At Nasser Medical Complex in Khan Younis, nurses are teaching mothers to hold premature babies against bare skin for hours at a time. The technique is called kangaroo mother care — prolonged skin-to-skin contact paired with exclusive breastfeeding — and the WHO says it reduces neonatal mortality by 32 percent compared with conventional incubator-based care. For Gaza's decimated health system, it is both a clinical innovation and a forced adaptation. Rania Fadel, 24, delivered twin boys on September 25. Yahya was healthy. Ilyas weighed 1.4 kilograms at birth and spent nearly two weeks in the neonatal intensive care unit with blood and lung complications. After 11 days of separation — Rania was recovering from a Caesarean section — she was finally able to hold him skin-to-skin for 90 minutes. He began breastfeeding. Staff report he improved. The programme, supported jointly by WHO, UNICEF, and UNFPA, launched at Nasser Hospital in September and is being introduced gradually in the external neonatal care unit and maternity wards. The clinical rationale is well-established. Kangaroo care regulates infant body temperature, supports breastfeeding initiation, and accelerates weight gain in premature and low-birthweight babies. WHO guidance recommends at least eight hours of skin-to-skin contact per day. Nasser's team is targeting a minimum of two hours, constrained by staffing, space, and each family's circumstances. The programme currently prioritises medically stable babies who do not require oxygen support. Khawla al-Madhoun, director of nursing for the maternity and neonatal departments, was explicit: the technique cannot replace an incubator when intensive care is needed. The context makes the programme's necessity stark. Before October 2023, Gaza had eight neonatal intensive care units with 178 incubators. By November 2024, Israeli military operations had destroyed three of those units outright. Available incubators fell to approximately 54 — a 70 percent reduction. Fuel and electricity shortages imposed by Israeli restrictions further degraded the equipment that remained. Photos from Nasser show two babies sharing a single incubator. Despite a nominal ceasefire from October 2025, Israeli strikes have continued, and the equipment shortage persists. The war has simultaneously driven up demand for neonatal care. Displacement, food shortages, poor nutrition, economic collapse, and the physical toll of life in tent camps — cooking over open fires, carrying water — have increased rates of premature birth and low birthweight. Linda Abu Nasira, 23, gave birth three days before being interviewed. She lives in a tent in al-Mawasi, Khan Younis, raising two toddlers while caring for a newborn who developed a fever. She holds her daughter skin-to-skin for about 30 minutes every two hours. She does not know when the baby can be discharged. The kangaroo care programme is a genuinely useful clinical intervention being deployed in conditions that should not exist. It costs almost nothing — the mother's body does the work. That is both its strength and the indictment embedded in its necessity. When a health system has lost 70 percent of its incubators and mothers are giving birth in displacement camps, a low-tech stopgap is not a sign of resilience — it is a measure of how much has been destroyed. UNICEF and partners have delivered some replacement incubators and ventilators, but the gap between need and capacity remains enormous. The structural picture is clear: a military campaign has systematically degraded Gaza's neonatal infrastructure, the blockade constrains resupply, and international agencies are deploying body-heat-based interventions because the machines are gone. Kangaroo care works. It should be standard practice everywhere. But its emergency rollout in Gaza is not a heartwarming story about maternal love triumphing over adversity. It is a clinical workaround for the deliberate destruction of a healthcare system.
