By Dima Nazzal
Over a decade ago, a United Nations report described the Gaza Strip as virtually unlivable, adding that it would require “Herculean efforts” to change that.
Today, after six months of bombardment, mass displacement and siege by Israel, the task of rebuilding Gaza seems practically unimaginable.
I’m a scholar and a systems engineer who, as research director of the Center for Health and Humanitarian Systems at Georgia Tech, looks at the intersection of public health and education, with a focus on optimizing systems for effective and equitable access to essential services.
I know that in the best of times, designing complex systems that involve people, communities, technologies and limited resources – often with conflicting priorities and impacting multiple segments of society – is an extremely complex challenge. Doing so in the midst of a geopolitical conflict makes the problem seem infeasible.
But what we are dealing with now in Gaza is on a different scale altogether. The enclave is facing cascading crises – a condition in which multiple interrelated crises occur sequentially or simultaneously, each triggering or exacerbating the next. And as hard as it is to look beyond the daily horrors of warfare in Gaza, there will be a time when the world starts to turn to recovery and reconstruction. The concern is that the cascading crises will make this process that much harder and moreover amplify the human costs of this conflict for years to come.
Beyond the death toll
As the 2012 U.N. report questioning Gaza’s “livability” alludes to, the occupied enclave has long faced severe problems relating to providing for the people living in what is one of the most densely populated areas in the world. My mother, who lives in the West Bank, often visited Gaza in her capacity as a member of the Palestinian National Council and the General Secretariat of the General Union of Palestinian Women. She would share tales of its rich culture but also of noticeable issues like the persistent sewage smell and unemployment exceeding 45%.
Of course, after months of Israeli bombardment following the Oct. 7, 2023, attack by Hamas, the immediate concern is for people’s lives. Already, the conflict has killed more than 33,000 people in Gaza, according to health authorities in Gaza.
But devastation caused by armed conflicts extends beyond immediate casualties. Causal pathways – that is, chains of events through which the long-term consequences will be felt – mean the current conflict will almost certainly lead to lasting societal and health crises. And these, research has shown, can overshadow the destruction that results from an active conflict both in scope and in severity.
Analysis of 13 recent armed conflicts by the Geneva Declaration Secretariat, a U.N.-backed initiative, found that indirect deaths exceeded direct deaths in 12 of them.
The report places a conservative estimate that for every person directly killed by war, four more are killed by its indirect consequences – things such as waterborne diseases due to the lack of safe, clean water and destruction of water sanitation facilities, or deaths due to birth complications because of health services being disrupted.
Given the scale and scope of destruction of six months of bombing, the consequential impact of war in Gaza may be even worse. And whereas there is usually a lag before these effects are felt, in Gaza they are already occurring. Economic collapse, infrastructure destruction, environmental damage and displacement have created a multidimensional crisis.
Compromised systems
To understand the challenge of overcoming cascading crises in Gaza, it is worth taking a snapshot at the impact of the monthslong conflict.
The war has devastated the enclave’s economy. The U.N estimated in mid-February that almost half of all cropland had been damaged and that some 70% of Gaza’s fishing fleet had reportedly been destroyed.
In the first few months of bombing, nearly 70% of Gaza’s 439,000 homes and about half of all buildings – including commercial outlets – were damaged or destroyed.
Meanwhile, the destruction of Gaza’s health infrastructure has led to about three-quarters of hospitals and two-thirds of primary health care clinics shutting down, leaving only 10 out of 36 hospitals barely functioning – amputations are carried out without anesthesia, and miscarriages have increased by 300%.
AP Photo/Ismael Abu Dayyah
This health crisis has been worsened by a lack of clean water and essential medical supplies. It has contributed to soaring rates of infectious diseases, acute respiratory infections, severe dehydration and diarrhea.
Hospitals and clinics struggle to operate without electricity, and many health care workers have been injured or killed, which drastically affects the capacity of the health care system. And many schools and universities have been destroyed, making education inaccessible. When the war does end, Palestinians in Gaza will emerge from conflict with their education, health, housing and economic systems all deeply compromised.
The cost of rebuilding
These factors are all interconnected. In other words, they worsen one another and create a cascading effect of negative outcomes for Palestinians in Gaza. Take, for example, the issue of mass displacement, with 1.7 million people forced from homes that have been largely destroyed: This impacts people’s ability to make a living, leading to increased poverty and a higher risk of malnutrition.
The conflict’s aftermath necessitates rebuilding multiple facets of society, including social structures, health, infrastructure and education – all of which have been disrupted in profound ways.
Take education as another example: The disruption of schooling for children not only affects individual learning and development but also has long-term implications for the overall well-being of the community. The trauma of war means many children will face severe challenges even when the bombs stop. This education loss will impair employment opportunities, which in turn has an effect on the overall economy.
Addressing this will require an integrated approach that not only focuses on the physical rebuilding of schools but also considers the quality of education and psychological and social support for children. The U.N. projects that 1 million children – almost every single child in Gaza – will need mental health and psychosocial support. Meanwhile, the reconstruction of Gaza’s public health systems will require solutions that are not just about addressing immediate medical needs, but that also consider the broader infrastructure – including mental health services and vaccination programs, as well as the provision of essential medications.
Rebuilding cities facing cascading crises the nature of which Gaza is confronted with is a daunting prospect. And while the task may seem insurmountable at the present, with cooperation, coordination and courage it is not unachievable.
But it is a challenge that becomes that much more difficult with each day that the war in Gaza goes on.
Dima Nazzal is Director of Professional Practice, Georgia Institute of Technology.
The Conversation arose out of deep-seated concerns for the fading quality of our public discourse and recognition of the vital role that academic experts could play in the public arena. Information has always been essential to democracy. It’s a societal good, like clean water. But many now find it difficult to put their trust in the media and experts who have spent years researching a topic. Instead, they listen to those who have the loudest voices. Those uninformed views are amplified by social media networks that reward those who spark outrage instead of insight or thoughtful discussion. The Conversation seeks to be part of the solution to this problem, to raise up the voices of true experts and to make their knowledge available to everyone. The Conversation publishes nightly at 9 p.m. on FlaglerLive.
ASF says
Any Flaglerlive articles to come about the 50 survivors of the October 7th massacre that have committed suicide since the attacks? Any to look forward to about all the Israelis displaced due to rockets being shot into Israel by Hamas, the Islamic Jihad, Hezbollah? Any to look forward to (tommorrow perhaps) about the 18 Israelis hurt, one critically, in oine Hezbollah drone hit committed just this week? We notice that no articles appeared after a Hamas rocket took out an Israeli childrens hospital. That must have been an oversight.
Convince Hamas to release the hostages and instruct them and their terrorist c0horts to stop trageting Israel with terror, violence and threats of annihilation 24/7. Problem solved. Let us know how it goes.
Pierre Tristam says
After Dresden was wiped out, ASF and Hippy would have wanted us to run a half dozen articles about the PTSD a couple of Air Force bomber crews suffered and the terrible sorrow families of lost crews endured, ignoring the 25,000 lives lost below (Kurt Vonnegut excluded, thankfully) and the razed city. But there is such a thing as false balance in service of propaganda, which is what these AIPAC faithfuls are asking for. You’re getting that propaganda–just another form of dehumanizing Palestinians by implying the superiority of Israeli lives–in 95 percent of American media. You won’t get it here. So it goes.
DaleL says
Dresden, Hamburg, Berlin, Tokyo, Hiroshima, etc. were all horrible tragedies and by modern standards, war crimes. So were the bombing of Rotterdam, London, Coventry, etc. It is important to understand though that one side in WWII was also murdering millions of civilians based just on their ethnic status and religion.
Hamas attacked Israel on 10/7/2023 and committed murder with horrible atrocities. The people of Gaza are complicit with Hamas in the same way as the people of Germany were complicit in the Holocaust. As long as terrorists such as Hamas have power, there can be no lasting peace.
Israel has adopted a policy of disproportionate “pain”. When Israel is attacked, the IDF will disproportionately respond. That is what is happening in Gaza.
It is long past time to take the “victims” out of the equation. (Victims = both sides) The surrounding Muslim countries need to organize a peace force, with western backing, to separate the warring sides. Gaza needs to be rebuilt, Hamas removed and a responsible government imposed. Similarly, the peace force should remove Israel’s control of the West Bank.
Israel has a right to be secure within its borders. The West Bank and Gaza should similarly be secure from IDF and settlers.
Ban the GOP says
The victims are mostly children so you are pretty sick person to support murder of children. Hamas killed like 50 people Israel as they are denied basic necessities from Israels blockade. in retaliation Israel has murdered tens of thousands of children…
ASF says
“Hamas killed like 50 people”??? Hamas not only killed 1200 people in one fell swoop on October 7th alone, they have, as usual, been deliberately exploiting their own populace–especially women and children–as Human Shields.
There was already a ceasefire in place on October 7th when Hamas comitted its massacre–and was assisted in doing so by so-called “innocent Palestinian civilians” in some cases. Hamas also continues to hold hostages whose status they refuse to account for (including Americans.)
In addition Hamas and the IJ continue to shoot off rockets into Israel that typically land back into their own backyards, killing yet more Palestinian civilians. Palestinians continue to wreak terrorist attacks which the Palestinian governments continue to reward with stipend payments–the more Jews killed in said attacks, the higher the amount of the stipend. In fact, some of the perpetrators of October 7th are already receiving those financial rewards, funded by “humanitarian aid” $$$ given to the Palestinian governments. This is despite the passage of The Taylor Force Act which was designed to prevent such occurances.
Unfortunatel, the Biden Administration has been circumventing the provisions of the Taylor Force Act by funneling ever-increasing amounts of US tax payer $$ to the Palestinian governments through UNWRA, without correcting any of the underlying issues. Just last week, Antony Blinken stated that the PA told him personally that they would consider correcting the practice of “Pay-for-Slay” funding. How impressive…Not.
Hamas Ministry casualty numbers are not only inflated but do not differentiate between the numbers of civilians killed as opposed to militants killed. All those deaths are lumped together and recorded as “civilian deaths.”
Hippy says
And not a comment about the root of the problem and what it takes for this all to stop. That dare is still out there for you Pierre. Write one of your intriguing editorials that address the root of the problem and the facts of who is funding the terrorism against Israel, who really does not give a shit about the Palestinians and uses their deaths as a headlines across the world. The root of the problem that funds the Hamas to hide behind the Palestinians knowing it will cause deaths. Do it Pierre. Or at least publish an article written by someone else that address Iran and their support and funding of the terrorists and their attacks against Israel.
This will never end until the world does something about the root of the problem and that does not happen until the media starts exposing it. Israel is not going to stop defending themselves and eliminating the threat against them and if the world is going to ignore and allow that threat to hide behind innocent women and children of Gaza. Innocent women and children are going to die.
Kennan says
Whether we like it or not. Period. Period we as a country have completely lost all credibility on the international scene because of our bias and inhumane handling of the Genocide in Gaza.
The Biden administration, Benjamin, Netanyahu, and the IDF have expose themselves, by perpetrating war, crimes and blatant racist behavior in what we all know is a “ non-war” situation. A non-war situation that is being called a war in hopes of justifying the collective punishment of every Palestinian civilian as well as all Israeli hostages.
The plan was never to get just Hamas. It was to “ Mow theLawn”, ethnically, cleanse, and destroy Gaza. There is nothing left, and Israel can claim all of it for themselves. That quite frankly is the plan. Netanyahu never wanted the two states solution. He said it on numerous occasions. He even had a re-drawn map of what Gaza would look like after this so-called war. The war we should be fighting is a war against racism, and in this case, Zionism.
Benjamin Netanyahu is the most extreme right wing leader in Israel’s history, and that is saying something considering the apartheid state they have been for several decades. The international community knows who Netanyahu is, but they truly sad part is that is that Israels behavior and treatment of Palestinians is being fully supported by the United States! Unfortunately, the situation has become so disgusting and criminal that it can no longer be ignored. Everyone knows October seventh 2023 was horrible and the vast majority of the world has condemned it.
The killing of UN refugees, doctors, press, core, and let’s not forget all the humanitarian aid workers that have been intercepted and killed. Remember, these are not collateral damage situation! These are purposely targeted situation! Nothing Yahoo, the IDF and various officials have no viable answer, and or proof to counter this, and our state department continues to run cover for these animals while the vast majority of human beings see what is happening before their eyes.
Listen carefully. The memories of the 1200 is released killed on October 7, 2023 as well as all of the hostages has been muddied and disrespected by the actions of Benjamin Netanyahu, the IDF and the corrupt Isra Ely government. They have meticulously destroyed 80% of Gaza, displaced everyone. I can pretty safely say 50,000 are dead. 70% women and children. 500,000 on the brink of starvation, in a couple of months they will be dead. How many members of Hamas have we got? We don’t hear a whole lot about that do we Bi Bi? Well, that’s OK. When you have sufficiently destroyed RAFA with the thoughtless help of the United States, it’s weapons and our tax dollars, while simultaneously waxing poetic about how humanistic we in the West are. We can now officially say that we are the “FACE OF h HYPOCRISY.
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ASF says
Gee, I guess that Flaglerlive’s Anti-Zionist crowd know more than the Biden Administration which vehemently does NOT label Israel’s defensoive actions–however they might disagree with them–as constituting “genocide.”
Ah, the true “FACE OF HYPOCRISY”–especially after October 7th (which occurred in the midst of an already existing ceasefire and was cinducted during a Jewish holiday, featuring not only up close and gleeful acts of slaughter but also rape and torture.) In fact, some of the perpetrators of those war crimes are already receiving “Pay for Slay” stipends, courtesy of the totally benign and peace-seeking Palesitnian governments..
We should also note that the Palestinian factions continue to not only shoot rockets into Israel but also continue to commit terror attacks against random Israelis–all while bewailing their total victim status and moaning about “Why won’t those genocidal Israel just let us be????” Hmmmm, here’s a thought…Maybe it’s because you keep shooting off rockets, keeping hostages, committing terror and swearing to subsume Israel “from the River to the Sea.”
Pierre Tristam says
The only difference between the Biden’s administration response to the genocide of Palestinians and that of the Clinton administration’s response to the genocide of Rwandan Tutsis, whose 30th-year “anniversary” we just marked, is that the Biden administration continues to enable the Palestinian genocide with American weaponry. That administration is no reference when it comes to defining genocide, nor is it any longer a reference when it comes to devising solutions to the conflict, as its pathetic veto of the resolution calling for a Palestinian state–after all that Biden palaver about a two-state solution-clearly indicates. We should also note that the Israeli genocide is ongoing, as are its hosannahs in its Amen corner, viz., the comment above.
Pogo says
@Dima Nazzal
If only there were funds to aid the afflicted…Ismail Haniyeh weeps.
https://en.wikipedia.org/wiki/Ismail_Haniyeh
And endures another dreary day in Doha.
https://en.wikipedia.org/wiki/Doha
God willing… the check is in the mail.
Islam’s Dogpatch
https://en.wikipedia.org/wiki/Mecca
https://en.wikipedia.org/wiki/Dogpatch
Kennan says
You are so right ASF! Nothing happened after October 7th.
We don’t live in a country anymore, as much as we live in a ‘LOBBY’. As long as our economic waants are met and powerful Jewish lobbies continue to funnel money at us, then the U.S. can continue to be BLIND to the indiscriminate killing of 50,000 civilians, most of which are children and women, reporters, UN workers,workers delivering humanitarian aid, targeted on purpose by the way! Oh, by the way. If anyone is silly enough to go get food from humanitarian drops, they get shot too!!! PALESTINIAN civilians. Not Hamas. Am i moving too fast for you? I can slow down if you like.
Listen, my father, a Syrian was a Middle East expert interviewed by every news organization at one time or another. I myself have been all over the Middle East, and although it makes me no better than anyone else, i have a very unique and nuanced understanding of all of this.
I’m really getting tired of hacks putting forth obtuse ideas based on few or no facts. THE TRUTH SELLS ITSELF.
The bullshit the supporters of Netanyahu,the IDF, AND ‘The chosen People’ are peddling is laughable, but not funny.
The U.S. and Israel are running out of excuses. The State Department has devolved into just not answering anymore. The majority of the world no longer trusts the U.S. and Israel. American validity and standing in the world will disappear after the genocide in Gaza plays out. The U.S. and ISRAEL are perias.
Bill C says
Chag Pesach sameach! Passover celebrates the passage of Jews from slavery to freedom. How does this holy celebration of Jewish values square with the sub-human treatment of Palestinians?
ASF says
Using one of the most important Jewish holidays of the entire Jewish calender as a rhetorical cudgel against the one sole majority Jewish nation in existence. Now, that’s really a progressive move!