From Libya to Afghanistan, 140 Million People Trapped in Humanitarian Crises in Eastern Mediterranean Region
Al Shifa Hospital in northern Gaaza at time of WHO delivery of medical supplies on 16 December, 2023

From earthquakes in Afghanistan to floods in Libya and the conflicts in Gaza and Sudan, WHO’s Eastern Mediterranean region, is beset with one of the world’s largest concentrations of people trapped in humanitarian crises and in desperate need of emergency health services, food aid, as well as peace,  said Dr Ahmed Al-Mandhari, WHO Regional Director for the Eastern Mediterranean, Tuesday. 

“Our region is home to 38% of the global population in need of humanitarian aid, which means over 140 million persons,” said Al-Mandhari, speaking from the WHO Regional Office in Cairo at an end-year WHO briefing.  “This number represents the everyday tragedies experienced by the people of Syria, Afghanistan and Iraq after earthquakes. The lived horrors of the people of Libya after catastrophic flooding, drought in the Horn of Africa, the rapidly worsening conflict in Sudan, and of course, the humanitarian crisis that continues to unfold in Gaza with unprecedented brutality.”

The Palestinian death toll in Gaza from the conflict between Israel and Hamas is now approaching 20,000 people, with high levels of hunger, crippled health services and growing prospects of disease outbreak, Mandhari warned.  At the same time, the  brutal war raging in Sudan between the Sudanese Armed Forces and the paramilitary Rapid Support Forces (RSF), has led to the displacement of some 7 million people, leaving some 4.9 million people on the brink of famine, he said.

Dr Ahmed Al-Mandhari, WHO Director for the Eastern Mediterranean Region

Unlike Gaza, the Sudanese civil war has been happening pretty much “off the radar screen”, added Dr Richard Brennan, Regional Emergency Director, WHO Regional Office for the Eastern Mediterranean, at the briefing. 

“We’re not seeing much on the news media, in the international media,” observed Brennan.  However, there has been a marked escalation in hostilities over the past several days as RSF forces advance on the city of Wad Madani, south east of Khartoum, where hundreds of thousands of poeple from the capital had taken refuge and many are now forced to flee.

“Over 24 million people are in need of aid. It’s the largest displacement crisis in the world today,” said Brennan of the Sudan war. “There are high levels of fighting and violence, high levels of displacement, a major food and security crisis. People are going hungry.  There is a rapidly progressing cholera outbreak, as well as rapidly spreading outbreaks of malaria, dengue and measles.”

Dr Richard Brennan, Regional Emergency Director, WHO Regional Office for the Eastern Mediterranean

Meanwhile, the western Sudanese region of Darfur, there has also been a fresh escalation of war-related violence against civilians, including “terrible stories of sexual violence against women and atrocities against the husbands and partners,” said Brennan. But despite the crisis there are large areas of the encircled region to which WHO and other humanitarian relief groups have no access at all. “We can only reach Darfour from cross border operations via Chad,” he said.

Sudan war: pink indicates areas controlled by Sudanese Armed Forces and allies as of 10 December 2023; green indicates control by Rapid Support Forces; yellow indicates control by Sudan People’s Liberation Movement-North.

WHO immediate aims for Gaza relief in ‘shrinking humanitarian space’

On Sunday, 11 December the WHO Executive Board approved a draft resolution to the World Health Assembly calling for the “immediate, sustained and unimpeded passage” of humanitarian relief to Gaza, including healthworkers, vehicles and supplies.

The most immediate needs include restoring the functionality of at least four hospitals in northern Gaza, with the support of emergency medical teams; expanding bed capacity and operations in southern Gaza hospitals, now in the line of fire as well; and a “better organized” medivac for wounded and ill Palestinians to Egypt or elsewhere abroad, said Dr Richard Peeperkorn, representative to WHO’s Jerusalem-based office in the Occupied Palestinian Territories (OPT).

Dr Richard Peeperkorn, WHO Representative, occupied Palestinian territory

But such aims faced huge challenges in light of the “shrinking humanitarian space.. and military activities making it very difficult for the One UN, including WHO, to move supplies, staff and patients.”

Coordination for safe passage of patients, health workers and supplies is “incredibly cumbersome,” he added, noting that a WHO mission to two northern Gaza hospitals had to be cancelled on Tuesday, due problems in coordinating safe passage.

On a visit to Al Ahli Hospital, in Gaza’s north last week, Peeperkorn said that he was “shocked” both by the scenes of urban devastation around the hospital and the needs inside, which were “unlike anything I had seen in my life.”

He described wounded people being brought in for emergency treatment on horse and donkey carts with over 200 patients “everywhere”, including the chapel of the hospital, operated by the Anglican Church.

Yesterday, Peeperkorn said he had received reports that “the fence surrounding the hospital had been demolished and there were tanks stationed outside.” A dozen people on the hospital grounds were reportedly arrested and remain in detention, including five staff.  That follows on a pattern of previous Israeli detentions and arrests of health workers at Al Ahli and elsewhere, he said.

“They’ve asked who to support with medical supplies, water and fuel. So we are planning a mission there tomorrow. But we hope on the current circumstances that this is possible,” Peeperkorn concluded.

More calls for Gaza cease-fire but prospects remain dim

WHO Executive Board meeting on the health and humanitarian situation in Gaza, Sunday. 10 December saw a fragile consensus reached.

“Stop this war, with no delay,” said Al Mandhari of the Gaza conflict.

In Sudan, “we absolutely need a ceasefire but unfortunately the military offensive is continuing, and more and more people are going to get caught up in the crisis because of the onward march of the military offensive,” added Brennan.

Yet another UN Security Council vote on the Gaza situation was scheduled for later Tuesday. Under US pressure, a fresh UN Security Council call for a “an urgent and lasting cessation in hostilities” had reportedly been watered down to call for an “urgent suspension of hostilities”.

Real prospects for a cease-fire in the near term seemed dim as Israel’s military advanced deeper into Gaza, including areas of the south where over 1.9 million displaced Palestinians are now living, after fleeing the north. Hamas has meanwhile said it will not negotiate over the release of more hostages under Israeli fire, demonstrating its resolve by lobbing missiles at Tel Aviv again on Tuesday, after releasing a new video Monday of three elderly Israeli hostages pleading for the Israeli government to prioritize their release along with the other 112 people still in captivity.

Israel initially launched air strikes on Gaza, followed by a ground invasion, in response to the 7 October Hamas incursion into Israeli communities near the Gaza enclave, in which gunmen killed over 1000 men, women and children in their homes along with young people at an outdoor festival.  Another 240 Israelis and foreign workers were carried back to Gaza, including about 30 children.

Some 114 hostages, mostly women and children, were released in a series of exchanges with Palestinian prisoners held by Israel during a week-long humanitarian pause in late November, before hostilities resumed. Israel has now seized large parts of northern Gaza, flattening most of the urban landscape, and carrying the battle to the tiny enclaves southern strongholds where most of Gaza’s population is now living in schools, around hospitals and makeshift shelters.

Israel, supported by the United States, Canada and other allies, has maintained that Hamas forces sytematically built tunnels, stored weapons and even hid hostages in and around health infrastructure, and any permanent cease-fire that leaves the organization’s military prowess intact would pave the way for more bloody attacks like that of  7 October, which Hamas leaders have already pledged to repeat.

Palestinians, supported by a large majority of other UN member states, have charged that the Palestinian civilian toll, including deaths of more than 7,000 children, has been disproportionately high, and the targeting of health facilities remains in contravention of international law regardless of claims about Hamas military deployment.

Regarding attacks on healthcare facilities, Mandhari issued an appeal to all sides, saying: “WHO and UN is always saying that attacks on healthcare is a breach of international humanitarian law, ..and any attack on these institutions or mobile teams on the ground is considered that way.  And we always call those conflicting parties to respect that law.  And if there is any breach, WHO encourages the relevant units, departments or organizations …to take it seriously and start doing whatever investigations are needed and then act against those who breach that sort of law.” 

Image Credits: @WHO, Eliajah Pepe/Wikipedia .

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