Gaza: Displaced, pregnant, and living in a tent

Maha* went to the hospital as her labour had just begun, only to be turned away because all delivery rooms were full. Discouraged, she returned to her makeshift tent in the cold winter weather, one of many in Rafah’s camps for internally displaced people. Rafah, a city in southern Gaza, housed 300,000 Palestinians before the war; that number soared to 1.5 million as Gazans fled bombings and evacuation orders in the North and Middle Areas of the enclave. Unfortunately, Maha wasn´t able to return to the hospital. She gave birth to her deceased son in a public bathroom.

The war in Gaza, marked by the dire lack of humanitarian aid and attacks on healthcare facilities, has completely disrupted access to maternal healthcare, exposing both mothers and their children to serious and even life-threatening health risks. In the Rafah area, the Emirati maternity hospital stands as the main remaining facility attending to the maternal health needs of displaced pregnant women.

The needs are enormous: According to the World Health Organization, an estimated 50,000 women are pregnant, and according to UNICEF an estimated 20,000 babies have been born since the start of the war.

“With so many people displaced, the situation in Rafah is terrifying,” said MSF emergency coordinator in Gaza, Pascale Coissard. “All places are overcrowded, with people living in tents, schools, and hospitals. The Emirati hospital is now dealing with three times the number of deliveries it handled before the war.”

The humanitarian crisis unfolding in Gaza has left expectant mothers without medical check-ups for months, as primary healthcare services are virtually unavailable, and women in labour are unable to reach hospitals because of the lack of fuel and capacity in the few remaining hospitals. Displaced women living in deplorable conditions are giving birth in plastic tents and public buildings. Those who manage to deliver in a hospital often return to their makeshift shelters mere hours after undergoing a Caesarean section.

To reduce the risk of morbidity and mortality among mothers and newborns, MSF is supporting the Emirati hospital with postpartum care by adding 12 beds to the ward to reach a 20-bed capacity, allowing more patients to receive proper monitoring post-delivery.

“Without enough supplies and too many patients, the healthcare system is overstretched, and mothers are forced to be discharged just hours after giving birth,” explains MSF midwife activity manager Rita Botelho da Costa. “The first 24 hours postpartum are the riskiest for complications, and with people living in dire conditions, it's important to keep the patient in the hospital as long as possible.”

With so little access to maternal healthcare services, many pregnant women have not received any maternal healthcare since the start of the war and haven´t been able to check on the health of their children. 

At six months pregnant, 33-year-old Rana Abu Hameida was admitted to the maternity ward at the Emirati hospital because she was suffering from pregnancy complications. Rana never had an ante-natal checkup since the start of the war. “After I was displaced, it became difficult to get transportation and to find healthcare services,” she said. Abu Hameida was displaced from Beit Lahya in North Gaza and, like Maha, is now sleeping in a tent. “It´s challenging to find a place for treatment or organizing my life so I can resume monthly checkups. I´m staying in a tent; life is hard, especially when it comes to finding food or water and sleeping without proper bedding.”

When pregnant women don´t have proper access to maternal healthcare, enough food, or adequate shelter, they and their children are more likely to experience health issues, including infections. The children of malnourished pregnant or breastfeeding women are at immediate risk of health issues and potential long-term developmental challenges.

Over a third of patients seeking antenatal care exhibited anaemia, a condition often associated with an iron deficiency, which is a critical concern for pregnant women who often require iron supplementation. Additionally, nearly half of these women had genitourinary infections, such as urinary tract infections.

In Rafah, MSF teams are providing postpartum care as well as mental health support in the Emirati hospital. In Al Shaboura Clinic, pregnant women are provided antenatal care, including screening for malnutrition, and given supplementary therapeutic food if needed.

In the first week of January, MSF gynaecologists and obstetricians provided antenatal care to over 200 patients at the Al Shaboura clinic. In the Emirati hospital’s post-natal care ward, within the first week of expanding the ward, MSF teams received over 170 patients. However, without sufficient humanitarian aid to Gaza and protection for the few health facilities that remain functioning, the provision of care will continue to be a drop in the ocean.

MSF reiterates our call for an immediate and unconditional ceasefire and for the protection of health facilities to safeguard lives. We also stress the urgency to promptly restore the flow of humanitarian aid into Gaza and re-establish the healthcare system, upon which the survival of mothers and children in Gaza critically depends.

Access to maternal healthcare in Rafah, southern Gaza | MSF

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MSF Southern Africa

About Doctors Without Borders (MSF)

Doctors Without Borders (MSF) is a global network of principled medical and other professionals who specialise in medical humanitarian work, driven by our common humanity and guided by medical ethics. We strive to bring emergency medical care to people caught in conflicts, crises, and disasters in more than 70 countries worldwide.

In South Africa, the organisation is recognised as one of the pioneers of providing Antiretroviral Treatment (ART) in the public sector and started the first HIV programmes in South Africa in 1999. Until today, the focus of MSF’s interventions in the country has primarily been on developing new testing and treatment strategies for HIV/AIDS and TB in Eshowe (Kwa-Zulu Natal) and Khayelitsha (Western Cape).

In Tshwane, we run a migration project, and we offer medical and psychosocial care to migrants, refugees, and asylum seekers, who struggle to access public health services under South Africa’s increasingly restrictive.

Previously we offered free, high-quality, confidential medical care to survivors of SGBV in Rustenburg.

To learn more about our work in South Africa, please visit this page on our website (www.msf.org.za). To support MSF’s work: