As Israel Tightens Grip, Gaza’s Health Workers Face ‘Agonising Choices’
A Palestinian boy with his cat in the ruins of an apartment bombed by Israel.

Health workers in Gaza face “agonising choices” in the face of Israel’s order that all people evacuate the north of the territory: “abandon ill patients amid a bombing campaign, put their lives at risk while remaining on-site to treat patients or endanger patients’ lives while attempting to transport them to facilities that have no capacity to receive them”.

This is according to the World Health Organization’s (WHO) Eastern Mediterranean Region, which “strongly condemned” Israel’s “repeated” evacuation orders – including more than 2,000 patients in 22 health facilities.

“The lives of many critically ill and fragile patients hang in the balance: those in intensive care or who rely on life support; patients undergoing hemodialysis; newborns in incubators; women with complications of pregnancy, and others all face imminent deterioration of their condition or death if they are forced to move and are cut off from life-saving medical attention while being evacuated,” said WHO EMRO.

Although Israel’s evacuation deadline expired on Saturday, Israel has not yet deployed ground troops into the areas of Gaza that it ordered evacuated.  Meanwhile, some Palestinian health workers in the hospitals affected have chosen to stay with their patients, who cannot be moved in any event.

Dr Christos Christou, president of Medecins sans Frontieres (MSF), described the situation in health facilities in Gaza as “horrific and catastrophic”, with surgeons at Al-Shifa Hospital currently “operating without painkillers”.

“People are trapped, unable to escape, with absolutely nowhere safe to go. They’re deprived of essential needs – water, food, protected shelter, medicines,” added Christou. “This is unimaginable. This is inhumane. As doctors, humanitarians, human beings, we cannot tolerate this. While we are frightened of what is coming, our only hope is for humanity to prevail.”

Huge death toll

At least 2,750 Palestinians have been killed and 9,700 have been wounded in Israeli air strikes on Gaza since 7 October, the Palestinian health ministry said on Monday. This is the highest Palestinian death toll since Hamas took control of Gaza in 2007, wresting power from the Fatah-aligned Palestinian Authority in a violent takeover, after both sides failed to win a clear majority in elections, the last ever to be held. 

Israel launched unprecedently intense airstrikes on Gaza after Hamas attacked  towns, villages and collective farms inside Israel on 7 October, killing around 1,300 people and abducting 199 others, including babies, children and elderly, whom it is currently holding hostage in Gaza.

Around half the population of Gaza is under the age of 18, and the UN Children’s Agency, UNICEF, called for an immediate ceasefire last week, saying that “hundreds and hundreds of children have been killed and injured”.

UNICEF has also called for Israeli children held captive by Hamas to “be safely and immediately reunited with their families and loved ones”.


Palestinians killed on designated safe route to the south

Meanwhile, some 70 Palestinians were killed on Friday while trying to leave northern Gaza along one of the routes designated as safe by the Israeli Defense Force (IDF) when their convoy was bombed, according to media reports.

Amnesty International said on Sunday that it had verified six videos of the Israeli attack on a civilian convoy on Salah al-Din Road, and a follow-up bombing of ambulances that arrived to assist. IDF has denied responsibility for the attacks.

The Israeli strikes on Gaza have been unprecedented in their intensity.  Hamas has also continued to fire missiles into southern and central Israel, leading to the evacuation of Israeli communities in proximity to the Gaza border. Although most Israeli civilians have access to shelters, the total Israeli death toll so far in the hostilities has now risen to over 1400, according to Israel, including several dozen foreign workers, students and Palestinian-Israeli citizens.

White phosphorus use?

Last week, Human Rights Watch (HRW) said it had verified videos that showed Israel had fired white phosphorous “over Gaza City’s port and in two rural locations along the Israel-Lebanon border.”

“Upon contact, white phosphorus can burn people, thermally and chemically, down to the bone as it is highly soluble in fat and therefore in human flesh. White phosphorus fragments can exacerbate wounds even after treatment and can enter the bloodstream and cause multiple organ failure,” according to HRW.

“Its use in densely populated areas of Gaza violates the requirement under international humanitarian law that parties to the conflict take all feasible precautions to avoid civilian injury and loss of life,” HRW added.

However, Israeli military spokesperson Lieutenant Colonel Peter Lerner denied that the army had used the substance, saying “categorically no” in an interview with CNN. 

Gaza is without power, low on water and food 

Meanwhile, Israel has implemented a total blockade of Gaza alongside its aerial bombing and is not allowing aid trucks carrying food, water, fuel and medical supplies to enter Gaza from Egypt via the Rafah crossing.

“There is not one drop of water, not one grain of wheat, not a litre of fuel that has been allowed into the Gaza Strip for the last eight days,” said Philippe Lazzarini, Commissioner-General of the United Nations Agency for Palestine Refugees (UNRWA), at a media briefing on Sunday.

“Gaza is running out of water, and Gaza is running out of life.  Soon, I believe, with this there will be no food or medicine either.”

Gaza’s only power plant ran out of fuel Wednesday afternoon, shutting down electricity, water and wastewater treatment, according to UNICEF spokesperson James Elder.

“Most residents can no longer get drinking water from service providers or household water through pipelines,” said Elder. “At least six water wells, three water pumping stations, one water reservoir, and one desalination plant serving more than 1 million people have been damaged by airstrikes.”

In its situation report on Monday, UNRWA said that over one million people – almost half the total population of Gaza – have been displaced. 

“Some 600,000 Internally Displaced Persons (IDPs) are in the Middle Area, Khan Yunis and Rafah, of those, nearly 400,000 are in UNRWA facilities – much exceeding our capacity to assist in any meaningful way, including with space in our shelters, food, water or psychological support.    

“Despite the Israeli Forces’ evacuation order, an unknown number of IDPs remain in UNRWA schools in Gaza City and the north. UNRWA is no longer able to assist or protect them. Over 160,000 IDPs were sheltering in 57 UNRWA premises, including – but not only – Designated Emergency Shelters in these areas at the time of the Israeli evacuation order.” 

UN Secretary-General Antonio Guterres said on Monday that the UN had food, water, medical supplies and fuel in Egypt, Jordan, the West Bank and Israel that could be “dispatched within hours” but “our staff need to be able to bring these supplies into and throughout Gaza safely, and without impediment”.

Guterres also said that “all hostages in Gaza must be released. Civilians must not be used as human shields,” in a New York Times article last Friday.

“International humanitarian law — including the Geneva Conventions — must be respected and upheld. Civilians on both sides must be protected at all times. Hospitals, schools, clinics and United Nations premises must never be targeted.”

At least 14 UNRWA staff members have been killed in the past week, while the International Federation of Red Cross and Red Crescent Societies (IFRC) said that five of its members had been killed in attacks on ambulances.

“It is clear that the two sides in this conflict cannot achieve a solution without concerted action and strong support from us, the international community. That is the only way to save any chance of security and opportunity for both Israelis and Palestinians,” Guterres concluded.

Image Credits: UNRWA.

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