Rethinking Gaza’s Post-Conflict Medical Humanitarian Needs on United Nations Day

The 24 October marks the United Nations Day and 2025 marks the UN’s 80th anniversary. The key message marking the 80th anniversary is that “By promoting peace, human rights and social progress, including access to healthcare and education, the United Nations has improved the lives of people around the world, creating better living standards for all.” Beyond cherishing the privilege of living in peaceful and safe communities the UN has contributed to in the past eight decades, at the dawn of hope for peace in Gaza, it is time to prepare for Gaza’s post-conflict healthcare and medical humanitarian needs.

The Gaza Strip, wedged between Israel, Egypt, and the Mediterranean Sea, has been plagued by conflict and political turmoil for nearly three-quarters of a century, consistently grappling with immense challenges in meeting the vast medical and humanitarian needs of its population. The ongoing Israel-Hamas conflict has again resulted in significant casualties and widespread destruction, exacerbating the challenges of addressing post-conflict medical and humanitarian relief needs.

According to United Nations’s estimates, over 40,000 people had died in the first six months of conflict, including more than 10,000 children. United Nations Women reported in April 2024 that over 10,000 women—including approximately 6,000 mothers—had been killed, leaving behind 19,000 orphans. The war has also left more than 92,000 injured in the first half a year, while only 16 of Gaza’s 36 hospitals remained partially operational. With food supplies paralyzed by the conflict, one in five people was nearing famine conditions. United Nations Children’s Fund (UNICEF) estimated that around 70 children were injured daily in this conflict, with countless more psychologically traumatized by exposure to violence—over 1 million children required mental health support. Oxfam reported that most water infrastructure was damaged in the first six months of the conflict, with 88% of groundwater wells and all desalination and wastewater treatment plants destroyed, when locals received only 4.75 liters of water per day—just one-third of the minimum emergency standard—heightening risks of waterborne diseases, especially among children. According to the updated figures of the Ministry of Health in Gaza, there were 61,722 fatalities and 154,525 injuries among Palestinians from 7 October 2023 to 13 August 2025. World Health Organization estimated on 13 August 2025 that more than 14,800 patients needed lifesaving medical care that was not available in Gaza. United Nations Nutrition Cluster warned deteriorating nutritional status of Gaza children, with nearly 13,000 new admissions of children for acute malnutrition treatment in July 2025. Ministry of Health in Gaza reported that there were a total of 235 malnutrition-related deaths (including 106 children) from 7 October 2023 to 13 August 2025, among whom 170 (including 45 children) died in the past 1.5 months.

Damage to medical facilities in Gaza has drastically reduced access to essential health services, including trauma care, maternal health, and chronic disease management. The destruction of water, sanitation, and hygiene (WASH) infrastructure has worsened public health risks, increasing the potential spread of waterborne illnesses. Meanwhile, the conflict has devastated the local economy, leaving resources for medical supplies and staff scarce, directly impacting the healthcare sector. Additionally, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) estimated that nearly 90% of Gaza’s population (1.9 million) has been displaced in the first half year of the conflict, with over 60% of homes destroyed, uninhabitable, or damaged. According to the latest estimate by the International Organization for Migration’s Site Management Cluster, among 2.1 million Palestinians living in Gaza, more than 780,000 were displaced during the period between 18 March and 12 August 2025.

Gaza’s healthcare workers face compounded challenges: attacks on medical facilities, severe shortages of medical supplies, and ethical dilemmas in providing care under extreme constraints. These factors amplify their stress, anxiety, and sense of helplessness. Losing colleagues to the conflict and having to communicate complex issues with patients' families under extreme conditions further adds to their emotional burden. Moreover, healthcare workers themselves lack basic necessities such as adequate nutrition and safe drinking water, undermining their capacity to deliver care and their own mental health. Gaza Ministry of Health reported more than 1,4000 healthcare workers killed as of 13 August 2025. Attacks on the two main hospitals in Khan Younis, Nasser and the European Gaza hospitals, in May 2025 had further crippled the Gaza health care system, triggering renewed calls for the protection of civilians, including medical personnel, and medical facilities in line with International Humanitarian Law. The lack of media coverage and support for these healthcare workers exacerbates their feelings of isolation and neglect. United Nations further reported that as of 13 August 2025, at least 520 humanitarian workers were killed in the conflict, including 356 from United Nations, 53 from Palestine Red Crescent Society and 4 from International Committee of the Red Cross.

The Sphere Handbook: Humanitarian Charter and Minimum Standards in Humanitarian Response—a globally recognized, authoritative set of core principles and minimum standards in life-saving domains of humanitarian response—can guide efforts to meet Gaza’s post-conflict medical humanitarian needs. Established in 1997 under the International Council of Voluntary Agencies (ICVA) in Geneva, the Sphere Project unites humanitarian agencies to improve humanitarian assistance quality and accountability. Its standards were developed by experts from major agencies like Amnesty International, the International Federation of Red Cross and Red Crecent Societies, Oxfam, United Nations Population Fund, United Nations High Commissioner for Refugees, United Nations Children's Fund, World Food Programme, World Health Organization, and World Vision.

For more than a decade, the Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC) has served as Sphere’s first Sphere Country Focal Point for China, promoting these internationally endorsed standards. The 2018 edition of Sphere standard includes a Chinese translation co-developed by CCOUC. As the China Focal Point, CCOUC also developed the world’s first Simplified Chinese and Mandarin online course on Sphere standards: Humanitarian Charter and Minimum Standards in Humanitarian Response: The Sphere Project in Practice. The course is not only widely recognized but also rich in content and easy to understand, helping to understand humanitarian practices guided by the Sphere Standards and improving disaster and humanitarian response levels in China. It is structured into five chapters that systematically explain the main contents and practices of the Sphere Standards. The first chapter is "What is the Sphere Project," serving as an introduction to the Sphere Project. It covers the origins of the Sphere organization, its core beliefs, the Humanitarian Charter, protection principles, and the humanitarian core standards. Chapters two to five are technical chapters focusing on the four technical areas outlined in the latest 2018 Sphere Handbook, including water supply, sanitation and hygiene promotion (WASH), food security and nutrition, shelter and settlement; and health. This free online video course in Chinese can be registered for on the Xuetangx online learning platform (https://www.xuetangx.com/course/cuhk0000188866/19318736). The course helps students and humanitarian workers explore the international Sphere Project organization and its globally recognized minimum humanitarian standards.

Moreover, in a 2018 paper on the Rohingya crisis, the CCOUC team identified five key health risks in refugee camps aligned with Sphere standards: WASH, food/nutrition, shelter/non-food items, healthcare services (including primary care), and health information. Limited water resources and poor water quality, food poisoning, hepatitis A and E, and malnutrition were found to pose significant health risks. Environmental health risks such as fires, poor indoor air quality, vector-borne diseases, injuries, and floods were also significant. Additionally, the lack of protective non-food items (such as footwear) and dignity-maintaining items (like female hygiene products) created further issues. Portable medical documents, such as vaccination cards and basic medical history summaries, were also scarce.

International medical NGOs can play a crucial role in addressing the immediate and long-term medical humanitarian needs in post-conflict Gaza, including:

Gaza’s post-war landscape presents complex, cascading medical and humanitarian challenges. Addressing these needs requires a multifaceted approach, including immediate medical assistance, long-term economic recovery, and psychological support for individuals who have experienced repeated trauma.

The complexity in Gaza is compounded by the fact that, prior to the recent 22 months’ conflict, nearly half of the population had been living in refugee camps for years, which have transformed from tents into makeshift concrete slums. Many of these individuals resist being labeled as "Gazans," as it undermines their rights to return as refugees to their original homes in Israel. The reconstruction process in Gaza necessitates substantial international support and cooperation to address the widespread humanitarian and rebuilding needs in the region. Securing adequate funding to support the operation of medical facilities, mental health services, and the reconstruction of healthcare infrastructure is more urgent than ever. The global community must unite to ensure that the people of Gaza receive the care and support needed to rebuild their lives and communities.

Amid global uncertainties, CCOUC remains committed to its mission of advancing research and education on medical humanitarian response, striving to support vulnerable populations worldwide.

(An earlier version of this commentary was published in Chinese in the online news media HK01 here.)