“There will be a significant increase in the number of people with disabilities in Gaza”

Since October 7 and the escalation of violence between Israel and Hamas, some 30.000 Palestinians have been killed and 70.000 injured in the continuous bombing of Gaza by Israeli forces. This deadly offensive comes in the wake of a massive attack launched on Israel by Hamas, in which 1,200 Israelis were killed and 240 Israelis and foreign nationals were taken hostage.

HI Physical Therapist, Maria Marelli: My role is to assess the condition and morale of the team, understand their working dynamics and organizational structure, and support them in their work. I followed them at work in the shelters: the mobile team, consisting of physical therapists, nurses and occupational therapists, is showing immense dedication amidst challenging conditions.

Overcrowded Rafah

The scale of the crisis is staggering. The shelter we visited (a former school) was designed for 2,000 people but now houses 28,000, with families crammed into classrooms, corridors, tents in what was the school yard. The absence of facilities forces people to sleep on the floor. Sewage water is spilling on corridors and common spaces, with tents scattered everywhere.

Despite these challenges, the teams are managing to provide essential care even with the basic equipment they have, as trucks with supplies are stuck at the border.

HI treats both war-related injuries and non-war-related ailments, including fractures, burns, and long-term disabilities. There are not many organizations who do that. People with disabilities, the elderly, and people who are bedridden are often overlooked, especially in emergency situations.

The assistance we provide in shelter

We visited a child with a femur fracture, who has been fitted with an external fixator for four months. It is an unusual extended period. Upon examination, the surgeon advised that an additional surgery was necessary to reposition the external fixator. Due to the high demand for surgical procedures, the child has been placed on a waiting list. Meanwhile, we continue to dress the wound and preserve movements and strength at ankle, knee and hip level as much as possible. We focused on strengthening the structure around the injured leg and the unaffected leg. To aid in mobility, we provided crutches and began training the child to navigate stairs and safely sit and stand from the floor, where he sleeps.

We also visited a woman with a clavicle fracture who was fortunate enough to undergo surgery using an internal fixator. Following the surgery, she was discharged from the hospital but experienced severe limitations in shoulder movement. It was the final session for her, and she displayed immense happiness as she could now dress herself and wear a hijab without assistance because you need to put your hand above you head to properly place the hijab and it was a movement she was not able to do. We visited her in a shelter where she and her husband were lucky enough to have a private space. Now she can fix her hijab, she can venture out and take care of herself, including washing independently.

The number of people with disabilities is skyrocketing

There will be a significant increase in the number of people with disabilities in Gaza. That is sure. Even a seemingly minor injury or fracture, if improperly treated or if it gets infected, which is highly possible given the terrible hygiene conditions, could lead to complications and lifelong disabilities.

No hygiene, no sanitation

Before the escalation of violence, Rafah was once a relatively small city hosting around 200,000 people. Most of the services were concentrated in Gaza City and northern Gaza. Rafah was not well served, since it hosted fewer inhabitants. Now, I am astonished by how people manage to survive hygienically. People are everywhere, and it's striking to see almost all children walking around without shoes. It has been 5 months of war, children are starting to outgrow the clothes and shoes their parents took with them at the beginning of the war.

What will be the future?

Many people cope by holding onto a vision of returning to normality, believing that things will revert to how they were. I am impressed by the dignity maintained by our team in this situation.

HI volunteers for Victim Assistance

We currently have 40 mobile team members in Rafah, with an additional 30 in the Middle Area, and we have recently opened a team in Khan Younis. Communication is incredibly challenging, with frequent disruptions to phone services. Internet is present only, and not always, in the office.

In the Rafah office, we sleep in the safe room, which is the corridor of the office, to shield ourselves from any potential shelling during the night. Our living and working conditions are far from ideal— water is limited, and there is insufficient space for privacy or for work: colleagues come to work in shift because we don’t have enough spaces for all: three rooms accommodate staff; some of us work in the kitchen.

Call for an immediate ceasefire

HI continues to be alarmed by the very high number of civilian victims, the lack of safe humanitarian access and the limited number of trucks being able to enter the Gaza strip daily. Along with more than 800 organizations, HI is calling for an immediate ceasefire to put an end to the carnage and ensure the provision of humanitarian assistance to the affected population.