Palestinians fleeing Khan Younis arrive in Rafah, Gaza, 26 January 2024. Photograph: Ibraheem Abu Mustafa/Reuters

Sometimes a disaster is so large that it obscures its own details. Behind the number of dead and displaced in Gaza, for women and girls the conflict has been disproportionately grinding. In a “cruel inversion” of the history of this conflict, the head of UN Women told the Associated Press, women and children have borne the brunt of the war.

The details are unfathomable. There are about 50,000 pregnant women in Gaza and 40% of those pregnancies have been classed as high risk; 180 give birth daily. The healthcare infrastructure has been all but obliterated. According to the charity Care: “There is no doctor, midwife or nurse to support women during labour. There is no pain medication, anaesthesia or hygiene material when women give birth.” Babies are born on the ground in the wilderness, umbilical cords cut with whatever sharp object there is to hand, and tins filled with hot water keep the newborn warm. C-sections, painful in the aftermath even when drugs are plentiful, are being performed without any anaesthesia at all, by surgeons who do not have any water to wash their hands, let alone sterilise them, and no antibiotics for any resulting infections. In some cases, according to Washington Post reporting, C-sections were performed on women postmortem.

When mother and child prevail in these impossible circumstances, they are then faced with displacement and hunger while nursing painful tears, wounds and malnourished babies. Pregnant women have had to make the 20-mile journey from the north to the south in Gaza. They arrive in circumstances that Unicef says “breach famine thresholds”, and which are particularly concerning when it comes to the fate of tens of thousands of pregnant and breastfeeding women, the majority of whom consume only one or two types of food. Mothers cannot access sufficient food and clean water to produce milk for their babies, and when formula is available in the camps of the displaced, finding the clean water to boil and mix with it is a daily challenge. In December, month-old babies born in the camps of the displaced had never been washed. “So many aspects of motherhood,” said a CNN report in November, “once routine, are now a matter of life or death.”

Those who make it to those painful unsupported births and the precariousness that follows are the lucky ones. Only weeks after the war started, there were reports of miscarriages and stillbirths having risen by 20%. With something like 85% of Gaza’s population now displaced, and large numbers settling in camps, the true scale of the maternal mortality, infant mortality and pregnancy loss crisis is certainly larger than even aid and news organisation reports suggest. But what girls and women have to go through doesn’t end there.

Women at the site of an airstrike in Rafah, Gaza, 3 February 2024. Photograph: Ismael Mohamad/UPI/Rex/Shutterstock

At a 5 sq km tent encampment in Rafah, no aid is allowed to enter, starving the inhabitants of food, medical supplies, hygiene and sanitary products. Due to the lack of period products, those bleeding postpartum and from miscarriages, as well as women and girls who are menstruating, have to use parts of tent fabric, clothes and cutoff pieces of towels, increasing the risk of infection and toxic shock. There is one shower for every 2,000 people and one toilet for every 500.

It has been jarring to be in the slipstream of mainstream feminist discourse over the past few weeks, as all this unfolds. Surreal to watch it swirl around Barbie’s ostensibly not sufficiently feminist Oscar nominations, which drew a contribution from Hillary Clinton herself, after she stated her objection to calls for a ceasefire. Some of this is just human nature – our own contexts and cultures dictate our immediate priorities. But there are other impulses, uncomfortable to contemplate but hard to ignore, that de-emphasise the particularly inhumane and urgent situation when it comes to Gaza’s women and girls.

Palestinian women are seen as not sharing the sort of values that are called upon to come to their rescue. The fact that Gaza voted for Hamas 18 years ago has been deployed to prove that there is collective responsibility for the group’s actions on 7 October and that there are no innocents. In another impulse, the entire value system in Gaza is brought into question by raising features such as the lack of LGBTQ+ rights. In addition to reports of sexual violence during Hamas’s attack, these are seen as factors that should void sympathy for those in Gaza and render them suspect and aligned with Hamas, with Israel as the party that shares liberal progressive values. A New York Times letter responding to some US Ivy League students’ blaming of Israel for the Hamas attack captured this collapse. Didn’t “Hamas’s many followers at Harvard and Columbia,” the letter asked, “realise that Hamas brutally persecutes the LGBTQ community in Gaza, subjugates women, and tortures and summarily executes dissidents?” The argument may as well simply say: they are not like us, and they started it.

It is an argument that is a race to the bottom of humanity, giving licence to smear a whole population with the crimes of its worst, and abdicate the responsibility to think critically and empathetically about cultures and politics shaped by years of occupation, crisis and siege. In the US, a voter on the news programme Face the Nation said she was concerned about her reproductive rights, but that it would be “hypocritical” to use those concerns to justify voting for Joe Biden when he is supporting strikes and blockades on a population that have led to calamitous maternal experiences and outcomes. That sort of clarity feels like a lot to ask at the moment, among competing influences of parochialism, tribalism and propaganda. But the details coming out of Gaza are so graphic, so relentless, that now may be the time to think about what progressive values, feminist or otherwise, really mean if they stop at the threshold of what is familiar.

Nesrine Malik

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