Pregnant women and newborns face trauma, infection, malnutrition in Gaza under Israeli assault

Special Pregnant women and newborns face trauma, infection, malnutrition in Gaza under Israeli assault
An injured child is brought to the Al-Aqsa Hospital after the Israeli attack. (Getty Images)
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Updated 20 November 2023
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Pregnant women and newborns face trauma, infection, malnutrition in Gaza under Israeli assault

Pregnant women and newborns face trauma, infection, malnutrition in Gaza under Israeli assault
  • Even if they survive childbirth, mothers and babies are not out of danger as shortages threaten health and development
  • The siege of hospitals and blocking of aid deprive women in labor of pain relief and premature newborns of incubators

LONDON: What should have been a time of great joy and excitement has become a living nightmare for thousands of new and expectant mothers living under siege and constant Israeli bombardment in the Gaza Strip.

For Layla, 28, whose name has been changed for her safety, bringing a new life into the world at a time of so much death and destruction fills her with dread. “What worries me most is falling in love with life, amid all the death, once I hold my baby,” she told Arab News.

Like 5,500 other pregnant women in the Gaza Strip, Layla is due to give birth very soon amid a conflict between Israel and Palestinian militant group Hamas that has devastated healthcare infrastructure and deprived the population of access to nutritious food, clean water and public sanitation.

The closure of hospitals and clinics under the intense bombardment and chronic shortages of electricity, fuel and medicine are among the biggest challenges faced by the roughly 50,000 pregnant women in Gaza.




Prematurely born Palestinian babies in Shifa Hospital in Gaza City. (Dr. Marawan Abu Saada via AP)

As of Nov. 10, some 18 hospitals and 51 primary care centers across the embattled enclave are no longer operational, meaning fewer than 60 percent of hospitals and 30 percent of public health centers are operating to some degree.

Fikr Shalltoot, Gaza director for Medical Aid for Palestinians, or MAP, a British charity operating in the Palestinian enclave, said that pregnant women in Gaza “face a dire reality, with limited access to essential health services amid a near-total humanitarian disaster.”

“With over 180 births daily and a staggering 235 attacks on healthcare infrastructure since Oct. 7, the situation is critical,” Shalltoot told Arab News. This leaves women deprived of emergency obstetric services and forces many to give birth in unsafe conditions.

“Closed hospitals force births in shelters, homes and streets amid rubble, raising infection risks,” she said. “Maternity hospitals, like Al-Hilo, face attacks.”

Hospitals in Gaza have been on the frontline of the conflict, overwhelmed by wounded civilians since the start of Israel’s military campaign, which came in retaliation for the Hamas attacks of Oct. 7, which killed 1,200 and saw more than 200 people, both Israelis and foreigners, taken hostage.

Some 135 health facilities across Gaza have been damaged or destroyed. Although these facilities are protected under international humanitarian law, Israel claims Hamas has been using hospitals, particularly Gaza’s largest, Al-Shifa, to host underground command centers.




The aftermath of an explosion at the Ahli Arab hospital in central Gaza. (AFP)

Hamas and medical staff deny these facilities are being used to store weaponry, conceal hostages, or move fighters along a sophisticated network of tunnels. Israeli forces who took control of Al-Shifa on Wednesday are yet to provide evidence to support their claim.

There are at least 650 patients, including 22 in intensive care and 36 premature babies, at Al-Shifa, according to local media, in addition to some 400 medical staff. More than 2,000 Gazans have also taken refuge within the facility.

Amid the destruction and shortages, made worse by Israel’s restrictions on the entry of humanitarian aid into Gaza via the Rafah border crossing with Egypt, physicians have been forced to take extreme measures, such as performing cesareans without anesthetic or pain relief.

“Some women face complications while giving birth, and to stop the problem and because there are no (capabilities), tools, (or) time, (physicians) are faced with the extreme option to take out the uterus,” Soraida Hussein-Sabbah, gender and advocacy specialist at ActionAid Spain, told Arab News.

At Al-Awda Hospital, the only provider of maternity services in northern Gaza, doctors performed 16 cesarean C-sections last weekend under extremely challenging circumstances, according to local media.

Hussein-Sabbah said that although there are many trained and specialized obstetrics physicians and nurses in the Gaza Strip, as well as private and public maternity hospitals, “these cannot operate normally right now.”

INNUMBERS

• 50,000 Pregnant women in Gaza.

• 5,500 Women due to give birth soon.

• 180 Average number of births daily.

Despite this, “any specialized person found in a shelter, or any place … will continue serving as much as possible,” she added.

Elaborating on the dangers of conducting cesareans under such extreme circumstances, Zaher Sahloul, head of MedGlobal, a US-based medical NGO, said that while “doctors typically try to deliver as fast as possible,” performing such surgery requires them to “cut through multiple layers” and then “suture multiple layers.”

Performing such an operation without anesthetic, or even a partial dosage of pain relief, would be agonizing.

“It is, as you can imagine, an extremely traumatic experience, something that would be associated with PTSD,” Sahloul told Arab News. Medical professionals are also forced to discharge new mothers within three hours, which poses additional risks.

New mothers are typically monitored for a minimum of 24 hours because the postpartum period is associated with various complications, including hemorrhage. Even before the latest outbreak of violence in Gaza, “the two biggest causes of (maternal) deaths were bleeding and sepsis,” said Sahloul.

“The lack of water and sanitation puts them at an even higher risk of infection and sepsis. (Hospitals) do not (even) have any blood to transfuse these patients if they start to have complications.”

Even if they survive the ordeal of childbirth in these conditions, mother and baby are not out of danger. The lack of hygiene facilities, nutritious food, clean drinking water, safe sleeping spaces, and other basic comforts and necessities threaten health and development.




A Protester holds a placard at The Hague in support of Palestinian children. (Getty Images)

Fatty acid and vitamin deficiencies in lactating mothers can compromise newborns’ immune systems, putting them at risk of communicable diseases as well as cognitive development challenges, said Sahloul.

Fatema, another woman trapped inside Gaza, has resorted to using clean clothes to manage discharge as she lacks access to sanitary towels. Embarrassed, and with limited privacy, she has then buried those clothes, she told ActionAid.

More than 1.4 million Palestinians have been displaced since Oct. 7, according to the UN’s humanitarian office, OCHA. Many have set up makeshift tents outside hospitals, while others have squeezed into the corridors of schools or have slept out in the open.

MedGlobal’s Sahloul warned that with limited access to food and water, malnourished women face the risk of “preterm delivery,” which is also associated with fetal and neonatal morbidity and mortality.

Shalltoot of MAP, meanwhile, cautioned that as access to obstetrics services becomes increasingly difficult, “maternal deaths will rise, stress-induced complications soar, and malnutrition worsen, affecting childhood survival.” Moreover, “without fuel, premature babies relying on neonatal care face a life-threatening crisis.”

She added: “Maternity care at Al-Awda Hospital hangs in the balance. Doctors report a surge in premature births due to the bombing of homes, a heartbreaking crisis where premature deliveries are performed while mothers lay dying.”

Three premature babies at Al-Shifa died on Tuesday after the hospital’s neonatal intensive care unit was knocked out of operation. The lives of at least 36 others are in danger amid a lack of electricity and fuel for incubators, according to the facility’s director.

With women and children making up more than 70 percent of the casualties — one in four of them women of reproductive age — access to maternal health services is critical, said Shalltoot.




Palestinians queue as they wait to buy bread from a bakery, amid shortages of food supplies and fuel. (Reuters)

“Gaza is in urgent need of support to protect the lives of mothers and newborns,” she said, adding that “a ceasefire is imperative for pregnant women and infants.”

She said: “Without immediate access to fuel, aid, and medical experts, we face the looming threat of infectious diseases. Mass starvation, treatable deaths and a healthcare system in ruins are imminent unless swift action is taken.

“Opening multiple crossings is crucial to prevent a humanitarian freefall. Our plea is clear — act now to avert a catastrophic crisis.”

MAP has delivered a range of items, including medications and medical disposables that can be used to support delivery and the treatment of women and babies. “With our partner in Gaza, Ard El Insan, we have released all of our medications and food items for malnourished children and their families,” Shalltoot added.

Save the Children and ActionAid have also called for an immediate ceasefire and the opening of a humanitarian aid corridor.

“For this to happen, there is a need for a unified and coordinated call and pressure for the Rafah crossing to open, and the Israeli occupation forces to comply with international humanitarian law and allow for aid to come and civilians to be saved,” said ActionAid’s Hussein-Sabbah.

As of Nov. 14, at least 11,320 Palestinians have been killed in Gaza, of whom over 4,650 are children and more than 3,145 are women, according to the Hamas-run health ministry. A total of 198 medics have also died.

Earlier this month, Antonio Guterres, the UN secretary-general, described Gaza as “a graveyard for children” and “a crisis of humanity.”




A mother covers her child's face to protect from the smoke as Palestinians leave from the northern part of the Gaza. (Getty Images)

In a statement to Arab News, Save the Children said: “During this humanitarian catastrophe, civilians, especially children, continue to pay the heaviest price for the ongoing violence.

“Children are being killed at a devastating rate, whole families are being wiped from the registry, and a growing number of people, including children, are being left with no surviving family members.”

Attacks on schools and hospitals are considered “a grave violation against children by the UN and may amount to violations of international humanitarian law.”

Calling for an end to “the continued, systematic assaults,” the NGO said that “hospitals and schools cannot be battlegrounds, and children cannot be targets. Yet in Gaza, all three are attacked on a daily basis.

“Even during wartime, basic elements of humanity must prevail.”


Source close to Hezbollah says three fighters killed in Israel strike

Source close to Hezbollah says three fighters killed in Israel strike
Updated 9 sec ago
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Source close to Hezbollah says three fighters killed in Israel strike

Source close to Hezbollah says three fighters killed in Israel strike
Hezbollah said it had fired on several Israeli targets, including soldiers and spy equipment
The violence has killed at least 375 people in Lebanon

BEIRUT: Three Hezbollah fighters were killed Saturday in an Israeli strike on a house in southern Lebanon, a source close to the Iran-backed group told AFP.
“Three Hezbollah fighters were killed, and two others seriously wounded in an Israeli air strike on a house in the area of Al-Jebbayn,” the source, who asked to remain anonymous, said.
Lebanon’s state-run National News Agency reported earlier on Saturday that “enemy aircraft carried out a strike targeting a house in Al-Jebbayn, and rescue teams were headed to the area.”
Hezbollah said it had fired on several Israeli targets, including soldiers and spy equipment.
Since Hamas’s unprecedented October 7 attack on Israel triggered war in Gaza, there have been near-daily cross-border exchanges of fire between the Israeli army and Hezbollah, a Hamas ally.
The violence has killed at least 375 people in Lebanon, mostly fighters but including 70 civilians, according to an AFP tally.
In northern Israel, 10 soldiers and eight civilians have been killed, according to the army.
In recent days, Hezbollah has intensified its attacks against Israeli military positions, with tensions across the Middle East surging.
On April 13, Iran, which supports both Hezbollah and Hamas, launched an unprecedented drone and missile attack on Israel in retaliation for a deadly April 1 air strike which levelled its consulate in Damascus.

Iran, Israel appear to pull back from brink as Gaza bombed again

Iran, Israel appear to pull back from brink as Gaza bombed again
Updated 8 min 21 sec ago
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Iran, Israel appear to pull back from brink as Gaza bombed again

Iran, Israel appear to pull back from brink as Gaza bombed again
  • Israel had warned it would hit back after Iran launched more than 300 missiles and drones a week ago
  • The Iran attack was itself in retaliation for an air strike widely blamed on Israel

TEHRAN: Iran has dismissed as akin to child’s play Israel’s reported retaliation for an unprecedented Iranian strike, as both sides on Saturday appeared to step back from wider conflict stemming from the war in Gaza.
However, a deadly blast at an Iraqi military base emphasized the high tensions which persist in the region, as did more deadly Israeli strikes in Gaza and intensifying clashes in the West Bank.
Fears have soared this month that escalating tit-for-tat attacks between Israel and Iran could tip over into a broader war in the Middle East.
Israel had warned it would hit back after Iran launched more than 300 missiles and drones a week ago in its first-ever direct attack on its arch enemy’s territory.
The Iran attack was itself in retaliation for an air strike — widely blamed on Israel — that levelled the Iranian consulate in Damascus and killed seven Revolutionary Guards on April 1.
The Israeli retaliation appeared to come on Friday, when Iranian media reported blasts in the central province of Isfahan.
Fars news agency reported “three explosions” close to Qahjavarestan, near Isfahan airport and the 8th Shekari army air base.
“What happened last night was no attack,” Iranian Foreign Minister Hossein Amir-Abdollahian told NBC News.
“It was the flight of two or three quadcopters, which are at the level of toys that our children use in Iran,” he added.
“As long as there is no new adventure on behalf of the Israeli regime against Iran’s interests, we will have no response.”
Israeli officials have made no public comment on what — according to a senior US congressional source who spoke to AFP — were retaliatory Israeli strikes against Iran.
Sanam Vakil, director of the Middle East and North Africa program at Britain’s Chatham House think tank, said the reported Israeli strike had been “calibrated to avoid damage and further Iranian aggression.”
Iranian political expert Hamid Gholamzadeh said the incident in Isfahan, while “insignificant,” needs to be seen in the context of the “fight for balance of power” between the two countries.
“The region is on fire and an all-out war can be ignited any moment,” he said.
While tensions rose after the attack on Iran’s consulate, violence involving Iran-backed groups had already been surging across the Middle East since the outbreak of the Gaza war.
Officials in Iraq said one person was killed and eight wounded in an explosion at a military base south of Baghdad housing a coalition of pro-Iranian armed groups.
There was no immediate claim of responsibility.
Since the Gaza war began, violence has also flared in the other occupied Palestinian territory, the West Bank.
The Israeli army said Saturday that its forces killed 10 militants and arrested eight other people during a 40-hour raid on a refugee camp in the northern West Bank.
The Palestinian health ministry said 11 people were wounded in the Israeli raid, including a paramedic who was shot trying to get to the wounded.
Israel has faced growing global opposition over its military offensive in Gaza, which has reduced vast areas of the besieged Palestinian territory to rubble, while aids groups have warned the north is on the brink of famine.
Israeli Prime Minister Benjamin Netanyahu, who is under pressure over the rising civilian toll, needs “further escalation and another war to distract the world attention” away from suffering in Gaza, Iranian analyst Gholamzadeh said.
There have been particular fears about Israel’s intention to send troops into the southernmost city of Rafah, where most of the population is now sheltering having fled violence elsewhere.
Foreign ministers of the G7 group of developed economies, meeting in Italy on Friday, said they opposed a “full-scale military operation in Rafah” because it would have “catastrophic consequences” for civilians.
But even without a full operation, the city has been under regular bombardment.
On Saturday, Gaza’s Civil Defense agency said an overnight Israeli strike in Rafah killed nine members of a family including six children.
Agency spokesman Mahmud Bassal said the Israeli army had also hit several other areas of Rafah overnight, adding: “It has been a very hard night.”
The war was triggered by an attack on Israel by Hamas on October 7 that resulted in the deaths of 1,170 people, mostly civilians, according to an AFP tally based on Israeli official figures.
Israel has responded with a retaliatory offensive that has killed at least 34,049 people in Gaza, mostly women and children, according to the latest toll from the health ministry in the Hamas-run territory.
Israel’s military said it struck dozens of militant targets over the past day, including the site in north Gaza from which a rocket was fired into the Israeli city of Sderot.
Witnesses in the central Nuseirat refugee camp said the Israeli army told them to evacuate one home, then several were destroyed.
“They instruct us to evacuate and return later, but where do we go back? To ruins?” asked resident Abu Ibrahim.
“How long will this farce continue?“
A UN report on Friday said “multiple obstacles” continue to impede delivery of urgently needed aid.
Despite some recent aid convoys being able to reach Gaza, the WFP cited “the real possibility of famine” in the north.
Efforts to seal a long sought-after truce have stalled, according to mediator Qatar.
Turkish President Recep Tayyip Erdogan, a staunch critic of Israel’s war in Gaza, met with Qatar-based Hamas leader Ismail Haniyeh on Saturday, calling for unity among Palestinians.
After Washington vetoed a Palestinian bid to become a full UN member state earlier this week, president Mahmud Abbas said his West Bank-based Palestinian Authority would “reconsider” its relationship with the US.


Erdogan in mediation talks with Hamas leader amid domestic controversies

Erdogan in mediation talks with Hamas leader amid domestic controversies
Updated 20 April 2024
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Erdogan in mediation talks with Hamas leader amid domestic controversies

Erdogan in mediation talks with Hamas leader amid domestic controversies
  • The meeting ‘is part of president’s attempts to reposition himself as credible defender of Palestinian cause,’ analyst tells Arab News
  • Turkiye does not consider Hamas a terrorist organization, unlike Washington and Brussels

ANKARA: The meeting between Turkish President Recep Tayyip Erdogan and Hamas leader Ismail Haniyeh in Istanbul on Saturday has sparked debate over Turkiye’s attempts to play a greater mediating role for the Palestinian cause amid domestic controversies over the ruling government, which has lost support among its conservative electoral base since local elections last month.
Haniyeh’s visit is his first meeting with Erdogan in Turkiye since the start of the Israeli-Hamas conflict in Gaza.
For Wolfango Piccoli, co-president of Teneo Intelligence in London, the meeting is part of Erdogan’s attempts to reposition himself as a credible defender of the Palestinian cause after his recent electoral defeat.
“Hosting the Hamas leader is likely to reinforce the impression in the West that Turkiye is at best a transactional partner, not an ally,” he said.
Turkiye does not consider Hamas a terrorist organization, unlike Washington and Brussels. The country has also strongly criticized Israel’s military operation in Gaza, which Erdogan previously described as genocide. Hamas also established a presence in Istanbul in 2011, although not on par with its political office in Doha.
Ankara has also been a major humanitarian donor to Gaza, alongside several Gulf states, and has actively helped several Palestinians from Gaza receive medical treatment in Turkish hospitals.
“I will continue to defend the Palestinian struggle and be the voice of the oppressed Palestinian people as long as Allah gives me life, even if I am left alone,” Erdogan said in his speech to parliament last Wednesday.
The Turkish president has always been on friendly terms with Haniyeh.
In a recent phone call to the Hamas leader, Erdogan offered his condolences after three of his sons were killed in an Israeli air strike in Gaza.
“Israel will definitely be held accountable before the law for the crimes against humanity it has committed,” Erdogan told Haniyeh, according to an AFP report.
For Betul Dogan Akkas, assistant professor of international relations at the department of international relations at Ankara University, given the current fragile situation in Gaza, there is a significant need for the mediation efforts by Qatar and Turkiye.
“With Haniyeh and other officials based in Qatar, there is now a more effective political bureau compared to the past. The current military balance in Gaza is very critical; they are cornered in Rafah. On the other hand, Hamas needs to build a more strategic power,” she told Arab News.
Akkas thinks that if this Saturday’s visit of Haniyeh contributes to further collaboration between Turkiye and Hamas to address that strategic power deficiency, it would be meaningful.
“Haniyeh could take on a more effective role due to Gaza’s current situation because they need a way out,” she added.
Domestically, however, Erdogan’s Justice and Development Party, known as the AKP, has come under heavy criticism for its flourishing and uninterrupted trade with Israel, even during its military offensive in Gaza.
The AKP’s Islamist rival, the New Welfare Party or YRP, played this trade card during the local elections on March 31, highlighting Erdogan’s failure to halt economic ties with Israel despite his harsh rhetoric against the Jewish state.
The YRP accused the government of applying double standards by strongly criticizing Israel while continuing trade relations. After the elections, the YRP won some local administrations previously held by the AKP.
Turkiye’s exports to Israel exceeded $5.4 billion in 2023, accounting for 2.1 percent of its total exports, according to official data.
Following nationwide criticism, the Turkish Trade Ministry recently imposed restrictions on some 54 categories of exports to Israel, including cement, steel, machinery, construction materials, chemical compounds, and several metal products, and these restrictions are expected to remain in place until Israel declares a ceasefire in Gaza.
On April 16, Erdogan compared Hamas to Turkish independence fighters who resisted foreign occupiers during the liberation of the country and the establishment of the modern Turkish Republic in 1923.
His comments were seen as one of the most blatant endorsements by the Turkish leader since the start of the war in October.
According to Piccoli, while such words may play well with domestic audiences, they are unlikely to be welcomed in Western capitals, including Washington.
Erdogan will make his first official visit to the US since the election of President Joe Biden in 2020 on 9 May. The Palestinian cause is expected to feature in the talks.
Piccoli believes that Haniyeh’s visit is unlikely to lead to any concrete Turkish action against Israel.
“The economic restrictions and Haniyeh’s visit reflect Turkiye’s desire to ensure that the Gaza conflict is not overshadowed by tensions between Israel and Iran, including the Iranian attacks of April 13-14 and the Israeli strikes on Isfahan in the early hours of April 19,” he said.
Earlier this week, Erdogan blamed Prime Minister Benjamin Netanyahu for Iran’s unprecedented attack on Israel, Piccoli added.
On the other hand, how Turkiye will be able to mediate between Palestinian and Israeli negotiators is raising concerns, especially after Erdogan’s harsh criticism of Israel’s military actions in Gaza.
The fate of the hostages held by Hamas since Oct. 7 will also be a source of concern for such mediation efforts.
Turkish Foreign Minister Hakan Fidan visited Qatar April 16-17 and met with Haniyeh and Qatari Prime Minister Sheikh Mohammed bin Abdulrahman Al -Thani.
Turkiye was to host intense diplomatic negotiations on Saturday as Egyptian Foreign Minister Sameh Shoukry was also expected to travel to the country to discuss the situation in Gaza with Fidan.
For Piccoli, while the recent negotiations may go some way to assuaging domestic public anger, the Erdogan government’s outreach to Hamas is likely to reinforce the impression in the US and the EU that Turkiye is no longer aligned with the West and is now — at best — a potential partner rather than an ally.
For the moment, Erdogan has been cautious about commenting on his meeting with Haniyeh.
“We will keep the agenda between us and Mr.Haniyeh,” he said when questioned by journalists on Friday.


Palestinians to reconsider US ties after veto of bid for full UN membership, Abbas says

Palestinians to reconsider US ties after veto of bid for full UN membership, Abbas says
Updated 20 April 2024
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Palestinians to reconsider US ties after veto of bid for full UN membership, Abbas says

Palestinians to reconsider US ties after veto of bid for full UN membership, Abbas says
  • Washington vetoed a Palestinian request for full United Nations membership

CAIRO: The Palestinian Authority will reconsider bilateral relations with the US after Washington vetoed a Palestinian request for full United Nations membership, President Mahmoud Abbas said in an interview with the official WAFA news agency.


Israel says its forces kill 10 militants in West Bank raid

Israel says its forces kill 10 militants in West Bank raid
Updated 20 April 2024
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Israel says its forces kill 10 militants in West Bank raid

Israel says its forces kill 10 militants in West Bank raid
  • “Security forces eliminated 10 terrorists during encounters” over more than 40 hours, the army said
  • Eight soldiers and a police officer had been injured in the raid

TULKARM, Palestinian Territories: The Israeli army said Saturday that its security forces killed 10 militants in an ongoing raid around Nur Shams, a refugee camp in the north of the occupied West Bank.
“Security forces eliminated 10 terrorists during encounters” over more than 40 hours, the army said in a statement.
The army said eight soldiers and a police officer had been injured in the raid.
An AFP journalist in nearby Tulkarem heard gunshots and blasts coming from Nur Shams on Saturday.
Residents contacted by AFP said there was a power outage and food was running short in the camp, saying nobody was allowed to enter or leave.
Since early last year violence has flared across the West Bank, which Israel has occupied since 1967. The violence has further escalated since the war in Gaza broke out on October 7.
Israeli forces say their frequent raids in the West Bank target Palestinian militants, but civilians are often among the dead.
Around 480 Palestinians have been killed by Israeli troops or settlers in the West Bank since the Hamas assault on Israel triggered the Gaza war, according to Palestinian official sources.