Healthcare Access, Conflict, and Political Constraint in Gaza

In Gaza, healthcare is survival in its rawest form. It isn’t about waiting for appointments or choosing a doctor. It is about whether care exists at all, whether you can reach it alive, and whether it has anything left to offer once you do.

Dr. Feroze Sidhwa, a surgeon from California, volunteered at the European Hospital in Khan Younis. He had seen mass-casualty events before, including the Boston Marathon bombing. But Gaza is different. Here, the disaster happens every day. Half the patients he treated were children. There were never enough beds, staff, or supplies. Even if the Strip had a hundred times more hospitals, they would still be overwhelmed, he said.

The hospital wasn’t just a medical facility. It was shelter. Families whose homes were destroyed slept in hallways, stairwells, and outside operating theatres. People came for electricity, running water, a tiny fragment of safety. Sewage systems were failing. By day 3, every member of Dr Sidhwa’s healthcare team who had come to Gaza together to volunteer was experiencing diarrhoea. Infection spread fast.

Fuel shortages made everything worse. The Palestinian Red Crescent ambulance network couldn’t respond to every call. They mapped the territory and only sent ambulances when casualties were confirmed. Moving patients through rubble-strewn streets, lifting cement, waiting for permission, it all delayed care. Electricity in operating rooms ran almost continuously, but the rest of the infrastructure strained under the load.

Triage became a daily moral and medical challenge. Children under five suffered from severe diarrhoea and respiratory infections. Pregnant women with type 1 diabetes faced life-threatening complications, no insulin, little food. Minor injuries, if untreated, became fatal. The slow deaths piled up alongside the immediate ones.

Attacks on healthcare made it worse. Since October 2023, WHO documented over 720 strikes on hospitals, killing at least 1,580 health workers. Ambulances were targeted 144 times. Essential medicines were at zero stock in 46% of cases. No hospital in Gaza is fully functional. Of 36 hospitals, half operate only partially. Primary care centres are worse: just 1.5% are fully functional, 46.5% partially.

The toll on children is staggering. Over 11,000 have injuries that will cause permanent disability. Four thousand urgently need medical evacuation for care that doesn’t exist inside Gaza. More than 18,500 patients are waiting to leave. At least 1,000 have already died while waiting for permission to travel. Minor infections escalate. Malnutrition and dehydration silently claim lives. Hospitals operate at capacity. Corridors overflow with the sick and displaced. Even simple interventions are often impossible.

Political constraints shape every decision. Dr. Sidhwa emphasises that humanitarian medicine in Gaza cannot be separated from politics. Restrictions on fuel, supplies, and movement are not accidents. Airstrikes, blockades, and selective resource deliveries dictate what is possible in practice. Doctors can work miracles, but they cannot treat what never reaches them.

Mental health frays alongside physical health. Children witness trauma daily. Families endure hunger, displacement, and constant fear. Caregivers improvise solutions that would be unnecessary anywhere else. Dr. Sidhwa calls it a form of ‘continuous, structural violence,’ where survival is a constant negotiation of scarcity.

Beyond trauma, routine medical needs collapse. Pregnant women wait for insulin or safe food. Children with chronic conditions deteriorate without medicine. Minor infections escalate. Malnutrition and dehydration steadily kill. Hospitals operate at full stretch. Even simple treatments become impossible.

The long-term consequences are bleak. Gaza’s healthcare system, already fragile before October 2023, faces generational setbacks. Training pipelines for doctors and nurses are disrupted. Facilities are destroyed. Supplies run out. Even if the fighting stopped tomorrow, the backlog of untreated injuries, chronic illness, and maternal care would take years, maybe decades, to clear.

International support is minimal and slow. UNICEF’s Humanitarian Action for Children 2026 appeal requires US$673.8 million, yet only 1.4% has been funded. Hospitals struggle to provide basic care. Families improvise. Children die from preventable conditions. Political decisions that constrain access continue unabated.

Dr. Sidhwa insists medical professionals have obligations beyond operating theatres. In Gaza, witnessing the consequences of policy, on fuel, access, and weapons, demands advocacy. ‘We have to speak the truth,’ he says. ‘Do no harm isn’t enough if people are systematically deprived of care.’

The crisis is not abstract. It is lived in crowded wards, in children with preventable infections, in pregnant women without insulin. It is measured in hours lost, lives postponed, families rearranged around scarcity. Care is limited not just by war, but by the political machinery that allows suffering to continue. Even the most skilled surgeons can only respond to what the system lets them see. The rest, too many lives, slip away.

Further information and opportunities to engage with organisations working in this area are listed below:
https://www.map.org.uk/
https://www.palestinercs.org/en
https://www.unrwa.org/

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