Urgent health update: Consequences of war on Gaza and West Bank/East Jerusalem [and now Lebanon] 10/27/24

Israeli air, land, & sea bombardment continues across Gaza, causing further civilian casualties, displacement, & destruction of houses & other civilian infrastructure. The siege of Northern Gaza is choking off almost all humanitarian aid, and intense ground attacks increase casualties as Israel issues evacuation orders – with nowhere to go. 

The extension of the war to the West Bank, Lebanon, Syria and Yemen is a health and human rights emergency, and an escalation that threatens world war. 

REPORTS

UNDP

A new assessment that the UN Development Programme (UNDP) and the UN Economic and Social Commission for Western Asia (UNESCWA) launched today estimates that poverty in the State of Palestine will rise to 74.3 percent in 2024, affecting 4.1 million people, including 2.61 million people who are newly impoverished.

The assessment, titled ‘Gaza War: Expected socioeconomic impacts on the State of Palestine’ also projects that the gross domestic product (GDP) will contract by 35.1 percent in 2024 compared with a no-war scenario, with unemployment potentially rising to 49.9 percent.

The assessment suggests that a comprehensive recovery and reconstruction plan, combining humanitarian aid with strategic investments in recovery and reconstruction along with lifting economic restrictions and promoting recovery-enabling conditions, could help put the Palestinian economy on a restorative track to realign with Palestinian development plans by 2034. But this scenario can only play out if recovery efforts are unrestricted. UNDP

EYEWITNESS ACCOUNTS

A personal account of pregnancy and birth during wartime. Jewish Currents

Numbers are cumulative

GAZA

As of 10/22/24 per OCHAOPT

Killed: 42,718 (374 this week)

Injured: 100,282 (1,269 this week)

Israeli soldiers killed in Gaza: 356 (3 this week)

Israeli soldiers injured in Gaza: 2,362

Hostages in Gaza: 101

504 health attacks

Among the 13,319 children killed, 786 were under 1 year old. Some 35,055 children lost one or both parents. For more detail, see the Health Cluster’s Unified Dashboard here.

For more details: here, Here

Israeli attacks

·       33 people killed and 85 wounded in Israeli strike on the Indonesian Hospital in the Jabalya refugee camp in northern Gaza, including at least 21 women and children. According to medical staff, the IDF surrounded the hospital and cut off its electricity supply. The Gaza government media office and Palestinian news agency WAFA said the death toll from the strikes could rise because some people were believed to be trapped under the rubble, with rescue teams unable to reach them.

·       87 people killed or are missing under rubble with 40 injured, after an Israeli strike in north Gaza's Beit Lahiya, a number which the IOF disputed, claiming it used precise munitions against a Hamas target. Oxfam said four of its engineers were killed in an Israeli strike in Khan Yunis despite traveling in a clearly marked vehicle and after prior coordination with Israel. 

·       Israel is emptying northern Gaza of its inhabitants during its ongoing ethnic cleansing campaign. One of the key strategies it is using to achieve this is by hospitals, and the Kamal Adwan Hospital in Beit Lahia has become a primary target.

·       In the 24 hours before 10/20, 108 people were killed in bombings across the territory, according to local health officials. “The nightmare in Gaza is intensifying. Horrifying scenes are unfolding in the northern strip amidst relentless Israeli strikes and an ever-worsening humanitarian crisis,” Tor Wennesland, the UN special coordinator for the Middle East peace process, said.

·       The UN Human Rights Office stated “the manner in which the Israeli military is conducting hostilities in north Gaza, along with unlawful interference with humanitarian assistance and orders that are leading to forced displacement, may be causing the destruction of the Palestinian population in Gaza’s northernmost governorate…” noting blocking of “all essential supplies between 1 and 14 October” and only “a token amount of aid” since. They decry continuous bombing and attacks  which “have made it extremely dangerous for civilians to flee,” and report “Palestinians targeted while fleeing,” and restrictions and attacks on rescue teams and medics “hindering lifesaving operations, including the recovery of Palestinians trapped under rubble.”

·       IOF have made life in north Gaza “impossible” for Palestinians, many of whom were already facing starvation, while also ordering their displacement and preventing supplies from entering, OHCHR said in a statement.

·       At least seventeen Palestinians, including four children, have been killed in yet another Israeli airstrike on a school housing displaced people in the Nuseirat camp in the central Gaza Strip. Several casualties are also reported in an airstrike on a youth club in the Al-Maghazi camp in central Gaza. Amongst those killed in the attack on the Al-Shuhada school on Thursday was Professor Ashraf Al-Jadi, the Dean of the Nursing Faculty at the Islamic University of Gaza. An 11-month-old baby was also killed and at least 32 wounded, the Quds News Network (QNN) reported.

·       Israeli soldiers have just conducted what Gaza’s Civil Defense is calling a “major massacre” in Jabaliya, with more than 150 people killed or injured and dozens of buildings destroyed. On 10/17, an UNRWA school hosting internally displaced people (IDPs) was bombed in Jabalya refugee camp, killing 39 and injuring 160. Other attacks on Jabalya killed 33. It is the latest atrocity amid the military’s weekslong siege of northern Gaza. “It’s getting worse and worse,” says Dr. Mohammed Salha in a call from the Jabaliya refugee camp, where he is acting director of Al-Awda Hospital.

·       Attacks in Deir al Balah killed 24, including the Director of Emergency Medical Services for Central Gaza.

Hospitals and Health Care

• On 10/18-19, Israeli missiles hit all 3 remaining hospitals in the North–Kamal Adwan, Indonesian and Al-Awda. The top floors and front yard of the Indonesian Hospital, with >40 trauma and chronic patients and medical staff, lost power and 2 died. Al-Awda Hospital and the entrance to the laboratory of Kamal Adwan were also hit, resulting in casualties. As of 10/21, 100 patients remain at Kamal Adwan (7 in the ICU) with a constant influx of new casualties to the ER: 200 trauma patients arrived in 24 hours, exhausting blood units. Medical crews work without food or rest, patients die amid overcapacity, and wounded lie in the streets with their rescue blocked. Internet outages limit efforts to ascertain conditions at the Indonesian and Al Awda hospitals. No UNRWA medical points are currently operational in North Gaza.

·       Gaza’s health ministry said hundreds of patients, staff, and some displaced individuals have been detained in north Gaza’s last functioning hospital. “Israeli forces have stormed and are present inside Kamal Adwan Hospital” in the city of Jabalia. The director general of WHO, Tedros Adhanom Ghebreyesus, said his staff have lost contact with personnel at the facility since reports of the Israeli raid surfaced.

• The still partially functioning hospitals (76%) lack sufficient water, 94% struggle with sanitation, 71% cannot achieve proper hand hygiene, 82%  lack PPE, and all lack means to maintain cleanliness. 94% can’t segregate waste, and 88% lack means to safely dispose of sharps and infectious waste. At least 56 supply items will be exhausted by November. UNRWA laboratories now perform only 4 tests, compared to 35 prior to October 2023. 

• There are 14 international Emergency Medical Teams (EMTs) in central and southern Gaza and one national EMT is deployed at Al Shifa Hospital. WHO has appealed for all EMTs to be allowed entry to support the provision of primary services and surgeries.

• According to WHO data, communicable disease rates are already alarming, with >1.1 million cases of acute respiratory infections, 669,000 cases of acute watery diarrhea, 225,000 cases of skin diseases, 132,000 cases of acute jaundice syndrome, as well as 18 cases of acute flaccid paralysis.

• A new report focuses on the extreme hardships faced by older people. Only 40% of elders can obtain the medications they need and “many are dying prematurely. Their nutrition has declined, they’ve lost weight, and their psychosocial wellbeing is collapsing. They live with a fear of death or of losing their families,” noted Dr. Umaiyeh Khammash, Director of Juzoor. 

·       Mental health professionals struggle with Gaza’s overwhelming trauma. Well-known psychiatrist Yasser Abu Jamei, who heads the Gaza Community Mental Health Program (GCMHP), told EI of the unique burden on mental health workers and the complex challenges they are facing. These mental health workers are not only experiencing the same traumatic conditions, but also work with the most affected and traumatized people. They are often themselves displaced, a reality which leads to secondary trauma. Abu Jamei said his staff helped with 16,000 cases during the first six months of the war. The lack of mental health medications in Gaza has further exacerbated the situation.

Evacuation and displacement

• UN estimates that >60,000 have been displaced from North Gaza to Gaza City in the past 2 weeks. There is overcrowding and an urgent need for shelter. Family separations are reported, as are unfilled requests for bodies to be collected from under the rubble. There are limited mental health and psycho-social support (MHPSS) activities, and efforts are underway to expand the provision of protection services. Elderly and special needs individuals require assistive devices that are unavailable.

Polio

• Between 10/14-20, the 2nd round of polio vaccinations reached 420,100 children in central and southern Gaza. WHO conducted  missions to deliver vaccines and equipment to central Gaza areas beyond the “humanitarian pause.” To date, 71% of children have been reached. Negotiations continue with Israeli authorities on the 3rd phase of the vaccination drive in northern Gaza, originally scheduled to begin on 10/23.

·       World Health Organization: its polio vaccination campaign in north Gaza has been postponed due to Israeli bombardments, mass displacement and lack of access. The campaign's final phase, aimed to vaccinate more than 119,000 children. (Haaretz)

Food & Nutrition

• Analysis shows the risk of famine remains high. About 1.84 million people (86% of the population), face crisis or worse levels of food insecurity (IPC Phase 3 or above), including 664,000 people facing emergency levels of food insecurity (IPC Phase 4) and nearly 133,000 facing catastrophic levels of food insecurity (IPC Phase 5). The sharp decline in goods entering Gaza in September combined with the end to access in the north will have horrific consequences in the coming winter months: nearly 2 million people (91% of the population) are projected to be in crisis or worse, particularly in Rafah and the north. “Only by ensuring widespread access to adequate food, medical supplies, water, and basic services across the Gaza Strip can the risk of a rapid descent into famine be contained.” Senior Deputy Director of UNRWA Affairs, Sam Rose, stressed: “Whether people are on the verge of famine or in famine, they are in absolutely desperate conditions and this is completely man-made.” More than 3 months’ worth of food supplies are still awaiting entry into Gaza.

• Acute Malnutrition has increased ten-fold since October 2023 and is projected to worsen. 60,000 children (age 6-59 months) will become acutely malnourished in the coming year. “Nearly 1 in 5 children suffer from wasting, the most life-threatening form of malnutrition… The world must act now to prevent this catastrophe from becoming a full-scale famine,” said UNICEF Deputy Executive Director Ted Chaiban.

Aid

• Between 10/1-21, of 448 planned aid movements across requiring coordination with Israeli military, 45% (201) were denied, 36% (162) were facilitated, 15% (67) were impeded, and 4% (18) were cancelled. This includes 70 coordinated aid attempts in the north via Al Rashid checkpoint, of which only 6% (4) were facilitated by Israel. Denied movements include a mission to rescue 40 people in rubble in Jabalya, repeatedly denied since 10/18. Urgent resupply for Kamal Adwan Hospital was denied 10/20.

• Since 10/10/2024, 10 humanitarian workers (5 UNRWA staff and 5 NGO staff) and 4 health workers have been killed and others injured, some at home with their families. Oxfam reported 4 water engineers were killed en route to repair infrastructure in Khan Younis. The same day, an Al Awda Hospital ambulance was hit near Jabalya, injuring 6 people, including a paramedic.

WEST BANK AND EAST JERUSALEM

This week, Israeli forces killed 3 Palestinians and injured 59 (27 children).
Killed: 759
Injured: 6,455
624 health attacks

Israeli Attacks

• Israeli military killed 2 men during operations in Jenin and Tulkarm. A 59-year-old mother of seven was shot and killed by Israeli forces in Jenin governorate while harvesting olives on her land on the West Bank side of the Barrier. The UN Human Rights Office (OHCHR) said the farmers “were not posing any threat whatsoever when Israeli security forces fired multiple shots at them without prior warning.” 

Settler Violence
This week, settlers carried out 41 attacks against Palestinians, resulting in 7 injuries (2 children), 10 by settlers and 4 by soldiers, and property damage. Since 10/7/23, OCHA documented 1,536 attacks by settlers against Palestinians, causing 152 injuries, 1,226 cases of property damage, and 158 leading to both. Settler violence displaced 285 households (1,669 people, 807 children) in  Bedouin and herding communities. For more information, please see the OCHA West Bank snapshot. 

• More than half of this week’s incidents (24) were related to the olive harvest, injuring 6 and vandalizing 670 trees. During October 2024, 180 settler incidents were documented, affecting 90 communities, of which 60% were related to the olive harvest season. Settlers have fired bullets and tear gas, thrown stones, and burned homes, all with the expected impunity.

• Israeli forces have compounded the difficulties faced by Palestinian farmers during the olive harvest, attacking them, restricting access to their lands, confiscating tools, and forcing them to abandon their crops. 

• The Israeli NGO Peace Now reported  43 new settlement outposts have been established since October 2023, compared with 7 yearly in the 3 prior decades. Although illegal under Israeli law, the Israeli government financed them with NIS28 million (US$7.5 million) in 2023 and allocated NIS75 million (US$20 million) in 2024. Authorities have also retroactively “legalized” 8 outposts and allocated NIS7 billion (US$1.9 billion) for roads serving them. All this is illegal under International Humanitarian Law. 

Demolitions

This week, Israeli authorities demolished 24 Palestinian-owned structures, displacing 23 (8 children) due to lack of Israeli-issued building permits, almost impossible to obtain. Since 10/7/23, Israeli authorities destroyed 1,829 Palestinian structures across the West Bank, displacing 4,611 Palestinians (1,939 children). For more on demolitions and displacement, see the OCHA demolition dashboard.

• One of the structures destroyed was a business that provided oxygen to East Jerusalem hospitals, operating since 1957.  

• On 10/16, the Jerusalem Municipality issued a final warning for the demolition of a 2-story building in Al Bustan area of Silwan, East Jerusalem. The building houses Al Bustan Association, offering over 1,000 Palestinians with youth education programs, legal workshops and scouting activities, sports teams, cultural groups and women’s groups. According to the Norwegian Refugee Council (NRC), representing 85 demolition cases, “Al-Bustan, home to about 1,550 Palestinians and 150 housing units...is near the Jewish Quarter of the Old City. This has led Israeli authorities to focus on increasing the Jewish presence and displacing Palestinians. All structures in Al-Bustan are currently unprotected and at risk of demolition.” 

ISRAEL

·       A few hundred people, including many families and several government ministers, gathered on Israel's southern border with Gaza for a two-day conference entitled "Preparing to Resettle Gaza."

·       The Israeli conviction that the other side only understands military force, making diplomacy and de-escalation irrelevant, isn't just because the Middle East is a tough neighborhood. It's also partly due to straight-up, old-world racism.

·       More than 2,000 Israelis have signed an open letter calling on the international community to use “every possible sanction” to secure an immediate ceasefire between Israel and its neighbors. Published in 11 languages, the letter argues that “change from within is not currently feasible” due to the majority of Israelis supporting the continuation of the Gaza war.

·       Relations between Israel and the UN appear to have hit rock bottom as the country prepares to pass legislation banning the UN relief and works agency for Palestinians (UNRWA) from operating in Gaza and West Bank. The bills seek to majorly restrict the UN agency's activity, although no alternative mechanism to provide its services has been established.

LEBANON

·       Israel’s claims of tunnels under major hospitals and the strike near Rafik Hariri hospital made Lebanese doctors fear they could suffer the same fate as the medical facilities in Gaza. Israel has repeatedly struck hospitals in Gaza over the past year – which the World Health Organization has condemned as a “systematic dismantling of healthcare.” Israeli strikes have killed at least 115 healthcare workers in Lebanon in the past year and have forced most hospitals in border areas and Dahiyeh to close. The Guardian

UNITED NATIONS

·       Commissioner-general Lazzarini: three of UNRWA’s operations regions – Gaza, the occupied West Bank and Lebanon – are in real crisis and have as never before been, in urgent need of the services of the UN organization. “But at the same time, we have never been so much under attack and pressure. Now, would UNRWA leave Gaza, it would impact our current effort of saving life.”

·       The impact of the year-long war on Gaza has caused human development to be set back by close to 70 years by the end of 2024, according to new assessments by the UN Development Program (UNDP). ”The state of Palestine is experiencing unprecedented levels of setbacks,” per UNDP deputy special representative.

US

·       Interview: “We have lost all credibility.” Hala Rharrit on quitting the State Department and ending U.S. complicity in Gaza.

·       American Psychological Association (APA) is abandoning its commitment to human rights by refusing to speak out on Palestine. American Psychological Association claims to “prioritize human rights advocacy,” but if its leaders want to truly honor that commitment they must recognize and address the genocide of Palestinians in Gaza today. 

·       ACLU leadership rejects staff demands to condemn US role in Israel’s Gaza war. More than 650 ACLU staffers signed a petition calling on the organization to decry the ongoing war and divest from Israel.

·       University of Michigan recruited state attorney, Dana Nessel, general to crack down on Gaza protesters. In a highly unusual move, regents bypassed local prosecutors, believing Nessel would be tougher on student protesters.

·       US professors in trouble over protests wonder if academic freedom is dying. Universities have cracked down on professors for pro-Palestinian activism, saying they are protecting students and tamping down on hate speech. Faculty members say punishments have put a “chill in the air.”

INTERNATIONAL

AUSTRALIA

·       An ongoing Zionist pressure campaign against Australian universities has resulted in government recommendations for an investigation. The resulting inquiry will put academia under constant political scrutiny in defense of Zionism. Mondoweiss

JORDAN

·       For the small number of Gazan cancer patients who are receiving care in Jordan’s capital, Amman, that knowledge brings burdens. As well as their illness, they battle deep feelings of guilt, fear and homesickness.

SOURCES

OCHAOPT, Palestine Chronicle, Mondoweiss, Jewish Currents, Palestine Chronicle, New York Times The Guardian, The Intercept, Democracy Now, Haaretz, Electronic Intifada, UN Development Program