Urgent health update: Consequences of war on Gaza and West Bank/East Jerusalem-July 6, 2024

Israeli bombardment from the air, land, & sea, as well as ground incursions & heavy fighting, continue across much of Gaza, especially in Gaza City, Rafah & Khan Yunis (where 250,000 people were placed under a 7/1 evacuation order by the Israeli authorities.) & Beit Hanoun & Shuja’iyeh. ~90% of the Gazan population are now Internally Displaced by Israeli military action, (displaced up to 10 times) & 110,000 are refugees in Egypt. 

ARTICLES

In the US, the right of medical personnel to speak out about the ongoing assault on Gaza and the urgent need for a ceasefire is under threat. Health and Human Rights Journal

A call from 40 public health scientists for an end to the continuing humanitarian and environmental catastrophe in Gaza. Environmental Health

Israel Is Killing Gaza’s Medical Workers. Dr. Yassar Arain Saw the Results Firsthand. The silence of the US medical establishment amid the genocide is manifest hypocrisy, says Yassar Arain. Truthout

Personal testimony of harrowing escape from Gaza. The Nation

Be sure to watch JVP Health Advisory Council latest webinar The destruction of healthcare in Gaza: A scientific assessment of settler-colonial violence

Numbers are cumulative.

GAZA

·       Killed: 38,011 (246 this week), >10,000 estimated under the rubble

·       Injured: 87,445 injured (1016 this week)

·       Israeli soldiers killed in Gaza 323 (9 this week)

·       Israeli soldiers injured in Gaza: 2,069.

·       Hostages: 120

·       WHO: Israel has attacked 464 health care facilities, killed 727 health care workers, injured another 933, damaged or destroyed 113 ambulances. Among the doctors, 55 specialists were killed.

Attacks

·       6/27 & 6/30, 19 people killed, dozens injured, internally displaced persons (IDPs) tents & homes hit in Rafah.

·       6/28-29 & 7/2-3, 35 Palestinians (9 children) killed, several dozens injured, attacks on houses in Gaza City.

·       6/29, 4 Palestinians (2 children) killed, others injured, a house hit in Al Bureij Refugee Camp & Deir al Balah. 7/2 in Deir al Balah, many injured, 12 killed including head of the Burns & Plastic Surgery Dept. at Nasser Medical Complex, Dr. Hasan Hamdan, & his family. 

Prisoners

• 7/1 50 Palestinian prisoners released, including Dr. Abu Salmiya, director of Al Shifa Hospital after 7 months in Israeli custody. ~9,623 Palestinians in Israeli custody, including 3,379 held without trial and 1,402 held as “unlawful combatants.” This does not include an unknown number of Gazans detained by Israel since 10/7.

• Abu-Salmiya: "Israel arrests everyone, including medical teams. There are prisoners who died from torture, & there are physicians & medical staff members who are still being held and in need of treatment." The Israel Prison Service said "the decision to release the director of Al-Shifa was made by the IDF and the Shin Bet – not the prison service," adding that Abu-Salmiya "was not released due to prison overcrowding."

·       The fate of >100 imprisoned Gaza health workers remains unknown as media reports on deaths during interrogations emerge

Disability

·       6/30 Palestine Red Crescent Society, in collaboration with Palestinian Agricultural Relief Committees & Atfaluna Society for Deaf Children, inaugurated the first shelter for IDPs with disabilities (PwD) in Deir al Balah. The site will make available support & services for ~100 families, including relief programs, health care, rehabilitation, & psychological support.

·       UNICEF & Rehabilitation Sector for PwD in the Palestinian NGOs Network (PNGO):   PwD face challenges in overcrowded & non-inclusive shelters, women with disabilities are especially vulnerable to abuse, water distribution & latrines inaccessible. ~ 10,000 people, ½ of them children, were disabled since 10/7. Destruction of hospitals & rehabilitation centers, restrictions on patient evacuations, & limits to entry of assistive devices (wheelchairs, crutches, hearing aids, etc.) place the lives of PwD at risk.

Public Health

·       Unexploded ordnance (UXO) & rubble pose significant risk of injury or death, particularly to IDPs, returning refugees, & children. >37 million tons of debris contain about 800,000 tons of asbestos, other contaminants, ~10% of ammunition potentially fails to function. A range of challenges prevent scaling up of mine action work, including funding, administrative delays (esp. visas), lack of security, & denial of entry of supplies.

·       Garbage and sewage continue to accumulate, rotting in the heat near displacement sites, with the pervasive stench causing nausea. Amid desperate sanitary conditions, extreme heat & lack of clean water fuel the spread of infectious disease, exacerbating the burden on already overwhelmed and severely under-resourced health facilities. Hospitals struggling with >10,000 cases of Hepatitis A & 880,000 cases of respiratory illnesses, with rampant diarrhea, skin infections & lice outbreaks. Diarrheal infection rates are 25 times higher than pre-conflict. UNRWA warns of threats of cholera which would, “further deteriorate inhumane living conditions.”

• Fuel shortages continue to severely impact water & sanitation & living conditions. Fuel received meets only 10% of daily WASH requirements. ~ 50% of still functional water wells stopped pumping water due to lack of fuel, ~106 water trucks have ceased operations. 2 desalination plants in central & southern Gaza ceased operations 6/30-7/1 due to the lack of fuel. 1 of 3 pipelines coming from Israel, shut down, causing further reductions in water. 7/4, Emergency Committee of Khan Younis warned that fuel shortages halted the operation of wastewater systems & aggravated sewage overflow into populated areas, increasing health & environmental risks.  

Humanitarian Aid

·       Breakdown of law & order is affecting the collection of humanitarian aid from Kerem Shalom Crossing, compounding challenges facing aid operations, including insecurity, damaged roads, lack of fuel, & access limitations. Food available in the market is now largely unaffordable. In northern Gaza, improved access has enabled the World Food Program to bring in large amounts of canned food & wheat flour, but there are severe shortages of meat, vegetables, fruits, & sugar. WFP: Gazans are food insecure:  “do not have enough food to keep going. Many of them go to bed hungry, having 1 meal a day if they are lucky.”  “Famine is not just about food. People need nutrition. They need access to healthcare. They need clean water, & they need shelter.”

·       557,000 women in Gaza face severe food insecurity, especially mothers & adult women with increased caregiving & domestic responsibilities in tents & makeshift shelters, “leading many to skip meals or reduce their intake to ensure their children are fed.” 76% of pregnant women suffer from anemia, 99% lack nutritional supplies & supplements. 55% of new mothers face health conditions that undermine breastfeeding, 99% face challenges in securing enough breastmilk, compromising infant survival, growth & development. Women are also burning wood, plastic & other waste materials to cook, exposing themselves & their families to hazardous smoke & pollutants that cause respiratory & other health issues.

·       Already impeded humanitarian missions have further declined. In July, Northern Gaza: of planned humanitarian assistance missions coordinated with Israel, 8% facilitated, 69% impeded, 8% denied access, 12% cancelled. 

·       Coordinated humanitarian assistance missions to southern Gaza in June and July remain about the same: In July: 78% facilitated, 11% impeded, 2% denied, 9% cancelled.

·       Entry of aid to northern Gaza faces extensive delays, inconsistent procedures, & bottlenecks. There are 2 checkpoints where Israeli forces control movements between northern & southern Gaza, but all aid missions are funneled through a single checkpoint on any given day. Salah Ad Din Road checkpoint has been closed since 6/27. Convoys continue to wait long hours in exposed locations before being allowed to move towards the checkpoint, posing safety & security risks for personnel. Movements to & from Kerem Shalom Crossing continue to be hampered by security risks, most recently following the evacuation order for Khan Younis, encompassing parts the crucial Salah Ad Din Road artery.

Hospitals

·       European Gaza Hospital: 7/1 evacuation order forced 320 medical staff & patients, including those in bed with IVs, to flee. Completely empty by the evening of 7/2, the majority of patients were referred to Nasser Medical Complex, which reached full capacity with >350 inpatients, amid critical shortages of medications & surgical supplies. 7/4, WHO and OCHA transferred medical equipment from EGH to Nasser. ICRC was forced to transfer its staff & patients to the Red Cross Field Hospital in Rafah. Al Amal Hospital in Khan Younis was similarly affected, receiving an influx of injured people after they could no longer be absorbed at Nasser complex. 

·       Evacuation of the EGH reduced cumulative bed capacity at the 6 partially functional hospitals in southern Gaza to 1,334 beds. Only 15 of Gaza’s 36 hospitals remain (partially) functional, & partially accessible to patients due to insecurity, access constraints & Israeli damage. Of 103 primary health-care centers, 43 are operational; of 10 field hospitals in southern Gaza, 4 are fully functional, 4 partially functional, 2 non-functional. 

·       Denial of fuel severely compromises health services. WHO: power blackouts at neonatal, dialysis, & ICUs place lives at risk, “injured people are dying because ambulances are facing delays due to shortages of fuel.” Water & WASH clusters require 150,000 liters of fuel/day, just over 195,000 liters entered Gaza between 6/25-27. WHO: health workers are forced to “make impossible choices” & triage among critical needs, with limited fuel supplies now being directed to key hospitals as well as to 21 Palestine Red Crescent Society (PRCS) ambulances. 

·       Medical students, now needed the most after the targeting of medical workers and the desperate need for healthcare professionals, have found a way to resume their education. They confront many challenges: no equipment, constant panic, the absence of academic staff & an environment that is not conducive to learning

Focus on Jabalya Refugee Camp

An assessment of Jabalya Refugee Camp following the Israeli withdrawal on 5/30:  

·       Critical shortages of safe drinking water. Military damaged water supply, only a fraction of wells remain functional. Sanitation conditions are dire; sewage is overflowing & leaking near sleeping areas, solid waste is accumulating, there are no cleaning materials available. Hepatitis A, skin diseases (particularly among children), respiratory illnesses are on the rise. 

·       Food is insufficient. People rely on bread & canned food when available. No fresh vegetables, fruits protein sources, such as meat and milk, are contributing to anemia due to iron deficiency. No commercial food supplies have reached the area for 2 months, prices on the local market are exorbitant. No malnutrition screenings nor supplementary feedings are being conducted.  

·       Lack of support for persons with disabilities hinders movement &  access to services. People with hearing impairment were killed, presumably due to an inability to hear warnings from Israeli forces. 

·       No education for children, who are exposed to serious risks, including child labor, with tens of unaccompanied & separated children being particularly vulnerable.  

·       Damaged and unsafe structures and piles of rubble threaten health and obstruct aid delivery & service providers, while unexploded ordnance poses significant risks. Minimal communications also limit abilities to seek assistance. 

WEST BANK & EAST JERUSALEM

Israeli authorities approved the “legalization” of 5 unauthorized (illegal under international law) settlement outposts, Evyatar (Nablus), Sde Efraim & Givat Assaf (Ramallah), Heletz & Adorayim (Hebron). Settlers from those outposts: 27 attacks against Palestinians in 2024. Palestinian landowners from Dura have hundreds of dunams of lands adjacent to the Adorayim outpost, which Israeli army prevented them from accessing since 10/7. Israeli forces attacked, beat, threatened & threw farmers off their land when they attempted to access it. Zoning map of Adorayim settlement outpost includes additional 120 dunams of land belonging to Dura that have not been accessed by the owners since 10/7.    

• Killed: >561, including 136 children). This week 3 killed by Israeli forces

• Injured: >5,420 including 830 children. >1/3 of the injuries were caused by live ammunition. This week 40 were injured by Israeli forces & settlers.

·       Killed & injured: 14 Israelis, including 9 members of Israeli forces & 5 settlers killed by Palestinians; ~105 Israelis, including 90 soldiers, were injured. In addition, attacks by West Bank Palestinians resulted in 8 Israelis & 4 Palestinian perpetrators in Israel killed. 

·       Since 10/7, 28 airstrikes killed 77 Palestinians (14 children) in West Bank. 

·       7/2: UN: ~ 200 houses damaged during Israeli operation in Nur Shams Refugee Camp (Tulkarm), including 7 homes destroyed by military bulldozers or explosions, displacing 11 families (28 adults, 19 children). The road connecting Tulkarm with Nablus & Jenin was damaged, disrupting water supplies, electricity & internet services. 

·       6/26, 1 Israeli soldier killed, 16 injured by explosives during an 8-hour search-and-arrest operation in Jenin City & refugee camp. Israeli forces entered the camp,  arrested 3 Palestinians, including a member of the Palestinian Legislative Council & a doctor recently released from Israeli prison. Israeli forces exchanged fire with Palestinians. 1 Palestinian was injured by live ammunition & shrapnel, another was physically assaulted by Israeli forces. 

·       6/30-7/1, Israeli operations in Nur Shams Refugee Camp, Tulkarm City, & Refugee Camp killed 3 Palestinians, injured 10. 6 households (36 people, including 15 children) were displaced. The operations involved 4 bulldozers & air drones, & damaged infrastructure & roads.   

·       This week, Israeli settlers perpetrated 15 attacks, including 3 incidents causing 10 Palestinian injuries & 5 that damaged ~190 Palestinian-owned olive trees & other property. Palestinians perpetrated 3 attacks that injured 1 Israeli & damaged 2 cars. 10/7-7/1: 1,050 attacks by Israeli settlers against Palestinians, 107 led to Palestinian fatalities & injuries, 828 led to damage to Palestinian property, 115 led to both casualties & damage to property. >45,600 Palestinian-owned trees & saplings destroyed by people known or believed to be Israeli settlers.  

·       Recent settler attacks include:
     -Settlers from Ma’ale Amos vandalized ~80  olive trees near Kisan village, Bethlehem.
     -Settlers from outpost near Adei Ad settlement, Ramallah, trespassed Turmusa’yya & vandalized  & stole property
     -Israeli forces & settlers affiliated with the Ateret Cohanim physically assaulted and injured 2 Palestinians, raiding & seizing the Al Khaldi family home in the Old City of Jerusalem. Family filed a court petition, court ruled in their favor, settlers were removed from the property. Household furniture & belongings were vandalized. 
     -Settlers reportedly from Yitzhar attacked & injured Palestinians  in Madama, south of Nablus.
     -Settlers injured 8 Palestinians, including a child, during 2 raids on Bedouin community of Umm al Kheir, south of Hebron. Armed settler from an outpost near Carmel settlement took his sheep into a Palestinian-owned animal shelter to feed on its fodder. Palestinian residents threw stones at the settler, after which more armed settlers arrived, shot at them, physically assaulted community members with sticks, bats & pepper-spray.
     -Settlers entered Masafer Yattam, threw stones and set fires
     -Settlers entered Fandaqumiya, threw stones and burned a car.
     -Dozens of settlers threw stones at Palestinian drivers & burning tires on the road near the Giv'at Assaf outpost, east of Ramallah.

·       Between 10/7-7/1: Israeli authorities demolished, confiscated or forced the demolition of 1,061 Palestinian structures, 38% were inhabited homes. 2,368 people, including 1,047 children, were displaced. Over ½ were displaced during military operations, particularly in Jenin & Tulkarm cities & surrounding refugee camps; 42% were due to the lack of permits; 7% were displaced by punitive demolitions. 

·       In the past week, Israeli authorities demolished 35 Palestinian-owned structures due to the lack of Israeli-issued building permits, including 2 in East Jerusalem & 33 in West Bank Area C, displacing 10 households (60 people, including 25 children) & 270 others.

·       Israel's Supreme Planning Council is set to discuss plans for the construction of 6,016 housing units in dozens of West Bank settlements. Peace Now: the plans include the expansion of settlements in the heart of the West Bank.

ISRAEL

·       Israeli police officers were filmed grabbing, punching, & choking lawmaker Naama Lazimi of Israel's Labor Party during Saturday night's anti-government demonstration in central Tel Aviv.

·       Far-right Israeli Finance Minister Bezalel Smotrich said Israel approved building 5  new illegal outposts in the West Bank in response to unilateral recognition of a Palestinian state by some countries, adding that "we will establish a new settlement" every time this happens

·       Israel pledges to establish a system to transfer sick Gazans for medical treatment abroad via Egypt, and will present updates on the progress of the scheme within a week. The petitioners' lawyers were forced to leave the High Court hearing under guard, because of a right-wing protest against it.

·       Israel reconnects Gaza with electricity for water desalination & sewage plant.
Israeli security officials said repair of electric wires & connecting them to the Israeli grid is carried out as a humanitarian effort to prevent disease outbreaks & contamination in Gaza that may endanger IDF forces & Israeli residents.

·       Israel’s military leadership wants a cease-fire with Hamas in case a bigger war breaks out in Lebanon, security officials say. It has also concluded that a truce would be the swiftest way to free hostages.

·       Finance Ministry approved funding for displaced residents of the north until 7/7, after being instructed that the conflict with Hezbollah would end by this date, the search for additional funding has been spurring fierce political arguments

·       Thousands gathered in Tel Aviv for an Israeli-Palestine peace conference" organized by a confederation of some 50 organizations & individuals from Israel's left & pro-peace camp. "It's time to reach a deal. To stop the war. To make peace."

·       Hamas responds positively to amended U.S. deal, but Israeli security branches accuse Netanyahu & Smotrich of sabotage

US

·       Two U.S. officials briefed on an updated list of weapons shipments said the Biden administration has sent large amounts of munitions to Israel since October 7, including over 10,000 highly destructive 2,000-pound bombs and thousands of Hellfire missiles.

·       ‘Nurses Against Genocide’ protest ANA’s silence. “ANA your hands are red, 160 nurses dead. Silence is complicity. Our code compels us.” 4 defiant nurses disrupted the American Nurses Association Member Assembly in Washington DC. Campaigns by Health Care Workers for Palestine, Union Nurses for Palestine & Doctors Against Genocide have called upon the ANA & American Medical Association to end their silence & condemn publicly the atrocities committed by the IOF in Gaza & West Bank against the Indigenous people of Palestine. 

INTERNATIONAL

·       Hezbollah launches over 250 rockets & 20 guided drones at Israeli positions, at distances of up to 35 kilometers into the Galilee & Golan heights, in response to Israel’s assassination of a Hezbollah senior commander in Tyre, southern Lebanon, identified as Muhammad Naameh Naser, 59, head of the “Aziz” unit. Israel bombs surroundings of southern Lebanese towns of Kufr Shuba, Rashaya al-Fakhar, and Kuf Hamam. 

·       European Union condemned a decision by Israel to legalize 5 settler outposts in the West Bank, announced by far-right Finance Minister Smotrichy. The EU called the move "another deliberate attempt at undermining peace efforts" and stressed that actions "weakening the Palestinian Authority must stop."

Sources:

OCHAOPT, Haaretz, Truthout, Washington Post, The Guardian, People’s Dispatch, Portside, Electronic Intifada, New York Times, Workers World, Mondoweiss, Gaza Ministry of Health