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The Al Basma fertility clinic in Gaza City after an Israeli missile strike. December 2023. Credit: Mohammad Ajjour.
UNITED NATIONS, Mar 12 (IPS) - With enough steel and concrete, the hospitals that have been smashed to bits in Gaza can be rebuilt. But a construction plan paired with an army of bulldozers will not be enough to reconstruct the entirety of Gaza's health care system, which, after many months of war, has been decimated by the Israeli military forces.
From the full-scale destruction of Gaza's roads, polluted water systems and sewage infrastructure. To the long-standing networks of doctors, nurses, pharmacists and medical professionals with specialized knowledge who have been killed or left the Strip. The restriction of medications and critical vaccinations destroyed telecommunication and electricity networks, and data systems that monitor health at the community level and manage the medical history of thousands of patients and families across Gaza have all "disappeared," says Karl Blanchet. He is the director of the Geneva Center of Humanitarian Studies at the University of Geneva in Switzerland. Blanchet told IPS that to rebuild the system, you would need to "start from scratch," which would be expensive.
A recent needs assessment report published by the World Bank, the European Union and the United Nations estimates that "the total recovery and reconstruction needs are estimated at USD 53.2 billion." The report adds that Gaza's healthcare sector alone—including the reconstruction of hospitals, private and public health facilities, pharmacies, dental practices, and maternity clinics, in addition to the short-term restoration of essential services such as mental health assistance, rehabilitation, nutrition, and non-communicable disease treatments—will cost over USD 1.7 billion.
According to the latest data collected by the UN Office of the Coordination of Humanitarian Affairs (OCHA), 1,060 health workers have been killed in the Strip since October 7, 2023, and only 18 out of 35 hospitals, or 50 percent, are "partially functional." Additionally, Health Care Workers Watch—an initiative that monitors attacks on healthcare facilities and workers in Palestine—estimates that Israeli forces have unlawfully detained 339 health workers in Gaza, including nurses, pharmacists, administrative staff, technicians, physicians and paramedics.
However, Dr. Mona Jebril, a research associate at the University of Cambridge's Center for Business Research, told IPS that even before October 7, Gaza's healthcare sector struggled under the oppressive weight of the Israeli occupation and political jockeying between Hamas, Fatah and the Palestinian Authority. The historical legacies of sanctions imposed on the Strip by the international community after Hamas came to power in 2007, limited funding, the complete siege of Gaza by the Israeli government and the cycle of destruction brought on by repeated wars kept the sector functioning, but barely.
"The health system has always been attacked," said Jebril. "Maybe sometimes a little damage to a clinic and an ambulance here or there. But after the seventh of October, we noticed a different pattern, where actually the hospital itself has been burned, targeted, and destroyed."
Similar observations have been outlined in a recent report published by the UN Human Rights Office of the High Commissioner (OHCHR), which concluded that "Israeli Defense Forces (IDF) operations on, within and around hospitals generally followed a pattern with often catastrophic impacts" on the facilities, the people reliant on their services, and those who were sheltering inside. The report found that IDF operations against hospitals started with airstrikes, followed by a complete siege of the facilities by ground troops, followed by raids, the detention of medical staff and patients, followed by forced evacuation and finally, the withdrawal of IDF troops. The report added that the severe damage and destruction left behind effectively rendered the hospitals "non-functional."
Notably, Annie Sparrow, a practicing clinician in conflict zones and an associate professor at the Icahn School of Medicine at Mount Sinai in New York, who volunteered in Syria during the civil war, credits Russian President Vladimir Putin with "understanding so effectively that people won't stay where there's no doctor."
"Putin created five million refugees in six weeks, which is a world record," said Sparrow. "He started bombing hospitals and clinics on the first day of the war in Ukraine, and Israel has learned these lessons from Russia and perfected it." She added, "Attacking hospitals was once exceptional and now for Putin it is military doctrine."
The mass destruction of Gaza, including the bombing of hospitals and the killing of civilians, technically ceased on January 19, 2025, when Hamas and Israel agreed to a shaky three-phased ceasefire deal that requires ongoing negotiations. Although the first phase of the agreement is currently underway—each phase lasts for 42 days and includes the return of all Israeli hostages—the reconstruction of Gaza won't begin until the deal's third phase, when Israeli troops withdraw completely from the Gaza Strip and the war is declared over.
But, given the current political climate, including President Donald Trump's controversial plan to forcibly and illegally displace Palestinians from Gaza to Egypt and Jordan to build the "Riviera of the Middle East" and Israeli Prime Minister Benjamin Netanyahu's flat-out rejection of a Palestinian state, Jen Gavito, a non-resident senior fellow at the Atlantic Council—an American think tank based in Washington D.C.—told IPS that she is skeptical the deal will reach phase three.
"With all things related to reconstruction right now, it's hard to do it with a straight face," said Gavito. "Having worked on peace negotiations, the statement we always made was that until there is a permanent solution that allows Palestinian self-determination, all of this is moot."
To counter Trump's Gaza proposal, Arab leaders met in Riyadh, Saudi Arabia, on Friday, February 21, to hammer out an alternative reconstruction plan that would allow Palestinians to remain in Gaza. Although the details have yet to be released, some reports suggest there was little agreement on who would govern the enclave and fund its reconstruction.
Arab mediators and the United States are currently trying to resolve differences between Hamas and Israel over a January 19 ceasefire agreement after Israel blocked aid to the region.
Regardless of how the final plan for the reconstruction of Gaza's healthcare system shakes out, Dr. Omar Lattouf, a heart surgeon and one of the founders of the Gaza Health Initiative—a global coalition of healthcare and humanitarian workers organizing to assist in the rebuild of Gaza—told IPS that he is optimistic about the reconstruction of the healthcare sector even if it has to be rebuilt "brick by brick."
"We don't know what's going to happen. It's impossible to predict, but one thing we know for sure is that there will always be people there: sick people, injured, hungry people, orphans, widows, and people who need help," said Lattouf.
"As harsh as this is going to sound, irrespective of politics and how many people will be killed—and that's a painful statement to make—there will be people who are injured and need to be treated," he said. "There's no way everybody's going to vanish."
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© Inter Press Service (2025) — All Rights Reserved. Original source: Inter Press Service
