Rehabilitation needs and challenges in Gaza strip (Palestine) after the ceasefire: A call for coordinated action

Abstract

Tens of thousands of people suffered serious, life-altering injuries as a result of the humanitarian and health crises caused by the fighting in the Gaza Strip (Palestine) (October 2023–October 2025). The rehabilitation system is on the verge of collapse due to the majority of rehabilitation facilities collapsing, the scarcity of assistive technology, and the severe lack of qualified personnel. As a key element of Gaza’s recovery, this brief report emphasized the urgent need for concerted international action to develop rehabilitation capability. It suggests creating a task force headed by the UN and co-chaired by the World Health Organization and an impartial donor. The task force would be organized around four operational pillars: workforce development, infrastructure and sanitation, logistics and supply chains, and clinical rehabilitation services. Restoring trauma and wound care services, reopening facilities for orthotics and prosthetics, tele-rehabilitation, and growing community-based rehabilitation programs are among the priority initiatives. Using focused strategies to engage the Palestinian diaspora could improve sustainability and capacity building. Resolving the interrelated problems of functional disability, public health decline, and infrastructure destruction calls for a coordinated, transparent, and data-driven strategy. Therefore, in order to restore autonomy, dignity, and long-term resilience for Gaza’s damaged population, rehabilitation must be integrated into larger humanitarian, rebuilding, and public health efforts.

Introduction

Between October 2023 and October 2025, the hostilities in Gaza strip (Palestine) have resulted in a humanitarian catastrophe, leaving tens of thousands with life-changing injuries such as severe limb trauma, spinal cord injury, traumatic brain injury, major burns, and amputations. ¹ According to the World Health Organization (WHO), there are nearly 42,000 people in Gaza living with such injuries, about one quarter of all reported conflict-related injuries, with children significantly affected. ¹ Many rehabilitation services have collapsed or are only partially functioning: less than one third of pre-conflict rehabilitation services remain operational, essential assistive devices are scarce, and the prosthetic and inpatient rehab centers are severely impacted. ² Against this backdrop, the need for rehabilitation is no longer a supplementary concern, it is central to individual, community, and public health recovery. ³

Given the dire circumstances facing the Gaza Strip, ⁴ it is imperative to have a deeper comprehension of the actors who are currently involved or who may be called upon in the future. The current brief report’s primary goals were to (i) outline the work being done by some organizations and to generate some specific ideas about reconstruction and rehabilitation; (ii) recommend organizations and nations that can provide assistance; and (iii) explain how this assistance can be arranged, particularly if some emigrated Palestinians return to aid in reconstruction.

The human and clinical impact

The Gaza conflict/war has produced a catastrophic humanitarian and clinical crisis, with escalating injuries and mortality.^5,6 Epidemiological reports revealed a predominance of blast-related trauma and complex injury patterns, compounded by the collapse of healthcare infrastructure and mass displacement.^7,8 Mass casualty events are recurrent, such as the June 2024 incident at Shuhada al-Aqsa Hospital involving 47 casualties, where 76.6% suffered blast injuries. ⁹ These patients frequently present with multi-regional trauma to the head, chest, abdomen, and limbs, often requiring immediate, complex surgical intervention. ⁹ Both gunshot and explosive injuries cause extensive lower limb trauma, with the latter leading to higher rates of amputation and severe tissue destruction. ⁷

The conflict/war has severely disrupted continuity of care, leading to loss of functional independence and further deterioration of public health.^6,10 The systematic destruction of healthcare facilities and depletion of essential resources have paralyzed acute and chronic disease management.^6,7 Hospitals across Gaza operate under extreme duress, many partially destroyed or nonfunctional, with shortages of medicines, surgical equipment, and personnel. ¹¹ Remaining hospitals, such as Al Aqsa Martyrs and European Gaza, face unsustainable surgical workloads, leaving over two million residents without access to basic medical care. ⁶

Current humanitarian and health efforts by key organizations in Gaza

The United Nations (UNs) Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), ¹² the World Food Program (WFP), ¹³ the International Committee of the Red Cross (ICRC), ¹⁴ WHO, ² the Palestine Red Crescent Society (PRCS), ¹⁵ UNs Children’s Fund (UNICEF), ¹⁶ and Médecins Sans Frontières (MSF) ¹⁷ are just a few of the organizations that are providing assistance. The ICRC continues to facilitate transfer of remains and detainee-related tracing operations and is engaged in protection and forensics-related activities. ¹⁴ The UNRWA is providing education, shelter, food and cash distribution, and camp-based services. ¹² WHO emphasized rehabilitation coordination with emergency medical teams. ¹ It coordinated health-system, supplies, and reporting. ¹ The PRCS provide ambulance and front-line emergency medical response. ¹⁵ The WFP distribute food parcel and logistics. ¹³ The UNICEF continues large-scale child protection, nutrition programs and humanitarian cash transfers targeted to vulnerable households, including children with disabilities. ¹⁶ The MSF, who provide hospital support and emergency surgery, ¹⁷ reopened a wound-care clinic in Gaza City on 15 October 2025 and resumed water-trucking operations (90,000–180,000 L/day) and targeted trauma care there. ¹⁷ MSF partially resumed operations, reopening a wound-care facility that serves over 640 trauma patients across many distribution sites. ¹⁷

Systemic and logistical challenges

The loss of rehabilitation centers, assistive devices, and trained professionals has deepened the crisis. ⁴ Blast and orthopedic injuries dominate trauma cases, demanding complex interventions that are often unfeasible due to limited capacity, resource shortages, and the collapse of neurosurgical and rehabilitation services. ⁷

Systemic challenges include administrative barriers restricting the entry of goods and personnel, financial instability delaying humanitarian funding, and poor coordination between local and international actors.^6,10 Years of blockade and political instability had already weakened Gaza’s health infrastructure, and the escalation has made procurement and distribution of medical supplies nearly impossible. ⁸ The absence of a unified national recovery framework further undermines efficiency, with fragmented efforts failing to meet the immense healthcare demands. ⁶

Here is a recommended coordination model. It is capital to establish a UN-led rehabilitation and recovery task force (under UNs Office for the Coordination of Humanitarian Affairs/health cluster and co-chaired by WHO and a neutral major donor) with four operational cells (health/rehab clinical services; infrastructure/water/sanitation; logistics and supply-chain; and workforce and capacity building). Each cell should have a named lead agency, an operations manager, agreed standard operating procedures for procurement and quality control, and a consolidated data portal for needs, inventory and outcome metrics. This task-force should produce an initial 6-month operational plan with defined key performance indicators and a transparent donor-tracking mechanism to ensure funds reach priority rehabilitation services. ² Mobility restrictions compound the crisis, obstructing patient transport, humanitarian access, and staff movement. ¹⁸ Damaged roads, checkpoints, and ongoing hostilities impede emergency care and cross-border transfers. ⁶ These systemic, logistical, and administrative constraints collectively highlight the urgent need for coordinated international intervention to restore Gaza’s health system and ensure access to essential medical and rehabilitative services.^8,10

In addition to the World Bank and regional players like Egypt and Qatar, coordinated international efforts headed by agencies like the UNs Development Program (UNDP), ¹⁹ UNICEF, ¹⁶ WHO, ¹ ICRC, ¹⁴ and MSF ¹⁷ would probably be necessary for Gaza’s reconstruction and rehabilitation. ²⁰ Operationally, different actors are well-placed to lead distinct workstreams: WHO (working with the Emergency Medical Teams coordination cell) should lead rehabilitation needs assessment, clinical protocols and health-system integration; UNDP and the World Bank should coordinate reconstruction of health and water infrastructure and longer-term financing; UNICEF should lead child-focused nutrition, protection and disability-inclusive cash assistance; ICRC should lead protection, forensics and negotiation for humanitarian access; and international non-governmental organizations such as MSF can provide rapid trauma and wound-care and temporary surgical capacity. Furthermore, MSF could contribute to the rehabilitation of Gaza’s healthcare infrastructure by upgrading hospital energy systems—specifically by transitioning from diesel generators to solar-powered systems, similar to its “Green Initiative” project in Somalia, which successfully reduced dependency on scarce fuel supplies and improved the sustainability of medical services. Such a shift would ensure continuous power for critical hospital operations and lower operating costs. ²¹ Bilateral donors (Norway, Sweden, EU mechanisms, Turkey) and multilateral funds can finance infrastructure and technical assistance; regional partners (Egypt, Qatar) can support logistics, border-crossing arrangements and recovery hubs. A deliberate division of labor with defined leads will reduce duplication and speed.^2,19 Financial and technical assistance is anticipated, with an emphasis on reconstructing schools, healthcare systems, and infrastructure. A central coordination framework overseen by the UN will be necessary for the efficient administration of relief in order to guarantee transparency, give priority to humanitarian needs, and incorporate local government structures.

Engaging the Palestinian diaspora can provide rapid technical expertise, investment, and capacity building, but requires deliberate facilitation. International evidence shows diaspora professionals often contribute through remote technical assistance, short technical missions, financial remittances, and long-term return when there are clear incentives and reintegration supports. ²² Practical measures to mobilize the diaspora include: (i) a dedicated diaspora-engagement portal (listing needs and short-term assignments), (ii) temporary licensing and fast-track credential recognition for returning health professionals, (iii) small grants and matched-funding windows for diaspora-led rehabilitation enterprises (prosthetics workshops, tele-rehab platforms), and (iv) partnerships with universities and professional bodies abroad to support rapid training and supervised return missions. These measures increase the likelihood that emigrated Palestinians will be able to contribute safely and effectively. ²² A combination of emergency clinical care, large-scale food and financial distributions, water and sanitation, protection and family tracing, and health-system support (referrals, supplies, field hospitals) may be offered by the UN Office for the Coordination of Humanitarian Affairs, ²³ UNICEF, ¹⁶ and several health-cluster partners.

The way forward: Rebuilding rehabilitation capacity

Rebuilding rehabilitation capacity in Gaza is essential to address both the immediate and long-term consequences of war-related injuries, which frequently result in complex trauma and lasting functional impairments. ⁶ The way forward requires integrating early rehabilitation into emergency response, strengthening local human resources, promoting multidisciplinary teamwork, implementing tele-rehabilitation, expanding community-based programs, and establishing sustainable policy and international support frameworks.^6,10 Early rehabilitation within acute care settings can significantly reduce long-term disability from blast, orthopedic and traumatic brain injuries. ⁶

Operational priorities for the first 12–24 months should focus on: (i) re-establishing acute trauma and wound-care capacity (including mobile wound clinics and replenishment of dressings, antibiotics, analgesics and basic orthopedic implants); (ii) re-opening or re-establishing at least two regional prosthetics and orthotics hubs with rapid prosthetic fabrication capacity; (iii) workforce stabilization through immediate short courses (task-sharing) for physiotherapy assistants and community rehabilitation workers; and ( iv) restoring clean water, sanitation and infection-prevention capacity that underpins safe rehabilitation. These priorities create the minimum functional platform for safe surgical care, early rehabilitation and prevention of long-term disability.

A practical initial rehabilitation package could include: mobile wound-care teams (with dressings and negative-pressure equipment where feasible), a rapid prosthetic-fitting stream for amputees, tele-rehabilitation support for follow-up and remote supervision, and a community-based rehabilitation (CBR) training program to empower local caregivers. Programs should adopt measurable benchmarks (e.g. number of mobile clinic patient contacts/month, prostheses delivered, CBR workers trained) to guide phased scale-up. ¹ Severe loss of infrastructure and professional “brain drain” have depleted Gaza’s rehabilitation workforce. ²⁴ Rebuilding capacity therefore demands comprehensive training programs for physical, occupational, and speech therapists, prosthetists, and trauma-informed practitioners. Effective rehabilitation depends on multidisciplinary teams that coordinate surgical, physical, and psychological care to restore function and address post-traumatic mental health needs. ⁶

Given the damaged infrastructure and restricted mobility, tele-rehabilitation can extend access to therapy and follow-up care for displaced and chronically injured patients. ⁶ Recent systematic reviews demonstrate tele-rehabilitation is generally safe and can produce functional gains comparable to in-person care for many conditions, making it an evidence-based option where in-person services are limited. ²⁵ In parallel, CBR programs should empower families and local workers to support functional recovery within communities.^6,10

A national, integrated policy supported by sustained global cooperation is vital for rebuilding Gaza’s rehabilitation services. This includes clear strategies for workforce development, resource allocation, and coordinated data-driven service delivery.^6,10

Conclusion

The catastrophic sanitary conditions in Gaza intensify rehabilitation needs by promoting infection, malnutrition, and psychological distress, all of which hinder recovery from war-related injuries. The destruction of water, sanitation, and health infrastructure, along with mass displacement into overcrowded shelters, has created a severe public health emergency. Individuals with blast or orthopedic injuries face heightened risks of wound infection and delayed healing, while widespread trauma and poor hygiene undermine engagement in rehabilitation. Combined with the collapse of healthcare services and mobility restrictions, these factors critically impede recovery. Addressing the sanitation crisis is thus integral to any sustainable rehabilitation strategy, demanding coordinated, multi-sectoral, and internationally supported reconstruction efforts.

This brief report argued that without urgent and coordinated efforts to rebuild and expand rehabilitation capacity in Gaza Strip including workforce protection, supply chains for assistive technologies, community-based programs, and integration with mental health services, the long-term disability and social burden will escalate sharply.

To take home message

To lessen the long-term effects of war on people, society, and infrastructure, it is imperative that Gaza’s rehabilitation capacity be restored. This can be done through community-based initiatives, infrastructure restoration, workforce protection, and integration with mental health and sanitation interventions.