Pregnant women and newborns face trauma, infection, malnutrition in Gaza under Israeli assault

An injured child is brought to the Al-Aqsa Hospital after the Israeli attack. (Getty Images)
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Updated 20 November 2023
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Pregnant women and newborns face trauma, infection, malnutrition in Gaza under Israeli assault

  • Even if they survive childbirth, mothers and babies are not out of danger as shortages threaten health and development
  • The siege of hospitals and blocking of aid deprive women in labor of pain relief and premature newborns of incubators

LONDON: What should have been a time of great joy and excitement has become a living nightmare for thousands of new and expectant mothers living under siege and constant Israeli bombardment in the Gaza Strip.

For Layla, 28, whose name has been changed for her safety, bringing a new life into the world at a time of so much death and destruction fills her with dread. “What worries me most is falling in love with life, amid all the death, once I hold my baby,” she told Arab News.

Like 5,500 other pregnant women in the Gaza Strip, Layla is due to give birth very soon amid a conflict between Israel and Palestinian militant group Hamas that has devastated healthcare infrastructure and deprived the population of access to nutritious food, clean water and public sanitation.

The closure of hospitals and clinics under the intense bombardment and chronic shortages of electricity, fuel and medicine are among the biggest challenges faced by the roughly 50,000 pregnant women in Gaza.




Prematurely born Palestinian babies in Shifa Hospital in Gaza City. (Dr. Marawan Abu Saada via AP)

As of Nov. 10, some 18 hospitals and 51 primary care centers across the embattled enclave are no longer operational, meaning fewer than 60 percent of hospitals and 30 percent of public health centers are operating to some degree.

Fikr Shalltoot, Gaza director for Medical Aid for Palestinians, or MAP, a British charity operating in the Palestinian enclave, said that pregnant women in Gaza “face a dire reality, with limited access to essential health services amid a near-total humanitarian disaster.”

“With over 180 births daily and a staggering 235 attacks on healthcare infrastructure since Oct. 7, the situation is critical,” Shalltoot told Arab News. This leaves women deprived of emergency obstetric services and forces many to give birth in unsafe conditions.

“Closed hospitals force births in shelters, homes and streets amid rubble, raising infection risks,” she said. “Maternity hospitals, like Al-Hilo, face attacks.”

Hospitals in Gaza have been on the frontline of the conflict, overwhelmed by wounded civilians since the start of Israel’s military campaign, which came in retaliation for the Hamas attacks of Oct. 7, which killed 1,200 and saw more than 200 people, both Israelis and foreigners, taken hostage.

Some 135 health facilities across Gaza have been damaged or destroyed. Although these facilities are protected under international humanitarian law, Israel claims Hamas has been using hospitals, particularly Gaza’s largest, Al-Shifa, to host underground command centers.




The aftermath of an explosion at the Ahli Arab hospital in central Gaza. (AFP)

Hamas and medical staff deny these facilities are being used to store weaponry, conceal hostages, or move fighters along a sophisticated network of tunnels. Israeli forces who took control of Al-Shifa on Wednesday are yet to provide evidence to support their claim.

There are at least 650 patients, including 22 in intensive care and 36 premature babies, at Al-Shifa, according to local media, in addition to some 400 medical staff. More than 2,000 Gazans have also taken refuge within the facility.

Amid the destruction and shortages, made worse by Israel’s restrictions on the entry of humanitarian aid into Gaza via the Rafah border crossing with Egypt, physicians have been forced to take extreme measures, such as performing cesareans without anesthetic or pain relief.

“Some women face complications while giving birth, and to stop the problem and because there are no (capabilities), tools, (or) time, (physicians) are faced with the extreme option to take out the uterus,” Soraida Hussein-Sabbah, gender and advocacy specialist at ActionAid Spain, told Arab News.

At Al-Awda Hospital, the only provider of maternity services in northern Gaza, doctors performed 16 cesarean C-sections last weekend under extremely challenging circumstances, according to local media.

Hussein-Sabbah said that although there are many trained and specialized obstetrics physicians and nurses in the Gaza Strip, as well as private and public maternity hospitals, “these cannot operate normally right now.”

INNUMBERS

• 50,000 Pregnant women in Gaza.

• 5,500 Women due to give birth soon.

• 180 Average number of births daily.

Despite this, “any specialized person found in a shelter, or any place … will continue serving as much as possible,” she added.

Elaborating on the dangers of conducting cesareans under such extreme circumstances, Zaher Sahloul, head of MedGlobal, a US-based medical NGO, said that while “doctors typically try to deliver as fast as possible,” performing such surgery requires them to “cut through multiple layers” and then “suture multiple layers.”

Performing such an operation without anesthetic, or even a partial dosage of pain relief, would be agonizing.

“It is, as you can imagine, an extremely traumatic experience, something that would be associated with PTSD,” Sahloul told Arab News. Medical professionals are also forced to discharge new mothers within three hours, which poses additional risks.

New mothers are typically monitored for a minimum of 24 hours because the postpartum period is associated with various complications, including hemorrhage. Even before the latest outbreak of violence in Gaza, “the two biggest causes of (maternal) deaths were bleeding and sepsis,” said Sahloul.

“The lack of water and sanitation puts them at an even higher risk of infection and sepsis. (Hospitals) do not (even) have any blood to transfuse these patients if they start to have complications.”

Even if they survive the ordeal of childbirth in these conditions, mother and baby are not out of danger. The lack of hygiene facilities, nutritious food, clean drinking water, safe sleeping spaces, and other basic comforts and necessities threaten health and development.




A Protester holds a placard at The Hague in support of Palestinian children. (Getty Images)

Fatty acid and vitamin deficiencies in lactating mothers can compromise newborns’ immune systems, putting them at risk of communicable diseases as well as cognitive development challenges, said Sahloul.

Fatema, another woman trapped inside Gaza, has resorted to using clean clothes to manage discharge as she lacks access to sanitary towels. Embarrassed, and with limited privacy, she has then buried those clothes, she told ActionAid.

More than 1.4 million Palestinians have been displaced since Oct. 7, according to the UN’s humanitarian office, OCHA. Many have set up makeshift tents outside hospitals, while others have squeezed into the corridors of schools or have slept out in the open.

MedGlobal’s Sahloul warned that with limited access to food and water, malnourished women face the risk of “preterm delivery,” which is also associated with fetal and neonatal morbidity and mortality.

Shalltoot of MAP, meanwhile, cautioned that as access to obstetrics services becomes increasingly difficult, “maternal deaths will rise, stress-induced complications soar, and malnutrition worsen, affecting childhood survival.” Moreover, “without fuel, premature babies relying on neonatal care face a life-threatening crisis.”

She added: “Maternity care at Al-Awda Hospital hangs in the balance. Doctors report a surge in premature births due to the bombing of homes, a heartbreaking crisis where premature deliveries are performed while mothers lay dying.”

Three premature babies at Al-Shifa died on Tuesday after the hospital’s neonatal intensive care unit was knocked out of operation. The lives of at least 36 others are in danger amid a lack of electricity and fuel for incubators, according to the facility’s director.

With women and children making up more than 70 percent of the casualties — one in four of them women of reproductive age — access to maternal health services is critical, said Shalltoot.




Palestinians queue as they wait to buy bread from a bakery, amid shortages of food supplies and fuel. (Reuters)

“Gaza is in urgent need of support to protect the lives of mothers and newborns,” she said, adding that “a ceasefire is imperative for pregnant women and infants.”

She said: “Without immediate access to fuel, aid, and medical experts, we face the looming threat of infectious diseases. Mass starvation, treatable deaths and a healthcare system in ruins are imminent unless swift action is taken.

“Opening multiple crossings is crucial to prevent a humanitarian freefall. Our plea is clear — act now to avert a catastrophic crisis.”

MAP has delivered a range of items, including medications and medical disposables that can be used to support delivery and the treatment of women and babies. “With our partner in Gaza, Ard El Insan, we have released all of our medications and food items for malnourished children and their families,” Shalltoot added.

Save the Children and ActionAid have also called for an immediate ceasefire and the opening of a humanitarian aid corridor.

“For this to happen, there is a need for a unified and coordinated call and pressure for the Rafah crossing to open, and the Israeli occupation forces to comply with international humanitarian law and allow for aid to come and civilians to be saved,” said ActionAid’s Hussein-Sabbah.

As of Nov. 14, at least 11,320 Palestinians have been killed in Gaza, of whom over 4,650 are children and more than 3,145 are women, according to the Hamas-run health ministry. A total of 198 medics have also died.

Earlier this month, Antonio Guterres, the UN secretary-general, described Gaza as “a graveyard for children” and “a crisis of humanity.”




A mother covers her child's face to protect from the smoke as Palestinians leave from the northern part of the Gaza. (Getty Images)

In a statement to Arab News, Save the Children said: “During this humanitarian catastrophe, civilians, especially children, continue to pay the heaviest price for the ongoing violence.

“Children are being killed at a devastating rate, whole families are being wiped from the registry, and a growing number of people, including children, are being left with no surviving family members.”

Attacks on schools and hospitals are considered “a grave violation against children by the UN and may amount to violations of international humanitarian law.”

Calling for an end to “the continued, systematic assaults,” the NGO said that “hospitals and schools cannot be battlegrounds, and children cannot be targets. Yet in Gaza, all three are attacked on a daily basis.

“Even during wartime, basic elements of humanity must prevail.”


Israeli ‘aggression’ targets Syria’s Homs countryside, state news agency says

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Israeli ‘aggression’ targets Syria’s Homs countryside, state news agency says

Blasts had been heard in the vicinity of Homs city and that the cause was under investigation

HOMS: Initial reports indicate that an Israeli “aggression” targeted two villages in northern and western areas of Syria’s Homs province, the Syrian state news agency said on Tuesday.
Earlier, Syrian state television said blasts had been heard in the vicinity of Homs city and that the cause was under investigation.
Israel has been carrying out strikes against Iran-linked targets in Syria for years but has ramped up such raids since the Oct. 7, 2023, assault on southern Israel by Hamas-led militants.

Saudi Arabia sends aircraft loaded with food, medical supplies to Lebanon

Updated 38 min 16 sec ago
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Saudi Arabia sends aircraft loaded with food, medical supplies to Lebanon

  • Saudi aid agency KSrelief has transported hundreds of tonnes of aid to region since October

RIYADH: Saudi Arabia sent its 24th relief plane to Lebanon on Tuesday with humanitarian supplies including food and medical aid.

The conflict between Israel and Iran-backed Hezbollah has intensified of late, forcing thousands of Lebanese to flee their villages and neighborhoods while under fire in southern Lebanon and the country’s capital, Beirut.

Arab nations like Saudi Arabia and the UAE have sent aid supplies to Lebanon to help those displaced.

The aid plane flying the latest mission took off from King Khalid International Airport near Riyadh and headed to Rafic Hariri International Airport in Beirut, the Saudi Press Agency reported.

A statement from the Saudi aid agency KSrelief said the aid deliveries showed that the Kingdom was “standing with needy and affected countries … in the face of crises and difficulties.”

KSrelief launched an initiative in October to transport hundreds of tonnes of medical supplies and food aid to Lebanon.


Childhood cancer patients in Lebanon must battle disease while under fire

Doctor Dolly Noun, a pediatric hematologist and oncologist, checks Carol Zeghayer, 9, a girl who suffers from leukaemia ahead of
Updated 26 November 2024
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Childhood cancer patients in Lebanon must battle disease while under fire

  • More than war, parents fear that their children will miss life saving chemotherapy treatment
  • Among the tens of thousands fleeing their homes among them are families with children battling cancer

BEIRUT: Carol Zeghayer gripped her IV as she hurried down the brightly lit hallway of Beirut’s children’s cancer center. The 9-year-old’s face brightened when she spotted her playmates from the oncology ward.
Diagnosed with cancer just months before the conflict between Hezbollah and Israel erupted in October 2023, Carol relies on weekly trips to the center in the Lebanese capital for treatment.
But what used to be a 90-minute drive, now takes up to three hours on a mountainous road to skirt the heavy bombardment in south Lebanon, but still not without danger from Israeli airstrikes. The family is just one among many across Lebanon now grappling with the hardships of both illness and war.
“She’s just a child. When they strike, she asks me, ‘Mama, was that far?’” said her mother, Sindus Hamra.
The family lives in Hasbaya, a province in southeastern Lebanon where the rumble of Israeli airstrikes has become part of daily life. Just 15 minutes away from their home, in the front-line town of Khiam, Israeli troops and Hezbollah fighters clash amidst relentless bombardments.
On the morning of a recent trip to Beirut for her treatment, the family heard a rocket roar and its deafening impact as they left their home. Israeli airstrikes have also hit vehicles along the Damascus-Beirut highway, which Carol and her mother have to cross.
The bombardment hasn’t let up even as hopes grew in recent days that a ceasefire might soon be agreed.
More than war, Hamra fears that Carol will miss chemotherapy.
“Her situation is very tricky — her cancer can spread to her head,” Hamra said, her eyes filling with tears. Her daughter, diagnosed first with cancer of the lymph nodes and later leukemia, has completed a third of her treatment, with many months still ahead.
While Carol’s family remains in their home, many in Lebanon have been displaced by an intensified Israeli bombardment that began in late September. Tens of thousands fled their homes in southern and eastern Lebanon, as well as Beirut’s southern suburbs — among them were families with children battling cancer.
The Children’s Cancer Center of Lebanon quickly identified each patient’s location to ensure treatments remained uninterrupted, sometimes facilitating them at hospitals closer to the families’ new locations, said Zeina El Chami, the center’s fundraising and events executive.
During the first days of the escalation, the center admitted some patients for emergency care and kept them there as it was unsafe to send them home, said Dolly Noun, a pediatric hematologist and oncologist.
“They had no place to go,” she added. “We’ve had patients getting admitted for panic attacks. It has not been easy.”
The war has not only deepened the struggles of young patients.
“Many physicians have had to relocate,” Noun said. “I know physicians, who work here, who haven’t seen their parents in like six weeks because the roads are very dangerous.”
Since 2019, Lebanon has been battered by cascading crises — economic collapse, the devastating Beirut port explosion in 2020, and now a relentless war — leaving institutions like the cancer center struggling to secure the funds needed to save lives.
“Cancer waits for no one,” Chami said. The crises have affected the center’s ability to hold fundraising events in recent years, leaving it in urgent need of donations, she added.
The facility is currently treating more than 400 patients aged from few days to 18 years old, Chami said. It treats around 60 percent of children with cancer in Lebanon.
For Carol, the war is sometimes a topic of conversation with her friends at the cancer center. Her mother hears her recount hearing the booms and how the house shook.
For others, the moments with their friends in the center’s playroom provide a brief escape from the grim reality outside.
Eight-year-old Mohammad Mousawi darts around the playroom, giggling as he hides objects and books for his playmate to find. Too absorbed by the game, he barely answers questions, before the nurse calls him for his weekly chemotherapy treatment.
His family lived in Ghobeiry, a neighborhood in Beirut’s southern suburbs. Their house was marked for destruction in an Israeli evacuation warning weeks ago, his mother said.
“But till now, they haven’t struck it,” said his mother, Suzan Mousawi. “They have hit (buildings) around it — two behind it and two in front of it.”
The family has relocated three times. They first moved to the mountains, but the bitter cold weakened Mohammad’s already fragile immune system.
Now they’ve settled in Ain el-Rummaneh, not far from their home in the southern Beirut suburbs known as Dahiyeh, which has come under significant bombardment. As the Israeli military widened the radius of its bombardment, some buildings hit were less than 500 meters (yards) from their current home.
The Mousawis have lived their entire lives in Dahiyeh, Suzan Mousawi said, until the war uprooted them. Her parents’ home was bombed. “All our memories are gone,” she said.
Mohammad has 15 weeks of treatment left, and his family is praying it will be successful. But the war has stolen some of their dreams.
“When Mohammad fell ill, we bought a house,” she said. “It wasn’t big, but it was something. I bought him an electric scooter and set up a pool, telling myself we’d take him there once he finishes treatment.”
She fears the house, bought with every penny she had saved, could be lost at any moment.
For some families, this kind of conflict is not new. Asinat Al Lahham, a 9-year-old patient of the cancer center, is a refugee whose family fled Syria.
“We escaped one war to another,” Asinat’s mother, Fatima, added.
As her father, Aouni, drove home from her chemotherapy treatment weeks ago, an airstrike happened. He cranked up the music in the car, trying to drown out the deafening sound of the attack.
Asinat sat in the back seat, clutching her favorite toy. “I wanted to distract her, to make her hear less of it,” he said.
In the medical ward on a recent day, Asinat sat in a chair hooked to an IV drip, negotiating with her doctor. “Just two or three small pinches,” she pleaded, asking for flavoring for her instant noodles that she is not supposed to have.
“I don’t feel safe … nowhere is safe … not Lebanon, not Syria, not Palestine,” Asinat said. “The sonic booms are scary, but the noodles make it better,” she added with a mischievous grin.
The family has no choice but to stay in Lebanon. Returning to Syria, where their home is gone, would mean giving up Asinat’s treatment.
“We can’t leave here,” her mother said. “This war, her illness … it’s like there’s no escape.”


Why has Israel increased its attacks on Syria?

Updated 26 November 2024
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Why has Israel increased its attacks on Syria?

  • The Syrian Observatory for Human Rights war monitor has recorded at least 86 Israeli attacks, with 199 Iran-backed fighters, Syrian soldiers and 39 civilians killed
  • Observatory head Rami Abdel Rahman said Israel has mainly hit border crossings, Damascus apartments, and the positions of Iran-backed groups

BEIRUT: Last week Israel launched its deadliest strikes on Iran-backed groups in Syria, killing more than 100 fighters in the latest escalation since two months of full-blown Israel-Hezbollah war spilled over.
What are the reasons for this escalation, and what exactly is Israel targeting in Lebanon’s neighbor Syria?
Israel intensified its strikes against Syria from September 26, days after launching an intense bombing campaign mainly targeting Hezbollah strongholds in Lebanon.
Since then, the Syrian Observatory for Human Rights war monitor has recorded at least 86 Israeli attacks, with 199 Iran-backed fighters, Syrian soldiers and 39 civilians killed.
On November 20, Israeli strikes on the city of Palmyra killed 106 Tehran-backed fighters, with one raid targeting a meeting of commanders.
It was the deadliest Israeli attack on Iran-backed groups since Syria’s war erupted in 2011, said the Britain-based Observatory which has a network of sources inside the country.
The casualties included 73 pro-Iran Syrian fighters, 11 of whom worked for Hezbollah which also lost four Lebanese members. The remaining 29 casualties were mostly from Iraq’s Al-Nujaba group.
On Monday, Israel struck again, this time at a crossing on the Syria-Lebanon border, the latest in a wave of attacks targeting such routes since September.
Observatory head Rami Abdel Rahman said Israel has mainly hit border crossings, Damascus apartments, and the positions of Iran-backed groups, including Hezbollah weapons and ammunition depots.
“Syria today has become a de facto part of Israel’s battlefield,” he said.
On November 19, Syrian Foreign Minister Bassam Sabbagh visited ally Tehran and condemned “more than 130” Israeli attacks on his country since the Gaza war started in October 2023.
These included an April 1 attack on an Iranian diplomatic building in Damascus that killed seven Islamic Republic Guard Corps members including two generals, triggering Iran’s first ever attack on Israel.
Since 2011, Israel has carried out hundreds of strikes in Syria, mainly targeting the army and Iran-backed groups.
Israel rarely comments on such strikes, but has repeatedly said it will not allow Iran to expand its presence there.
Israel’s military said Monday’s strikes targeted “smuggling routes to transfer weapons to” Hezbollah, and follow other operations against “Syrian regime smuggling routes” in recent weeks.
For Century Foundation analyst Sam Heller, “the deterrent balance that had existed between Hezbollah and Israel has broken down” since the Lebanon war.
“Israel is now bombing Lebanon at will, and additionally hitting what are purportedly Hezbollah and Iran-linked targets in Syria without fear of real reprisal” by the group.
“This all seems like an attempt by Israel to sustainably weaken Hezbollah,” as it pounds its “logistical lines via Syria and pushes for a resolution to the war that will prevent Hezbollah from resupplying and rebuilding,” Heller added.
Renad Mansour of Chatham House said Israel’s Syria strikes “targeted the financial and military supply chains that fuel the axis of resistance” — Iran-backed armed groups that include Hezbollah and Palestinian, Yemeni and Iraqi militants.
On Sunday, UN special envoy for Syria Geir Pedersen said it was “extremely critical” to end the Lebanon and Gaza fighting to avoid dragging Syria into a regional war.
Escalating Israeli attacks have added to the country’s woes after 13 years of conflict and successive economic crises compounded by Western sanctions.
Damascus has not responded to Israel’s attacks and has tried to distance itself from the Gaza and Lebanon wars.
“Any counterattack against Israel would invite massive retaliation against Syria’s leadership or essential infrastructure,” Heller said.
A source close to Hezbollah said “Syria’s role is not to attack Israel, but rather to serve... as a supply line from Iran and Iraq to Hezbollah.”
Tehran and Baghdad fear that Israeli strikes, which have already hit Yemen’s Houthi militants, could hit their territory even if a ceasefire is agreed, the source said, requesting anonymity to discuss sensitive matters.
Last week, Israel called on the UN Security Council to pressure Iraq into halting attacks launched by Iran-backed groups from its soil.
Tehran-backed Iraqi factions have claimed near-daily drone attacks on Israel in solidarity with allies Hamas and Hezbollah. Most of the attacks were intercepted.
The Baghdad government, which is dominated by pro-Iran parties, has accused Israel of trying to legitimize attacking Iraq, saying it was already taking measures to prevent attacks on Israel launched from its territory.
For more than a year, “Iraq has managed to stay relatively insulated from this wider regional war,” Mansour told AFP, adding that Iran and the United States also pushed for this.
But “in this time of transition between US President (Joe) Biden and (Donald) Trump, the Iraqi government is concerned that (Israeli Prime Minister Benjamin) Netanyahu has even more of a free hand to go after all the axis of resistance,” he said.


UK campaigners file emergency injunction over F-35 exports to Israel

Updated 26 November 2024
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UK campaigners file emergency injunction over F-35 exports to Israel

  • Move follows ICC issuing of warrants for Netanyahu, Gallant
  • ‘UK is now arming suspected war criminals,’ says Global Legal Action Network lawyer

LONDON: Campaigners in the UK seeking to block the sale of F-35 parts to Israel are applying for an emergency high court injunction after the International Criminal Court issued an arrest warrant for Israeli Prime Minister Benjamin Netanyahu.

The government has until Friday to file a defense against the campaigners from Global Legal Action Network and Al-Haq.

It is “unconscionable” that British manufacturers of F-35 parts continue to sell weapons systems that are used to kill Palestinians in Gaza, campaigners said.

On Nov. 18 at a high court hearing, the government admitted that potential damage to the UK-US relationship played a role in the continuation of exports.

In earlier hearings, ministers, some of whom have admitted that Israel is in breach of international law, were asked about the rationale for continuing exports.

The court was set to hear the case again in January next year.

Government ministers have said that F-35 parts enter a general export pool and that it is impossible to determine the destination of each part.

The Labour government reversed a decision by the former Conservative government to allow some arms export licenses to Israel to remain in place, finding a risk that the exports could be used to breach international humanitarian law.

GLAN lawyer Charlotte Andrews-Briscoe said: “It is unconscionable that the UK continues to allow British-made components for F-35s to be used in Israel’s extermination campaign against Palestinians.

“As of Thursday, the UK is now arming suspected war criminals who have been indicted by the world’s preeminent criminal court.

“For 13 months, GLAN and Al-Haq have argued that weapons sales to Israel are unlawful. When will it be enough? Does the UK government have any red lines?”

The emergency injunction follows the ICC’s issuing of arrest warrants for Netanyahu; former Israeli Defense Minister Yoav Gallant; and Hamas military chief Mohammed Deif.

The Israeli leader condemned the court’s decision as “antisemitic.”

GLAN and Al-Haq’s injunction is a sign of the impact caused by the ICC warrants.

Al-Haq spokesperson Zainah El-Haroun said: “The latest arrest warrants issued against Israeli Prime Minister Netanyahu and former Defense Minister Gallant for the commission of war crimes and crimes against humanity add to the insurmountable evidence that British weapons, particularly F-35 components, are being used to commit international crimes, including genocide.”