The World Health Organisation (WHO) in the Occupied Palestinian Territories has recorded at least 137 attacks on health care in Gaza over the past 36 days, resulting in 521 deaths and 686 injuries, including 16 deaths and 38 injuries to health workers on duty, from 7 October to 12 November. In the Occupied Palestinian Territories as a whole, the number of attacks exceeds 230, taking into account the 96 attacks in Cisjordania from 7 to 24 October.
Military attacks, coupled with the month-long blockade and lack of supplies, have put half of Gaza’s 36 hospitals and two-thirds of its primary health care centres out of operation, WHO Director-General Tedros Adhanom Ghebreyesus told the UN Security Council on 10 November.
Israel justifies these attacks by claiming that members of the Hamas terrorist organisation are hiding in a network of tunnels through health facilities. While journalistic investigations show the existence of such hiding places, according to international humanitarian law, health facilities and health professionals must be actively protected from hostilities, and under no circumstances targeted.
“The world cannot remain silent as hospitals […] are transformed into scenes of death, devastation and despair”.
As the WHO denounces in a strong statement issued on Sunday 12 November, “attacks on medical facilities and civilians are unacceptable and constitute a violation of international human rights and humanitarian law and conventions”. For this reason, the World Health Organisation insists that they “cannot be condoned”, because “the right to seek medical assistance should never be denied, especially in times of crisis”. “The world cannot remain silent while hospitals, which should be safe havens, are transformed into scenes of death, devastation and despair,” the statement concludes.
Similarly, the United Nations and organisations such as Médecins Sans Frontières and Save the Children warn that the blockade of humanitarian aid and the cutting off of supplies of food, water, medicines, electricity and fuel could constitute violations of international humanitarian law. Beyond military attacks, the blockade of supplies has brought Gazan hospitals to the brink of collapse, as reported by Palestinian health authorities and humanitarian organisations on the ground. In this context, the United Nations, the WHO, Médecins Sans Frontières (MSF), Save the Children and countries such as Spain and France are calling for an immediate humanitarian ceasefire.
22 Palestinian hospitals affected by military attacks
More than 230 health facilities were among the targets hit by Israeli bombs, killing more than 520 people. According to the WHO, most of those killed and injured in the attacks on health facilities were internally displaced persons and refugees. In addition, the 100 or so Israeli attacks have left 459 people injured, including 37 health workers. In terms of equipment, the IDF offensive has damaged 39 health service points, including 22 hospitals, and affected 31 ambulances.
Al Shifa Hospital siege: “No one can get in or out”
The latest reports point to an intensification of attacks in the vicinity of numerous Palestinian hospitals in recent days, particularly at Al-Shifa Hospital, Al-Rantisi Naser Paediatric Hospital, Al-Quds Hospital and others in Gaza City and northern Gaza, “killing many, including children,” the WHO denounces. “Intense hostilities surrounding several hospitals in northern Gaza are preventing safe access for health workers, the wounded and other patients,” continues the statement issued by the WHO on 12 November in the afternoon.
On the same Sunday 12 November, the Hamas-controlled Gaza Ministry of Health informed the WHO about the serious situation in Al Shifa Hospital, warning that there are still 600-650 patients inside, some 200-500 health workers and approximately 1500 internally displaced persons, with a lack of power, water and food. This situation puts the lives of all these people at immediate risk, while there is no safe passage outside the hospital, not even for ambulances.
Ministry of Health update about the dire situation at Al-Shifa Hospital – received on 12 Nov:
— WHO in occupied Palestinian territory (@WHOoPt) November 12, 2023
????600-650 inpatients, 200-500 health workers and approximately 1500 internally displaced people still inside the hospital.
????Lack of power, water and food, putting lives at immediate… pic.twitter.com/3MQfKdpqlY
“No one can get in or out and the hospital is unable to provide outside medical support because the hospital is surrounded. Some people were shot through the windows, so we have to move patients to the corridors,” the Gazan Ministry of Health denounced. According to information provided to the WHO by the Gazan authorities, 45 patients were unable to access dialysis treatments, and 37 premature babies had to be relocated to an operating room without incubators, although health workers tried to warm the room, but three died. Meanwhile, “around 100 corpses are decomposing at the entrance of the hospital, but health workers cannot go outside to bury them,” they complain.
More than a month of attacks on health targets
The attack on the parking lot of the Arab Al Ahli Hospital on 17 October was the bloodiest, killing 471 people and wounding 342, according to Gaza’s health ministry, while Western intelligence agencies believe the figures are considerably lower and visual investigations point to more like a hundred deaths, although no number has been verified, reports the New York Times. The bombing has been “strongly” condemned by the WHO, which notes that “the hospital was operational, with patients, health and care donors, and internally displaced persons taking shelter”.
The hospital was one of 20 hospitals in the northern Gaza Strip that received evacuation orders from the Israeli military, but according to the WHO, the evacuation order was “impossible to carry out given the ongoing insecurity, the critical condition of many patients, and the lack of ambulances, staff, health system bed capacity and alternative shelter for the displaced”. The authorship of the attack has not yet been clarified, but visual investigations by media outlets such as the New York Times and Al Jazeera cast doubt on one of the most widely used pieces of evidence arguing that the explosion was caused by an errant Palestinian missile.
Patients under siege and supplies depleted
Beyond the direct deaths and injuries caused by these attacks, the military offensive and the blockade of water, medical and fuel supplies and connectivity cuts in Gaza are pushing Gazan hospitals and health centres to their limits.
The need for humanitarian aid is imperative. The Head of Nursing at Gaza’s Shuhada Al-Aqsa Hospital, Khalil Al-Degran, warns that “more medicine, food, water and fuel are desperately needed to save lives”. As he explained to the WHO team in the occupied Palestinian territories on 29 October, “we cannot save all the victims of the shelling, there is a deep crisis in the hospital […] and if humanitarian aid does not come in, the hospital will turn into a morgue”.
According to the WHO, 45% of essential medicines had less than a month’s supply before 7 October, including antibiotics to treat infections, medicines to prevent heart disease and stroke, chemotherapy for cancer patients, insulin for diabetic patients, and medical supplies for surgery and dialysis.
“The situation in the hospitals is catastrophic and nightmarish”.
All these figures translate into despair, death and pain on the ground. According to David Cantero Pérez, general coordinator of Médecins Sans Frontières in the Occupied Palestinian Territories, “the situation in the hospitals is catastrophic and Dantesque, as in the case of one of our surgeons performing an amputation with partial sedation on a child on the floor, in front of his mother and sister”. “This case is a good illustration of the situation in the hospitals, which are on the verge of collapse,” Cantero explained at a press conference in Jerusalem on Monday 6 November.
Similarly, Raúl Incertis, a Valencian anaesthetist and MSF aid worker from Valencia, describes how “after the order given by Israel to move south, many of the health workers went to the hospitals to continue working, running great danger when they moved to the health centres, working very long shifts for 5 or 7 days without being able to leave the hospital”. Incentis, who had arrived in Gaza on 1 October to work in an orthopaedic and reconstructive surgery programme and managed to leave the Strip after three weeks trapped, explains how “when they were finally able to leave the hospital they went to see their families, if they existed, as many colleagues lost their homes and many relatives, like the MSF nurse who, while she was working, had her house bombed and her whole family died”.
Cantero, who has been working with MSF in the Occupied Palestinian Territories for years, stressed the need to put these events in context: “The Strip has been suffering a total blockade by land, sea and air for the past 16 years, and between 70 and 80% of its population was already living below the poverty line, dependent on external aid. It adds: “To this base we must add four weeks of continuous indiscriminate shelling and the massive displacement of the civilian population of around 1.5 thousand displaced persons”.
UN, WHO, Médecins Sans Frontières and Save the Children call for immediate ceasefire
In response, UN Secretary-General António Guterres, UN agencies such as UNICEF, WHO and the Office of the UN High Commissioner for Human Rights, as well as international bodies such as Save the Children have again called “for the parties to respect all their obligations under international humanitarian and human rights law” as well as “the immediate and unconditional release of all civilians held hostage,” in a joint statement.
The international president of Médecins Sans Frontières, Dr Christos Christou, also called for an immediate ceasefire “so that they can receive medicine and health care”.
On 7 October 2022, Hamas attacks killed 1.405 people and injured 5,431, according to Israeli authorities. In addition, more than 200 people, including children, were kidnapped and remain hostage to the terrorists.
The Israeli state responded with a total blockade and continued shelling of the Gaza Strip to combat the terrorist organisation and attempt to rescue the hostages. A response that has left more than eleven thousand civilians dead in a month of war and blockade, according to figures from the Hamas-controlled Gaza Ministry of Health, with two-thirds of the victims being women and children.
