Peri-operative management challenges in Gaza

Abstract

This narrative review discusses the challenges of presurgical and postsurgical management in the Gaza Strip against the background of continuous conflict and siege. Due to the massive assault by Israeli forces starting on October 7, 2023, the healthcare system in Gaza has been devastated by bombardment, total siege, and restrictions on medical supplies, fuel, and electricity. These have highly limited the opportunity for health providers to deliver desperately needed surgical care. The review underlines extreme shortages of medicinal supplies, insufficient infrastructure, and health services collapsing—such conditions that even elementary surgical operations become life-threatening. Of 35 hospitals paralyzed, 26 still try to work under precarious conditions in a few remaining healthcare centers, many of them without anesthesia, antibiotics, or sterile instruments. Much added to this psychological burden is the weight on healthcare providers working daily under threat and pressure, deteriorating the situation. The review also brings out that this interrupted continuum of care has led to a large number of patients not receiving the follow-up treatment required, thereby increasing morbidity and mortality. This relentless war is slowly converting Gaza into a human catastrophe, for which urgent international action is solicited to rebuild health infrastructure and mitigate crucial surgical-care constraints of this beleaguered area.