“…We render special tribute to that brave Palestinian woman, guardian of sustenance and life, keeper of our people’s perennial flame” The Palestinian independence declaration, 1988
Women and girls in Palestine have undergone systematic discrimination, violence and denial of their sexual and reproductive health and rights for decades. In this article, while mostly zooming in on the current horrific situation in the Gaza strip, I also point to the long term (and thus intergenerational) impact of reproductive injustice.
The Impact of War on Reproductive Health
The war on Gaza has deeply affected all Palestinians, but women and girls bear a disproportionate burden. Over 45,000 Palestinians have been killed by now, with at least 70% of casualties being women and children. Over one million women and girls have also been displaced, and access to SRHR services has been severely hindered. As a result, sexual and reproductive health related issues, including menstruation, pregnancy, childbirth, contraceptive access and bodily autonomy, have been gravely affected.
Women are forced to give birth in unsanitary, overcrowded shelters without privacy or adequate medical care. The lack of safety during transit means many deliver in dire conditions. Postnatal care, maternity services, and immunizations are absent, and cesarean sections are perilous due to shortages of medical supplies, including anesthetics. Every day, an estimated 183 women give birth in these conditions, with 15% facing complications. Maternal and newborn mortality rates have surged amid starvation, hostility and disease.
The December 2023 missile attack on Al Basma IVF center, Gaza’s largest fertility clinic, destroyed over 4,000 embryos and 1,000 other reproductive specimens. This attack underscored the dire state of reproductive health services in Gaza, compounded by the frequent rejection of RH equipment to enter Gaza including maternity kits, medical thread in reproductive health kits, medical scissors in children’s aid kits, as well as anesthetics and obstetrics clamps – and this in conditions where there’s little to no access to hygiene, medicine, prenatal and postnatal care, nor to period supplies. There is an urgency to integrate these services into broader humanitarian responses in Gaza. Currently, menstruating women and girls often resort to using scraps of cloth, plastic bags, or diapers. Some use norethisterone tablets to delay menstruation, despite harmful side effects, due to the lack of water and hygiene products.
Let’s also not forget the Palestinian women prisoners who face additional reproductive injustices. Since October 2023, 240 women have been detained by Israeli forces. Reports detail abuses including torture, strip searches, starvation, beatings, and threats of sexual violence. Detainees are denied menstruation pads, food and medicine, enduring inhumane and degrading treatment. On one occasion, Palestinian women in Gaza were allegedly kept in a cage without food during cold and rainy conditions. Such practices highlight the extreme reproductive and gender-based violence these women endure.
Continuing a pattern
Massive reproductive rights violations in a war setting are continuing a long-term pattern of reproductive injustice, even if far worse now. Indeed, Israel’s violations of international humanitarian law in this respect long predate 7 October 2023. Control of (and brutality towards) the sexual and reproductive rights of women and girls in Occupied Palestine has actually been a concern for decades. Eg. even before October 2023, 94,000 Palestinian women and girls already lacked access to sexual and reproductive health services according to the United Nations Population Fund (UNFPA). The human rights and legal implications of the systematic assault on pregnant and lactating women, newborns and children under the Israeli Occupation deserve more sustained attention in international law and human rights discourse.
The war in Gaza has added an extra dimension, though. According to many legal scholars, the widespread violation of reproductive rights in Gaza of the past fifteen months constitutes a critical aspect of genocidal violence. In South Africa’s applications to the International Court of Justice (ICJ), the main judicial organ of the UN, the reproductive harm inflicted by Israel was highlighted – and more in particular violating Article 2(d) of the Genocide Convention, which prohibits ‘imposing measures intended to prevent births within the group.’ The ongoing humanitarian crisis and systematic bombings in occupied territories profoundly affect reproductive rights, depriving women of fundamental freedoms and shaping the futures of entire generations. Reem Alsam, UN’s special rapporteur on violence against women and girls called out “the use of reproductive violence in the unfolding genocide in Gaza, which is unparalleled in other conflicts” (see also an OHCHR press release). At the core of these issues lie the principles of bodily autonomy, the right to decide whether to have children, and the ability to raise them in safe and sustainable communities.
Research has documented the long-term reproductive and fertility consequences of warfare in regions and countries as diverse as Iraq, Lebanon and the Netherlands. The parallel with what’s going on in Gaza since over a year is clear. Moreover, the strip has seen repeated military conflicts since 2008, with reproductive injustice endured by countless Palestinian women and girls over time, aggravated by environmental degradation linked to repeated conflict – and in turn adversely impacting their fertility and overall health.
Sadly, the ongoing sexual and reproductive health catastrophe in Gaza is just one of the latest (though perhaps one of the most horrific) emergencies for women and girls in a rapidly increasing list of war and conflict affected settings – see for example also the recent case of Sudan.
Way forward
Against this backdrop, the ICJ should have the intergenerational reproductive health injustice inflicted on the Palestinians firmly on its radar by now. The court has to take a stance towards reproductive injustice experienced for decades in Palestine, starting from – but going beyond – the ongoing horror in Gaza. (The same is probably true for the International Criminal Court, according to Reem Alsalem, UN Special Rapporteur on violence against women and girls.)
The ICJ’s proactive stance in addressing global challenges, as exemplified by the recent hearings on States’ legal obligations with respect to climate change, showcases its ability to tackle crises that intersect human rights and environmental justice. This could provide a framework for addressing other critical issues, including reproductive injustice. Just as the climate crisis intensifies human vulnerabilities, decades of military aggression in Gaza demand similar judicial recognition and intervention to uphold the reproductive rights of affected populations.
Where are the countries with “feminist foreign policies”?
Palestinian women have faced systematic denial of comprehensive sexual and reproductive health and rights since long before the current war on Gaza, even if the situation is far more grave now. While all states have a responsibility to seek peace in Palestine, countries with feminist foreign policies have a particular role in protecting the rights of women.
Gender responsive humanitarian work should also take place in Gaza, ensuring access to reproductive and sexual health services. Finally, more research is needed on slow violence (i.e. inattention paid to the attritional lethality of many environmental crises, including ‘collateral’ ecological damage of war) and its reproductive impact for the next generation of the Palestinians.
It’s high time more feminist and health movements and organizations speak up for what is happening in Palestine to women and girls.
Reproductive rights for all, reproductive justice for the Palestinians!