Pregnant Women in Gaza Are Selling Urine to Survive

It’s been over 21 months since Israel started its genocidal campaign in Gaza. Most of the region has been turned into rubble, and into a mass grave. And still our elected officials are cheering it on. Lawmakers are not the only ones complicit in this genocide. Well-paid consultants at places like Boston Consulting Group and the Tony Blair Institute have been actively planning to turn the site of the 21st century’s greatest collective shame into a luxury resort. And much of the Western media continues to provide cover for Israel’s crimes: sanitizing unspeakable violence, and treating Israeli lives as far more valuable than Palestinian ones. 

But what I want to do here and now is something every single person in the media should be doing: amplifying the stories of Palestinians who are living through genocide. Today I’m handing my Flaming Hydra space over to Husam Masrouf, a writer and poet from Gaza. 

Husam contacted me via a mutual acquaintance to try and tell an under-reported story about MUAC (Mid-Upper Arm Circumference): a measure used by aid agencies to identify pregnant women at risk of adverse birth outcomes, and its role in the starvation of Gaza.

Here is Husam’s reporting. The names in this story have been changed.

A surreal lifeline

A person might come to believe that their body is their own—that their insides, their blood, their bones are not for sale. But in Gaza, where life is reinvented under drones and dignity is redefined every day, even the body is no longer one’s own.

In Gaza, a pregnant woman sells her urine, not for scientific fraud or manipulation, but in order to eat. To feed the life inside her. 

The need for money in Gaza is urgent. Many have lost their sources of income because of the war. Life has come to a standstill, as if a wall has been erected in everyone’s path. To make matters worse, prices have skyrocketed; the price of some goods has increased a hundredfold. Everyone here is crying out in frustration, unable to meet their daily needs.  

As a result, some resort to bizarre ways to make ends meet, like Amal, 34, who has sold samples of her urine to several non-pregnant women in Gaza.

Before the war, Amal’s husband owned a women’s clothing store, and they had a good life. But the Israeli strikes destroyed the building that housed their shop, reducing everything to rubble. 

“I went for a malnutrition screening and was given food supplements because I met the criteria; I was five months pregnant and had suffered from malnutrition for a long time,” she told me. “I met a woman at an international clinic who offered to buy a urine sample from me for $28. At first I hesitated, but then I thought about my three children and our dire need, especially since my husband is unemployed. In the end, I agreed.”

No one can endure a collapse of services such as this. No one can pass through this tunnel without compromising their values. All of these people are victims of the faint, ineffectual global calls for aid to Gaza—whispers drowned out by bombs. 

Amal continues: “The woman told me she needed the urine sample to qualify for the nutritional supplements. She wasn’t pregnant, but her children were severely malnourished and lacked even basic nutrition. I remember her wrist was extremely thin, only skin and bone. A few days later, the same woman called me again and introduced me to two more women who wanted to buy a urine sample. I ended up selling my urine a second time, and more.”

“Baking bread for others isn’t enough to feed my children, especially since my husband is unemployed and mentally struggling after losing everything he had,” she concluded. “My greatest fear is that my children will die of hunger. The war and famine have broken something in us—something that can never be repaired.”

When you are pregnant and frail, but don’t meet the MUAC cut-off 

In western Gaza lives Farha, a 23-year-old woman recently separated from her husband. Her only brother was killed in the war.

“I used to work as a seamstress. My brother was a trader. We lived simply, but with dignity,” she says.

Now she does what she can to support herself and her sick, aging parents. “After my brother was martyred, I became the sole breadwinner. My father and mother can’t work. They can barely move.” 

She is pregnant with her first child, and paralyzed with fear. Her arm circumference missed the MUAC cutoff by millimeters, so she didn’t qualify: both measures are required by the aid agencies for nutritional assistance.

Farha feels completely abandoned. “This pregnancy is not a joy. It’s a burden at a brutal time. Every moment I fear death, our house being bombed, my body collapsing, my parents dying without medicine or food.”


She told me she’s even heard of aid workers stealing. “I know a woman who saw an aid worker loading cartons of nutritional supplements at night to sell at the market, where each unit sells for $5. Meanwhile, we die waiting in line.”


Farha pleads: “I ask only for justice. Why am I being measured with a tape?”

R.P., a fieldworker for Médecins Sans Frontières (Doctors Without Borders), has been on the front lines for months, assessing the nutritional needs of pregnant women. She declined to give her full name due to institutional media restrictions.

“We see women every day whose bodies are collapsing. They come to give birth without having eaten. They sit in the corridors, shivering, waiting for labor.”

She criticizes the MUAC system, originally designed to assess malnutrition, for becoming a tool of exclusion. “There are women who are visibly malnourished and exhausted, but because their arm circumference is over 230 mm, they’re denied supplements.”

She also describes a deadly bureaucracy. “Even when we escalate cases, the response is slow. Some women miscarry, or die, before they get their first dose.”

Calling the situation in Gaza “worse than Somalia in 2011,” she concludes, “What the women of Gaza need is not a policy, but a miracle. Not laws, not protocols. Just food, water, and someone to listen.”

Israel has been besieging Gaza for over nine months, and is now engineering mass starvation by preventing the entry of food, medicine, nutritional supplements, and baby formula. 

Between Amal and Farha are thousands of women we haven’t heard from, carrying life in hungry wombs, in the shadow of bombs, in half-ruined refugee tents. If and when they give birth, their children will carry in their cells the testimony of this age: That life triumphed, even when the whole world failed them.

Everyone here is hungry. Malnutrition is rampant. But the larger question remains: Why are people starving? Under what justification?

Husam Masrouf

If you would like to donate to Husam’s Gaza-based publishing project, the link is here.

If you would like to donate to help people in Gaza, Medical Aid for Palestinians is a great organization. 

Or you can donate to Crips for eSims for Gaza: an international collective of disabled people who have come together in support of Palestinans, helping Gazans regain internet access via eSims.