International healthcare workers report on war related injuries among civilians in Gaza

Findings suggest patterns of harm that exceed those reported in previous modern-day conflicts and provide critical insights to tailor humanitarian response

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A British led study published by The BMJ today provides detailed data on the pattern and severity of traumatic injuries and medical conditions seen by international healthcare workers deployed to Gaza during the ongoing military invasion.

Healthcare workers describe “unusually severe” traumatic injuries including complex blast injuries, firearm related injuries, and severe burns. Many respondents with previous experience of conflicts reported that the pattern and severity of injuries in Gaza were greater than those they had encountered in previous warzones.

It’s thought to be the first study to provide such detailed data from frontline clinicians during the conflict, which the authors say offers critical insights into the injuries and conditions most relevant to immediate management, rehabilitation, and long term health planning.

Since October 2023, Gaza has faced high intensity Israeli bombardment and ground military incursions. Publicly reported figures show that more than 59,000 Palestinians have been killed and over 143,000 wounded during the conflict, but other analyses suggest these figures may be higher.

To address this gap, healthcare workers were invited to take part in a survey about the nature and pattern of injuries and medical conditions they managed while in Gaza, ranging from explosive and firearm injuries to infections and chronic diseases.

A total of 78 doctors and nurses completed the survey using logbooks and shift records between August 2024 and February 2025, within 3 months of their deployment end date.

Participants represented 22 non-governmental organisations (NGOs) and were mainly from the US, Canada, the UK and European Union member states working in trauma surgery, emergency medicine, paediatrics, or critical care and anaesthesia.

Almost two thirds (65%) had prior experience working in an active conflict zone and their deployment to Gaza ranged from 2-12 weeks, contributing to a total of 322 weeks of frontline clinical care.

Overall, 23,726 trauma related injuries and 6,960 injuries related to weapons were reported. The most common traumas were burns (4,348, 18%), leg injuries (4,258, 18%), and arm injuries (3,534, 15%).

There were 742 obstetric cases reported, of which more than a third (36%) involved the death of the fetus, mother or both. Psychological trauma was also reported, with depression, acute stress reactions, and suicidal ideation being most common.

Some 70% of healthcare workers reported managing injuries across two or more anatomical regions and experiences of mass casualties were widespread, with 77% reporting exposure to 5-10 events and 18% managing more than 10 such scenarios. 

Explosive injuries accounted for the majority of weapon related trauma (4,635, 67%), predominantly affecting the head (1,289, 28%) whereas firearm injuries targeted the legs (526, 23%).

The most common general medical conditions reported were malnutrition and dehydration, followed by sepsis and gastroenteritis. Healthcare workers also reported 4,188 people with chronic disease requiring long term treatment.

In free text responses, healthcare workers frequently described injuries as unusually severe, including multi-limb trauma, open skull fractures, and extensive injuries to internal organs. Severe burns were also emphasised, particularly in children.

Respondents with previous experience of deployment in other conflict zones commented that the severity and pattern of injuries encountered in Gaza were greater than those they had previously managed.

Despite the strength of this data, the authors acknowledge limitations. For instance, relying on logbooks and shift records inevitably introduces uncertainty, especially during periods of large influxes of injured people. Nor can they rule out the possibility of duplication, although further analyses indicated minimal impact on overall estimates.

However, they say the volume, distribution, and severity of injuries seem to indicate patterns of harm that exceed those reported in previous modern-day conflicts. 

“These findings highlight the urgent need for resilient, context specific surveillance systems, designed to function amid sustained hostilities, resource scarcity, and intermittent telecommunications, to inform tailored surgical, medical, psychological, and rehabilitation interventions,” they conclude.

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Journal

The BMJ

DOI

10.1136/bmj-2025-087524 

Method of Research

Survey

Subject of Research

People

Article Title

Patterns of war related trauma in Gaza during armed conflict: survey study of international healthcare workers

Article Publication Date

25-Sep-2025

COI Statement

All authors have completed the ICMJE uniform disclosure form at www.icmje.org/disclosure-of-interest/ and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; OA cofounded OxPal 2.0, an initiative supporting medical education in Palestine in partnership with consultants from the University of Oxford, Oxford, UK and other medical schools in the UK and USA. MQ is head of Emergency Medicine at Nasser Medical Complex, Gaza. AD is medical director of the David Nott Foundation, a British non-governmental organisation (NGO). DN is cofounder of the David Nott Foundation, a British NGO. AM previously served as head of Plastic and Reconstructive Surgery at Al Shifaa Hospital, Gaza. SK is founder and director of Mobile International Surgical Teams Foundation, a UK NGO. NMay is chairman of Medical Aid for Palestinians. ASC is an honorary patron of Medical Aid for Palestinians, a British NGO. OET, AG, MJS, AJe, AD, MM, VR, NMam, SK, NMay, DN, and ASC have volunteered on multiple medical missions worldwide, including in Gaza, with various NGOs. All authors declare no other competing interests.

More than 150 companies, including miners, have ties to Israeli settlements — UN

Reuters | September 26, 2025 | 

Bethlehem city, in the central West Bank, before the current conflict. (Image courtesy of Dennis Jarvis.)

More than 150 businesses, including Airbnb, Booking.com BV, Expedia and TripAdvisor, are operating in Israeli West Bank settlements deemed illegal by the UN, a report by the organization’s human rights office showed on Friday.

The list, which was previously updated in 2023, now has 68 new names, taking the total to 158; Israel said it unfairly vilifies companies working legally.

New additions include major German cement maker Heidelberg Materials AG, which said it had disputed the listing, telling Reuters it was no longer active in occupied Palestinian territory. Most of the new companies were domiciled in Israel.

Seven firms previously listed were taken off, including British-registered online travel company Opodo and Spanish-domiciled online travel agent eDreams ODIGEO SA; the report said there were reasonable grounds to believe they were no longer involved in the activities that previously justified their inclusion.

All the companies listed were involved in one or more of the 10 activities that the rights office said raised particular human rights concerns. The accommodation platforms listed did not immediately respond to Reuters requests for comment.

Israel cites biblical and historical ties to the West Bank to dispute the 2024 ruling by the UN’s highest court – which is backed by most of the international community – arguing that the territory is not occupied in legal terms because the land is disputed.

“This database is meant to serve as a blacklist against businesses that have committed no wrongdoing, as there is no general prohibition in international law against business activity in areas of conflict,” the Israeli mission in Geneva said in a statement.

UN rights office calls for remediation

“Where business enterprises identify that they have caused or contributed to adverse human rights impacts, they should provide for or cooperate in remediation through appropriate processes,” the report said.

Most of the firms named in the database are domiciled in Israel but it also includes international firms listed in Canada, China and France alongside those from the United States, Germany and other countries.

Scrutiny of companies’ operations in the Israeli settlements has increased since Israel’s military campaign in Gaza and simultaneous increase in raids in the West Bank that Israel says target militants but which have harmed civilians as well.

The list, which focuses primarily on business activities related to construction, real estate, mining and quarrying, is not exhaustive, as the Office is still to screen more than 300 businesses submitted for assessment.

“This report underscores the due diligence responsibility of businesses working in contexts of conflict to ensure their activities do not contribute to human rights abuses,” UN Human Rights Chief Volker Türk said. The report also said that states should act to ensure businesses were not contributing to abuses.

Israel and the US have long protested the “disproportionate attention” given to Israel by the Geneva-based Human Rights Council.

Civil society groups say the database, mandated by the council in 2016, is an important tool to ensure transparency around business activities in the West Bank and to prompt companies to rethink their activities.

Israeli settlements have grown in size and number since Israel captured the West Bank in the 1967 war. They stretch deep into the Palestinian territory with a system of roads and other infrastructure under Israeli control, further slicing up the land.

A UN Commission of Inquiry on Tuesday found that since October 2023, Israeli policies have demonstrated clear intent to forcibly transfer Palestinians, expand Jewish settlements, and annex the entire West Bank. Israel dismissed the report and said the Commission was pursuing a politically-driven agenda.

US President Donald Trump said on Thursday that he would not allow Israel to annex the West Bank, rejecting calls from some far-right politicians in Israel who want to extend sovereignty over the area and snuff out hopes for a Palestinian state.

(By Olivia Le Poidevin; Editing by Philippa Fletcher)

From Myth To Modernity: How Vijaya Dashami Shapes Collective Identity And Social Values – Analysis

CELEBRATING DURGA/KALI

Durga image is immersed into river on Vijayadashami in eastern regions of the Indian subcontinent. Photo Credit: Biswarup Ganguly, Wikipedia Commons

 September 29, 2025 

By Dr. Neelu Rawat

Festivals are more than just occasions for celebration; they are potent social texts that show how societies construct their identities, reconcile moral dilemmas, and preserve myths for contemporary society.

 

One of the most notable instances of this continuity in India is Vijaya Dashami, also referred to as Dussehra. The celebration, which has its roots in the legendary victories of Goddess Durga over Mahishasura and Lord Ram over Ravana  reflects ageless tales of good triumphing over evil. But in the process of evolving from myth to modernity, Vijaya Dashami has evolved into a cultural performance that unites disparate identities, upholds moral principles, and adjusts to shifting social circumstances.

Vijaya Dashami offers a living lens to examine collective identity in the modern world, where fast urbanisation, digital communication, and changing societal norms are reshaping how traditions are conducted. In addition to reciting epics, the effigy burning, community meetings, and stage plays (Ramlila) serve as a forum for social criticism, gender discussions, and even political symbolism. They also serve to uphold society’s common moral standards. Therefore, Vijaya Dashami’s sociology resides in the way it connects legendary imagination with contemporary forms of solidarity, serving as a reminder that festivals are as much about the present as they are about the past.

Myth and Morality in Modern Times

The ageless notion of good triumphing over evil has always been represented by the tales of Durga’s victory over Mahishasura and Ram’s victory over Ravana. These myths continue to motivate people to address the injustices of the present rather than merely serving as a remembrance of the past. These days, Ravana and Mahishasura are viewed as symbols for the ills that individuals faces in their personalities such as jealousy, arrogance and carelessness about others and also society faces, such as differences, violence, injustice, and corruption, rather than merely as mythological villains.

For instance, protesters in Delhi and other cities burned effigies of “modern-day Ravanas” to symbolise dishonest politicians and officials during the 2011 anti-corruption campaign in India (Chakrabarty & Roy, 2013). The image of Goddess Durga was also used in numerous demonstrations following the 2012 Delhi gang rape (Nirbhaya case), where participants said that “every woman is Durga” and demanded the defeat of contemporary “Mahishasuras” who engage in gender violence (Kumar, 2016).

Collective Identity and Social Solidarity

For many years, Vijaya Dashami has been a potent hub for social cohesion and collective identity. Through shared rituals, effigy burnings, and Ramlila performances, the festival has historically united communities and provided a forum for participation in a shared cultural narrative among members of all castes, social groups, and localities.

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Such rituals reinforce collective consciousness by reminding people of their common ideals, as Durkheim (1995) contended, and Anderson’s (1983) concept of “imagined communities” explains how these meetings promoted a more comprehensive sense of belonging. This solidarity has grown across regional borders in the modern era.

Grand festivities like the Ramlila in Delhi’s Ramlila Maidan, which is televised and watched by millions of people, in India turn a local performance into a National occasion that brings together many regional and linguistic groups (Lutgendorf, 1991).

In a similar vein, Indian groups in the diaspora host major Vijaya Dashami processions and cultural events in places like Singapore, Toronto, and London. In multicultural contexts, these gatherings foster a feeling of shared identity in addition to reinforcing ties to Indian history (Vertovec, 2000). Vijaya Dashami demonstrates how festivals serve as both global identity markers and local bonding mechanisms, maintaining solidarity in a society that is becoming more divided and interconnected by the day.

Honouring Weapons as a Symbols of Duty, Discipline and Divine Power

One of the lesser-discussed yet significant aspects of Vijaya Dashami is the tradition of Ayudha Puja, or weapon worship, which is deeply connected to the idea of honouring tools of duty, discipline, and divine power. In Indian epics, both Ram and Durga invoked divine blessings before going to battle, and this symbolic act continues today in the rituals of the Indian Armed Forces.

On Vijaya Dashami, regiments across the Army, Navy, and Air Force perform Shastra Puja (weapon worship), offering prayers to rifles, tanks, aircraft, and other instruments of defence. This ritual underlines the ethical principle that weapons are not instruments of aggression but of duty and protection, to be wielded with discipline and responsibility. In modern times, the meaning of this practice extends beyond the military: it reflects a broader societal respect for the tools that sustain human life whether technology, machinery, or even digital devices. Just as soldiers seek divine blessing to use their weapons only in the service of justice and security, today’s professionals symbolically honour their tools of work, reminding us that technology and power, when guided by ethics, can also serve the greater good.

Gender and Power Narratives

The tale of Goddess Durga defeating Mahishasura has long represented the victory of feminine power against patriarchal powers of oppression. In the medieval period, patriarchal norms led men to dominate the organization and conduct of festivals like Vijaya Dashami, taking charge of leadership roles, performances, and ritual practices. Women were frequently restricted to being spectators or participants rather than decision-makers. The larger patriarchal framework of Indian society was mirrored in this imbalance (Chakravarti, 1993).

However, in recent decades, contemporary Vijaya Dashami festivities have placed a greater emphasis on women’s agency and involvement, reflecting changing gender norms. Goddess Durga embodies shakti, the eternal feminine energy, and today’s woman stands as a living symbol of that power resilient, assertive, and transformative in society.

From the recent instance where Colonel Sofiya Qureshi of the Army’s Corps of Signals and Wing Commander Vyomika Singh of the Indian Air Force performed weapon worship during Vijaya Dashami, to women’s committees in Kolkata taking charge of pandal planning and finances, and feminist reimagining of Durga in media campaigns, contemporary practices show how women across diverse sectors are reclaiming spaces once dominated by men and redefining the power of feminine energy in society.

Politics, Media, and Public Life

Once grounded in local cultural expression and religious symbolism, effigy burnings and Ramlila performances have become more and more politicised and media-driven spectacles. Rituals, according to sociology Clifford Geertz (1973), are “cultural performances” that civilisations use to dramatize their values. What was once a revered statement of the victory of virtue over evil has been transformed into a public platform for socio-political symbolism and Nation-building in the instance of Vijaya Dashami. In an effort to associate themselves with the moral authority of Ram’s victory over Ravana, political officials regularly attend effigy burnings.

For instance, Indian prime ministers and chief ministers frequently open Ramlila celebrations in Delhi’s Ramlila Maidan, turning a religious rite into a platform for socio-cultural and political prominence (Lutgendorf, 1991). At the same time, these performances have been magnified into national spectacles by mass media, initially via television and currently through internet channels. For example, Ramanand Sagar’s Ramlila television series in the late 1980s not only attracted record audiences but also had an impact on political mobilisation, particularly the Ram Janmabhoomi campaign (Rajagopal, 2001).

More contemporary examples of how media transforms ritual into consumable cultural content that is available to both local and international audiences include Instagram loops of Durga Puja pandals and live-streamed effigy burnings. As a result, Vijaya Dashami blurs the boundaries between faith, spectacle, and public life by serving as both a religious tradition and a mediated performance of governing authority.

Continuity and Change in Cultural Practice

Vijaya Dashami provides examples of how customs can uphold their essential principles while adjusting to contemporary situations. Fundamentally, the event upholds the moral and cultural teachings found in the stories of Ram and Durga by celebrating the ageless notion of “good triumphing over evil.” However, there have been substantial changes in the ways that these stories are executed. The impact of modernisation and globalisation on cultural practices is seen in the way that elaborate pandals, Instagram reels, broadcast Ramlila serials, and urban mega-events now either supplement or even replace traditional rural performances (Lutgendorf, 1991; Vertovec, 2000). For instance, Kolkata’s Durga Puja has developed into a global event that draws tourists, media attention, and corporate sponsorships while maintaining the idol immersion ceremony that marks Durga’s triumph (Banerjee, 2004). 

Even far from the homeland, Indian identity and moral narratives are maintained through the elaborate Vijaya Dashami festivities held by diaspora populations in places like New York and London, which combine traditional rites with regional cultural elements (Vertovec, 2000). These instances indicate how cultural traditions can change without losing their symbolic meaning, despite the festival’s dynamic forms and unchanging essence.

Conclusion 

Despite having its roots in ancient mythology, Vijaya Dashami is still relevant in the quickly evolving world of today. The festival’s lasting importance is demonstrated by its tales of virtue triumphing over evil, the celebration of collective identity, the assertion of female strength, and the interaction between ritual and public life. However, the way it is experienced has changed because to modernisation, media, and globalisation; diaspora communities can now celebrate their history far from home, women can now play active roles, and hamlet Ramlilas have become national spectacles. 

Vijaya Dashami is essentially a prime example of the dynamic continuity of culture, demonstrating how customs can change in shape while maintaining their moral and social foundation. In methods that bring communities together across time and distance, festivals serve as a living reminder that they are not only celebrations of the past but also mirrors of current society.

Reference

• Anderson, B. (1983). Imagined communities: Reflections on the origin and spread of nationalism. Verso.
• Banerjee, S. (2004). Rituals of power and power of rituals: Public celebrations and women’s participation in Bengal. Economic and Political Weekly, 39(17), 1685–1692.
• Chakrabarty, B., & Roy, S. (2013). Public policy and politics in India: How institutions matter. Routledge.
• Chakravarti, U. (1993). Conceptualising brahmanical patriarchy in early India: Gender, caste, class and state. Economic and Political Weekly, 28(14), 579–585.
• Durkheim, E. (1995). The elementary forms of religious life (K. E. Fields, Trans.). Free Press. (Original work published 1912)
• Geertz, C. (1973). The interpretation of cultures. Basic Books.
• Kumar, R. (2016). Violence, resistance, and identity: The politics of rape in India. Economic and Political Weekly, 51(9), 15–17.
• Lutgendorf, P. (1991). The life of a text: Performing the Ramcaritmanas of Tulsidas. University of California Press.
• Rajagopal, A. (2001). Politics after television: Religious nationalism and the reshaping of the Indian public. Cambridge University Press.
• Vertovec, S. (2000). The Hindu diaspora: Comparative patterns. Routledge.

Dr. Neelu Rawat

Dr. Neelu Rawat, Associate Professor, Department of Sociology, Central University of Punjab, Bathinda, Punjab, India.

DURGA

KALI

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