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In their own words: The people providing sexual and reproductive health care under bombardment in Gaza

"Although our hearts and bodies are tired and sad, we are still alive," said Aya Sallut, a midwife.

Week after week, heavy Israeli bombardment from air, land, and sea, has continued across most of the Gaza Strip.

According to the Ministry of Health, at least 21,320 Palestinians have been killed in Gaza since October 7th, about 70% of whom are women and children. Nearly 2 million people have been displaced from their homes, forced to live in extremely overcrowded and unsanitary shelters. The Ministry of Health says that 50% of pregnant women in the shelters suffer from thirst and malnutrition, and there is a lack of health care and vaccinations for newborns. 

The suffering is unimaginable, yet it is all too real. 

Many of those bearing witness to the seemingly endless death and misery are frontline healthcare workers - including those delivering sexual and reproductive healthcare.

But they, too, are at risk of being killed just for doing their jobs.

Israel continues to bombard Gaza’s health facilities and residential areas, despite mounting international pressure for a ceasefire - something IPPF and many other humanitarian organisations have been demanding for months.

According to the World Health Organization (WHO) there have been more than 200 Israeli attacks on hospitals and ambulances since Oct. 7, with many medical workers detained during Israeli raids. At least 300 healthcare workers have been reported killed, according to the UN. This is more than the total number of health worker deaths recorded across all countries in conflict last year, and in any single year since 2016.  

Staff at IPPF's local member association, the Palestinian Family Planning and Protection Association (PFPPA), are among the heroic healthcare workers in Gaza that continue to provide care as best they can in the ongoing humanitarian catastrophe. We fear for their safety - and that of the 2.3 million civilians in Gaza - every single day.

In their own words, PFPPA and other health workers describe what it's like to provide care under bombardment and blockade in Gaza and in the West Bank - offering glimpses of terror, devastation, and even some hope. 

Wafa Abu Hasheish, health worker

"The health situation for women is deteriorating every day that goes by. Menstrual pads are almost totally unobtainable. Everyone keeps asking me to find them, but it's difficult. I don't know how to communicate with anyone; there is no internet or phone connection. 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 pieces. Women are feeling humiliated and are depressed for being forced to take such actions. 

Still, whether from my home, in shelters or now where I am displaced in a home with 50 others, I continue to provide daily services to women including treating reproductive infections, urinary tract infections, anemia, and other diseases. I have provided care to at least 480 women."


Narmeen Al Shafee, midwife

"A woman who has been displaced to the school shelters came to my house crying. Her face looked exhausted. She was in her seventh month of pregnancy. She was concerned about the reduced fetal movement after hearing a story about a pregnant woman in the shelter who lost her baby. She was afraid that the same thing was going to happen to her. She was saying that she couldn't feel her baby's movement.

The first thing I did was try to calm her down using what I learned from our colleagues at work, who are psycho-social worker specialists. Eventually, she smiled, and I asked her if she experienced any cramps or pain in the lower abdomen or back, or if there was any blood or mucus discharge. She said no. Afterwards, I measured the height of her uterus, which was appropriate for the gestational age. Luckily, I was able to find something sweet and a glass of juice in the house. I had her lie on her left side for about half an hour to ensure fetal movement. Indeed, there was movement, and she felt relieved. She and her family stayed with us, since our house is large and has unused rooms.

The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) clinics currently do not provide prenatal care. I told this woman that if anyone staying at the shelters has a problem and needs advice, she can give them my address and mobile number."


Noor Abu Ruwaida, psychologist

"The psychological situation is devastating for women and girls, especially during menstruation, pregnancy, or breastfeeding.

The challenges include a lack of personal hygiene and menstrual supplies, the absence of vitamins for pregnant women, no clothing for postnatal women or their newborns, and inadequate nutrition. Due to the lack of prenatal services, pregnant women only know about the health of the fetus at birth.

As a psychologist, I have encountered a woman who gave birth a week ago and was having difficulty with breastfeeding. I provided guidance on the importance of nutrition and gave her both mental and psychological support."

(Noor Abu Ruwaida is not pictured)


Omar, social worker

"Residents of Gaza are facing genocide. Everyone is appalled by wars worldwide, but in my city, it's a different story. Everyone shares the same fate. 

One evening, without warning, a loud blast shook my house and those around me. It turned out that the occupiers had launched explosive rockets at a neighbor's house, destroying it and claiming civilian lives. Survivors are now suffering from psychological trauma. 

The occupiers indiscriminately target everything. Recently, their warplanes struck a school in the Nuseirat camp, forcing all evacuees inside to flee. I witnessed families leaving the school with nowhere to go. I have been trying my best to provide humanitarian and psychological support to homeless women sitting in the street to the best of my ability and expertise.

Some women from the neighborhood sought refuge in my home. Everyone was in a state of shock and complete collapse due to the loss of loved ones and the terror of planes and missiles.

One woman was in shock, and unable to talk about anything but her martyred brother. Another woman trembled in fear from the missile that had destroyed part of her home.  It was a difficult night for all of them, but I tried to provide psychological support as best I could.

These women are just a small part of an entire population in need of varying degrees of psychological and health support. Psychological warfare plays a crucial role in breaking one's will and resilience to life."

(photo predates 7 October)


Eman, Midwife

"A woman who was displaced from northern Gaza got in contact with me. She was pregnant and said that she had survived from death when evacuating her home under a belt of fire from the bombings. The woman was suffering from anemia and inflammation in the stitches from the previous caesarean section she had. From the size of her belly, the stitches seemed to open and became infected. She was also suffering from malnutrition.

I gave her calcium and iron vitamins that I had available and I gave her advice about nutrition, how to take care of the stitches, and some advice about caring for her young baby.

The cost of menstrual pads is now four times the cost since before the war. A number of women are now using baby diapers, if they have access to them, instead of pads.

Bathing for women is extremely difficult. Some have no choice but to bathe inside a designated classroom within the school shelters. Water is extremely scarce and is not clean, which seems to be a factor in causing a number of infections such as urinary tract infections. Women have used pills to stop their periods.

This is part of the catastrophic situation that women are experiencing in the Gaza Strip."

(Eman is not pictured, photo from 2021)

Woman with contraceptive pill

Aya Sallut, midwife

"Although our hearts and bodies are tired and sad, we are still alive. 

Water is scarce as well as hygiene and cleaning products. Menstrual pads, when found, are very expensive and women and girls are using pads made from clothing.

Personal hygiene is very bad and there is no sufficient place to bathe. Most women just clean themselves in the bathrooms only with a toilet available as there is no other place. Women and girls have to buy hot water if they can afford it. The majority of women have two liters of water to clean themselves with. Women are also getting colds and the flu due to these cold baths and not having any warm place to stay. There are no treatments for these illnesses in the shelters.

There is a lack of sufficient nutrition for women and particularly pregnant women and postnatal women, and they are unable to clean themselves nor care for their newborns as needed. A vast majority of newborns are unable to get their vaccinations. Women and babies are sleeping on floors in the cold and are being deprived of their most simple and basic rights.

There are so many aspects that we are all suffering from … this must end."

(Aya Sallut not pictured)


Nama Abu Khalifa, social worker

"Since the beginning of the war on Gaza on October 7, 2023, there have been numerous obstacles for me to reach my workplace in Ramallah. Every morning and evening, I undergo physical inspection by the Israeli occupation forces at the checkpoints. Additionally, there are armed settler attacks on the roads, attempts to intimidate passersby, and the placement of iron gates to close the entrances and exits of the village, tightening the grip on its residents. The gates are closed and opened without any prior warning, making it difficult for me to return home. 

Due to these challenges, I often find it difficult to reach my workplace. As a social worker at PFPPA for more than 20 years, I acknowledge the importance that my work can make on people’s lives, especially for survivors of gender-based violence and that regardless of the circumstances that we face these services must be available. As such, I created a WhatsApp account to communicate with beneficiaries and assist them as much as possible. Additionally, I got in contact with local community-based organisations and arranged with them to conduct sessions for village residents, particularly focusing on topics of how to deal with stress and anxiety during emergency situations for both themselves and their family members."






Arab World



Related Member Association

Palestinian Family Planning and Protection Association (PFPPA)

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