WHO has said it is “deeply concerned” that a full-scale military operation “could lead to a bloodbath” as prospects of a major new Israeli incursion into Gaza’s southern enclave of Rafah appeared to grow over the weekend – while hopes of a cease-fire deal see-sawed wildly. 

“A new wave of displacement would exacerbate overcrowding, further limiting access to food, water, health and sanitation services, leading to increased disease outbreaks, worsening levels of hunger, and additional loss of lives,” said the global health agency.  

The WHO statement Friday was repeated Monday afternoon on X  by WHO Director General Dr Tedros Adhanom Ghebreyesus – as previously positive signs of a possible ceasefire and hostage deal between Israel and Hamas receded last week, crashed over the weekend, and then rebound slightly again Monday evening with Hamas announcing publicly that it would accept an Egyptian-Qatari mediated proposal – even as Israel launched a wave of air strikes on Rafah’s eastern neighbourhoods. 

A full military incursion into Rafah will plunge the crisis into unprecedented levels of humanitarian need. A ceasefire is urgently needed for the sake of humanity. #Gaza pic.twitter.com/UDeW3ZYSHR

— Tedros Adhanom Ghebreyesus (@DrTedros) May 6, 2024

“Only 33% of Gaza’s 36 hospitals and 30% of primary health care centres are functional in some capacity amid repeated attacks and shortages of vital medical supplies, fuel, and staff,” said the WHO statement on the health situation in the Palestinian enclave, only about 365 square kilometres in size. 

“As part of contingency efforts [for a possible operation], WHO and partners are urgently working to restore and resuscitate health services, including through expansion of services and pre-positioning of supplies, but the broken health system would not be able to cope with a surge in casualties and deaths that a Rafah incursion would cause.   

“The three hospitals (Al-Najjar, Al-Helal Al-Emarati and Kuwait hospitals) currently partially operational in Rafah will become unsafe to be reached by patients, staff, ambulance, and humanitarians when hostilities intensify in their vicinity and, as a result quickly become non-functional,” warned WHO.  

“The European Gaza Hospital in east Khan Younis, which is currently functioning as the third-level referral hospital for critical patients, is also vulnerable as it could become isolated and unreachable during the incursion. Given this, the south will be left with six field hospitals and Al-Aqsa Hospital in the Middle Area, serving as the only referral hospital.” 

Over 1 million displaced Palestinians are crowded in and around Rafah, a town hugging up against the Egyptian border, which is also heavily barricaded against crossings by Palestinians except for the seriously ill – and wealthy, well-connected families who can afford steep fixer fees to evacuate.  

Crisis began building last week 

The current crisis began building up last week in the wake of a blunt series of statements by Israel’s Prime Minister Benjamin Netanyahu expressing his determination to invade Gaza’s Rafah area, whether or not a ceasefire and hostage deal is reached. 

Then on Sunday, a Hamas volley of rockets at an Israeli military base near the Kerem Shalom crossing into Gaza killed four Israeli soldiers – creating a political uproar inside Israel as it observed a national Holocaust remembrance day. Israel responded by shutting the Kerem Shalom crossing point to traffic Sunday morning  – one of the three vital humanitarian aid lifelines into the enclave.  Israeli-Hamas talks over a cease-fire and potential exchange of Israeli hostages and Palestinian prisoners held by Israel reportedly stalled – only to receive a new Monday evening with the Hamas announcement of a new offer, that Israel said it was “studying” – even as it launched a wave of “targeted” air strikes on what it claimed were Hamas strongholds east of Rafah.

Earlier on Monday Israel’s military issued orders to some 100,000 Palestinian civilians in parts Rafah close to the Israeli border to begin evacuating from the area, dropping leaflets in the targeted areas. The Israeli move, and its potential to expand to a larger attack, was decried by UN Human Rights Chief Volker Türk, who called Israel’s Rafah threat “inhumane” as well as by countries ranging from France to Saudi Arabia.  

“Gazans continue to be hit with bombs, disease, and even famine. And today, they have been told that they must relocate yet again as Israeli military operations into Rafah scale up,” the High Commissioner said. Israeli air strikes on homes in Rafah were reported to have killed over two dozen more people, including women and children over the past 24 hours, Turk’s office added. 

On Monday evening, air raid sirens were again sounding in Israeli communities around the Gaza perimeter – while Israel’s military spokesperson Daniel Hagari stepped up calls on Israeli television for Palestinians in “designated areas” of Rafah to move north and westward to the area of Al Mawasi, and northwards towards Khan Younis – in advance of planned Israeli operations got underway later Monday night. 

Some 400,000 displaced people are already located in Al-Mowasi, said Louise Wateridge, a spokesperson for the UN agency for Palestinian refugees, UNRWA, speaking from Rafah in a Geneva press briefing on Monday afternoon. 

Dashed hopes

“There was really a lot of hope over the last days that there would be a ceasefire,”  Wateridge said. “So, we’re genuinely devastated to wake up today and have the reality that is the [Israeli] leaflet drop and you know, reports of evacuations beginning.”  

“Nobody has a clear path where to go, there is no advice on where to go, there is no safety to be led to,” she added. “So, in each circumstance, in each family, now it’s a lot of panic and a lot of chaos, because even though we’re hearing the evacuation orders are confined to a small area in Rafah, in the east of Rafah, you can imagine as people start to move, the panic is going to spread. 

“Already outside the window here, we’re in more central Rafah, people are beginning to take down shelters and leave.”

In the wake of the closure of Israel’s Kerem Shalom crossing into Gaza, Egypt’s Rafah checkpoint also remains the only reliable source of food aid – now threatened by a looming Israeli operations, she pointed out. Food supplies had only recently begun to rebound parts of Gaza, like Jabalya, where there has been more commercial food on the market, which is really promising to see,” Wateridge said. But in parts of northern Gaza, which UN humanitarian aid convoys have been unable to reach, “the situation remains just devastating.”

Inside Israel, families of hostages who had been hopeful last week of a possible deal to release the remaining women, elderly and ill who remain amongst the estimated 100 people still held captive by Hamas blocking a main highway in Tel Aviv, calling on Netanyahu to “stop playing with the lives of our children”.  

UN Secretary General Antonio Guterres meanwhile called upon Israel and Hamas to ‘go the extra mile needed’ to finalise a deal in a statement Monday evening.

“The Secretary-General is deeply concerned by the indications that a large-scale military operation in Rafah may be imminent,” said UN spokesperson Stephane Dujarric in a statement. “The Secretary General reminds the parties that the protection of civilians is paramount in international humanitarian law.”

Some 1,139 Israelis, mostly civilians, were killed and another 252 people taken captive by Hamas on 7 October, with 105 hostages released in late November as part of a week-long ceasefire, and seven more unilaterally by Hamas or by Israeli operations, while around 267 more Israeli soldiers have died in the ensuing six months of conflict. Meanwhile, over 34,000 Palestinians have been killed during Israel’s prolonged invasion of Gaza, according to Gaza’s Hamas-controlled Health Ministry. Most of the victims are reported to be women and children, but Hamas data does not distinguish between civilian and military casualties.  

Image Credits: OHCHR , UNRWA , Channel 11, Israel TV.