By Dr Zahra Mohebi-Pourkan
Abstract
The systematic destruction of healthcare infrastructure in conflict zones represents one of the most severe humanitarian crises in modern warfare. This article examines the medical consequences of intensive bombing campaigns in the Gaza Strip through immediate, medium-term, and long-term frameworks, drawing on recent data from the World Health Organization (WHO), peer-reviewed studies, and humanitarian reports. The second part explores destructive bombing patterns elsewhere, revealing alarming commonalities in the targeting of medical facilities and the resulting public health catastrophes. As physicians witnessing these events unfold, we document not only the clinical effects of this violence but also the structural collapse of healthcare systems, which will take generations to rebuild.
1. Introduction
Practicing medicine in conflict zones presents unique challenges that test the very foundations of medical ethics and humanitarian principles. This is especially evident in the Gaza Strip, which has experienced one of the most intense bombing campaigns in history, with over 12,000 bombs, ranging from 150 kg to 1000 kg, dropped on this densely populated area. As physicians, we are trained to prioritize life above all else, yet we now observe the deliberate targeting of the very institutions and personnel dedicated to preserving life. This article examines the medical consequences of these bombings through a temporal lens—immediate, medium-term, and long-term—while contextualizing Gaza’s experience within broader global patterns of healthcare destruction in conflict zones.
2. Gaza: Immediate Medical Consequences (First Weeks)
2.1 Traumatic Injury Patterns
The immediate medical consequences of the bombing campaign in Gaza illustrate the devastating impact of modern explosive weapons on the human body. Physicians on the ground have reported complex injury patterns, including multiple fractures, peripheral nerve injuries, traumatic brain injuries, severe burns, and spinal cord injuries. These cases of polytrauma often involve combinations of injuries that are extremely difficult to treat, even in advanced trauma centers, let alone in facilities that are already compromised due to the ongoing attacks. The scale of these injuries is staggering: as of October 2025, over 167,300 people have been injured, with nearly 42,000 sustaining life-changing injuries, including more than 5,000 amputations. These numbers represent not just statistics, but generations of Palestinians who will endure permanent disabilities, which will have profound implications for their quality of life and the potential for societal recovery.
2.2 Hospital Overload and Emergency Care Collapse
Gaza’s healthcare system, which was already fragile before the current escalation, has been overwhelmed by mass casualty incidents occurring at an average of eight per day. Hospitals such as Al-Shifa and Al-Ahli are operating at nearly 300% over capacity, facing a constant influx of complex trauma injuries that would challenge even the world’s most advanced medical centers. The destruction of 94% of hospitals has created a dire situation where the remaining facilities must manage not only the daily flow of new traumatic injuries but also the routine medical needs of the population.
3. Gaza: Medium-Term Public Health Crisis (Months)
3.1 Disease Outbreaks and Environmental Health
In the medium term, the destruction of water and sanitation infrastructure has created conditions conducive to the transmission of epidemic diseases. Physicians are reporting a rise in respiratory illnesses as families, deprived of basic supplies, are forced to burn plastic and cardboard for cooking and heating, releasing toxic fumes into overcrowded shelters. Dr. Khalil Al-Daqran, spokesperson for the Ministry of Health in Gaza, confirms that the use of plastics in clay kilns is contributing to the spread of pneumonia and asthma among the displaced population. The water supply system has been significantly damaged or rendered unusable, resulting in a catastrophic impact on hygiene and sanitary conditions. Without access to clean water, people are compelled to use contaminated sources, leading to the spread of waterborne diseases such as cholera, dysentery, and typhoid—conditions that were rarely seen in Gaza before the current escalation.
3.2 Maternal and Child Health Deterioration
The reproductive health crisis represents another critical dimension of the medium-term public health emergency. The UN reproductive health agency (UNFPA) estimates that 55,000 pregnant women are trapped in Gaza, facing displacement, bombardment, severe hunger, and malnutrition. Approximately 130 babies are born daily in these harsh conditions, with more than a quarter delivered by Caesarean section under increasingly precarious circumstances. Tragically, estimates indicate that every week in Gaza, at least 15 women give birth outside of healthcare facilities without skilled assistance, and around one in five newborns are born premature or with low birth weight. James Elder from UNICEF described the situation at Al Aqsa and Nasser hospitals: “We are witnessing large numbers of mothers with newborns in hospital corridors; the hospitals are simply overwhelmed due to the devastation of the healthcare system.”
3.3 Disruption of Chronic Disease Management
The conflict has severely disrupted care for patients with non-communicable diseases (NCDs), which affect approximately 40% of Gaza’s population. A recent cross-sectional survey of 968 patients with NCDs found that adherence to regular follow-ups decreased from 96.7% before the war to 40.7% during the conflict. Satisfaction with primary healthcare dropped from 92.9% to 57.3%, reflecting a systemic deterioration in the management of chronic diseases under bombardment. Medication unavailability or high costs were the most frequently reported reasons for non-compliance during the war, cited by 42.7% and 18.1% of respondents, respectively. Nearly one in five participants went without medication for their chronic conditions for two or more consecutive months, leading to guaranteed future complications and increased mortality from manageable diseases.
4 Gaza: Long-Term Healthcare System Collapse (Years)
4.1 Destruction of Healthcare Infrastructure
The systematic dismantling of Gaza’s healthcare system has been described by some scholars as “healthocide,” referring to intentional attacks on medical facilities, health workers, and infrastructure aimed at undermining civilian resilience and denying access to care. According to documentation from the World Health Organization (WHO), 94% of hospitals in Gaza have been damaged or destroyed, and all facilities lack basic medical supplies, electricity, and clean water. The scale of the assaults on healthcare is unprecedented; in 2024 alone, there were 940 attacks on healthcare facilities in Gaza, accounting for approximately one-quarter of all such attacks worldwide, despite Gaza making up only 0.03% of the global population. The rehabilitation sector has suffered particularly severe damage, with less than one-third of pre-conflict rehabilitation services still operational, and many of these are at risk of imminent closure. This crisis comes at a time when nearly 42,000 people in Gaza are living with life-changing injuries that require comprehensive rehabilitation services. The destruction of WHO’s main warehouse in Deir Al-Balah in July 2025 further compromised the medical response capacity. Concurrently, reports from the Ministry of Health indicate that 52% of essential medications and 68% of medical disposables are out of stock.
4.2 Rehabilitation Crisis and Disability
The crisis of amputations will have lasting effects on Gaza’s population. With over 5,000 individuals facing amputations and severe injuries to their arms, legs, and spinal cords, the need for prosthetic services and rehabilitation far exceeds the current capacity. These life-altering injuries account for one-quarter of all reported injuries, making physical disability a pervasive issue in Gazan society for decades to come. The WHO has emphasized the urgent need for prosthetics and assistive devices, stating that more than 15,000 individuals, including 3,800 children, require specialized treatment outside of Gaza. The term “healthocide” accurately captures the systematic destruction of rehabilitation capabilities while creating massive need, ensuring that long-term disability will be inevitable for thousands.
4.3 Mental Health and Psychosocial Impact
The psychological trauma inflicted on the population of Gaza represents another critical aspect of the long-term medical consequences. Dr. Peeperkorn from the WHO noted that “survivors struggle with trauma and loss, often facing daily survival challenges, while psychosocial referral services remain scarce.” The mental health impacts extend beyond direct victims to the healthcare workers themselves, who operate under constant threat of bombardment while witnessing their patients suffer and die from otherwise treatable conditions. A study of patients with non-communicable diseases revealed that 92.8% rated their pre-war quality of life as excellent or good, while 81.3% reported that their quality of life during the war had declined to poor. This drastic decline in subjective well-being reflects the compounded trauma of displacement, injury, loss of family members, and the destruction of homes and communities—all occurring while basic survival needs remain unmet.
5 Comparative Global Analysis: Impacts of Bombing on Healthcare Globally
5.1 Ukraine: Attacks on Healthcare and Rehabilitation Needs
The systematic targeting of healthcare infrastructure is not unique to Gaza, although the scale and intensity there are unprecedented. In Ukraine, the World Health Organization (WHO) has documented over 2,254 attacks on healthcare facilities since the full-scale war began three years ago. These attacks continue almost daily, with 42 recorded in 2025 alone, resulting in 12 injuries and three deaths among healthcare workers and patients. The rehabilitation crisis in Ukraine mirrors some aspects of the situation in Gaza, although on a different scale. The Ministry of Health estimates that by mid-2024, approximately 100,000 amputations had been performed due to the war, creating a massive demand for trauma care and rehabilitation services. WHO reports a severe shortage of trauma specialists, prosthetics, and rehabilitation services, emphasizing that “healing is often a matter of time but can also be a matter of opportunity.”
5.2 The “Healthocide” Pattern Across Conflict Zones
The term “healthocide” describes the calculated targeting of medical facilities, healthcare workers, and infrastructure across multiple conflict zones. This pattern is evident not only in Gaza but also in Sudan, where over 70% of hospitals have closed amidst ongoing fighting that disrupts water and power supplies to medical facilities. In Yemen, a decade of conflict has led to the gradual collapse of healthcare, with some hospitals shutting down due to a lack of fuel or security threats. What distinguishes the current situation in Gaza is the systematic destruction of healthcare. As noted by Leonard Rubenstein and Feroze Sidhwa, “over the past 20 months, Israel, fully backed by the United States, has abandoned any pretense of respecting the protections enjoyed by hospitals under international law.” The population-adjusted rate of injury to healthcare workers was 46 times higher, the rate of killings of healthcare workers was 143 times higher, and the rate of incidents obstructing access to healthcare facilities was 250 times higher in Gaza than in Ukraine.
5.3 Common Challenges and Systemic Implications
Across conflict zones, several common challenges emerge following bombing campaigns: prioritizing trauma care over other health needs, disrupting chronic disease management, the emergence of communicable disease outbreaks due to damaged water and sanitation systems, and creating long-term disability crises due to inadequate rehabilitation services. These patterns reveal the systematic nature of modern conflicts and their impact on health systems. The humanitarian system itself is overwhelmed and “not fit for purpose,” according to Paul Spiegel, a humanitarian health expert at Johns Hopkins University. The number of humanitarian emergencies has reached unprecedented levels, stretching the capacity of responding organizations beyond their limits. Spiegel notes that the system must “operationalize the concept of centrality of protection, integrate affected persons into national health systems, remake leadership and coordination, and make interventions efficient, effective, and sustainable.”
6 Conclusion and Recommendations
The medical consequences of bombing campaigns extend far beyond immediate trauma; they encompass medium-term public health crises and long-term healthcare system collapse. As physicians, we witness these impacts not as abstract statistics but as the daily reality for our patients and colleagues in conflict zones. The situation in Gaza represents an unprecedented escalation in the targeting of healthcare, but it follows patterns observed in Ukraine, Sudan, Yemen, and other conflict areas. We recommend:
1. Immediate protection of healthcare facilities and personnel through enhanced adherence to international humanitarian law.
2. Restoration of medical neutrality as a fundamental principle in conflict zones.
3. Investment in rehabilitation services to address the long-term disability needs created by these conflicts.
4. Strengthening of humanitarian systems to respond more effectively to complex emergencies.
5. Establishing accountability mechanisms for attacks on healthcare, including documentation and prosecution of war crimes.
A thorough examination of bombings from a medical perspective reveals that the health impacts extend beyond immediate casualties to encompass generational trauma, disability, and systemic collapse. As physicians, we have a professional and ethical obligation to document these impacts, advocate for the protection of healthcare, and work toward solutions that prioritize human health over military objectives. The future of medical care in conflict zones—and the lives of millions who depend on it—hangs in the balance.
Dr Zahra Mohebi-Pourkani is a general practitioner and family doctor who manages a government clinic in Kerman province, Iran. Alongside her medical practice, she writes about topics related to medicine and politics, medicine and society, and medicine and development.
6 October 2025
Source: countercurrents.org