Abstract:
Women’s reproductive health and well-being were and are being severely destroyed prior to and throughout the 2023-24 War on Gaza. With an overwhelming majority of the Gazan population being Muslim, this paper explores the specific issues and problems Muslim women in Gaza are facing during this on-going war. Access to essential resources including medical supplies, water, and electricity has been restricted by the Israeli government. As such, their ritual purification and structured hygienic practices have been greatly impeded. While the vast majority of the casualties and injuries are women and children, the violations towards the reproductive health and well-being of Gaza’s women and girls have also increased. Beyond the physical well being of Gazan women, their spiritual sanctity has also been endangered as a direct result of the war. Mothers are greatly revered in Islam, and it is reported that gendered violence during war is a deliberate attempt to humiliate women and girls. The entire reproductive cycle has been terribly disrupted, from pregnancy and child delivery to breastfeeding and neonatal care. To address the protected group of women, girls, and children, we must work together as an academic community to continue to document such atrocities and, first and foremost, advocate for an immediate and permanent ceasefire, to end the occupation and allow sufficient and unimpeded humanitarian aid and resources into Gaza today.
Introduction
The colonial violence and settler apartheid which has
intensified into the on-going 2023-24 War on Gaza has
been classified as a genocide.1,2,3 The occupation of
Palestine since 1948 has caused destruction and
devastation that disrupts every Palestinian and Gazan’s
health and human rights. 2,4,5 Since women’s
reproductive health and well-being are being severely
destroyed, the war on Gaza is a feminist issue.5 With the
overwhelming majority of the Gazan population being Muslim, this paper explores the specific issues and
problems Muslim women in Gaza are facing, as well as
their needs during this on-going war.
Muslim women have long been marginalised in
medicine, beyond what is currently taking place in Gaza
and Palestine. The first image to come to mind when a
non-Muslim person thinks of a Muslim woman is a
female being oppressed and restricted by the scarf on her
head.6 Khan et al. commented that such a generalised
and reductive perception of Muslim women has relegated them to the peripheries of healthcare, by
disproportionately discriminating against them as
healthcare providers in healthcare settings.6 Khan et al.
criticised this stereotype of Muslim women and stated
that it results in depleting them of adequate and
comprehensive healthcare as female patients and
impeding them from delivering safe care as female
Muslim physicians and healthcare providers.6
Such conditions are further intensified in the apartheid
against Palestinian women and children. Access to
essential resources including medical supplies, water, and
electricity has been restricted by the Israeli
government.4,5 With no supply of reproductive and
menstrual care, the prevalence of infections increases
every day.7 At the same time, the spiritual sanctity of
Gazan women has been endangered as a direct result of
this war beyond physical well-being.
Cleanliness is a hallmark of Islam, with physical
cleanliness signifying religious purification.8 Reduced
access to water and sanitation supplies prevents the
passage of ablution, which is required for several
religious practices and is central to a Muslim’s state of
being. This essay highlights how the physical and
spiritual well-being of Muslim women in Gaza is being
threatened, making this war a feminist issue that must be
urgently addressed.
Muslim Women’s General Hygienic Lifestyle and Needs
Ritual purification, or tahara in Arabic, dictates physical
and spiritual cleansing practices for Muslims.8,9,10
Muslims can attain religious renewal by performing such
acts of worship to Allah. For example, Islamic practice
involves purifying oneself through ablution, or wuduu in
Arabic, before the five daily prayers.9,10 Ablution
involves using water to wash one’s hands, arms, feet, and
face. Ablution becomes invalid after defecation,
urination, sleeping, flatulence, and more. Practising
Muslims are habitually in a state of cleanliness.
Full ablution, or ghusl, which involves the washing the
entire body from head to toe, is required after sexual
relations. Muslim women must also perform full ablution
after the completion of their menses and postpartum
bleeding.10 Muslims may perform dry ablution or
tayammum (purification using dry soil) if clean water is
unavailable or in insufficient supply.11 By performing
ablutions and maintaining cleanliness, Muslims seek to
get rid of physical impurities. They also serve as spiritual purifications, as Muslims strive to attain a state of inner
devotion and closeness to Allah.
The structured hygienic practices outlined in Islam
benefit both the individual and their community. Such
practices can be linked to decreased disease transmission
during the Covid-19 pandemic.9 The religious beliefs
that dictate physical cleanliness have also instilled
resilience and hope within believers as they combat
difficulties such as living through a pandemic.
The Impact of War on Muslim Women’s Health and Well Being
As Muslim women navigate purity through religious
norms, it becomes essential to evaluate the impact of
conflict and war on resources and religious identities.12
For instance, many Muslim women in India have found
solace through routine religious practices, including
performing daily ablution and prayers, when a rise in
Islamophobia has threatened the livelihood of their
Muslim communities. They have worked towards
maintaining an inner connection with Allah through
cleanliness and physical piety in a time when an outward
one might endanger them. Similarly, religious practices
have been impeded in Gaza’s on-going war when a
scarcity of clean water prevents women from performing
ritual ablutions.13
Another example is the health and safety of female
Syrian refugees who were threatened during the ongoing
Syrian war conflict since March 2011.14 Syria is a
Muslim-majority country with 92.8% Muslim.15 In this
case, women were displaced from their homes and into
new environments, resulting in isolation and anxiety.14
The study of Al-Natour, Morris, and Al-Ostaz observed
that the emotional and physical well-being of these
women worsened as access to medication and healthcare
services became scarce—all of which became a testament
of the will of refugee women working to keep the family
unit together through culture and religion.14 Muslim
women in Gaza face the same challenges as the result of
the on-going war. As of March 2024, more than one
million Gazan females have been displaced due to the
current war.13,16,17
The Impact of the 2023-24 War on Gaza on Muslim Women’s Health and Wellbeing
The violation of women’s health and human rights by the
Israeli occupation did not start on October 7, 2023; such
violation was present before June 2007 when the siege and closure policy was first enforced by Israel.1,16 The
violations became more dire after October 7, 2023 when
67% of all casualties were observed to be women and
children within the first month of the war.7 As of March
2024, the War on Gaza has taken the lives of more than
10,000 women,13 and more than 19,000 women have
been injured. More than 3,000 women may have become
widows and more than 10,000 children may have lost
their fathers, thereby making more women the heads of
their household. Thirty-seven mothers are killed in Gaza
every day.16,17
There are many verses in the Qur’an that emphasise the
importances of parents and specifically mothers in Islam.
Most significantly, verse 46:15 states that ‘And We have
enjoined upon man, to his parents, good treatment. His
mother carried him with hardship and gave birth to him
with hardship, and his gestation and weaning [period] is
thirty months’.18 This Qur’anic verse acknowledges the
difficulties mothers experience during pregnancy,
childbirth, nursing, and weaning a child. As such
Muslim children are commanded to respect and treat
their mothers with care. The verse continues to explain
that when a Muslim reaches adulthood, if they repent and
remain grateful for all their blessings, then they too
would ask to bear righteous Muslims as their children.
Therefore, the reproductive life cycle and the roles
women play in their families are known and revered by
practising Muslims.
Awadallah’s criticisms included the statement that
gendered violence during war is a deliberate attempt to
humiliate women and girls.16 Al- Halabi holds similar
opinions stating that the current war prevents women
from giving birth and nurturing their newborns in a safe,
secure, and healthy environment because women’s
freedom to carry a child to full-term with proper nutrition
has been impeded.1 Additionally, Al-Halabi criticised
how pregnant women in Gaza are projected by the
occupiers to be an enemy because they are carrying
future Palestinian generations and their resistance figure
to keep the family together.1 The author further
explained that this reframing of Gazan women as the
enemy by the occupiers distorts the traditional view of
Gaza’s society of child-bearing and nurturing Muslim
mothers, exploiting women’s identity and gender. Since
the family unit is the foundation of Gaza and Palestinian
society, the War disrupts Gazan women’s national
identity and dismantles the social structure that enables
them to display their resilience in retaining and re
forming their family. Inhibiting women from giving birth
to the next generation of Gazans deteriorates Gaza’s
traditions, culture, and existence.1
Gaza has been denied water, sanitation, and hygiene
(WASH) services long before the current war began.13
However, the severity of the restrictions has increased
dramatically with the war. For example, 70% of Gaza’s
civilian infrastructure (such as homes, hospitals, schools,
and WASH facilities) has been destroyed or severely
damaged.19 This leads to additional loss of daily
essentials like hot water, food, electricity and medical
supplies.4,5,16 Without access to sanitary resources and
clean water, women are at risk for health complications
related to dehydration, urinary infections, menstrual
hygiene, and pregnancy.13 With no supply of
reproductive and menstrual care, the prevalence of
infections increases every day.7 Not surprisingly, this has
placed immense psychological stress on women and
families in Gaza (Sabet et al. 2024).20
According to estimates from the UN Population Fund
(UNFPA), since October 7, 155000 women in Gaza are
pregnant or breastfeeding, with 5,500 expected to deliver
in every month.17 UNFPA further reported that Gazan
women and girls did not have adequate access to
reproductive health care services.16 As of February 29,
2024, many of the 17,000 women who gave birth during
the war underwent caesarean sections without
anaesthesia.16,20 A 300% increase of miscarriages was
reported due to the war, and anyone undergoing the
process of in vitro fertilisation was halted mid
treatment.20 Muslim women patients prefer and are more
comfortable to be treated by female physicians and
healthcare workers, specifically during obstetrics and
gynaecology care, when possible.21 However, this war
leaves women with no such option and forces them to
give birth in public areas, such as birthing in the corridor
of a hospital, with no privacy and care at all.1 It is
apparent that all forms of reproductive health, from
childbearing to child rearing, have been severely violated
during this war on Gaza. Women and mothers bear the
highly unfortunate burden of knowing that the United
Nations called Gaza during this 2023-23 War the most
dangerous place to be a child”.17
Conclusion
There are numerous medical interventions and practices
that must be outlined to specifically address women and
girls’ health problems in Gaza. Therefore, we urge the
greater feminist and humanitarian aid community to
further explore and document such research and
recommendations. Our goal in this essay is to shed light
on the many issues and show the War on Gaza is a
feminist issue, from an Islamic perspective for Muslim
majority Gaza. Areas needing academic attention include but are not limited to the War on Gaza and prenatal and
postnatal care of Muslims. It is essential to document the
various ways Gazan Muslim women handle their menses
and postnatal bleeding despite not having sufficient
supplies of water or laundry, and document how Gaza
women handle menopause which also leads into geriatric
care. To address the protected group of women, girls and
children, we must work together as an academic
community to continue to document such atrocities and,
first and foremost, advocate for an immediate and
permanent ceasefire, to end the occupation and to allow
sufficient and unimpeded humanitarian aid and resources
into Gaza today.
Acknowledgements: The authors would like to thank
ZM Sabra for her technical editing assistance.
Competing interests: None declared.
Disclaimers: The views expressed in the submitted
article are those of the authors and not an official position
of our institutions.
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