Médecins Sans Frontières (MSF) and two other international relief agencies all said that they are withdrawing emergency medical teams from Al Aqsa Martyrs Hospital in central Gaza after intensified fighting around the hospital area made it impossible for staff to continue emergency care functions. 

“After days of artillery fighting in Gaza’s Middle Area, Israeli forces dropped flyers with evacuation orders in the neighborhoods around Al-Aqsa Hospital,” said MSF in a statement on Saturday. “Over the last couple of days, drone attacks and sniper fire were just a few hundred meters from the hospital, and yesterday, a bullet penetrated a wall in the ICU.” 

On Sunday, two other relief agencies, the International Rescue Committee and the UK-based Medical Aid for Palestinians said that their Emergency Medical Teams also had been “forced to withdraw and cease activities” from the hospital in Deir Al Balah, which remains the only functioning hospital in Gaza’s “Middle” area. 

Speaking Sunday from Al Aqsa Hospital, WHO’s Sean Casey, WHO EMT Coordinator, described chaotic scenes where doctors struggled to provide trauma care to people who had been victims of bombardment and explosions. 

“The hospital is operating with about 30% of the staff that it had just a few days ago,” Casey said. “They are seeing hundreds of casualties in a small emergency department. They are treating children on the floor. The hospital director spoke to us, and his one request was that this hospital be protected, that they not be evacuated, that they are able to continue functioning,” Casey said. 

.@WHO has received troubling reports of increasing hostilities and ongoing evacuation orders near the vital Al-Aqsa Hospital in the Middle Area of #Gaza, which according to the facility’s director forced over 600 patients and most health workers to leave. Their locations are not… pic.twitter.com/Vzd9UWThNm

— Tedros Adhanom Ghebreyesus (@DrTedros) January 7, 2024

Meanwhile, a planned WHO mission to Al Awda Hospital in northern Gaza was cancelled Sunday for the fourth time since 26 December, “because we did not receive deconfliction and safety guarantees,” according to WHO’s Jerusalem-based Office for the Occupied Palestinian Territory on X (formerly Twitter). 

“The mission planned to move urgently needed medical supplies to sustain the operations of five hospitals in the north, including Al-Awda, said WHO. “It has now been 12 days since we were last able to reach northern Gaza. Heavy bombardment, movement restrictions, and interrupted communications are making it nearly impossible to deliver medical supplies regularly and safely across Gaza, particularly in the north.

Lacking adequate access, staff and supplies, doctors are being forced to perform more amputations on people who were unable to reach medical care, and now have severely infected limbs, Dr. Mohamed Obied, an orthopedic specialist at the hospital was quoted as saying. “And doctors are forced to amputate limbs more frequently, performing “above the knee, rather than below-knee amputations.”

Last Thursday, WHO’s Director General Dr Tedros Adhanom Ghebreyesus also deplored an Israeli attack on a Palestinian Red Crescent training center inside the Al Amal Hospital Complex in Khan Younis city in Southern Gaza, which reportedly killed five civilians including a newborn.  Some 14,000 displaced people are sheltering on the hospital grounds, Tedros noted.  

Growing hunger and risk of famine 

Along with the conflict, per se, the growing specter of extreme hunger, and looming famine, are amongst the other risks faced by Gaza Palestinians in the new year, said the UN’s Martin Griffiths, in a statement on Friday.

A fresh report by UN Secretary General to the UN Security Council further warned that “widespread famine looms”. More than half a million people, a quarter of the population face extreme hunger, stated the bleak summary, published on X by Al Jazeera’s UN corespondent ahead of its formal release.

“People are facing the highest level of food security ever recorded… famine is around the corner,” echoed Griffiths, UN Under-Secretary General for Humanitarian Affairs and Emergency Relief Coordinator, also writing on X.   

Bereft of food, shelter and warmth, the conditions for disease spread are also ripe, he underlined.

“Families are sleeping in the open as temperatures plummet.  Areas where civilians were told to relocate for their safety have come under bombardment…  

“A public health disaster is unfolding. Infectious diseases are spreading in overcrowded shelters as sewers spill over, he added. “The humanitarian community has been left with the impossible mission of supporting more than 2 million people, even as its own staff are being killed and displaced, as communication blackouts continue, as roads are damaged and convoys are shot at. 

“Meanwhile, rocket attacks on Israel continue, more than 120  people are still held hostage in Gaza, tensions in the West Bank are boiling, and the specter of further regional spillover of the war is looming dangerously close. Hope has never been more elusive… We continue to demand an immediate end to the war.” 

Israel under international pressure

Israel has come under increasingly intense international pressure, including charges of genocide, for its conduct during its invasion of Gaza, which began after Hamas gunmen entered some 22 Israeli communities around Gaza in the early morning hours of 7 October, killing 1200 people, mostly civilians, in their homes. 

Israel’s has since killed some 22,000 Palestinians, displaced 80% of the area’s 2 million residents, and turned northern Gaza City into an apocalyptic landscape of sand, rubble and blown out buildings during one of the most intense aerial bombing campaigns in history.   

After claiming “operational control” last week of most of northern Gaza, Israel’s military has now moved into central and southern areas of the densely-populated enclave, which is only 365 square kilometres in all, waging fierce battles there against Hamas fighters who are bunkered down in underground tunnels and still holding over 100 Israeli hostages, including the elderly, women and children. 

Speaking to the Times of Israel, the Israeli military spokesman said Hamas “systematically operates in the hospitals in the Gaza Strip and in the areas adjacent to them, using the residents as human shields and exploiting the hospital’s infrastructure, including electricity and water.”  

“Entire neighborhoods in the Gaza Strip have been converted into “fighting complexes” for Hamas, which include “ambushes, command and control apartments, weapon depots, combat tunnels, observation posts, firing positions, booby-trapped homes and explosives in the streets,” another Israeli military source was quoted as saying. 

Although Shifa’s hospital’s alleged Hamas underground “command and control” complex did not turn out to be as massive as Israeli military analysts originally had projected, significant evidence about Hamas military infrastructure under and around Gazan hospitals has been gathered and presented by Israel during the war. Several groups of Israeli hostages, mainly women and children, were also held in Gaza hospitals during part of their captivity, according to testimony by former Israeli hostages released in late November during a brief humanitarian pause and prisoner exchange.  

Image Credits: Democracynow.org, WHO , WHO , © UNRWA/Ashraf Amra.