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DUBAI: Since the war in Gaza began in October 2023, more than 28,000 women and girls have been killed — an average of one every hour — according to UN Women, making the besieged Palestinian enclave one of the most dangerous places in the world to be female.

Thousands more have been injured and nearly a million displaced. As food, water and basic healthcare become increasingly scarce under Israeli blockade, survival has turned into a daily struggle — and women and girls are bearing the brunt.

According to a group of independent UN human rights experts, nearly 13,000 women in Gaza are now the heads of their households, often caring for children without adequate shelter or essential supplies.

On May 21, experts issued an urgent appeal to the UN Security Council, condemning what they described as Israel’s “unprecedented assault” on Gaza’s civilian population — and warning of its particularly devastating impact on Palestinian women and girls.

“The devastation experienced by women, girls and entire communities is not incidental — it is the consequence of intentional policies and actions by Israel,” they said.

“The killings of thousands of women and girls may constitute the deliberate infliction of conditions of life calculated to bring about the physical destruction, in whole or in part, of the Palestinian people.”

Israeli forces launched military operations in Gaza in response to the Hamas-led attacks on southern Israel on Oct. 7, 2023, during which 1,200 people — mostly civilians — were killed and about 250 others, many non-Israelis, were taken hostage.

Since then, at least 56,000 Palestinians have been killed in Gaza, according to local health officials. Israel maintains that it does not deliberately target civilians and accuses Hamas of using Gaza’s population as human shields.

The crisis has been compounded by repeated Israeli blockades on humanitarian aid and commercial goods, pushing the territory into famine and prompting accusations that food is being weaponized.

Despite ongoing international attempts to broker a ceasefire, the conflict has devastated the enclave, triggering one of the world’s worst humanitarian disasters.

“More than two-thirds of Gaza’s population, about 1.7 million people, are now estimated to be crammed into an area of 69 sq. km — less than a fifth of the Strip,” Hadeel Qazzaz, Oxfam MENA’s regional gender coordinator, told Arab News.

In overcrowded tents and displacement camps, privacy is almost nonexistent. Care responsibilities have increased for women, and water shortages are taking a disproportionate toll.

“From queuing for hours in the heat for water to facing daily health risks due to lack of proper sanitation, the lack of clean and safe latrines is leading to serious health issues, including infections among women,” said Qazzaz.

At displacement sites reached by Oxfam in May 2024, water points were reportedly located up to a kilometer away. Women and girls were spending up to three hours a day collecting water — compared to 1.7 hours for men and boys.

But water is only part of the problem. Food insecurity presents another growing threat. Nine out of 10 displacement sites show visible signs of malnutrition among residents, with female-headed households among the most vulnerable.

“Women are skipping meals so their children can eat,” said Qazzaz. “Many are putting their own health at risk to keep their families going. When food parcels arrive, women often eat last — or not at all.”

An estimated 71,000 children and 17,000 women are expected to require urgent treatment for acute malnutrition in the coming weeks, highlighting the scale of the emergency and the desperate need for sustained aid access.

“Even when food is available, women often have to cook on open fires due to fuel shortages — exposing them to health risks and doubling the time needed to prepare a meal,” said Qazzaz.

Pregnant and breastfeeding women are especially at risk, with many becoming dangerously undernourished.

Since October 2023, Gaza has seen a 300 percent increase in miscarriages. Premature births and maternal deaths have surged, with many women forced to give birth without proper medical support.

“Maternal care is nearly nonexistent,” said Qazzaz. “Women are giving birth in tents, without skilled help, clean supplies or even pain relief.”

These accounts are echoed by medical workers on the ground.

“The situation in Gaza is precarious for everyone, but especially for pregnant women,” Denise Potvin, a Canadian nursing activity manager with Medecins Sans Frontieres at Nasser Hospital in Khan Yunis, told Arab News.

“Over the past weeks, we’ve seen malnutrition steadily increase. It’s very visible — there’s a huge vulnerability for pregnant and lactating women. The small amount of food entering Gaza through aid crossings is nowhere near enough to meet the needs of this population.”

Maternity departments are seeing more women arriving late — after giving birth at home — or showing up in emergency rooms because they couldn’t reach a hospital in time.

“Colleagues, including midwives and health professionals, are being woken up in the middle of the night to assist in home deliveries because women simply cannot reach hospitals,” said Potvin.

“Constant displacement, insecurity and lack of transport make it incredibly difficult for pregnant women to access care.”

Routine antenatal check-ups have become nearly impossible to access. With clinics shutting down, the ability to detect or treat complications has all but vanished.

“The space that organizations operate in is decreasing by the day,” said Potvin. “More people are displaced, and it’s harder to meet the growing needs of the population.”

She called on the international community to recognize the extreme vulnerability of pregnant women under siege.

“Imagine being a pregnant woman in this situation — living in a tent, unable to access prenatal care, giving birth without medical help, while also trying to feed your family, find clean water and maintain basic hygiene,” she said.

“Daily survival is already a huge challenge, and pregnancy only adds to it.”

Reports from UN Women, the UN Population Fund and independent rights monitors paint an increasingly bleak picture.

Women and girls with disabilities face even greater risks, including neglect, violence and denial of basic services.

From bombardment to birth complications, period poverty to famine, every aspect of life has been made much harder.

With 90 percent of households facing extreme water shortages, women and girls struggle to manage menstruation without access to clean water, soap, sanitary pads or private spaces.

Around 700,000 women and girls of menstruating age — many experiencing their first periods — are facing these challenges in shelters and displacement camps.

A rapid gender analysis by Oxfam found that 690,000 menstruating women and girls lack access to clean facilities and sufficient water for basic hygiene.

Each person is allocated just 6.6 liters of water a day — less than half the global emergency minimum. Toilets are unsanitary, overcrowded and often unsafe for women and girls, with up to 1,000 people sharing a single facility.

The Oxfam report warned: “Girls are vulnerable to harassment and abuse and resort to using old clothes or only their underwear when sanitary pads are unavailable” — a situation that has led to infections, maternal complications and even infant deaths.

Despite the immense logistical challenges, the UN Population Fund continues to address urgent sexual and reproductive health needs.

Since October 2023, it has distributed two-month supplies of disposable menstrual pads to more than 300,000 women and girls. More than 12,000 new mothers have received postpartum kits for recovery in conditions where professional care is almost impossible.

To help women regain a sense of dignity and autonomy, the agency has also provided cash and voucher assistance to more than 150,000 women and girls, enabling them to buy essential hygiene items like soap, towels, pads, and underwear amid severe shortages.

These relentless hardships — from caregiving and hunger to hygiene struggles in unsafe conditions — are taking a psychological toll. Mental health issues are on the rise, with mounting reports of stress, anxiety and depression among women and girls.

With Gaza’s education system in collapse, many girls have become full-time caregivers for their younger siblings.

“Girls are being more deeply affected,” said Qazzaz. “The war has pushed many out of school and into caregiving roles. Some are being forced into early marriages as families try to reduce economic burdens.”

As household tensions rise, so too does gender-based violence.

Experts say only a ceasefire would offer immediate relief to the women and girls of Gaza.

“Even a temporary end to the violence would offer critical psychological relief for women carrying enormous emotional and caregiving burdens,” said Qazzaz. “It would give families a chance to breathe, regroup, and begin to heal.”

A truce would also help restore access to hospitals, allow medical teams to resume work, and ensure that essential aid — from food and medicine to hygiene supplies — reaches those in need.

Meanwhile, the independent UN experts have issued a stark warning about the wider implications of the conflict.

“In Gaza, the rules of engagement and fundamental protections owed to civilians have been intentionally, persistently and flagrantly violated,” they said.

“If the Security Council fails to confront this profound breakdown in compliance and accountability, and what it means for humanity and multilateralism, the very foundations of international law risk becoming meaningless."