UN Report Details Physical and Mental Health Impact on Released Israeli Hostages

Mia Schem Taken Hostage on October 7

Israel’s Ministry of Health is submitting a special report to the United Nations detailing the mental and physical conditions of those kidnapped by Hamas, who returned to Israel about a year ago. Freed hostages, who were taken during the October 7 Hamas massacre, endured “severe physical and sexual abuse” while in captivity.

The report also highlights that 100 hostages are still being held captive by Hamas terrorists in Gaza.

The report, prepared by the Ministry of Health and now presented to the UN, is divided into two sections. The first section outlines the neglect, abuse, torture, and humiliation endured by the hostages released or rescued from captivity in Gaza, along with the effects of these experiences on their physical and mental health. This section is based on interviews with medical teams who treated the hostages upon their return to Israel. The second section discusses rehabilitation models considered suitable for returnees, drawing on data from primary care nurses, physicians, and mental health professionals who have been providing ongoing care, including through specialized clinics for returnees.

According to the report, women, men, and children who returned from captivity reported that they endured severe physical and sexual abuse, such as beatings, isolation, deprivation of food and water, branding, hair-pulling, and sexual assault at the hands of Hamas terrorists. Additionally, some of them reported that the captors sexually assaulted them or forced them to undress. For examples of cases of physical and sexual abuse see Annex I below.

“The report we are submitting to the UN is a harrowing testimony to the brutal experiences suffered by the hostages in Hamas captivity – cruel violence, psychological abuse, physical torment, and acts that defy comprehension,” said. Uriel Busso, Israel’s Minister of Health. “These are actions that cannot be tolerated and demand that the world wake up and take action. The report highlights the horrors the hostages endured and reveals to the world the brutality of the enemy with whom Israel is engaged. The testimonies presented in this report serve as a wake-up call for the international community to apply increased pressure on Hamas and its supporters to free all the hostages without delay. I urge the global community to utilize all available means to end this cruelty and bring the hostages home immediately. It is a moral and humanitarian imperative, and the time to act is running out.”

“Since the war began, medical teams have been working day and night to treat and save the many wounded, both physically and mentally,” added Dr. Hagar Mizrahi, head of the medical directorate at the Ministry of Health. “From the outset, the healthcare system has been entrusted with the care of those who were cruelly kidnapped by Hamas. We have been exposed to the horrors and appalling conditions that the returnees endured, as well as the profound suffering of those who were murdered in captivity.”

The report listed acts of physical and sexual violence against men, women and children.

Torture by withholding medical treatment or causing intentional pain during treatment:
1. The hostages were denied medical treatment for acute injuries caused on October 7 and subsequently, in addition to for untreated chronic conditions. Fractures, shrapnel wounds, and burns were treated inadequately, leading to complications that required additional surgeries that could have been prevented with proper care. Upon arrival in Israel, intensive treatment was given to the returned hostages.
2. The captors also tortured those injured by performing painful procedures without anesthesia.
3. Many hostages also suffered from untreated chronic conditions (e.g., heart failure, diabetes, hypothyroidism), leading to severe short-term medical deterioration, such as low blood pressure, bradycardia, and hypothermia. In one case a hostage died from untreated medical complications. Also, several older women required urgent life-saving treatment due to untreated hypertension and hypothyroidism.

Starvation, poor nutrition, and holding of hostages in harsh sanitary conditions:
4. About half of the returned hostages described being deliberately starved during their captivity. They were given a poor diet, which often led to hunger that worsened over time. In addition to inadequate nutrition, they were kept in dark spaces, increasing the risk of vitamin D deficiency. This malnutrition resulted in an average weight loss of 815 kg (10-17% of body weight), with children losing an average of 10%, and in one extreme case, a girl lost 18% of her body weight.
5. Poor nutrition may lead to Sarcopenia, delayed wound and fracture recovery, and a weakened immune system. Malnutrition also negatively impacts cognitive function and mental health, and as for children, it may hinder development and growth.
6. The captors attempted to improve some of the hostages’ appearance and weight before their release. Those who received excess food before returning to Israel were at risk of
Refeeding Syndrome and electrolyte imbalances such as hypokalemia, hypomagnesemia, and hypophosphatemia, particularly among elderly hostages. In cases with complex medical backgrounds, these electrolyte disorders can be life-threatening. Additionally, the hostages were denied essential medications and treatment for their injuries, leading to the risk of widespread metabolic disorders.
7. The poor quality of food and water, combined with unsanitary conditions, led to increased morbidity among the hostages. Many suffered from diarrhea, abdominal pain, and sometimes constipation. They had limited access to showers and returned with skin infections, including Dermatitis.
8. Infections were detected in hospital cultures (Clostridium, Salmonella, Vibrio, Shigella, Giardia, E. coli). Some were diagnosed with Q fever, while two returned hostages suffered from acute cases of Q fever. Several of the elderly women developed Deep Venous Thrombosis due to age, pre-existing medical conditions without medication, and lack of mobility during captivity.

Psychological abuse of the hostages:
9. The abduction of children, women, men, and the elderly from their homes is a traumatic event, often occurring after the murder of family members or close friends. In some cases, children were taken without their parents or after their parents’ murder. The terrorists caused widespread destruction, with hostages witnessing their homes burning, acts of rape and looting which took place in their communities. The captives were transported to Gaza in open vehicles, often alongside the bodies of those murdered. They endured beatings, humiliation, and verbal, physical, and sexual violence during the journey.
10. The captivity was designed to torture the hostages psychologically, break their morale, and make them easier to control. Their time in captivity was marked by intense trauma: family separation, immobilization, arbitrary and frequent transfers, and exposure to further violence. Some captives witnessed the killing of other captives, further deepening their sense of helplessness and hopelessness.
11. In captivity, the hostages were often subjected to solitary confinement, poor sanitation, severe medical neglect, lack of sleep, starvation, sexual abuse, violence, threats, and brainwashing through media designed to break their spirit and make them submissive.
12. Medical and psychosocial teams who treated the returned hostages report severe consequences for their health and well-being. Many exhibited sharp mood swings, with some showing signs of hypomania upon return, followed by extreme depression only a few hours afterwards. Even those who appeared strong initially showed difficulties adjusting to reality, sometimes experiencing dissociative episodes.
13. Some returned hostages had paranoid anxieties, fearing retaliation against their loved ones still in captivity if they spoke about their experiences. The inability to share their trauma with therapeutic factors, which made it harder to process their trauma.
14. The returned hostages have been experiencing “survivor’s guilt,” feeling responsible for being rescued while their loved ones remain in Gaza. This guilt delays their return to routine and rehabilitation. Some wish to return to captivity to help those left behind, feeling they are “not rehabilitated” as long as their loved ones are still there. The concern for those remaining is unbearable for them and their families.
15. Many returned hostages experience fear, restlessness, emotional detachment, and confusion. Some were afraid to leave their rooms, even in the hospital’s protected areas. They struggled to let go of behaviors from captivity, like barely eating and neglecting hygiene. Others hoarded food, fearing they would not have enough for the next day, despite knowing this was irrational.
16. The returned hostages also reported severe nightmares and sleep deprivation, trying to avoid repeating nightmares. Some experienced derealization, struggling to accept their presence in the Israeli hospital as real, rather than a dream from captivity. They avoided anything that reminded them of their traumatic experiences, including certain foods.
17. Most returned hostages had no home to return to and learned upon their arrival in Israel of the deaths of family and friends, the destruction of their homes, and the collapse of their communities. Many found themselves without the support they once had, which has significantly hindered their recovery and rehabilitation. This is compounded by the ongoing sense of threat, as the ceasefire has collapsed, and they continued to experience rocket fire from Gaza and the war on the northern front.
18. Medical and psychosocial teams believe that the returned hostages will require substantial resources and tailored treatment to succeed in their rehabilitation and reintegration. It is clear that as long as those still in captivity are not released, the rehabilitation and integration of the returned hostages will not proceed optimally, if at all.