Israel launched what it described as a “targeted operation” into Gaza’s besieged Shifa Hospital early Wednesday morning – which was immediately denounced by the World Health Organization as “unacceptable” and contrary to international law – regardless of whether Hamas made use of the facility for military purposes. 

Meanwhile, on Tuesday, an Israeli delegation visiting Geneva on behalf of the estimated 229 people held hostage by Hamas, met with WHO’s Director General Dr Tedros Adhanom Ghebreyesus as well as the president of the International Committee of the Red Cross, pleading with them to intervene more forcefully on the release of the captives, including 30 children, a pregnant woman, and 20 older people, with a range of injuries and chronic health conditions.  

‘Hospitals are not battlegrounds’ – WHO DG 

In statements early Wednesday morning, Israel’s military spokesman said that elite troops had entered the hospital, ostensibly to root out Hamas operatives, weapons and entrances to an extensive underground tunnel system – that may have been used to hide and transport some of the 240 Israeli hostages to other parts of Gaza.  

Speaking at a Wednesday afternoon press briefing, Tedros condemned the entry, saying:   

“Israel’s military incursion into Al Shifa hospital in Gaza City is totally unacceptable.. Hospitals are not battlegrounds.  We are extremely worried about the safety of staff and patients. 

“WHO has lost contact with health workers at Shifa Hospital. But one thing is clear – under international humanitarian law, health facilities, health workers, ambulances and patients must be safe-guarded and protected against all acts of war. 

“Not only that, but they must be actively protected during military planning.  

“Even if health facilities are used for military purposes, the principles of distinction, precaution and proportionality always apply,” added Tedros. “The safety of patients and staff, as well as the integrity of the health care systems in the wider community, are of paramount concern,” he added. 

Israel’s military said that the entry of troops was accompanied with Arabic-speaking medics, incubators and other supplies to address the plight of some 36 premature babies teetering between life and death. 

Aching relief needs everywhere in Gaza

For the first time since the conflict began, fuel began to move into Gaza via the Egyptian Rafah crossing. A truck with 23,000 litres of fuel was permitted to cross to resupply the depleted reserves of the UN Refugee Agency, which is sheltering hundreds of thousands of Palestinians displaced by the fighting in tent camps and other temporary locations in the south of the tiny enclave – whose largest city in the north now lies in ruins. 

The Jerusalem-based Representative WHO’s Office for the West Bank and Gaza, Richard Peeperkorn, described the fuel entry, previously opposed by Israel, as a “promising step.”

But the supplies, which were approved for the re-supply of UNRWA installations only, are nowhere sufficient to meet the broader needs of Gazans, Peeperkorn and the WHO Director-General both said.  

“At least 120,000 litres a day are needed to operate hospital generators, ambulances, desalination plants, sewage treatment plans and telecommunications,” pointed out Tedros.  

“The problem can be easily fixed, the supply of electricity must be restored and sufficient fuel must be allowed to enter, to run vital infrastructure and distribute lifesaving aid,” he added.

Infectious diseases rising

“What’s critically important is the water and sanitation,” said Peeperkorn, saying that some 4000 tons of rubbish per day was piling up in overcrowded camps in southern Gaza where solid waste removal services ceased functioning yesterday due to a lack of fuel. 

Sewage pumping stations, water wells, and Gaza’s two main water desalination plants in Rafah and the middle portion of Gaza also were not functioning due to a lack of fuel, Peeperkorn noted. 

In addition, said Tedros, heavy rains have flooded makeshift camps, “making conditions even worse” for those displaced. 

“We see a real problem in that disease surveillance is interrupted,” added Pepperkorn, noting that official reports on deaths and injuries had not been made for the past three days. 

But regardless of the limited reporting capacity, WHO is seeing sharp rises in acute respiratory infections, diarrhea, as well as skin diseases, scabies and Hepatitis A, he said. 

“And I want to really be clear that over the last three days, we have not received updates to date on injuries and deaths due to the intensifying hostilities and levels  of connectivity so it makes it much harder to evaluate,” he said.

The latest reports are of 11,078 Palestinian casualties since the original 7 October Hamas incursion into Israel, in which some 1200 Israelis and foreigners were killed, mostly civilians.   Since then, Israel has conducted one of the most intensive aerial bombing campaigns in modern history devasting large parts of Gaza City. Hamas has fired over 9,500 missiles into Israel, including a direct hit on the coastal city of Ashkelon Wednesday.  

Meanwhile, only about 10 hospitals are still operating on the strip out of the original 36, Tedros said, with about 1400 beds available out of an original 3500.  

And movement of critically ill patients to treatment across the border in Egypt remains challenging, Peeperkorn said. 

“We need to establish a mechanism that a medevac  becomes operational over the next three months,” Peeperkorn said, referring to the timely and efficient evacuation of critically ill patients. On Wednesday, some 30-50 critically-ill patients were evacuated to Egypt, he said. But thousands more will require medical transport over the next several months. 

WHO and ICRC meetings with Israeli delegation of hostage families

On Tuesday, four hostage families, accompanied by Israel’s Foreign Minister and Health Minister, were in Geneva to plead with WHO’s Tedros and Mirjana Spolijaric, president of the International Red Cross Committee, for more forceful international intervention on the fate of the captives. 

It was the first high-level meeting between Israeli ministers, the ICRC and WHO’s leadership on the matter since the conflict began. 

Spoljaric said in a statement that the ICRC was “doing everything in our power to gain access” to the hostages but “cannot force its way into where hostages are held” and “can only visit them when agreements, including safe access, are in place”.

Today I met families of hostages and Israel's foreign and health ministers. The families' pain is simply heart-wrenching.

The hostages must immediately be released.@ICRC will not stop working to gain access to them: and we need agreements to be reached that allow us to work. pic.twitter.com/CLkbiB7VRt

— Mirjana Spoljaric (@ICRCPresident) November 14, 2023

Tedros, in his remarks on the meeting, stated, ” I heard and felt their pain and heartache. WHO continues to call for the hostages to be released unharmed, without any condition. We are deeply concerned for their health and well-being, just as we are concerned for the health and well-being of the people of Gaza, which is becoming more precarious every hour.”

At a briefing for Geneva’s UN press, the families appealed to the UN and international community to do more to obtain the release of their family members, beginning with  “even a sign of life”.  

Ilan Regev Gerby, the father of two children in their twenties kidnapped together from a weekend festival, fought back tears as he replayed a tape of his last phone conversion with his hysterical children, as Hamas forces entered the festival grounds on 7 October.  

Idit Ohel, mother of 22 year old Alon Ohel, described learning about her son’s fate from a Hamas video, uploaded to social media. The video, aired at the briefing, showed him and two other friends being hauled away by Hamas forces in a truck from the same outdoor festival, holding a tourniquet to the lower part of his arm, which was blown off by a grenade thrown into his hiding place, according to one eyewitness who survived.

“I ask the UN for security, for freedom and humanity,” said Ofri Bibas Levy, whose brother, sister-in law and their two children, ages four and 10 months, were kidnapped from their home  in a community near Gaza on 7 October. “Where is the humanity of two boys being held underground for 40 days?”

There have been reports of progress on a Qatari- brokered deal for the release of 50 hostages, mainly women and children held by Hamas, in exchange for the release of Palestinian female prisoners and a three-day truce – something that could unlock a humanitarian cease-fire allowing more health and humanitarian aid to flow into the besieged strip. 

A breakthrough has so far remained elusive insofar as Israel has been calling for the simultaneous release of all hostages, while Hamas is clearly interested in a staged release of the captives, in a bid to slow down and eventually halt  Israel’s military advances which aim at its overthrow. 

Even so, US President Joe Biden sounded an optimistic note Tuesday evening in a press briefing in Washington DC, where he send a message to hostage families saying, “hang in there we are coming.”

Image Credits: WHO/EMRO, WHO/EMRO, E. Fletcher/Health Policy Watch.