Rafael Castro Delgado
Doctor of Medicine, Full Professor of Emergency Medicine at the University of Oviedo, emergency physician (SAMU-Asturias), researcher at the Asturias Health Research Institute, coordinator of the Pre-hospital Care and Disaster Research Group, and director of the Pre-hospital Care Research Network and advisor to WHO technical working groups related to emergencies and disasters
This article has added value because it is peer-reviewed and provides real, detailed clinical information from professionals on the front line of the Gaza conflict, with a large amount of data.
It is not a population-based or representative study and may be subject to some recall and reporting bias, as in extreme emergency situations, data may be incomplete or inaccurate, which means that it does not have the robustness of an epidemiological study with population-based data. Even so, the quality is good for the context (active conflict and lack of surveillance systems) as the information it provides is unique and difficult to obtain in a context where access to health data is very limited; in this case, the article is highly relevant.
It describes severe injury patterns, with a direct comparison by professionals experienced in other conflicts. It therefore provides evidence for planning humanitarian and health responses, including surgery, intensive care, mental health and rehabilitation. In addition, it is noteworthy that it documents other health problems beyond war wounds, such as malnutrition, sepsis, chronic diseases and psychological trauma, offering a comprehensive view of the health crisis.
The article can serve as a basis for international humanitarian and emergency aid agencies to design response strategies, as it provides a detailed map of health needs in a high-intensity conflict, something that is rarely achieved during the active phase of a war.
Limitations, already acknowledged by the authors themselves, include the secondary data source, possible but minimised duplication of cases, not being representative of the whole of Gaza, as it only includes hospitals where international teams worked, and reflecting a specific period (August 2024 – February 2025).
This study may have significant implications in several areas:
- Humanitarian and health planning, as it allows for the identification of the most urgently needed resources.
- Documentation and human rights, as it provides scientific evidence that can be used to inform international organisations such as the WHO or the UN and contribute to reports on human rights violations and war crimes.
- Long-term public health, as it points out that the conflict has generated an enormous burden of disability, especially amputations, severe burns and psychological trauma, and can therefore guide the design of rehabilitation and health reconstruction programmes for the affected population.
- Development of surveillance systems in conflicts, as the authors themselves highlight the need for resilient health surveillance systems, even in war contexts, to obtain reliable real-time data and improve response.