GAZA STRIP, Occupied Palestinian Territory – "My family and I have been displaced more than 18 times,” Riman said last week, shortly before the current ceasefire took effect. “We are staying in a place that feels like a grave."
Riman and her family had recently fled northern Gaza to Khan Younis, on foot, with what little they could carry. Riman is pregnant and terrified of childbirth under current conditions, her body weakened by starvation, exhaustion and fear. Hunger is never far from her mind, and she faints constantly during the day due to lack of food.
A crisis for mothers and pregnant women
An estimated 55,000 pregnant and breastfeeding women are suffering from acute malnutrition in Gaza, fueling catastrophic birth outcomes for mothers and newborns. One in three pregnancies is high risk, and premature and low-birth-weight infants now account for 60 to 70 per cent of newborns, compared with 20 per cent before October 2023.
After two years of relentless conflict, access to maternal health care is extremely limited. Gaza’s health system lies in ruins – around 94 per cent of hospitals are damaged or destroyed and around a third of health facilities have been impacted.
“It costs 50 shekels [around $15] to get to Al-Aqsa Hospital. I don’t even have 5 shekels [$1] right now. I can barely take care of my children,” Riman told UNFPA, the United Nations sexual and reproductive health agency.
She is, however, holding onto hope, and her plea is simple and universal: "The first thing we need is safety. We don’t want more bloodshed. We want stability."
Nour is also pregnant and displaced, and acutely aware of the conflict's impact on her fetus. "I could feel the baby kicking and reacting fearfully to the sound of bombings," she told UNFPA as the ceasefire was being brokered.
Nour has not been able to access antenatal care, further compounding her anxieties about her and her baby’s health. Despite the overwhelming difficulties, her hope for her child's future remains a powerful driving force: "I pray that when my child comes into this world, it will be better."
Children born into conflict
Iman and her family were one of 450,000 people who recently fled Gaza city when Israel stepped up its military assault. Her family has been displaced so many times they’ve lost count. She recently gave birth and managed against the odds to get to a hospital, but following childbirth, had to walk back to her family’s tent on foot.
Weeks later, her newborn and children have been sleeping on the family’s only blanket on the ground, and Iman is constantly afraid that stray dogs will attack them at night. There is no clean water, and insects and mosquitoes plague them.
Iman is also struggling to keep her newborn alive: "When he was two weeks old, the baby formula ran out, and there was nothing else to feed him. He became malnourished… I was forced to feed him a biscuit, even though I knew it was dangerous."
Iman’s plea is fueled by exhaustion: “We just want to rest. We don’t want to hear the sounds of bombing and gunfire anymore. We want to return home.”
A fragile hope and urgent needs
The recent ceasefire agreement offers a much-needed, long-overdue glimmer of hope for Palestinian women. But while it may have ended the fighting, it has not ended the crisis. After two years of relentless suffering, women have been left with nothing – no food, no water, no shelter, no healthcare, no peace of mind.
UNFPA is scaling up its response in Gaza to sustain and restore life-saving services for women and girls, including maternal healthcare. On 12 and 13 October, desperately needed medical equipment and supplies that were prepositioned inside the Strip, including delivery beds, fetal monitoring machines and incubators, were delivered to UKMed, Kuwaiti, International Committee of the Red Cross and Red Crescent, Al-Awda, Nasser, Al-Khair, and Palestinian Red Crescent Society hospitals.
More life-saving supplies are en route to further strengthen and restore reproductive health services across Gaza.
Still, winter is approaching, and there is no time to lose. This must not be another false dawn; the ceasefire must be sustained and respected, all crossings must be opened, and a massive flood of aid must enter Gaza.
The unique needs of women and girls must be central to the immediate humanitarian response, and in the longer term, they must be empowered and supported to heal, thrive, and lead the rebuilding of their communities.
