In Gaza, becoming a mother is a matter of life and death

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(CNN) — Rajaa Musleh, 50, has been taking refuge at Al-Shifa Hospital, Gaza’s largest medical facility, which is overrun not only with patients but also with displaced people who are desperate for treatment. The hospital was able to provide some protection from Israel’s brutal air strikes.

The Gaza representative of U.S. healthcare NGO MedGlobal fled his home on the northern coast of the Gaza Strip after the Israeli military declared war on Hamas and called on civilians to evacuate the area in response to a deadly terror attack on October 7. Travel to Shifa. Operate on the ground.

The United Nations Office for the Coordination of Humanitarian Affairs said on Monday that more than 1.4 million people have been displaced in Gaza. Many civilians have been forced to flee to refugee camps or hospitals that have exceeded capacity, often living in unsanitary conditions.

She said Shifa Hospital was overcrowded, with many women and girls sleeping on the hospital floor and outside without access to physical or mental health care, water or privacy.

“Women were on the streets and in the hospitals,” Muslay said. “Personally, I can’t go to the bathroom more than twice a day…in a crowded situation.”

“Some people are lucky if they have the opportunity to use a bathroom that 40, 50 or 60 people need to use.”

Muslay is one of hundreds of thousands of women in Gaza facing a desperate health crisis as Israel’s sweeping blockade of the Strip restricts critical reproductive supplies, including pregnancy, postpartum and menstrual products, as well as basic necessities such as drinking water and food. Meanwhile, mothers say they face the desperate reality that they have no way to protect themselves or their children from Israel’s relentless bombing, which has hit residential areas, hospitals and schools.

Israeli airstrikes have killed at least 9,155 people, according to figures released by the Palestinian Health Ministry in Ramallah from sources in the Hamas-controlled enclave. According to the Ministry of Health, the vast majority of those who died (73%) were women, children and the elderly.

Rights groups say Israel’s massive bombing of civilian areas, evacuation orders and complete blockade of territory constitute war crimes. Israel said it was targeting Hamas operatives in Gaza, adding that the armed group “deliberately buries its assets in civilian areas” and uses civilians as human shields.

Shortages push women and the hospitals that treat them to the brink

Reham Ahmed Saadi dreamed of having a baby girl. Now nine months pregnant with her second child, she is preparing to give birth in a war zone while trying to keep her family afloat.

In a message forwarded to CNN by the Palestinian Medical Relief Association, the 28-year-old said she was terrified of every aspect of giving birth amid intense conflict: “From preparing baby and postpartum supplies, to traveling to the hospital during delivery, and safely discharged from the hospital after delivery.”

“The war destroyed the joy of my pregnancy,” she added.

Dr Tanya Haji-Hasan, a pediatric intensive care physician with Doctors Without Borders (Doctors Without Borders), said severe shortages of water, food and medicine were causing “an avalanche of human suffering” in Gaza hospitals.

She told CNN that medical staff on the strip have run out of basic supplies, including gauze for wound care and external fixators, the needles and rods needed for orthopedic surgeries. They were forced to treat injured survivors without anesthesia or painkillers.

Rafah, the only crossing point between Gaza and Egypt for Palestinians or aid in and out, remained closed in the early weeks of the war. It was recently partially opened to allow a small number of aid trucks to trickle through, as well as a limited number of injured Palestinians and foreigners.

The Palestinian Health Ministry said on Wednesday that nearly half of its hospitals were now out of service due to a lack of necessary fuel supplies and continued bombing.

In stressful situations, women are more likely to miscarry or give birth prematurely, endangering “the survival of the baby,” Haji-Hasan said. For patients who rely on medical equipment such as ventilators or dialysis machines, reduced power supply is a death sentence.

She added that premature babies require incubators, ventilators and infusion pumps to recover, all of which rely on electricity. “Without these things, those premature babies wouldn’t survive.”

On Monday, humanitarian agency Care International reported that pregnant patients were being forced to undergo emergency caesareans without anesthesia. According to CARE, women can be discharged from hospital after just three hours after giving birth due to lack of hospital capacity.

CARE Country Director for West Bank and Gaza Hiba Tibi said food shortages pose a threat to the health of 283,000 children under five years old, as well as pregnant or breastfeeding women.

Palestinian women use an open fire to cook at a shelter for displaced families, mainly from the northern Gaza Strip, at a UN-run school in Rafah, southern Gaza Strip, October 27, 2023, amid ongoing fighting between Israel and Israel Traditional unleavened bread. and the Palestinian Hamas movement.  (Photo by SAID KHATIB/AFP) (Photo by SAID KHATIB/AFP via Getty Images)

Haj-Hassan said some of his colleagues in Gaza only have access to 33 milliliters (about 1.12 ounces) of drinking water per day – a fraction of a glass of water – warning that reduced supplies could prevent mothers from breastfeeding their babies or Ability to feed infant formula.

Amal, who was displaced from her home in Gaza City to Khan Younis in the southern Gaza Strip, is nine months pregnant and nervously awaiting her birth.

“What if I need a caesarean section? How will I give birth? There is no generator in the hospital. What if the remaining power runs out? What is more dangerous than this is that there is no anesthetic. The hospital has no medical services. There are no health facilities,” citing safety concerns , Amal asked CNN not to use her real name.

Her next pressing question: how to care for her children. The limited water had to be boiled with wood or old gas before it could be consumed.

“If you can get a bucket full of water, you’re lucky,” Amal said. “(The mother) is feeding the baby adult milk. They boil it. Or (to feed the baby) they crush some cookies and add water and stir them together. “That’s a meal. ”

Haji-Hasan said there have been outbreaks of diarrheal diseases and respiratory infections, including pneumonia, as people live in closed settlements.

Eman Bashir, 32, said most of the children she knew, including her own, “suffered from diarrhea and vomiting.” The mother of three, also in Khan Younis, She was displaced from the north after the Israeli army issued an evacuation order.

She added that she had heard of some women giving birth in schools because “most hospitals cannot operate”.

Conflict is affecting every aspect of women’s health, from sexual health to menstruation.

The International Planned Parenthood Federation (IPPF) reported on Monday that contraceptive products are in short supply. Heather Barr, deputy director of women’s rights at Human Rights Watch (HRW), told CNN that one of the consequences of unmet demand for contraceptives is unintended pregnancy.

Barr warned that rates of sexual violence could increase in crisis situations “because there is a sense of impunity.”

“Women need sanitary products, pads, painkillers. “Women are in huge pain, they sleep on the floor without mattresses,” mother Bashir, 32, told CNN.

“Most pharmacies have ceased operations,” Bashir added. “Even medications (which women take to stop their periods) are no longer enough.

“We have started to go back to ancient times, when women used cloth patches during their menstruation. “In this case, women cannot avoid facing menstruation. ”

Ibrahim Dahmanpkg

CNN producer and family living in Gaza document their survival

Amal, a resident displaced to Khan Younis, said she heard that many women use birth control pills to stop or reduce blood flow during menstruation. Those who don’t, she said, use “old methods, washed clothes.”

Multiple aid workers told CNN that displaced women are likely living in camps where a lack of clean and safe toilets, running water and reduced access to privacy can lead to thrush, hepatitis B and toxic shock syndrome. Infections such as disease spread.

Nesma ElFar, commercial director at MotherBeing, said the Cairo-based health platform is working with NGO Together For Tomorrow to donate more than 400,000 hygiene products, including pads, reusable underwear, wipes and diapers, to civilians in Gaza. .

She told CNN that she had received confirmation that the product had arrived at the Rafah crossing, but did not know when the aid would be entering Gaza.

Palestinian mothers are balancing their own health care needs with the responsibilities of caring for their children, many of whom are affected by the psychological trauma of war.

Haji-Hasan said Israeli bombings separated families and increased children’s fear of death. She told CNN that one of her colleagues in Gaza told the story of a girl running in front of a car about two weeks ago.

“When asked why, (the child) said, ‘I just want to die. I can’t deal with the fear of death anymore,” Haji-Hasan added. She said medical staff use the term “wounded children without surviving families” to describe children orphaned by the war in Gaza.

KHAN YOUnis, GAZA - OCTOBER 15: Children cry after Israeli air strikes in Khan Younis, Gaza, October 15, 2023. Following warnings from the Israeli government, many Gaza citizens fled to the south. After Hamas launched a large-scale attack, Israel blocked Gaza and launched continuous retaliatory air strikes, killing at least 1,400 people and displacing more than 300,000 people.  On October 7, the Palestinian armed organization Hamas launched a surprise attack on Israel from Gaza via land, sea and air, killing more than 1,300 people and injuring about 2,800 people. Israeli soldiers and civilians were also taken hostage by Hamas and transferred to Gaza. The attack prompted Israeli Prime Minister Benjamin Netanyahu to declare war and declare an emergency wartime government.  (Photo by Ahmed Hassabala/Getty Images)

Many aspects of motherhood that were once routine are now matters of life and death.

“Every day, a sister and a mother, a woman loses her husband, her father, her brother. These are Palestinian women. These are Gaza women,” Musleh, a 50-year-old woman who sought refuge in Shifa said.

“We are under fire, under death, under ethnic cleansing, under injustice – under the injustice of a world that sees what is happening but remains silent.”

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