Abstract: A Cross-Sectional Study Investigating the Physical and Mental Health of Aid Workers In Palestine (Society for Social Work and Research 31st Annual Conference)

Schedule:

Friday, January 22, 2027

Union Station 23 (Hilton San Francisco Union Square)

* noted as presenting author

Nadeen Odeh, MSc, Medical Student, University of California, San Francisco, CA

Niveen Rizkalla, PhD, Associate Researcher, University of California Berkeley, CA

Hind Eliyan, MPH, MSc, Public Health Sciences Graduate Student, University of California, Davis, CA

Jess Ghannam, PhD, Clinical Professor, University of California, San Francisco, CA

Background

The year 2024 was the deadliest year on record for humanitarian aid workers, driven largely by the genocide in Gaza. Aid workers face significant psychological and physical stressors that adversely impact their well-being. In Palestine, these risks are compounded by a pattern of targeted attacks against aid workers. Between October 2023 and January 2025, the World Health Organization verified 654 attacks on healthcare facilities in Gaza. The West Bank and Jerusalem have also witnessed an escalation in violence. Aid workers who live and work in the same traumatic conditions as the communities they serve are doubly exposed through direct (personal) and indirect (professional) trauma. This study aimed to investigate (1) the relationship between fieldwork trauma exposure and health outcomes, (2) the relationship between living in the same conflict zone as the population served and health outcomes, and (3) the regional differences in health outcomes across Gaza, the West Bank, and Jerusalem.

Methods

We conducted a cross-sectional study of 198 aid workers in Palestine, including healthcare workers, mental health professionals, first-responders, and other aid workers. Participants were recruited through local and international organizations operating in Palestine between July and November 2025. Data were collected via an online survey administered in English and Arabic. Trauma exposure was assessed using a self-report scale measuring the extent to which participants’ fieldwork involved war trauma, refugee resettlement, and integration. Living in the same conflict zone as the population served was operationalized as a binary variable. Health outcomes included post-traumatic stress disorder (PTSD) symptom severity measured by the Harvard Trauma Questionnaire, secondary traumatic stress measured by the Secondary Trauma Questionnaire, and self-reported general fatigue, general physical pain/discomfort, and weight changes.

Results

After adjusting for sex, age, and economic status, greater trauma exposure was significantly associated with increased PTSD symptom severity (β = .17, p = .001), fatigue (β = .21, p = .032), and weight changes (β = .27, p = .017). Aid workers living in the same conflict zone as the population served exhibited significantly higher levels of fatigue (β = .37, p = .014) and weight changes (β = .54, p = .001). Regional differences were observed in trauma exposure, PTSD symptoms, fatigue, pain, and weight changes (all p ≤ .005). Aid workers in Gaza exhibited consistently higher levels of trauma exposure, PTSD symptoms, fatigue, pain, and weight changes, compared to those in the West Bank. Aid workers in Gaza also reported higher levels of fatigue than those in Jerusalem.

Implications

Aid workers in Palestine experience substantial mental and physical health burdens, with the greatest impacts among those with higher fieldwork trauma exposure and those living in the same conflict zone as the population they serve, particularly in Gaza. Overall, the findings underscore the urgent need for trauma-informed support, material resources, and protections for aid workers who are operating under extreme and sustained traumatic conditions of a genocide while continuing to serve the most vulnerable populations. They also highlight the critical importance of advancing justice and accountability to address systemic drivers of oppression.