Implementation and feasibility of telemedicine post-surgical follow-up clinics in Gaza during active conflict

The conflict in Gaza has devastated its healthcare infrastructure, leaving many hospitals nonfunctional and created a significant need for specialized medical care. Peripheral nerve surgery is one such subspecialty due to endemic nerve injuries caused by shrapnel and high velocity trauma, requiring timely intervention and long-term follow-up. The scarcity of specialists in Gaza presents a major challenge not only in treating these cases but also in monitoring patients after international volunteer surgical missions conclude. This study describes the feasibility of implementing an online telemedicine clinic to provide post-surgical follow-up care for patients in Gaza during an active war, and outlines the steps taken to ensure continuity of care for postoperative patients under severe system disruptions. A remote telemedicine initiative was implemented to provide post-surgical care to patients operated on by a London-based volunteer surgeon during his surgical missions, thereby unburdening local teams. These follow-ups were conducted through online clinics with the assistance of local junior doctors, offering continuous care for patients after complex nerve surgery. During these clinics patients were monitored for clinical progress, surgical complications, and further management plans including physical therapy, diagnostics, or local referrals. Satisfaction rates from local staff and treated patients were also assessed. Six telemedicine clinics were held across northern and southern Gaza between September 1st to 31st 2024, with a total of 115 patients reviewed from 144 successful contacts (80% attendance rate). Most cases involved single nerve injuries ( n = 69), brachial plexus injuries ( n = 8), and complex fractures ( n = 8). Patients were able to access postoperative review with the operating surgeon through telemedicine. Clinical investigations, medication prescriptions, and physiotherapy referrals were successfully coordinated through the service. Patient satisfaction responses were positive, with 85% reporting “very satisfied” and 15% “satisfied”. Local surgeons also reported the service to be useful. This experience suggests that structured telemedicine follow-up for complex surgical patients is feasible in a conflict setting despite major logistical barriers. Reliable local collaboration, communication systems, and basic digital infrastructure appear essential for successful delivery. These findings support consideration of structured follow-up pathways when visiting teams undertake complex surgery in conflict settings.