Palestine refugees face unprecedented health challenges to amid Gaza war: UNRWA Annual Health Report 2023

28 May 2024

UNRWA Director of Health, Akiro Seita, holds up the newly released UNRWA Annual Health Report 2023 in Geneva, Switzerland

Palestine Refugees in the Gaza Strip are facing an unprecedented health emergency caused by the most devastating war in their history, according to UNRWA’s 2023 Annual Health Report, released today.

Across UNRWA’s five fields of operation – Jordan, Lebanon, the West Bank, including East Jerusalem, Gaza, and Syria – over two million patients depend on the Agency’s health services. Despite challenges to it operations, including defunding, UNRWA managed to deliver nearly seven million primary healthcare consultations in 2023, maintaining high levels of immunization, including in Gaza, which has played a crucial role in preventing outbreaks of vaccine-preventable diseases.

“The health crisis among Palestine refugees can only be mitigated with immediate and sustained healthcare interventions and support. UNRWA remains committed to addressing these urgent needs and improving the health and wellbeing of Palestine Refugees,” said Dr. Akihiro Seita, UNRWA Director of Health.

The war in Gaza has severely impacted the health and well-being of Palestine Refugees, with increased levels of injury, trauma, and mental health disorders. Destruction of infrastructure and transportation has further complicated healthcare delivery, while overcrowded living conditions and limited access to clean water have heightened the risk of infectious diseases. Rising cases of acute hepatitis and various forms of diarrhea have been reported. Additionally, malnutrition has worsened, with one in three children under the age of two in northern Gaza suffering from acute malnutrition.

In the last quarter of 2023, healthcare access declined as 14 of 22 health centres had to cease operating and power outages crippled telehealth systems. In response, UNRWA opened 155 emergency shelters and deployed 108 mobile medical units, coordinated the shipment of essential medicines, and implemented disease outbreak surveillance.

“Our staff remained at the frontline in Gaza, as of May 2024, UNRWA has lost over 191 staff members, including 11 healthcare professionals. Our hearts go out to the affected families. This report underscores our gratitude for the dedication of our healthcare staff, who continue to deliver quality services despite their loss and being displaced several times,” noted Dr. Seita.

In the West Bank, meanwhile increased movement restrictions and rising violence have posed additional challenges. UNRWA adapted by finding temporary solutions to ensure access for patients and that medical supplies were delivered without interruption.

Notes to Editors

Maternal and child healthcare remained a priority, with extensive services provided. Meanwhile, non-communicable diseases like cardiovascular diseases, diabetes, and hypertension continued to rise due to lifestyle factors. Communicable diseases were largely controlled through vaccination and outbreak management, but hygiene-related diseases reemerged in Gaza towards the end of 2023, after the war broke out in October. Mental health issues also increased due to ongoing conflict and economic instability, despite mental health and psychosocial support services being integrated in all health centres.
UNRWA’s focus on technology was demonstrated by a significant increase in the utilization rate of the Non-Communicable Diseases Mobile Application (e-NCD) and the Maternal and Child Health Mobile Application (e-MCH).

Executive Summary of UNRWA’s Annual Health Report 2023:

As we reflect on the challenges and achievements of the past year, we must address the unprecedented war unfolding in Gaza. At the time of writing in April 2024, UNRWA has lost over 188 staff members including 11 health care professionals. Our thoughts and prayers remain with the families who have suffered unimaginable loss. This report is a testament to our deep appreciation for our healthcare staff, who have remained committed to delivering quality health service, even in the face of personal risk.

For much of 2023, the Agency focused on treating its 300,000 patients with non-communicable diseases (NCDs), providing developmental care for 350,000 children under five, and promising safe delivery for 70,000 pregnant mothers. Of the 5.97 million Palestine refugees registered across all fields of operation, over half continue to rely heavily on Agency health services. Before October, Palestine refugees in Gaza comprised the largest demographic benefiting from these services, consistently leading in the utilization of NCD care, child health care, preconception care, antenatal care, mental health care and many other UNRWA-provided services.

But in the last three months of 2023, Gaza’s share of medical consultations dropped rapidly, as UNRWA was forced to close 14 of its 22 health centres and power outages shuttered access to telehealth systems. Not only did access to basic healthcare become near impossible, but the hostilities also created dozens of new health catastrophes, with mounting war injuries, internal displacement, mental health crises, the destruction of sanitation infrastructure, and the probable conditions for epidemic and famine. To address these rapidly changing health needs, UNRWA opened 155 emergency shelters and 108 mobile medical units, implemented surveillance for potential disease outbreaks, and coordinated the shipment of medicine and medical equipment through the Rafah crossing. Concurrently, the Agency’s West Bank offices were forced to adjust to increased movement restrictions, finding temporary solutions to bring patients and healthcare workers together and ensure the uninterrupted delivery of medical supplies.

Palestine refugees face unprecedented health challenges to amid Gaza war: UNRWA Annual Health Report 2023

Executive Summary of UNRWA’s Annual Health Report 2023:

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