Impact of Conflict on Gazan Children with Heart Disease (2025-2026)

Background

Armed conflict causes tremendous challenges to the health of civilians, particularly vulnerable populations such as children. While the world’s attention in Gaza has focused on the tragic loss of life through violence, another cohort of casualties has gone unaddressed: Gazan children born with congenital heart disease.

Historically, these children have received special travel permissions to cross the Gaza-Israel border for surgical intervention and cardiology care at an Israeli hospital or been operated on by medical teams in Gaza who are part of non-governmental organizations (NGOs). Since the onset of armed conflict in October 2023, however, no child with congenital heart disease has been able to cross the border, nor have any cardiac surgical teams entered the conflict zone.

Prior studies have demonstrated a high incidence of congenital heart disease in Gaza (10 per 1000 population), meaning that hundreds of children have been born with congenital heart disease in Gaza since the beginning of conflict. However, the impact of armed conflict on these children, their families and healthcare providers is poorly defined.

Project Description

Building on the work of a previous team and leveraging long-standing partnerships with NGOs and Israeli medical centers, this team will continue to document and analyze the impact of the Israel-Hamas conflict on Gazan children with congenital heart disease. Ultimately, the team aims to move for emergency reinstatement of travel permissions for Gazan children to receive urgent surgical care; model the economic impact of failure to do so; and utilize its findings to develop novel assessment tools for use in conflict settings.

To achieve these goals, team members will break into subteams, each of which will pursue a specific aim:

1. Estimate the impact of the Israel-Hamas conflict on the delivery of cardiac care within Gaza and model long-term economic consequences. This subteam will use index data to model the current and projected loss of life and disability-adjusted life years on a population level. They will use this data to perform in-depth economic impact analysis and model the cost of ongoing conflict across different predetermined periods.
2. Analyze the psychological and social impact of the Israel-Hamas conflict on the Gazan families of children with congenital heart disease. This subteam will continue to conduct focus groups with these families and perform qualitative analysis. They will use existing validated assessment tools and perform in-depth mixed methods analyses to generate a novel assessment tool applicable to families in other conflict settings.
3. Analyze the psychological and social impact of the Israel-Hamas conflict on healthcare providers who previously cared for Gazan children with congenital heart disease. This subteam will continue to conduct focus groups and individual interviews with Israeli doctors and healthcare providers from three medical centers in Israel that have previously been the main providers of cardiac surgical care to Gazan children. They will use existing validated assessment tools within these focus groups and perform in-depth mixed methods analyses to generate a novel assessment tool applicable to healthcare providers in other conflict settings.

Anticipated Outputs

Simulation model of the economic impact of cessation of pediatric cardiac surgical care; novel assessment tools for families of children with congenital heart disease and healthcare providers caring for this population; proof of concept for similar projects in various conflict areas; academic manuscripts; presentations to stakeholders

Student Opportunities

Ideally, this project team will include 3 graduate students and 6 undergraduate students from disciplines such as medicine, economics, conflict studies, global health and health policy. Students with various levels of experience are welcome. Graduate students with experience in qualitative and mixed-methods research will be particularly strong candidates.

This project will operate in subteams composed of one graduate student, two undergraduate students and a team leader or collaborator. Students will participate in a comprehensive literature review, quantitative and qualitative data analysis, economic impact modeling, development and validation of quantitative assessment tools, manuscript drafting and editing, cooperation with NGOs and international health ministries and hospitals, and the creation of policy reports. Students will also have the unique opportunity to learn from and integrate many diverse perspectives, including those of NGOs, Palestinian and Israeli health officials, Gazan families and Israeli healthcare providers.

Some students may have the opportunity to travel during spring break or the summer 2026. This may include travel to Israel to conduct focus groups and/or travel to other locations to present findings to the WHO and other stakeholders.

Timing

Fall 2025 – Summer 2026

• Fall 2025: Conduct literature review; submit IRB amendments; develop economic simulation model; perform in-depth analysis of existing qualitative and quantitative data; develop novel quantitative assessment tools
• Spring 2026: Pilot novel quantitative assessment tools; disseminate economic simulation model; meet with policy stakeholders to relay project findings
• Summer 2026 (optional): Continue piloting novel quantitative assessment tools; draft and submit manuscript

Crediting

Academic credit available for fall and spring semesters; summer funding available

See earlier related team, Impact of Conflict on Gazan Children With Heart Disease (2024-2025)