Why women, children are disproportionately impacted by the conflict in Gaza: Experts

(NEW YORK) — Women and children in Gaza are bearing the brunt of the Israel-Hamas war, according to United Nations agencies and experts.

More than 10,000 people have been killed in Gaza since the conflict began Oct. 7, and more than 25,000 others injured, the Hamas-run Gaza Health Ministry said Monday. Since Hamas launched its surprise terror attack on Israel, at least 1,400 people have been killed and more than 6,900 others injured in Israel, the Israeli prime minister’s office said Monday.

As of Friday, 67% of all deaths in Gaza were made up of women and children while thousands more have been injured, according to several U.N. agencies, including the United Nations Children’s Fund (UNICEF), the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), the United Nations sexual and reproductive health agency (UNFPA) and the World Health Organization (WHO).

In war zones, men often take combatant roles while non-combatants are overwhelmingly women and children — as well as the elderly, experts said.

“What it does is limit access to health care for them for many reasons, it may be the health care facility is destroyed or there’s no access to the facility or there’s no equipment, things like that,” Dr. Harry Johnson, an OB-GYN at the University of Maryland Medical Center who has experience practicing in war zones, told ABC News.

Israeli Minister of Defense Yoav Gallant has said the Israeli military is doing everything possible to prevent civilian loss of life. Humanitarian agencies have repeatedly warned of an unprecedented humanitarian crisis unfolding in Gaza amid Israel’s total siege.

Air raids and bombardments have damaged several facilities, including hospitals, limiting access to care, particularly for pregnant people and children.

As of Friday, an estimated 50,000 women are pregnant in Gaza with 5,500 due to give birth in the next 30 days, according to the UNFPA. About 15% may experience pregnancy-related or birth-related complications requiring medical care, the health agency said.

Johnson said in traditional prenatal care, common conditions like diabetes and hypertension would be taken care of. But with a conflict, that care may be lost, which could have a negative outcome on the pregnancy, the health of the mother and the health of the baby.

Dr. Dabney Evans, an associate professor of global health in the Rollins School of Public Health at Emory University, said blockades might be preventing people from accessing care and, additionally, medical centers might be so overwhelmed with those who have been physically injured that it’s hard to provide services to those needing medical care in other areas.

Doctors in Gaza have said health care facilities are overcrowded, with workers dealing with a lack of supplies to treat patients.

Humanitarian organizations, including the World Health Organization and agencies that are part of the United Nations, are calling for an immediate cease-fire to allow aid such as food, medicine and fuel supplies to enter Gaza. Some people in Gaza were given clearance to leave for the first time on Nov. 1 via Egypt’s Rafah border crossing since the Oct. 7 attack, with limited aid flowing into Gaza.

“Being able to provide the medicines and the services that are essential for folks,” Evans said. “We know with the conflict that’s been going on, there have been limitations on fuel, water, and that’s creating a crisis in and of itself. Hospitals and health facilities require fuel, for example, to keep incubators running.”

However, Israeli officials have resisted allowing fuel shipments into Gaza, noting that Hamas militants have stored fuel.

The WHO says there are currently 130 premature babies in neonatal intensive care units in Gaza who might be affected if fuel runs out and incubators and other medical equipment no longer work.

Not being able to get to a hospital may force some women to give birth in shelters or in their homes without a medical professional present, which can increase the risk of perinatal death.

It’s not just pregnant women whose care is disrupted, but also those who need other reproductive services.

“After your reproductive years, women can have quite a bit of medical problems,” Johnson said. “Some of them maybe resulted from their childbirth or menopause. A lot of different things that are specific to women that oftentimes are not cared for during time of conflict because the facility or the physicians or nurse midwives or nurse practitioners are not available to the patient.”

He said women who were on hormone therapy or scheduled to have fibroids treated or to end urinary incontinence also see their care disrupted and, in many cases, cut off.

In addition, women and children who are left behind in cities and towns may not have access to clean water, increasing their risk of diarrheal diseases, or access to food, which increases the risk of malnutrition, the U.N. agencies warned.

Women and children stuck in conflict areas are also at increased risk of mental health struggles.

“This is true for, both carers and mothers — whoever may be doing the caregiving — as well as children, which is that there’s a lot of traumas happening,” Evans said. “Whether they are experiencing direct physical injury or not, they are seeing and witnessing a lot of things which are very, very troubling and so those are going to have both short- and long-term effects on mental health.”

She added, “I think it’s really important for individuals and for state governments to take note that multiple U.N. agencies are coming together in this moment and what they are telling us is that a better response is needed. It’s a really important signal … that this is a moment, this is a crisis in which we are being called to pay attention, and we must respond.”