How Israel's war has created a neonatal nightmare in Gaza

Neonatal care Gaza
7 min read

Around 60,000 pregnant women in Gaza are living in fear of the fate of their unborn children as Israel's genocidal war and its deliberately created famine spares no one.

Yasmin Abdulrahman fled to southern Gaza in March just days after the death of her newborn baby, who lived only 11 days before succumbing to malnutrition.

He had been born after four months of near-famine conditions across the Strip. Yasmin recalls that she spent over 30 hours without food at one point in February, even though she was in her last month of pregnancy and needed extra and specialised nutrition for her baby.

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At birth, Abdulrahman was just 1.2 kg (around 2.6 lb) and was severely dehydrated, so he had to stay under intensive monitoring in the neonatal department at the Kamal Adwan Hospital in north Gaza.

However, tragically, he died after a week.

"The doctors said there was no milk, no solutions, hardly any medicines he needed," Yasmin is crying as she explains. "My son wasn't the only one – I saw many newborn babies in a similar state. Some died when he did, others before."

Thirty children have died in the hospitals in north Gaza, including 23 in Kamal Adwan. Half of them were newborns. Ten others had starved to death in the central and southern regions of the Strip by April, according to health ministry spokesperson Ashraf al-Qudra, who says what's documented doesn't reflect the whole picture, due to the difficulty taking a proper register of the deaths as many newborns have died at home and in other situations.

Rise in miscarriages and preterm births

Every month, around 4,500 babies are born in Gaza. Between October 7 and mid-April, the health ministry observed a noticeable increase in miscarriages and premature births, says al-Qudra. This has escalated during the last three months, as have cases of severe bleeding during childbirth, and placental abruption, which has risen by 25 percent.

Dr Omar Abu Mohsin, a consultant in obstetrics and gynaecology at Al Hilal Emirates Hospital in Rafah testifies to this. He believes the cause is that thousands of pregnant women are walking long distances, and being forced to endure physically exhausting displacements — which can last hours or even days, during which they have to carry heavy loads and are deprived of rest and healthcare.

Additionally, the constant terror and anxiety have led to mental health disorders among the population, which also factor in the higher rate of miscarriages and preterm births.

In November, 28 premature babies were evacuated from the Al Hilal Emirates Hospital to the Rafah border crossing for transfer to Egypt [Getty]

According to a press release published on the International Rescue Committee's (IRC) website in April, pregnant women in Gaza are suffering from premature labour and miscarriage at a rate three times higher than at the beginning of the conflict, as a result of displacement, trauma, and malnutrition.

Most of these children are born severely underweight and in poor health due to malnutrition of the mothers. This is why the remaining Neonatal Intensive Care Units (NICU) are overflowing, says Wissam Sakani, head of public relations at Kamal Adwan Hospital.

Cases of anaemia and immunodeficiencies have also risen among pregnant women, and the same afflicts their newborns, adds al-Qudra, pointing out the exacerbation of occult bacteremia, which is when bacteria is present in the child's bloodstream. This has been attributed to soaring environmental pollution and the severe shortage of cleaning products and sanitation.

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Lack of incubators threatens new lives

Currently, four NICUs are still operating in Gaza – one in the Al-Aqsa Martyrs Hospital in central Gaza; one in Kamal Adwan Hospital; one in the European Gaza Hospital and one in the Al-Helal Al-Emirati Hospital in the south.

Each would usually be able to absorb around 50 babies, however, their occupancy rate right now is over that by 500 percent.

Because of this, doctors are being forced to put five or six babies into one incubator, because, for example, in Kamal Adwan Hospital there are only 14 incubators — in which there are over 40 babies.

Neonatal wards lack the basics

Abdullah Hamad's son, who was born prematurely in early April, is still in the NICU in the Al-Helal Al-Emirati Hospital and is suffering from many health issues.

Abdullah's wife Marwa was displaced six times during her pregnancy, and ended up in a tent in Rafah, malnourished and emaciated, when she went into labour early.

Marwa, who suffered postpartum haemorrhaging after giving birth, and is still recovering, says her son needs advanced blood tests, hearing tests, and retinopathy of prematurity (ROP) screening to prevent problems those in his circumstances are vulnerable to. However, these are not available in Gaza due to the current situation.

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Premature infants born before the 32nd week of pregnancy need intensive monitoring and would usually be supported using an incubator or a ventilator to ensure they’re getting enough oxygen.

In north Gaza, there’s only one source left producing oxygen cylinders for medical purposes at a small plant in Kamal Adwan Hospital, which provides both Al-Awda Hospital and the Al-Ahli Arab Baptist Hospital in Gaza City with a daily supply of medical oxygen cylinders.

However, the mentioned plant, which runs on electricity produced by a small generator which runs on diesel, can only provide limited and irregular amounts to the hospital because of Israel's siege and restrictions.

This increases the risk of premature babies dying, as happened in November when 20 babies in incubators died in hospitals in the north after they were invaded by Israeli forces and left non-functional.

Breastfeeding impossible and lack of formula 

Further exacerbating the situation is that acute malnutrition in the mothers has left them unable to breastfeed naturally, says Doctor Hussam Abu Safiya, the head of Gaza's Kamal Adwan Hospital's paediatric unit, who says signs of malnutrition are rife in the department.

Malnourished babies will display low weights, "crepe-like skin", weak immune systems, and severe dehydration.

"Some children come to the hospital days or weeks after birth, suffering bloating in their bodies,  which results from lack of protein, which the child should have obtained via the mother's milk or formula milk specially for breastfeeding babies. Unfortunately, the hospital lacks formula milk, essential nutrients and medicines, which increases the danger of death for newborns and breastfeeding babies," he says.

Genocidal intent

Today in Gaza 90 percent of children under 2, and 95 percent of pregnant and breastfeeding women, face severe food poverty — "meaning they have consumed two or fewer food groups in the previous day — and the food they do have access to is of the lowest nutritional value," according to UNICEF in April.

Ted Chaiban, deputy CEO for UNICEF warned in February: "The Gaza Strip is poised to witness an explosion in preventable child deaths which would compound the already unbearable level of child deaths in Gaza."

UNRWA's total withdrawal from north Gaza, and the closure of its healthcare and food distribution centres since October, are at the root of the crisis now being suffered by pregnant women and newborns, as previously, UNRWA surgeries had provided these essential services.

Their loss has had a devastating impact on newborns, and increased miscarriages and premature births, the usual risks of which are compounded by the wholesale destruction of hospitals, says Ismail al-Thawabta, director of Gaza's governmental media office.

Israel's actions violate international humanitarian law, which has adopted provisions to enhance protections for women and children, due to their vulnerability. For example, article 16 of the Fourth Geneva Convention of 1949 stipulates that "expectant mothers" should be given "particular protection and respect".

However, what is happening, as lawyer Salah Abdel Ati from the International Commission to Support Palestinian Rights (Hashd) says, provides compelling evidence that the occupation is committing the crime of genocide, and one aspect of this is by targeting pregnant women, as well as newborns and even unborn babies.

This is an edited translation from our Arabic edition. To read the original article click here.

Translated by Rose Chacko   

This article is taken from our Arabic sister publication, Al-Araby Al Jadeed and mirrors the source's original editorial guidelines and reporting policies. Any requests for correction or comment will be forwarded to the original authors and editors.

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