. I don’t,” he says. serena victor At Mercy Corps.

The overwhelming humanitarian crisis has thrown health institutions into chaos. “Never in modern history have we seen this level of violence, terror, fear, and deprivation perpetrated against any nation,” Harris said. “In a sense, we are exploring uncharted territory.”

Gaza’s impending public health crisis

Even if the war were to end tomorrow, survivors would face lifelong health consequences. Many will have physical disabilities. Some people suffer from severe mental illness. Some people develop chronic lung disease, heart disease, and cancer from chemical contaminants in bombs and destroyed buildings, Harris said.

The effects will be most severe on children. Sustained malnutrition early in life stunts growth and impairs brain development, leading to deficits in cognition, memory, motor function, and intelligence, Haji Hassan said. Your child’s immune system will also be weakened, making them more susceptible to illness. Studies have shown that malnutrition during pregnancy increases the risk of your baby developing obesity, high blood pressure, heart disease, and type 2 diabetes.a February report One in five pregnant women treated at Gaza clinics was malnourished, as was one in 10 children seen there, according to research by the international aid group Project Hope.

But the most widespread harm may be the impact on mental health, Harris said. “Imagine what it’s like for people who are going through this situation relentlessly every day. They feel terrible uncertainty. Where to go, what will happen next? You never know where your next bit of food is going to come from,” she says. Such traumatic experiences are associated with depression, anxiety, post-traumatic stress disorder (PTSD), and suicidal thoughts. For children, this trauma can disrupt brain and organ development and increase the risk of learning disabilities and mental health conditions. Without early intervention, these problems can persist into adulthood. “There’s going to be a huge burden of mental illness going forward, and it’s going to be very difficult to deal with,” Harris said.

Even adults who experienced adversity in childhood 12 times more risk Develop alcohol and drug use disorders and attempt suicide. They are also more likely to have physical health conditions such as heart disease and cancer. Young people who survive conflict are almost three times more likely to develop severe mental illness, including psychosis, than young people who have not experienced war.

Current postwar plans are not enough

Given these results, there is a need to establish a long-term health plan for Gaza. Such plans should address rebuilding infrastructure, developing mental and physical rehabilitation programs, and regular disease screening.

“It seems ridiculous for city officials to say what will happen now when people are dying trying to get a handful of bread for their families. It just doesn’t do the math,” Victor said. Masu. “But we need to think about it.”

But most organizations are just getting started. The few organizations that have protocols in place, such as the Palestinian Red Crescent Society and CARE International, are working for the next year or two, but not for decades. WHO is developing a plan to address health needs from April 2024 until the end of the year. “We are working on several different scenarios. A good scenario would be a ceasefire, so that we can really look at things. [long-term plans]” says Harris. Another possibility is that there is a war going on.

This uncertainty, along with the pressing question of who will govern Gaza in the aftermath of the conflict, makes preparing for the future extremely difficult. “The reason why we so desperately want not just a ceasefire, but a peaceful solution, is because until that happens, any plan or even consideration is just a castle in the air,” Harris said. says.

Israel restricts aid groups’ access to the area, making the few workers in Gaza unable to operate safely. “Half the time they can’t do anything. They can’t move around safely. Basic things like communications continue to be cut off,” Victor says. And many of them died. For example, a 29-year-old man who is a member of WHO’s limb reconstruction team in the Gaza Strip. Dima Abdullatif Mohammed AlhajiHarris said she was killed along with her six-month-old baby, two brothers, and her husband in an Israeli airstrike.

These risks and obstacles complicate long-term planning. “You can make any plan you want, but if you don’t know your needs, you won’t have a very useful plan,” he says.