Healthcare system challenges in the Gaza Strip during armed conflict: findings from a cross-sectional survey of medical professionals

Authors

DOI:

https://doi.org/10.12923/2083-4829/2026-0020

Keywords:

health systems resilience, armed conflicts, health services accessibility, wounds and injuries, Gaza Strip

Abstract

Introduction. Armed conflicts place considerable strain on healthcare systems by damaging infrastructure, limiting access to essential medical resources and increasing demand for emergency care. This study assessed the functioning of the healthcare system in the Gaza Strip during the ongoing conflict from the perspective of healthcare professionals working in the region.

Material and methods. A cross-sectional survey was conducted between December 2023 and May 2024 among 57 health-care professionals working in six major hospitals in the Gaza Strip. The questionnaire assessed healthcare system performance, availability of personnel and medical resources and the types of injuries encountered in daily practice. Descriptive statistics, the chi-square test and the Wilcoxon signed-rank test were used for data analysis.

Results: The most commonly reported shortages involved dressing materials (26.0%), water (20.1%), medications (16.0%), and specialized medical equipment (12.4%). More than half of respondents reported that at least half of injured patients required immediate medical attention. The distribution of reported injuries associated with mortality differed significantly from the expected distribution (χ²(15) = 51.87; p < 0.001), with burns reported more frequently than expected. Respondents also reported a marked decline in the healthcare system performance after the onset of the conflict (mean score 2.82 vs. 1.49; Z=−5.55; p<0.001).

Conclusions: The findings show that the deterioration of healthcare delivery in the Gaza Strip is driven not only by damage to medical infrastructure but also by shortages of essential supplies and the increasing burden placed on healthcare workers. Overall, these challenges may limit the capacity to provide timely and effective care, particularly for patients with severe trauma. The strengthening of healthcare systems in conflict settings requires protecting healthcare personnel, maintaining reliable supply chains and ensuring uninterrupted access to essential medical resources.

References

1. Aly S, Surapaneni T, Subeh M, et al. Spatial-temporal patterns and typology of attacks against healthcare in the Occupied Palestinian Territory. East Mediterr Health J. 2025;31(2):59-67.

2. Palestinian Central Bureau of Statistics. Ramallah: PCBS. Available from: https://www.pcbs.gov.ps [cited 2023 Oct 15]

3. World Health Organization. Occupied Palestinian Territory: WHO Health Emergency Appeal 2026. Geneva: World Health Organization; 2026. Available from: https://www.who.int/publications/m/item/occupied-palestinian-territory--who-health-emergency-appeal-2026 [cited 2026 Sep 29]

4. Poole DN, Andersen D, Raymond NA, et al. Damage to medical complexes in the Gaza Strip during the Israel–Hamas war: a geospatial analysis. BMJ Glob Health. 2024;9(4):e014768. https://doi.org/10.1136/bmjgh-2023-014768

5. World Health Organization. HeRAMS occupied Palestinian territory: Gaza infographics April 2026. Geneva: World Health Organization; 2026. Available from: https://www.who.int/publications/m/item/herams-opt-gaza-infographics-2026-07 [cited 2026 Sep 29]

6. Safeguarding Health in Conflict Coalition. Care in the Crosshairs: Violence Against Health Care in Conflict 2025. Washington (DC): SHCC; 2026. Available from: https://www.insecurityinsight.org/wp-content/uploads/2026/04/2025-SHCC-Annual-Report.pdf [cited 2026 Sep 29]

7. Afzal MH, Jafar AJN. A scoping review of the wider and long-term impacts of attacks on healthcare in conflict zones. Med Confl Surviv. 2019;35(1):43-64. https://doi.org/10.1080/13623699.2019.1589687

8. Bielka K, Kuchyn I, Horoshko V. Intensive care units during the Ukraine war: challenges and opportunities. Intensive Care Med. 2023;49:1011-1014. https://doi.org/10.1007/s00134-023-07117-5

9. Gostin LO, Rubenstein LS. Attacks on health care in the war in Ukraine: international law and the need for accountability. JAMA. 2022;327(16):1541-1542. https://doi.org/10.1001/jama.2022.6045

10. Barten DG, Tin D, Granholm F, et al. Attacks on Ukrainian healthcare facilities during the first year of the full-scale Russian invasion of Ukraine. Confl Health. 2023;17:57. https://doi.org/10.1186/s13031-023-00557-2

11. Fouad FM, Sparrow A, Tarakji A, et al. Health workers and the weaponisation of health care in Syria: a preliminary inquiry for The Lancet-American University of Beirut Commission on Syria. Lancet. 2017;390(10111):2516-2526. https://doi.org/10.1016/S0140-6736(17)30741-9

12. Meier BM, Rice H, Bandara S. Monitoring attacks on health care as a basis to facilitate accountability for human rights violations. Health Hum Rights. 2021;23(1):55-70.

13. Agresti A. Categorical data analysis. 2nd ed. Hoboken (NJ): John Wiley & Sons; 2002.

14. George D, Mallery P. IBM SPSS statistics 26 step by step: a simple guide and reference. 16th ed. New York: Routledge; 2020.

15. Górska E. Development aid in Palestine: wrong assumptions and maintaining the status quo. Politeja. 2019;16(4):317-339. https://doi.org/10.12797/Politeja.16.2019.61.18

16. Blanchet K, Najem M, Shadid L, et al. Rebuilding the health sector in Gaza: alternative humanitarian voices. Confl Health. 2024;18(1):42. https://doi.org/10.1186/s13031-024-00599-0

17. Abed Alah M. Echoes of conflict: the enduring mental health struggle of Gaza healthcare workers. Confl Health. 2024;18(1):21. https://doi.org/10.1186/s13031-024-00577-6

18. Lamberti-Castronuovo A, Valente M, Bocchini F, et al. Exploring barriers to access to care following the 2021 socio-political changes in Afghanistan: a qualitative study. Confl Health. 2024;18(1):36. https://doi.org/10.1186/s13031-024-00595-4

19. Abreha BB, Fisseha G, Tsadik M, et al. Under-five mortality during the war in Tigray: a community-based study. Confl Health. 2024;18(1):55. https://doi.org/10.1186/s13031-024-00614-4

20. Mahgoub EAA, Khairy A, Osman S, et al. War and education: the attacks on medical schools amidst ongoing armed conflict, Sudan 2023. Confl Health. 2024;18:23. https://doi.org/10.1186/s13031-024-00584-7

21. Makali SL, Lembebu JC, Boroto R, et al. Violence against health care workers in a crisis context: a mixed cross-sectional study in Eastern Democratic Republic of Congo. Confl Health. 2023;17:44. https://doi.org/10.1186/s13031-023-00541-w

Downloads

Published

2026-10-01

How to Cite

Obel, K., & Zabkowski, T. (2026). Healthcare system challenges in the Gaza Strip during armed conflict: findings from a cross-sectional survey of medical professionals. Polish Journal of Public Health, 136, 109-112. https://doi.org/10.12923/2083-4829/2026-0020