Displacement, personal loss, and psychological strain among physicians and nurses working in Gaza, 2023-2024

On January 26th 2024, the International Court of Justice (ICJ) recognized plausible grounds for genocide being committed in Gaza by Israel. A hallmark of the violence has been unprecedented attacks on health workers since October 7th, 2023. We use the word "genocide" to refer to this period of accelerated violence and displacement in Gaza, following ICJ findings, detailed reports by human rights organizations, and statements by genocide scholars concluding that Israel is indeed committing genocide. To assess impacts of this violence, between December 2023 and January 2024 we conducted an anonymous cross-sectional online survey of physicians and nurses working in Gaza prior to and during the genocide. Participants reported on workplace displacement, personal losses, and psychological impacts using the Professional Quality of Life Scale for Health Workers (ProQOL-H). 56 participants completed one or more survey components. Among 46 participants reporting on displacement, 25 (54%) reported having to change workplaces at least once. Among 41 participants documenting personal loss, 17 (41%) reported that a family member was killed and 32 (78%) reported that a close colleague was killed. Among 35 participants completing the ProQOL-H, 17 (49%) respondents reported "high" compassion satisfaction (scores of 24-30), 13 (37%) reported high burnout, and 13 (37%) reported high secondary traumatic stress. This is markedly different from CS, BO, and STS scores reported by nurses in the West Bank in a recent study, likely reflecting the genocide in Gaza. Further work with survivors is needed to characterize their experiences and reconcile them with culture-specific coping strategies such as sumud. Culturally relevant, mixed methods follow up to this work is needed to inform interventions to support the recovery of survivors and rebuild Gaza's healthcare system. This will only be possible when the genocide is brought to a permanent end, along with the conditions which have enabled it.