Yes. We do need a 'different' Gaza.

Featured perspective from Ammal Awadallah, Executive Director of IPPF Member Association, Palestinian Family Planning and Protection Association (PFPPA).

The absence of airstrikes in Gaza is not the same thing as peace. A tense calm hangs in the air, broken by the devastating reality of families returning to what remains of their lives. The scale of the destruction is staggering: over 48,000 lives lost, more than 110,000 injured, and 69% of buildings destroyed. The health system is shattered, with 617 attacks on healthcare facilities.

I will never forget the 8th of October 2023, the day our only sexual and reproductive health center in Gaza was bombed. Watching the videos of my team returning to their former workplace in Northern Gaza, only to find their desks and equipment buried under rubble and dust, was devastating. It's a stark reminder of the immense rebuilding efforts needed. And now, we face further proposals of forced 'relocation' and takeover.

The international community faces a defining moment. For years, I have watched the cycles of violence and destruction. Now, women and girls in Gaza should finally be able to access services without the fear of being bombed on their journey. But can the global response truly match the scale of their suffering?

Throughout the past 15 terrifying months of bombings, I’ve led our teams working in Gaza. Despite huge challenges, our 42 frontline providers have delivered over 235,000 essential sexual and reproductive health services to 59,000 people. Even with the current ceasefire, which remains tenuous at best, access remains severely restricted. Israel’s control over the flow of goods continues to hinder recovery efforts, preventing essential supplies and commodities from reaching those who need them. My teams in both Gaza and the West Bank face constant pressures - navigating checkpoints, enduring delays, and carrying the emotional weight of working under difficult conditions. These barriers are not simply logistical; they are inherently political.

Many health facilities are buried under rubble, some with the remains of loved ones still inside. Imagine trying to access care in that environment. For women seeking contraception, post-rape support or maternal care, the psychological toll is unimaginable. The loss of healthcare workers is just as devastating and deeply personal for the Palestinian Family Planning and Protection Association (PFPPA). Earlier this year, our own team member, Dr Thabat Salim, was killed in an Israeli airstrike.

Our team in Gaza are not exempt from the immense suffering faced by everyone else. They too have lost loved ones, homes and any sense of security. Many are living in tents or shelters, struggling to access water, menstrual products, food and medicine. And yet, despite their own unimaginable losses, they continue to find the strength to get up every day and provide care. How they manage to do so in these conditions is beyond comprehension. But with every life lost and every new hardship endured, the suffering deepens, leaving wounds and trauma that will last for generations, long after the bombs stopped falling.

While foreign military budgets grow, humanitarian aid is dwindling. The challenge feels overwhelming. With the U.S. freezing nearly all foreign assistance worldwide (with the exception of Egypt and Israel) we’re relying more than ever on other countries to step up. These cuts are particularly troubling given the U.S. government’s complicity in the bombings over the past 15 months, including their military support and proposal for displacement.

Aid is incredibly important, but it must not be charity. It must be a pathway to justice. In Gaza’s context, that means reparations and accountability, especially given the very real possibility of future genocide trials. Accepting aid as an individual is a necessary, but hard, reality. It can highlight the lack of autonomy and the ongoing occupation. So aid must do more than address immediate needs. It must help restore dignity, honour agency, and pave the way for long-term recovery. Crucially, we must also listen closely to our communities. Are we providing the most affected Palestinians the services they truly need? 

PFPPA has a proven track record of delivering localised, vital SRH services even under the most challenging circumstances. With additional funding, we can do so much more. Rebuilding our center and expanding services is just the start to ensuring that women and girls, including survivors of sexual and gender-based violence, have access to the comprehensive care they need.

Gaza is now facing a new crisis as it struggles to recover. Netanyahu has repeatedly publicly embraced the Trump administration’s proposal to take over the Gaza Strip and displace Palestinian residents, saying that we need to build a ‘different Gaza’.  I agree, we do need a ‘different Gaza’. But not one imposed through displacement and control. We need a Gaza defined by Palestinian voices, where they can live in peace and freedom, and enjoy autonomy and opportunity. Gaza belongs to the Palestinian people.

The world is watching but it’s time to act. To act boldly, equitably, and justly. Palestinians deserve nothing less.