Healthcare collapse and disease spread: a qualitative study of challenges in Gaza strip.

Abstract

Importance: The Gaza Strip has been enduring a severe humanitarian crisis due to prolonged conflict, blockade, and systemic instability, resulting in the collapse of its healthcare system.

Objective: To explore the impact of healthcare collapse on the spread of infectious diseases in Gaza, focusing on the challenges faced by healthcare workers, the barriers to disease management, and the coping mechanisms employed by the community.

Design, settings, and participants: In this qualitative research, semi-structured interviews and focus group discussions with healthcare professionals, humanitarian workers, and community members in the Gaza Strip were utilized. In total, 30 interviews were conducted with healthcare professionals and humanitarian workers, and 6 focus group discussions (FGDs) with community members were held in three different locations across the Gaza Strip. Each interview lasted approximately 45-60 min, and FGDs ranged from 60 to 90 min. All interviews and discussions were audio-recorded with participants' consent. The semi-structured interview guide used in this study was specifically developed by the research team to address the study's objectives. The guide was informed by a review of relevant literature and expert input to ensure comprehensiveness. An English-language version of the interview guide has been provided as a Supplementary File 1.

Main outcomes and measures: Descriptive themes of participant experiences to identify key challenges and patterns related to the collapse of the healthcare system and its impact on infectious disease spread.

Results: The study found that the collapse of healthcare infrastructure in Gaza could have exacerbated the spread of infectious diseases, as it created conditions that may have increased the risk of transmission. Key challenges included severe shortages of medical supplies and equipment, overcrowded healthcare facilities, and inadequate sanitation and hygiene conditions. These issues were compounded by the psychological stress and burnout experienced by healthcare workers. The lack of effective disease surveillance and delayed international aid further impeded the response to infectious disease outbreaks. Participants reported a reliance on traditional remedies and community networks due to a loss of confidence in the formal healthcare system.

Conculsions and relevance: The findings underscore the urgent need for comprehensive international support to rebuild Gaza's healthcare infrastructure and improve disease management. Addressing the shortages of medical supplies, enhancing disease surveillance, and providing psychological support for healthcare workers are critical steps in mitigating the spread of infectious diseases. The study highlights the broader implications of healthcare system collapse in conflict zones and calls for coordinated global efforts to address the underlying issues contributing to public health crises in such settings.