Urgent health update: Peer reviewed literature on the consequences of the war on Gaza and the West Bank/East Jerusalem - February 28, 2026

Friends, in our never-ending attempts to deal with the length of our health reports, we are alternating the full health report every other week, with the report on journal publications in the intervening weeks.

But of course, the US and Israel just attacked Iran and we must focus on that first.

The JVP Health Advisory Council strongly condemns the illegal war launched by Israel and the United States against Iran. As health care workers, we understand clearly that imperialist wars of aggression historically have led to large numbers of civilians injured and killed, the destruction of civilian infrastructure including health care institutions, and the poisoning of the environment with toxic military detritus. The Iranian population, already suffering from severe sanctions and a repressive regime, will suffer more health harms from these attacks. This military assault will destabilize the entire area and will not lead to a positive future for Palestinians, Israelis, or others in the region. We must join forces to stop this military fiasco now.

Here is JVP national’s statement on opposing the war. here

Action alert to email congress asking them to vote yes on the War Powers Resolution. here

Other background resources: here, here

And now to Palestine…..

Peer-reviewed literature:

Commentaries & Editorials

The Lancet Psychiatry: In this correspondence, the author discusses his recent first-hand experience working in a primary healthcare facility in Gaza from 12/25 to 1/26  emphasizing that “the burden experienced by people with mental illness presenting to primary care…warrants urgent attention.” The author notes that “presentations included mood and anxiety disorders, complex grief reactions, sleep disturbances, symptoms consistent with post-traumatic stress disorder, and suicidal ideation” and calls on the international community and humanitarian organizations to “urgently address three requirements: first, deploy training in mhGAP and psychological first aid to primary care staff; second, establish referral pathways for patients with severe mental illness; and third, ensure consistent supply of essential psychotropic medications through humanitarian corridors.” here

Research Articles

The Lancet Global Health: This article reports results from the Gaza Mortality Survey, a population-representative household survey conducted between 12/30/24 and 1/5/25. 2,000 households across 200 primary sampling units were surveyed, documenting the vital status of 9,729 household members as of 10/6/23. The authors estimated 75,200 violent deaths between 10/7/23 and 1/5/25, representing approximately 3.4% of Gaza’s pre-10/7 population. Women, children, and older adults comprised more than 56% of violent deaths. The authors also estimated 16,300 non-violent deaths, of which 8,540 represent excess deaths above pre-10/7 projections. The Gaza Ministry of Health’s estimate of violent deaths for the same period was 34.7% below this study’s estimate. here

The Lancet Global Health: In a commentary accompanying the above article, Aldabbour and Irfan highlight the value of the mortality estimates produced by the Gaza Mortality Survey and explain how these data can be used to derive additional indicators that “illustrate the cumulative harm and long-term demographic consequences of armed conflict.” For example, the authors discuss the advantages to calculating life expectancy, which “can integrate mortality estimates across different age groups, thus capturing the disproportionate loss of life among children and young adults that can be obscured when attention is fixed on a total toll count.” here

The Lancet eClinicalMedicine: “This study computationally estimates and characterizes injuries in Gaza to serve as a comparison to reported figures, forecast future injuries, and aid in planning to meet reconstructive needs.” The multivariate negative binomial regression model predicted 116,020 injuries for the period of 10/7/23-5/1/25, similar to the 118,014 injuries reported by the Gaza Ministry of Health. “Injuries were greatest in air and shelling attacks, during periods of actively moving conflict, and in densely populated areas, especially in urban settings before and after they were devastated to rubble. Of those injuries, 29,000–46,000 were predicted to require reconstructive surgery, with over 80% due to explosions, and rising to 34,000–48,000 by 5/2026.” The authors note that they “demonstrate that the burden will continue to grow without cessation of hostilities, further exacerbating reconstructive surgical need.” here

Women’s Health: This mixed methods study examined how Israel’s war on Gaza has impacted adolescent girls’ and young women’s basic needs and health outcomes. Data from a household survey of young people aged 10-24 (n=1,011), in-depth interviews (n=100), and key informant interviews (n=24) conducted 8-12/24, identified “severe and intersecting financial, physical, and social obstacles… Restricted access to clean water, sanitation, hygiene services and menstrual products heighten health risks, while the collapse of maternal health services threatens mothers and children.” here

Psychological Trauma: This article presents results from the Arabic translation and psychometric validation of the Moral Distress Instrument and the Moral Injury Events Scale among health care workers providing care in Gaza. In a cross-sectional study conducted between 1-4/25, the two scales demonstrated excellent reliability and good concurrent validity. Higher levels of moral distress (MD) and moral injury (MI) were positively associated with more severe depression, anxiety, post-traumatic stress symptoms, and suicidal ideation. The authors encourage clinicians and researchers to “identify, assess, monitor, and mitigate MD and MI in professionals of diverse disciplines working in different settings.” here

Plastic and Reconstructive Surgery–Global Open: This article describes the development of a multinational, multidisciplinary team focused on reconstructive surgical planning in Gaza offering a replicable, ethical framework for context-sensitive collaboration in conflict zones. Key lessons learned included “the importance of early stakeholder engagement, leveraging short-term goals for long-term progress, adapting to dynamic conflict conditions, establishing internal infrastructure, and maintaining flexible communication channels.” The authors note that they “prioritized early engagement of Gaza-based partners and institutional review board approvals from relevant Palestinian entities to ensure contextual relevance.” here

Medicine, Conflict, and Survival: This review describes the state of medical education in Gaza before 10/7/23, examines the ways in which it has been disrupted and damaged since, and outlines strategies for recovery. “Medical schools and hospitals have been damaged, destroyed, or militarized, while students and faculty have faced displacement, resources scarcity, and severe psychological distress. Education has been further disrupted by power outages, internet restrictions, unsafe travel and harsh living conditions.” Key strategies for recovery include “expanding online programs, offering diverse training opportunities, creating safe learning environments, and supporting mental health” as well as “recognizing Gazan medical students’ frontline volunteering. here  

Conflict and Health: This study uses data from the WHO Health Resources and Services Availability Monitoring System database to assess aggregate and by-governorate hospital functionality and hospital system capacity in Gaza in the 13 months following 10/7/23. By 10/28/23, more than 71% of hospitals were partially functional and more than 28% were nonfunctional. At two points during the study period – 11/2023 and 4/2024 – more than 71% of hospitals were nonfunctional. “This study provides additional evidence that the Gaza Strip’s hospital system was directly affected by the first year of the conflict, greatly impacting the ability to provide critical health services.” here

OMEGA – Journal of Death and Dying: Qualitative interviews with 30 internally displaced widows (aged 24-58) residing in refugee shelters and informal camps in Rafah investigated “the intersectional challenges confronting Gazan widows during the Israeli-led genocide and military blockade.” The analysis identified six themes including “the compounded effects of widowhood and forced displacement, war-related physical and psychological injury, economic precarity, inadequate shelter, barriers to accessing essential services, and faith-based religious coping in the absence of institutional protection.” The authors conclude that redress “cannot be achieved through charity or capacity-building measures alone; it requires a sustained commitment to justice, accountability, and the affirmation of Palestinian collective rights and dignity.” here

Journal of Orthopaedic Surgery: A cross-sectional survey and chart review conducted in 9/2024, sought to characterize emergency department (ED) orthopedic injury patterns in four referral hospitals in Gaza. Among 449 patients, most ED “presentations followed explosive violence. Fractures predominated, with a large share open; comminuted and segmental patterns were frequent, and neurovascular compromise was common. Many patients reached some form of care rapidly, yet few received first aid before ED arrival, indicating prehospital collapse amid unsafe transit.” They emphasize that “immediate priorities include the entry of essential medical supplies and safe protection for hospitals and healthcare workers to operate.” here

International Review of Psychiatry: “Drawing on liberation psychology, decolonial mental health, and human rights approaches, this article reframes Palestinian distress as a rational response to systemic violence, displacement, and precarity…synthesizing existing research on the psychological consequences of recurrent large-scale violence while emphasizing culturally rooted protective factors such as family cohesion, community solidarity, and sumud. The authors offer strategies for decolonizing mental health and psychosocial support including “locally led program design, reciprocal training and supervision models, culturally anchored approaches, ethical positionality, and sustained support for Palestinian practitioners navigating dual roles as caregivers and affected civilians.” here

Scientific Reports: A cross-sectional study conducted in Gaza between 7-11/2024, examined the burden for and risk factors of impetigo and scabies among children (n=409). 87% of children were diagnosed with impetigo, 36.7% with scabies, and 24.2% with co-infection. More than three-quarters of respondents lived in overcrowded areas and 61% reported a sleeping-space occupancy exceeding 10 individuals. Limited access to clean water was associated with higher odds of impetigo and using public bathrooms was associated with higher odds of scabies. The authors highlight “an urgent need for coordinated hygiene interventions focused on restoring clean-water access, providing soap and disinfection supplies, and reducing shelter overcrowding.” here

Social Work in Public Health: “This paper examines the intersection of settler colonialism, environmental degradation, and health inequities in occupied Palestine, emphasizing how olive grove destruction, land and water contamination, and military violence produce direct social and health harms for an already oppressed population. We call for public health social work to advance environmental justice, health equity, and decolonial practices through advocacy, global solidarity, and centering Indigenous Palestinian voices.” here

BMC Primary Care: A cross-sectional study of 423 adults with diabetes, hypertension, and/or dyslipidemia, conducted in West Bank primary health care centers between 3/2025 and 6/2025, examined barriers to medication adherence. The data indicated that “medication adherence was low, largely reflecting access-constrained treatment interruption due to medication shortages and health-system disruption rather than behavioral non-adherence: only 10.3% for diabetes, 10.0% for hypertension, and 7.8% for dyslipidemia. Key barriers included high medication costs (44.4%), multiple daily doses (38.5%), war-related unemployment (37.6%), and psychological distress (depression: 14.7%). The authors emphasize that “effective solutions require psychosocial support, simplified regimens, and culturally sensitive approaches.” here