The Attrition of Gaza’s Doctors: When Human Capital Gives Out

When a healthcare system disintegrates, the damage is rarely limited to rubble and depleted medicine cabinets. The far more permanent erosion occurs within its human capital—the doctors and nurses who simply reach the end of what a human being can endure. In Gaza, the breakdown of medical infrastructure is increasingly measured not just in destroyed wards, but in the psychological attrition of those expected to keep them running.

According to Gaza’s Government Media Office, at least 1,700 medical personnel have been killed and 83 remain in Israeli detention since October 2023. Beyond those raw figures lies a subtler institutional crisis. A report in the Public Library of Science indicates that 41 percent of surveyed healthcare workers have lost family members, while 46 percent suffered both personal bereavement and workplace displacement. Crucially, 78 percent lack access to any mental health support, creating an environment where operational continuity is sustained almost entirely by exhaustion.

For some, the line between professional duty and personal tragedy snapped irrevocably. Manar Fayyad, a 29-year-old anaesthesiologist at Al-Aqsa Martyrs Hospital, permanently abandoned his career after being called to an operating room on December 27, 2023, only to discover that the deceased patient before him was his 34-year-old brother, Shadi. Fayyad now avoids social contact, copes through solitary writing by the sea, and seeks to leave Gaza altogether. Conversely, emergency nurse Khaled Raafat, who lost his wife, children, mother, and several siblings in an October 18, 2023 strike, took an extended absence before remarrying, starting a new family, and returning to the same hospital floor.

Others seek survival through internal relocation. At Nasser Medical Complex in Khan Younis, nurse Hiba al-Tawil transferred out of the intensive care unit after watching her brother die there, finding that remaining in the unit compounded her trauma. Munir al-Bursh, director general of Gaza’s Ministry of Health, articulated the institutional trap: Protecting medical personnel is not just about securing medicines and equipment. It also means safeguarding their mental health and giving them time to rest and recover. Yet, as al-Bursh noted, providing that rest is functionally impossible amid acute staffing shortages, ongoing detentions, and a continuous influx of casualties.

At the psychological clinic inside the Nasser Medical Complex, psychologist Reham Abu Rokba attempts to treat post-traumatic stress disorder using cognitive behavioural therapy across roughly twelve individual sessions and medication. But institutional remedies require time and stability—two commodities entirely absent in a war zone. When four out of five medical workers cannot access psychological care, the question is no longer how a health system functions under pressure, but how long it can operate before its workforce simply disappears.

Written by Thomas Nussbaumer thomas.nussbaumer@alpineweekly.com