PFPPA's health worker in Gaza, Wafa, delivering SRH care to women in Rafah, Gaza, in February 2024. - Credit: IPPF
PFPPA's health worker in Gaza, Wafa, delivering SRH care to women in Rafah, Gaza, in February 2024. - Credit: IPPF

The forgotten women and girls in Gaza: A sexual and reproductive health catastrophe

As horrors continue to unfold by the minute in Gaza, the methodical onslaught on the sexual and reproductive health of women and girls in the territory highlights the vitalness of sexual and reproductive health, particularly around gendered violence.

Israel’s longstanding violations of international humanitarian law predate the 7 October. Control and brutality towards the sexual and reproductive rights of women and girls in Occupied Palestine have always existed as a systematic concern. Before October, 94,000 women and girls already lacked access to sexual and reproductive health services according to the United Nations Population Fund (UNFPA). This figure has now risen to over 1 million in under five months.

70% of casualties during Israel’s current military assault on Gaza, now amassing over 29,000 deaths in total, are women and children. Women and girls have historically been greater casualties in situations of conflict, apartheid, and genocide. In Gaza, the devastating, and ongoing, impacts are seen by the world in real-time. The situation is dire, with little to no access to hygiene, medicine, prenatal and post-natal care, and period supplies.

The United Nations estimated that 50,000 pregnant women were living in Gaza at the time of the initial besiege in October, and an estimated 183 women give birth every day – 15% of which will face some sort of complication. Alongside starvation, brutal hostility, and the very real threat of death and disease, reports of women undergoing labour and delivery without any form of medical aid have been made, including reports of Gazan women forced to undergo C-sections without anaesthesia.

Menstruating women and girls have no access to sanitary products, with many forced to use tent scraps and others missing their periods completely due to the stress. Women have been taking norethisterone tablets, which are typically recommended for disorders including excessive menstrual bleeding, endometriosis, and painful periods. Wafa, one of our healthcare workers at PFPPA told me, “There is lack of menstrual pads and women are using pieces of cloth and placing under them plastic bags, to avoid leakages on their clothing. At times, if they can find baby diapers, they use them after cutting them into a number of pieces.”

Our team on the ground in Gaza have been valiantly trying to support women and girls, whilst also losing their houses, and being forced to flee within Gaza several times, with constant concerns over their own and their families’ lives. Another of our midwives, Eman, told me earlier on in the crisis about a woman who was displaced from northern Gaza. She was pregnant and said that she had survived when evacuating her home and being under a belt of fire from the bombings. The woman was suffering from anaemia and inflammation in the stitches from the previous caesarean section she had not so long ago and from the size of her belly the stitches seemed to open and became infected. She was suffering from malnutrition and a lack of vitamins.

Another staff member relayed to me the horrors on the ground, “Women and babies are sleeping on floors in the cold and are being deprived of their most simple and basic rights.”

These are just some of the testimonies from thousands of cases of women’s sexual and reproductive health being compromised throughout this crisis. Pregnant women are miscarrying due to stress and shock, and the availability of medical facilities to birth safely is now virtually non-existent. Without a full and immediate ceasefire, we can expect to see this vicious cycle continue, with thousands more maternal and newborn deaths.

Since the beginning of February, our teams in Gaza have been providing pre-and post-natal care in the internal displacement camps, particularly in the Deir AlBAlah and Rafah areas. We have five teams, consisting of a social worker, midwives, and doctors, who are also distributing UNFPA menstrual hygiene kits to women and girls.

Within the last few days, concern over hundreds of Palestinian women and girls detained by Israel was voiced by the U.N. High Commissioner for Human Rights. It stated that at least two women had been raped and that others had been “subjected to multiple forms of sexual assault.”

The same report revealed that Palestinians in Israeli prisons endure daily violence, and Israel has detained thousands of Palestinians since the start of the war. Gendered violence towards women, often sexual based, is deliberately used as a war tactic in an attempt to humiliate women and girls.

The Israeli occupation in Gaza and the broader Palestinian territories amplifies the gender issue for Palestinians. Reproductive health and justice are issues in all conflict situations. This reality is acutely felt in Palestine.

The escalating situation in Gaza exposes the alarming fact of the sexual and reproductive health emergency that primarily impacts women and girls. Over a million people now lack access to basic amenities because of Israel’s ongoing breaches. The startling figures highlight the critical need for international attention and involvement, as do eyewitness testimonies of difficult deliveries and a shortage of essentials.

The struggle is made even more horrific by the intentional use of gendered violence. In these terrible circumstances, our unrelenting advocacy highlights the crucial importance of an immediate and lasting ceasefire and specific help for the neglected women and girls of Gaza.