Gaza’s health situation worsens amidst relentless Israeli assaults

Israel targets health infrastructure in central and southern Gaza, worsening the already grim state of healthcare delivery

December 30, 2023 by Peoples Health Dispatch

Al-Amal Hospital in Khan Younis, southern Gaza, is one of the hospitals in Palestine to be most recently attacked by the Israeli Occupying Forces (IOF). Following Israeli attacks that killed 31 people and injured at least 20 on December 27, another strike killed 10 and injured 20 more the following day. The attacks also hit floors hosting the headquarters of the Palestinian Red Crescent Society (PRCS), resulting in damage to the dispatch system used by the PRCS to coordinate emergency responses.

“The damage of this network, which is the only means of communication in light of the interruption of communications, poses a great challenge for ambulance and emergency crews in reaching the wounded and sick,” PRCS said in a statement following the attacks.

Attacks on health infrastructure in central and southern Gaza are unfolding in a manner similar to the scenario previously witnessed in the northern areas. Richard Peeperkorn from the World Health Organization (WHO) office for the occupied Palestinian territories recently anticipated that this will result in fewer health workers and patients being able to reach those hospitals, depriving them of access to any care. “This scenario was witnessed all too often in the North. Gaza cannot afford to lose any more hospitals,” Peeperkorn said.

Like all hospitals in Gaza, Al-Amal is currently providing shelter to thousands of people displaced by Israeli strikes: approximately 14,000 people sought refuge at the hospital in the past weeks. Even more people have taken refuge in other health centers. Al-Shifa Hospital, Gaza’s largest institution of this kind, is providing shelter to around 50,000 internally displaced people.

Conditions inside the hospitals continue to be horrifying, as witnessed by the WHO missions that delivered supplies in recent days. According to Sean Casey, WHO Emergency Medical Teams Coordinator, the needs of the people flowing into the hospitals are multiple times greater than what the health system in Gaza can currently secure. During his visit to Al-Aqsa Hospital, Casey observed that the current capacities do not come close to those needed to treat the complex cases being brought to the hospital.

The situation is similar in other hospitals. Al-Awda Hospital in Jabalya, which is trying to scale up operations after a prolonged Israeli siege on its premises, is struggling to provide adequate care to orthopedic and trauma patients due to a lack of materials. Mohammad Obaid, head of limb reconstruction at the hospital, warned that many of the patients reaching them had been injured weeks ago, arriving at the point of care with infected wounds. Unable to perform biopsies and to avoid patients falling into septic shock, health workers are forced to opt for amputation.

All of this is happening amid a shortage not only of medical stock but also of health personnel. Health workers in Gaza have been on a non-stop call since October 7, making them physically and emotionally exhausted. “The doctors and nurses here are doing their best,” Sean Casey reported. “Their best is never going to be enough until there’s a ceasefire.”

Many health workers remain disappeared by the IOF, including Al-Awda’s Jabalya director, Ahmed Muhanna, who was taken to an unknown location with other members of the hospital staff 12 days ago. Dr. Muhanna’s arrest triggered an international appeal for his and his colleagues’ release, but their whereabouts remain unconfirmed.

Read more: Palestinian and international networks demand Israel release hospital director Dr. Ahmed Muhanna

In addition to the crumbling state of health infrastructure and the exhaustion of health workers, people in Gaza are living in increasingly worrying conditions. Similar to the hospitals, shelters are working at multiple times their capacity. Khan Younis Training Center, intended to host some 1,000 people, is currently sheltering 30,000. That translates to at least 400 people per toilet – a far cry from the maximum of 20 people per toilet foreseen by United Nations health experts in crisis situations.

As the average number of people sheltering in UNRWA centers in central and southern Gaza has risen to over 12,000 per center – four times their capacity – overcrowding is an obvious problem. In the current situation, public health experts have said that it should be expected that infectious diseases will kill even more people than Israeli attacks. Since mid-October, the WHO has recorded more than 100,000 cases of diarrhea and more than 150,000 cases of upper respiratory infections, along with cases of chickenpox, lice, and meningitis. With 90% of Gaza’s population exposed to acute levels of food insecurity, if the situation does not change drastically soon, these numbers could grow further and lead to devastating outbreaks.

Even if bigger outbreaks are avoided, the lack of food and looming famine is certain to have long lasting effects on people’s health. The most drastic consequences are to be expected among children, who are vulnerable to stunting, and pregnant and breastfeeding women. Reflecting on the conditions in which children in Gaza are living in, Israa, a woman who recently gave birth in Nuseirat, said: “I didn’t feel the joy of my baby’s arrival; instead, I feel pity for him and the conditions he was born into.”

The reports collected by WHO teams on the ground have only reaffirmed what the agency has been emphasizing for the past weeks: without an immediate and permanent ceasefire, health in Gaza will collapse, regardless of the trickle of aid coming in through humanitarian and international agencies.

People’s Health Dispatch is a fortnightly bulletin published by the People’s Health Movement and Peoples Dispatch. For more articles and to subscribe to People’s Health Dispatch, click here.