Digital health in humanitarian crises: A case study of Gaza and the West Bank

Digital health technology (DHT) has become an important aspect of healthcare systems due to its ability to improve patient outcomes and access to patient data, thereby increasing provider efficiency. However, in areas of armed conflict such as the occupied Palestinian Territories (oPT), the implementation of sustainable DHT is difficult due to Israeli military policies, which have resulted in weakened healthcare infrastructure, intermittent electricity, and restrictions on the freedom of movement. This study investigates the impact of DHT on healthcare delivery in the oPT with an emphasis on electronic medical records (EMRs), communication methods, and logistical challenges. Our findings showcase that in the West Bank, restricted EMR access and training for visiting healthcare workers (HCWs) resulted in medical students serving as scribes, while EMR crashes caused delays in healthcare delivery. In Gaza, the devastated healthcare infrastructure has resulted in the use of paper records and cell phone photos to store patient data. Language barriers and intermittent power outages compounded the difficulty of providing care. WhatsApp was a major platform for clinician contact in both locations; however, substandard cell phone connections caused communications deficiencies. To increase DHT integration, this study suggests creating an offline EMR system, a patient database, and an enhanced communication system that utilizes satellite Wi-Fi. There are benefits to incorporating an English-to-Arabic medical terminology guide within the EMR system to aid in overcoming the language barrier. Strengthening DHT in Gaza and the West Bank is crucial for improving patient outcomes, ensuring data accessibility, and enabling future research. Collaboration between international non-governmental organizations, the Palestinian Ministry of Health, and international health organizations is critical for reconstructing the healthcare infrastructure and improving health systems in Palestine.