Swaths of Palestinian territory have been declared “state land”, while settler violence has reached record levels, driving the displacement of at least 45 Palestinian communities since 2023, and reshaping the West Bank’s geography. In addition to causing injuries and deaths, Israeli settler violence and military operations produce chronic fear, psychological distress and persistent insecurity. This is particularly important in the Palestinian context, both in Gaza and the occupied West Bank. In the West Bank, access to care is conditional on whether a checkpoint is open, settlers are blocking a road, or soldiers permit an ambulance to pass. Too often, discussions of settlement expansion, annexation and settler violence focus exclusively on territory and international law.