The Humanitarian and Medical Crisis in Palestinian Territories: The Plight of Patients With Congenital Bleeding Disorders and Health Care Under Siege.

INTRODUCTION: The Palestinian territories, especially Gaza and the West Bank, are suffering a severe humanitarian and medical crisis due to ongoing conflict, blockades and resource shortages. Healthcare infrastructure is devastated, limiting access to care - especially for patients with chronic conditions like congenital bleeding disorders (CBDs).

METHODS: A detailed medical perspective on the healthcare situation in Palestine Territories was investigated via publications in the scientific literature, reports form non-governmental organizations, personal interviews with patient associations.

RESULTS: Hospitals in Gaza are beyond capacity, prioritizing trauma over chronic disease management. Medical facilities face damage and medicine shortages due to blockades, worsening patient outcomes. Healthcare workers endure extreme workloads, poor protection and frequent attacks, leading to burnout and high mortality. Continuous violence results in widespread trauma and mental health issues, particularly affecting children and vulnerable groups. Moreover, patients with CBD face chronic shortages of clotting factor medications, lack of comprehensive treatment centres and reliance on episodic rather than prophylactic therapy. This leads to increased complications and disability for approximately 562 Palestinians with CBD. Patient stories illustrate the reality of displacement, delayed surgeries and inadequate care. International aid efforts, such as support from the World Federation of Hemophilia and Haemo-Pal project, aim to improve care but are hampered by ongoing conflict, restricted movement and bureaucratic delays.

CONCLUSION: Immediate humanitarian action is needed to protect healthcare infrastructure, ensure unrestricted medical access and allow safe patient evacuation, supported by international advocacy to safeguard health rights during conflict.

PLAIN LANGUAGE SUMMARY: People living in the Palestinian Territories - especially in Gaza and the West Bank - are going through a major crisis. Because of ongoing conflict, blockades and not enough resources, hospitals and clinics are damaged and overcrowded. This makes it very hard for people, especially those with long-term health problems like bleeding disorders, to get the care they need. In Gaza, hospitals are so full that they mostly take care of people injured in the conflict. There are not enough medicines or staff, and many medical buildings have been damaged. Doctors and nurses are working under a lot of stress and danger, which makes their jobs even harder and puts their health at risk. As a result, many patients get sicker or even die. The constant violence also causes a lot of mental health problems, especially for children and other vulnerable people. For people with bleeding disorders, the situation is even more difficult. There are not enough special medicines to help their blood clot, and there are not enough treatment centres. Most patients can only get medicine when they are already having a bleeding episode, instead of getting regular treatments to prevent problems. This leads to more health issues and disabilities for about 562 Palestinians living with these conditions. The stories of patients show how hard it is for them - they often face delays in getting surgery, must move from one hospital to another, and do not always get the right care. People around the world have a responsibility to speak up for safe paths to deliver aid, for an end to attacks on hospitals and for everyone to have basic health care, no matter the political situation.