Humanitarian challenges in Gaza, between rehabilitation and mine clearance
Humanitarian challenges in Gaza, between rehabilitation and mine clearance
Cover Photo : © S. Hejji – HQ/HI
The Geneva press club and Humanity & Inclusion (Handicap International) are pleased to invite you to a conference with :

With (from left to right) Nicholas Orr, deminer, Explosive Ordnance Disposal specialist, head of operations for Handicap International in Gaza, Maria Marelli, physiotherapy specialist at Handicap International, Daniel Suda-Lang, Director of Handicap International Switzerland.
Just a few days before the 1-year anniversary of the start of the current conflict in Gaza, Handicap International would like to alert the media and the international community to the current situation of people with disabilities in the Gaza Strip, as well as the urgent need for essential demining work. The Geneva-based NGO has been working in Gaza since 1997, and currently employs 70 people, supported by approximately 300 community workers. Handicap International’s efforts are concentrated in Khan Younes and the south of the Gaza Strip, where 1.4 million displaced people are living in inhuman conditions.
One thing is certain: without a ceasefire and immediate, substantial, and inclusive humanitarian aid, the number of people with disabilities in Gaza will significantly increase, as poorly treated injuries or fractures can lead to lifelong disabilities.
Daniel Suda-Lang, Director of Handicap International Switzerland, recalls the highly complex general context of current humanitarian aid in Gaza, and stresses that this aid must not forget the people who were already disabled before the war, estimated at 21% of the population in Gaza, according to OCHA. People unable to flee and deprived of the goods and care essential to their disability, just like wounded civilians who are therefore disabled.
Maria Marelli, a physiotherapy specialist at Handicap International, shares her experience on the ground and the essential chain of health experts needed for the prevention, detection, treatment, and support of disabling injuries or pre-existing disabilities in a war situation.
Finally, Nicholas Orr, a deminer with 25 years of experience in Explosive Ordnance Disposal (EOD) in Afghanistan, Iraq, Kurdistan, Ukraine, Mali, Jordan, and Kuwait, and an instructor in the British Army. He will share his technical expertise on bombings and explosive remnants of war, their impact on the local population, the assessment of contamination, the expected difficulties in future demining efforts, as well as the need for education on the risks represented by these unexploded weapons.
DANIEL SUDA-LANG, DIRECTOR OF HANDICAP INTERNATIONAL SUISSE: “A YEAR OF CONTINUOUS BOMBARDMENT IN GAZA TRANSLATES INTO A GENERATION SUFFERING LIFELONG INJURIES, AMPUTATIONS AND DISABILITIES!”
Just a few days before the 1-year anniversary of the start of the current conflict in Gaza, what does Handicap International consider to be the current situation of people with disabilities in the Gaza Strip?
A year of continuous bombardment and shelling in Gaza has resulted in a generation suffering from lifelong injuries, amputations and disabilities. According to a World Health Organization report, between January 10 and May 16, 2024, 25% of those injured in Gaza – around 22,500 out of 90,000 people – were in urgent need of rehabilitation services. This figure highlights the enormous strain on Gaza’s limited rehabilitation capacity, and the crucial need for immediate support to prevent long-term disability due to untreated injuries.
The conflict is resulting in severe injuries, including loss of limbs, spinal cord injuries, traumatic brain injuries and other physical disabilities caused by the use of explosive weapons. Appropriate rehabilitation services, such as prosthetics, physiotherapy, occupational therapy and mobility aids, are very limited due to the huge demand and the high level of insecurity of those operating in this threatening situation.
Restrictions on movement and blockades prevent the flow of medical supplies, equipment and expertise needed for effective physical rehabilitation. The result is a deterioration in the health and functional capabilities of conflict-affected people, whose injuries lead to life-threatening health complications, or even death in some cases, due to the lack of appropriate medical care and rehabilitation.
Due to the collapse of Gaza’s medical system, the majority of amputees still have open wounds, untreated burns and fractures, as well as shrapnel in their bodies. Some even have shrapnel in their heads. Open wounds and severely damaged skin need to be dressed to prevent infection.
In Gaza, the demand for assistive devices is increasing with the new injuries caused by the military escalation. Many devices are destroyed or left behind when disabled people have to flee to safer shelters. The lack of maintenance of assistive devices, the unavailability of products on the local market and the difficulties of obtaining them outside Gaza significantly affect people’s recovery and lead to secondary complications.
Displaced people with disabilities face considerable difficulties in reaching shelters or safe spaces during escalations of violence. Most shelters are inaccessible, lacking ramps, adapted sanitary facilities or space for mobility devices such as wheelchairs. Shelters in Gaza, such as schools or makeshift centers, are overcrowded, exacerbating the mobility difficulties of people with disabilities and making them more vulnerable to injury or neglect. During displacement, families may be separated, leaving people with disabilities without caregivers or support systems, further complicating their access to essential services.
Could you outline the highly complex general context of current humanitarian aid in Gaza?
According to OCHA, civilians in Gaza are bearing the full brunt of military operations. In August, over 88% of the Gaza Strip remained under evacuation orders. Hundreds of thousands of displaced families continue to be forced to move around an area of around 47 km2 (approximately 13% of the total area of Gaza), which has become overcrowded and lacks essential infrastructure and services. Overview of humanitarian access – Gaza Strip | August 2024 | United Nations Office for the Coordination of Humanitarian Affairs – Occupied Palestinian Territory (ochaopt.org).
Between October 7, 2023 and September 18, 2024, at least 41,272 Palestinians were killed and 95,551 injured, according to the Gaza Ministry of Health.
Displaced people are likely to be even more so as the rainy season approaches, increasing flooding and high tides. Many people displaced by the hostilities have been forced to take shelter along the Mediterranean coast, where evacuation orders issued by Israel have asked them to surrender.
The Ministry of Health reported that 70% of medicines and 83% of medical supplies had run out. This severe shortage has forced hospitals and health facilities to suspend services and vital procedures such as heart operations, cardiac catheterizations and joint replacements.
The number of trucks entering the Gaza Strip continues to fall. The daily average in August was 69 trucks per day. The Israeli government continues to impose strict restrictions on the delivery of aid to Gaza. The complexity of bureaucratic procedures and the evolution of standard operating procedures mean that food and medical supplies expire before they can be brought in. Handicap International supplies, such as medical kits and food parcels, have been waiting so long at border crossings that they have expired or deteriorated, rendering them unusable.
Handicap International is currently present on the ground in Gaza. But how? With what resources? For what activities? What are the specific features of its action?
We currently employ (figures from August 2024) 70 people, and are supported by approximately 300 community workers. Our efforts are concentrated in Khan Younis, central Gaza and the southern Gaza Strip.
Distribution of basic necessities: our teams distribute basic necessities such as healthcare, kitchen and hygiene kits, diapers and baby blankets. Atlas Logistique, Handicap International’s logistics arm, has been managing a shared warehouse in Rafah for humanitarian supplies for NGOs since February 2024, and is setting up a second shared warehouse in the Middle East region.
Emergency aid and rehabilitation: we take care of the seriously injured and disabled and provide them with care equipment. Since October, 11,909 nursing (dressing) sessions, 13,557 physiotherapy sessions and 4,594 occupational therapy sessions have been organized, and 2,460 mobility aids and 1,239 bandage and dressing kits have been supplied.
Psychosocial support: our teams offer psychological first aid sessions to reassure and support those affected by the conflict. For children, games are particularly important in calming their anxieties. Our teams have already organized 807 recreational activities, such as sports, singing and dancing sessions, etc., for over 108,492 people, the vast majority of them children, in 413 shelters and camps.
Education on the risks of explosive remnants of war: we organize sessions to inform and raise awareness of the dangers caused by the presence of explosive remnants. More than 8,253 community awareness-raising sessions on the risks of explosive remnants of war have been organized in 973 camps, reaching over 180,261 children and adults.
Handicap International has been present on the ground in Gaza since 1997. In 20 years, how has Handicap International’s work evolved? What new challenges? What different work philosophy?
Over the years, Handicap International’s work in Gaza and the West Bank has expanded considerably in response to growing humanitarian needs caused by repeated escalations of violence, ongoing blockades and deteriorating socio-economic conditions. The scope of our organization’s work has broadened to include emergency response programs, explosive ordnance awareness, mental health and psychosocial support, and advocacy for the rights of people with disabilities. This evolution reflects a shift towards a more holistic approach, integrating an emergency response that includes people with disabilities with long-term support.
Handicap International integrates a holistic view of disability into its emergency response, ensuring that the needs of people with disabilities are taken into account in multidisciplinary services, as well as in education and protection. This approach reflects Handicap International’s commitment not just to responding to immediate needs, but to tackling the systemic barriers that prevent people with disabilities from fully participating in society.
Overall, Handicap International continues to adapt its strategies to the changing situation in Gaza, advocating for the rights and needs of people with disabilities in the ongoing conflict and working towards a more inclusive humanitarian response.
We’re not talking about people who were already disabled before the war, estimated at 21% of the population in Gaza, according to OCHA. How serious is this?
The situation of people already disabled before the war in Gaza, estimated at 21% of the population according to OCHA, has probably worsened significantly in the current conflict. This already alarming figure is set to rise, as the relentless bombardment continues to cause new injuries, amputations and disabilities.
According to a recent WHO report, some 15,000 people have suffered extremity injuries, and an estimated 3,000 to 4,000 amputations are expected. In addition, there have been over 2,000 cases of head trauma and spinal cord injuries, as well as more than 2,000 serious burns.
The continuing violence has probably pushed the number of disabled people well beyond pre-war estimates. With thousands more injured, many with amputations, severe burns, spinal or head injuries, the population of disabled people in Gaza is growing rapidly. This increase is putting a strain on already overburdened health and rehabilitation services, which are struggling to meet the urgent needs of the disabled.
Glad to see your famous Broken Chair refurbished in the Place des Nations. A symbol that’s still useful and appreciated?
Yes, happy! Restoration work took place in July. Its restoration was essential because the wood of which it is made, symbolizing the vulnerability of populations to explosive weapons, was naturally degrading over time.
Broken Chair is the spokesperson for our organization. It embodies the desperate yet dignified cry of civilian populations massacred by all forms of armed violence, and the obligation of states to protect them and bring relief to the victims. Set up to ban anti-personnel mines, over time and as the international context has evolved, we have extended our fight against cluster bombs and the bombing of civilians in populated areas.
The sad news is that, just as Broken Chair was being restored, Lithuania decided to withdraw from the Oslo Convention banning cluster bombs. We have warned that the arguments put forward by Lithuania – that we are living in exceptional times, that cluster munitions can be an effective deterrent against a potential enemy and that they have great military utility – are inadmissible. These weapons have been banned because of their catastrophic humanitarian consequences.
In 2023, the WHO passed a landmark resolution committing countries to developing and strengthening rehabilitation services in their health systems. Was this important for you? What will this change in concrete terms?
This resolution, which we have been defending for many years, is very important because rehabilitation concerns us all! You’ve no doubt already had to call on a healthcare professional for rehabilitation after an injury, or perhaps you have a loved one with a disability who needs a wheelchair. Rehabilitation encompasses everything that can be done to facilitate and optimize people’s daily lives, everything that can make them more independent at home, with their family and friends, at work – in short, in society. Imagine the situation of an injured or disabled person in one of the world’s poorest countries, without access to these services.
In a global context of conflicts, disasters, aging populations and global warming, the absence of rehabilitation for all those who need it is a serious public health problem and a question of human dignity. Millions of people develop avoidable long-term disabilities, preventing them from participating in society. Others who already have a disability see their condition worsen.
This historic resolution – the highest level of international commitment – will for the first time commit countries to developing and strengthening rehabilitation services in their healthcare systems, notably by reducing financial barriers. This includes access to technical aids (wheelchairs, canes, hearing aids, prostheses, orthoses, etc.), as well as other rehabilitation services (physiotherapy, occupational therapy, speech therapy, etc.).


