{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T22:45:48Z","timestamp":1793573148301,"version":"4.5.0"},"reference-count":30,"publisher":"BMJ","license":[{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ"],"accepted":{"date-parts":[[2025,9,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>To systematically document the patterns of war related injuries in Gaza, Palestine.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design<\/jats:title>\n            <jats:p>Survey study of international healthcare workers, August 2024 to February 2025.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting<\/jats:title>\n            <jats:p>Gaza, Palestine.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Participants<\/jats:title>\n            <jats:p>78 international healthcare workers deployed to Gaza.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main outcome measures<\/jats:title>\n            <jats:p>The main outcome was the type of injuries observed by international healthcare workers during the conflict in Gaza. A Delphi informed survey was distributed through non-governmental organisation rosters and secure WhatsApp and email groups. Respondents completed the survey using contemporaneous logbooks and shift records.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The survey collected data on 12 anatomical regions, mechanisms of trauma, and general medical conditions. 78 healthcare workers reported 23\u2009726 trauma related injuries and 6960 injuries related to weapons. The most common traumatic injuries were burns (n=4348, 18.3%), lower limb injuries (n=4258, 17.9%), and upper limb injuries (n=3534, 14.9%). Explosive injuries accounted for most of the weapon related trauma (n=4635, 66.6%), predominantly affecting the head (n=1289, 27.8%), whereas firearm injuries disproportionately affected the lower limbs (n=526, 22.6%). Healthcare workers reported 4188 people with chronic disease across 11 domains requiring long term treatment.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Healthcare workers deployed to Gaza reported an injury phenotype defined by extensive polytrauma (\u22652 anatomical regions), complex blast injuries from high yield explosives, firearm related injuries to upper and lower limbs, and severe disruption to primary care and the treatment of chronic diseases. The results provide actionable insights to tailor humanitarian response and highlight the urgent need for structured, resilient clinical surveillance systems.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Editor\u2019s note<\/jats:title>\n            <jats:p>This paper is based on research from an active war zone, where conventional research methods may be impossible to apply.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1136\/bmj-2025-087524","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:05:14Z","timestamp":1758845114000},"page":"e087524","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":29,"title":["Patterns of war related trauma in Gaza during armed conflict: survey study of international healthcare workers"],"prefix":"10.1136","volume":"390","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1788-3669","authenticated-orcid":false,"given":"Omar","family":"El-Taji","sequence":"first","affiliation":[{"name":"Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ameer","family":"Ali","sequence":"additional","affiliation":[{"name":"Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osaid","family":"Alser","sequence":"additional","affiliation":[{"name":"Department of Surgery, Islamic University of Gaza, Gaza, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Ghali","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Jomaa","sequence":"additional","affiliation":[{"name":"Medina, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Junaid","family":"Sultan","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Hull University Hospitals, Hull, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilal","family":"Irfan","sequence":"additional","affiliation":[{"name":"Center for Bioethics, Harvard Medical School, Boston, MA, USA"},{"name":"Center for Surgery and Public Health, Brigham and Women\u2019s Hospital, Boston, MA, USA"},{"name":"Department of Neurology, University of Michigan Medical School, Ann Arbor, MI, USA"},{"name":"Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anisa","family":"Jafar","sequence":"additional","affiliation":[{"name":"Humanitarian and Conflict Response Institute, University of Manchester, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Qandil","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Nasser Medical Complex, Gaza, Palestine"},{"name":"School of Medicine, Islamic University of Gaza, Gaza, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Jeelani","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedic surgery, Alder Hey Children\u2019s Trust, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ammar","family":"Darwish","sequence":"additional","affiliation":[{"name":"David Nott Foundation, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Mokhallalati","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Hull University Hospitals, Hull, UK"},{"name":"Department of Plastic and Reconstructive Surgery, Al-Shifa Hospital, Gaza, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"McMonagle","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, St Mary\u2019s Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Rose","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nizam","family":"Mamode","sequence":"additional","affiliation":[{"name":"Department of Transplantation, Queen Elizabeth University Hospital, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suheal","family":"Khan","sequence":"additional","affiliation":[{"name":"Mobile International Surgical Teams (MIST) Foundation, 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