Continuous traumatic stress in Gaza: when caregivers and communities share the same crisis

In Gaza, traumatic events do not belong only to the past. Repeated attacks, displacement, bereavement and deprivation continue to shape daily life, including the work of those providing healthcare. Drawing on my experience as a doctor living and working in Gaza during 2023-2025 and on selected clinical and humanitarian literature, I examine the usefulness of continuous traumatic stress (CTS) as a framework for understanding distress under ongoing threat. CTS does not replace post-traumatic stress disorder (PTSD) or other diagnoses. Rather, it draws attention to the difficulty of assessing fear, vigilance and impairment when danger is credible and protection is limited. I consider the effects on children and on healthcare workers who share their patients' circumstances, and discuss implications for mental health and psychosocial support (MHPSS). Clinical services remain essential, but their effectiveness depends partly on access to safety, food, shelter, medicines and functioning systems of care.