Abstract
The increased workload and constant fear for life can cause significant stress and depression among healthcare workers (HCWs). The aim of this study was to measure psychological stress, depression, and their causes in HCWs who practiced in the Gaza strip since the 2023 Israel-Gaza war. We conducted a cross-sectional survey between April 2024 and January 2025 for Palestinian and international HCWs who practiced in the Gaza strip after October 7, 2023. The survey collected demographic data and measured depression using the patient health questionnaire-9 (PHQ-9), stress using the perceived stress scale (PSS-10), and anxiety using the Generalized anxiety disorder-7 (GAD-7) scale. Out of 380 HCWs who agreed to fill out the survey, 231 completed it. Most HCW from Gaza had to change their residence, work for free, and had a HCW die since war. Most international HCW from Gaza had to work for free, work for 7-30 days continuously, not take a weekly break from work, had healthcare colleagues die since war, worked in a facility that was subject to Israeli military activity, and experienced food insecurity. Most HCW (~90%) experienced severe depression, severe anxiety, and severe stress. HCWs in the Gaza Strip and on medical missions face severe working conditions, including significant workplace-related aggression and injury. The widespread depression and anxiety in HCWs in Gaza may result in long-term consequences and a psychological toll on population health.