In Gaza, women's health faces a war of its own as gynaecological illnesses worsen amid Israel's horrific genocide

As two million Gazans once again face the prospect of forced displacement following Israel’s new wave of offensives on the Strip after ending the ceasefire, some 170,000 Gazan women of reproductive age bear the pain of displacement, destruction and the loss of their loved ones alongside another form of suffering – the pain of gynaecological illnesses such as endometriosis, fibroids, cysts and PCOS (polycystic ovarian syndrome.) The United Nations has called it a ‘war on women’s health.’

With Israel having halted all aid to Gaza since the beginning of March, stocks of painkillers and medications which women rely on to manage the pain associated with PCOS, endometriosis and other gynaecological disorders are quickly dwindling and any scheduled surgeries in the Strip’s remaining hospitals have been cancelled. The agony of their conditions is an added layer of suffering to their already catastrophic circumstances.

Fifty-seven-year-old widow and mother of nine Saada Ahmed has endometriosis. With this new wave of genocide, her condition has dramatically deteriorated and she says she cannot cope with the excruciating pain her condition causes for much longer.

Her endometriosis also causes severe vaginal bleeding, which a gynaecologist told her was the cause for other symptoms she is experiencing, such as shortness of breath, palpitations and frequent fainting. Only high doses of medication can stop the bleeding.

Saada was due to be operated on at Al-Awda Hospital in North Gaza. When the Israeli army dropped leaflets shortly after ending the ceasefire ordering residents of Jabalia and Beit Lahia to evacuate south, she found herself being displaced for the 13th time since October 2023.

“I feel like I have no value. I don’t know if I’ll bleed to death!” Saada tells The New Arab in tears. “I don’t know where to go. I keep calling my doctor but she doesn’t pick up. Maybe she’s been displaced too. I was scheduled to have a hysterectomy to end this suffering, but it seems this pain won’t let go of me.”

Khalida Al-Shawa, a 50-year-old mother of seven, was also scheduled to have a hysterectomy at Al-Shifa Medical Complex back in October 2023 to remove uterine fibroids.

When war broke out on October 7 2023, her surgery was postponed as all hospitals in Gaza went into emergency mode.

At first, Khalida refused to evacuate from north Gaza to the south. Desperate to receive her surgery, she returned time and time again to Al-Shifa’s Women and Maternity Hospital to see if there was any chance she could be operated on, but each time, she was turned away.

“The answer each time was, ‘We are in a state of war and can only accept emergency cases such as childbirth. Look for a private hospital because there is no solution for you here in this region,’” Khalida tells The New Arab. “But what kind of region is this where there is just destruction and devastation everywhere?”

The Israeli army’s complete destruction of the Al Shifa Complex in April last year destroyed any hope that Khalida would receive a hysterectomy.

She was eventually forced to move to the south with her children where she was reliant on tablets to stop the vaginal bleeding.

Sometimes the bleeding was so bad that she lost consciousness. Eventually, an American medical delegation at Al-Emirati Hospital in Rafah performed a hysterectomy.

“If it wasn’t for the medical delegation being there and taking pity on me, the answer would have still been, ‘There are martyrs and wounded and your condition isn’t that bad,’” she says.

Dr Ghassan Abu Al-Qumbuz is a well-known gynaecologist in Gaza, who was formerly the head of the oncology unit at Al Shifa’s Women and Maternity Hospital.

Now in Egypt, he tells The New Arab that Gazan women’s reproductive health is at great risk, due to the lack of medical treatment and follow-up, scarcity of medication and reliance on temporary field hospitals.

“There’s been an increase in the number of women suffering from PCOS as a result of stress,” he explains. “Malnutrition and vitamin D deficiency have caused a 70% increase in the number of women over the age of 50 developing uterine fibroids. We don’t have the numbers when it comes to the number of cases of gynaecological, uterine and ovarian cancers, but the death rate of female patients from these cancers has increased from 20% to 50%.”

He continues, “The Turkish Hospital was the only cancer hospital. Since it was destroyed in November 2023, gynaecological tumours have gone from being Stage 1 or 2 to Stage 3 or 4, making them difficult to remove surgically. There is no hope for many of these women.”

Nineteen-year-old Madeleine Matar was suffering from a large cyst on her left ovary and was taking hormonal medication in a bid to reduce the size of the cyst.

When the war on Gaza first broke out in October 2023, Madeleine went from pharmacy to pharmacy looking for the contraceptive pill, a known treatment for ovarian cysts, but could not find them. At the UNRWA clinics she visited, there were no specialists.

“The question always was, ‘You’re not married, so why do you need the Pill?’” shares Madeleine. “I felt embarrassed and helpless. No one understood the nature of my condition and at the UNRWA centre there was only a general practitioner who said she did not have enough experience dealing with ovarian cysts.”

Madeleine says she started to suffer from extreme pain and ended up in Al-Awda Hospital in North Gaza, requiring emergency surgery. Her cyst had been left for so long that it had caused ovarian torsion and her entire left ovary had to be removed.

Madeleine says due to the war destroying Gaza’s integrated healthcare system, her condition was neglected, causing her to almost lose her life.

Dr Muhammed Al-Sarraj, a gynaecological endoscopy specialist, says that the neglect of gynaecological diseases can have permanent and dire consequences. In fact, he has noted increased cases of secondary infertility in Gazan women as a result of such disorders not receiving timely treatment.

“The lack of hygiene due to there being no clean water, the scarcity of sanitary pads and the lack of medicine has caused gynaecological diseases to get worse, such as endometriosis, fibroids, ovarian cysts and chronic gynaecological infections that turn into infections of the fallopian tubes.”

With Nasser Hospital being the latest to be targeted by Israeli airstrikes, the number of hospitals in Gaza continues to diminish, and the suffering of women like Saada, Khalida and Madeleine only continues to increase.

Pre-wartime these were conditions that could have been treated and managed easily by medication or surgery. Now, Gazan women with gynaecological illnesses face the prospect of dying from these conditions instead.

Haya Ahmed is a doctor and freelance writer from Gaza