Urgent health update: Consequences of war on Gaza and West Bank/East Jerusalem-August 31, 2024

Joyce Msuya, Acting Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, briefed the Security Council on 8/29/24. After noting that they “have briefed this Council on the unconscionable suffering of civilian women, men and children on more than a dozen occasions,” she went on to recap the toll the Israeli war on Gaza has taken, including recent attacks on aid workers and the “devastating impacts on civilians” of repeated evacuation orders. She ended: “…civilians are hungry. They are thirsty. They are sick. They are homeless. They have been pushed beyond the limits of endurance – beyond what any human being should bear… [W]hat we have witnessed over the past 11 months – and continue to witness – calls into question the world’s commitment to the international legal order that was designed to prevent these tragedies. It forces us to ask: what has become of our basic sense of humanity?
In the face of this unconscionable human suffering, we need the Security Council – and all Member States – to act… We need strict adherence to international humanitarian law and international human rights law.” Read her complete testimony here. 

Jewish Voice for Peace Health Advisory Council Calls for a 7-Day Pause (Ceasefire) in Gaza for Polio Vaccine Campaign

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Interview                                                                                                
Interview with Human Rights Watch researcher Milena Ansari about the organization’s new report detailing the torture of Palestinian medical workers in Israeli prisons. HRW spoke with 8 doctors, paramedics and nurses who were picked up in Gaza before being transferred to the notorious Sde Teiman camp and other facilities, where they say they suffered beatings, starvation, humiliation, electric shocks and other forms of abuse. The men also describe threats of sexual violence during brutal interrogations and seeing another prisoner bleeding after being gang-raped with an M16 rifle by 3 soldiers. HRW has called on the International Criminal Court to investigate Israel for its attacks on healthcare workers. Democracy Now

Journal
Trauma care supported through a global telemedicine initiative during the 2023–24 military assault on the Gaza Strip, occupied Palestinian territory: a case series
The Lancet

GAZA STRIP

Numbers are cumulative

Israeli air, land, & sea bombardment continues across Gaza, causing further civilian casualties, displacement, & destruction of houses & other civilian infrastructure. Ground incursions, heavy fighting & impossible to keep up with evacuation orders (16 this month) continue, especially in Khan Younis, Deir al Balah, Gaza City & Rafah. 

·       Killed: 40,602 (3,327 this week)

·       Injured: 93,855 (711 this week)

·       Israeli soldiers killed: 339 (7 this week)

·       Israeli soldiers injured: 2,263

·       Hostages: 107

Israeli attacks

• 8/22-27, 36 killed (3 children) and >30 injured in attacks on homes and vehicles near Khan Younis.

• 8/23-28, 28 killed (5 children) and others injured in attacks on homes in An Nuseirat Refugee Camp and other locations, including an IDP shelter, in and near Deir al Balah.

• 8/24, 8 killed in a vehicle in Rafah.

• 8/25-29, 31 (10 children) killed and >15 injured in attacks on homes and the beach in and near Gaza City.

Evacuations 

New evacuation orders (16 this month) are announced almost daily, which have affected ~258,000 people (12% of Gaza’s population). New orders in Deir al Balah displaced humanitarian staff from various UN agencies, NGOs, and service providers, along with their families, hindering their ability to deliver essential support and services. The 8/25 order impacted 15 UN and NGO premises and 4 UN warehouses.

• 88.5% of Gaza has been placed under evacuation orders. The population is increasingly concentrating in the Israeli-designated zone in Al Mawasi, ~41 sq.km. (11% of Gaza’s total area); it lacks critical infrastructure, basic services, and unencumbered aid provision. Overcrowding (30-34,000 individuals/sq.km.) exacerbates dire shortages of water, sanitation and hygiene supplies, health services, protection and shelter.

• Evacuation orders and hostilities near hospitals and medical points place them at risk of non-functionality due to lack of safe access for patients, ambulances, and resupply. 8/26, MSF reported  people fled Al Aqsa Hospital due to its proximity to an evacuation order for Deir al Balah and a nearby explosion. Of 650 patients, only 100 remained.

• MSF & Palestinian Agricultural Development Association (PARC) provided emergency latrines, solar water pumps and basic health care to people arriving in Al Mawasi, Khan Younis. PARC pediatrician Dr. Youssef Salaf Al-Farra  explained, “Every day, we see between 300 to 400 people at the medical clinic, of which 200 cases are related to skin conditions.” For 3 months, MSF has unsuccessfully tried to import 4,000 hygiene kits (soap, toothbrushes, shampoo and laundry power) to improve conditions in Khan Younis, but Israeli military refuse to allow them in.

Hospitals & health care

• The Kamal Adwan and Indonesian hospitals again appealed for diesel to keep generators running. On 8/24, PRCS reported the 2nd floor of Al Amal Hospital, Khan Younis, was hit by Israeli drones. On 8/29, Israeli military destroyed the lead car of an Anera fuel delivery mission to Emerati Hospital, killing 5. Since October, WHO recorded 505 health attacks killing 752, injuring 982, and damaging 32 hospitals and 63 ambulances.

• 8/25, the MoH announced resumption of partial health services at the European Gaza Hospital in Khan Younis, after 50 days. Hospitals have been provided  with anesthesia and other medicines and supplies to cover about 44,500 patients. A total of 200 ICU beds have been delivered to support capacity in 5 facilities. Moreover, more than $400,000 worth of infection prevention and control supplies have been delivered to 5 hospitals, with plans to reach 2 others.

• 17 of Gaza’s 36 hospitals are now partially functional. MSF and the MoH expedited the opening of a field hospital in Deir al Balah. 9 of 14 field hospitals are operational (5 only partially), while 44% of primary care centers (58 of 132) and medical points (126 of 285) provide minimal services. 

Water & sanitation

• The WASH Cluster reports recent evacuation orders in Deir al Balah compromised 15 of 18 wells, reducing water production capacity by 80%. UNFPA reports this disruption has led to closure of 4 UNFPA maternal health delivery points in the middle area and Khan Younis governorates, which previously served thousands of women. Lack of water has also forced safe spaces for women and girls at risk of gender-based violence to close.

• Overcrowding, coupled with lack of clean water, sanitation and basic hygiene items are taking a heavy toll on children whose disease burden has increased. As of 6/30, WHO recorded 103,385 cases of scabies and lice, 65,368 cases of skin rashes and 11,214 cases of chickenpox.

Polio

• 8/23, WHO Director-General, Tedros Ghebreyesus, expressed grave concern about the first confirmed case of polio in Gaza in 25 years, adding that the 10-month-old unvaccinated child who had contracted the virus had developed paralysis in the lower left leg. 8/25, UNICEF announced that 1.2 million doses of Polio Vaccine Type 2 (nOPV2) were being brought to Gaza to immunize over 640,000 children jointly with WHO and UNRWA, and trainings for vaccinators have begun. The IRC underscored that “vaccinations are only one part of the response” and efforts to scale up access to safe, clean and treated water are necessary to prevent further disease outbreaks, including cholera, urging the lifting of all restrictions on the entry of chlorination supplies and fuel to run water systems, solar panels and electricity generators. 

• In a joint appeal for an urgent ceasefire, 20 aid agencies and 20 medical professionals explained that at least 50,000 children born during the conflict are “unlikely to have received any immunizations due to the collapsed health system,” and vaccination schedules for older children were likely to have been interrupted.

·       Wartime conditions complicate the project to vaccinate Gazan children against polio. Health organizations behind the plan to inoculate some 640,000 under-10s fear that conditions in the Strip will make it hard to distribute vaccines, which require two doses and refrigeration.

·       EU's 27 member states called for humanitarian pauses in the Israel-Hamas war in Gaza to allow a vaccination campaign against polio to begin. A senior WHO official said that the organization has received a "preliminary commitment" from the IOF "for area-specific humanitarian pauses" during a polio vaccination campaign. Pauses will last 3 days in different areas of the Strip, and will start 8/31 in central Gaza, per WHO's representative in the Palestinian territories.

• Based on WHO.’s experience with similar campaigns elsewhere 3 days might not be enough to achieve adequate vaccination. He said it was it “critical” that 90% of Gaza’s children be immunized “to stop the outbreak.”

·       Gazan health officials have reported multiple children with symptoms consistent with polio, most likely the result of what UNICEF and WHO. officials said were severely unsanitary conditions and deteriorating health services.

·       Poliovirus has been detected in wastewater samples in Khan Younis, in southern Gaza, and Deir al Balah, both of which have large populations of displaced Palestinians who have fled Israeli airstrikes.

Children

• The number of unaccompanied and separated children in Gaza has grown to 3-5% of the overall displaced population, estimates  the IRC. Doctors report children without surviving family members found in hospitals, living alone due to no alternative care arrangements. Since October, 41% of families were caring for children not their own. UN survey estimates this rate is >8 times higher than in other emergency situations, where the range is between 3-5%. IRC concluded, “children who are abandoned or separated from their families, as well as orphans, face particularly high risks of child labor, exploitation, neglect and mental health issues. Their access to critical resources for survival is also severely reduced.” UNICEF is distributing 450,000 identity bracelets to children, including the child’s name, date of birth, and phone # of a family member.

Humanitarian Aid

• 8/26 UN humanitarian aid operations in Gaza stopped after Israel issued new evacuation orders for Deir Al-Balah in the central Gaza Strip, a senior UN official told Reuters, adding that "we're unable to deliver today with the conditions that we're in."

• WFP has suspended missions following Israeli attack on an 8/28 convoy. The vehicle was hit at least 10 times as it approached the IOF checkpoint at the Wadi Gaza Bridge after completing a mission in southern Gaza. “Though this is not the first security incident to occur during the war it is the first time that a WFP vehicle has been directly shot at near a checkpoint, despite securing the necessary clearances.” WFP Exec. Dir. Cindy McCain, stated,  “this is totally unacceptable and the latest in a series of unnecessary security incidents that have endangered the lives of WFP’s team in Gaza... The current deconfliction system is failing and this cannot go on any longer...”

·       WFP staffers have called for McCain’s resignation in a letter saying she is “not fit for office” and “doing damage to WFP’s reputation" by failing to call for a cease-fire in Gaza. 

• In August, the number of humanitarian missions and movements within Gaza denied access by Israeli authorities has doubled in both the north (68 vs. 30) and the south (99 vs 53), compared to July. Between 8/1-29, of 199 humanitarian missions coordinated with Israeli authorities in the north: 37% were facilitated, 34% denied, 21% impeded, 8% cancelled due to logistical, operational, or security issues. In the south, of 372 coordinated missions, 46% were facilitated, 27% denied, 14% impeded, and 13% cancelled.

·       Aid groups say that approximately 1,600 trucks full of essential medicines and food are currently stuck at crossing points along the Gaza boundary. Israel’s repeated and incessant displacement orders, which are pushing Palestinians into an ever-shrinking corner of Gaza, have also impacted storage warehouses for humanitarian aid, the organizations say. >2 dozen international aid organizations warned of an “imminent collapse of the humanitarian response in Gaza, which would leave millions of civilians without aid.”

• The forced evacuation of WFP’s main operating hub in Deir al Balah, has drastically reduced capacity to provide critical food assistance. WFP lost access to its last operational warehouse in the governorate and had to evacuate 5 community kitchens, crucial for feeding displaced families. UN Under-Secretary-General for Safety and Security, Gilles Michaud, noted that over 200 UN personnel were evacuated from the key hub of Deir al Balah, further straining already overstretched operations. Heightened security risks threaten the planned polio vaccination campaign, which requires a large number of staff to enter Gaza.

• Food delivery is impaired by ongoing fighting, damaged roads, and limited crossing points. In the past 2 months, WFP reports it could bring in only ½ of the 24,000 metric tons of food required. Dwindling supplies and denied aid missions have forced a reduction in WFP food parcels. Lack of road repairs will make war-damaged roads impassable during winter rains and flooding. 

West Bank and East Jerusalem

·       Killed: 622 Palestinians, including 602 by Israeli forces, 11 by settlers, 7 unclear. 

·       This week, Israeli forces killed 13 Palestinians (4 children), including 8 in airstrikes, & injured 47 (9 children). A settler also killed a Palestinian.

·       Israelis killed: 11, including 7 soldiers, 5 settlers were killed by Palestinians in the West Bank/ East Jerusalem. West Bank Palestinians have killed 15 Israelis in Israel.

·       Since October, airstrikes have killed 136 and wounded 41. 1/2020-10/2024, airstrikes killed 6 Palestinians, all in 2023.

·       This week, settler violence displaced 2 households (19 people, 5 children). Since October, 261 households (1,566 people, 758 children), have been displaced by settlers. 

Israeli military attacks

• 8/28, Israeli attack on Jenin, Tulkarm and Tubas involving helicopters, drones, and ground forces killed at least 10 Palestinians and injured 11, a significant military escalation with hundreds of troops.

•  8/22, an airstrike killed 3 Palestinians, during a 16-hour operation in Tulkarm Refugee Camp, including a man heating milk for his child. Military bulldozers damaged infrastructure, residential buildings, and livelihood structures, displacing 21 households (85 people, 21 children). UNRWA documented flooding sewage and damage to road sections, 35 sewer holes, and 50 house water connections. 

• 8/25, Israeli forces shot and killed 2 Palestinians (1 child) near the Salfit governorate entrance. Israeli military claimed their vehicle drove against traffic, attempting to run over soldiers, injuring 1.  

• 8/25, Israeli forces shot and injured 2 Palestinians in Tarqumiya, near Hebron city. As Palestinian workers attempting to pass through a hole in the Separation Barrier, they were stopped by the military, ordered to lay on the ground, and then shot in the legs. 1 of the men had his leg amputated. 

• 8/25, Israeli military shot and killed a 16-year-old boy near Al Jalama checkpoint, north of Jenin. Palestinians opened fire from a car and Israeli forces responded with live ammunition, hitting a person inside the vehicle. 2 houses 50 m. away were hit with live ammunition, exploding a gas cylinder. 

• 8/26, Israeli forces shot and killed a man near Khirbet al Majaz in the Israeli-designated “Firing Zone 918 area” of Masafer Yata. He was a laborer in a group attempting to enter Israel when the military opened fire, hitting him in the head. Transferred to a hospital, he was later pronounced dead. 

• 8/26, Israeli airstrikes killed 5 Palestinians (2 children) in Nur Shams Refugee Camp, Tulkarm. Drones launched missiles at a group, killing 5 on the spot. Israeli military said they had planned attacks against Israeli forces. 

Attacks by settlers

In the past week, Israeli settlers perpetrated 31 attacks against Palestinians, resulting in 1 dead, 11 injured, and property damage. Since 10/23, OCHA recorded ~1,270 attacks by Israeli settlers against Palestinians, >120 that led to injury or death, about ~1,030 causing property damage, >130 causing both. 

“This is an incredible scaling up of the violence of the preceding months and in particular weeks,” said Francesca Albanese, UN Special Rapporteur on the Occupied Palestinian Territories, “with a full military assault, destroying hospitals, destroying roads, destroying vital infrastructure which had already been severely damaged during the preceding months, and Voila! telling the Palestinians to go, ordering mass evacuations. …“I see a serious pattern parallel with what is happening in the Gaza Strip”— patterns of torture, of destruction, of extrajudicial killings, of uprooting that are very similar to Gaza.” …“It is my responsibility to warn against the risk of the genocide leaking into the West Bank. There is similar rhetoric, similar patterns, and escalating violence, ordering similar things.

• 8/20, settlers from Rosh Ha’Ayin settlement burned down an agricultural structure in Az Zawiya, west of Salfit. Settlers set fire to a large room, destroying equipment, water tanks, crops and twenty-five chickens. Two days prior, settlers wrote threatening messages on the walls.

• 8/23, Israeli forces assaulted 2 men near Al 'Auja, Jericho. Accompanied by Israeli military, armed settlers attacked the 2 picnicking in the area, fired live ammunition at their vehicle, damaging tires and stealing the license plate. The 2 Palestinians were detained at a Jericho military base where they were injured and finally taken to Jericho Hospital for treatment. 

• 8/24 Israeli settlers attacked 2 villages including Sussia near Hebron, wounding a Palestinian woman and vandalizing a security camera and car. In Rujeib, south of Nablus, dozens of settlers from the Itamar settlement, threw stones and damaged vehicles

• 8/25, settlers injured 4 Palestinians and displaced 2 families (19 people, 5 children) from Al Buwieb, Hebron. When an armed settler attempted to increase his flock by stealing their livestock, the men stopped the settler and forced him out. He returned with 10 settlers who attacked the families with stones, sticks, and knives, and were met by other Palestinians who threw stones at them, injuring 3 settlers. The Israeli forces detained only the Palestinians under attack. While in custody, settlers stole farming materials, a generator, a refrigerator, and other belongings. The 2 previously had been displaced from Al Buwieb and relocated to Masafer Bani Na’im after 7 October. This is their 2nd displacement.  

• 8/26, Israeli settlers in a reservist unit shot and killed a East Jerusalem resident and injured 3 others in Wadi Rahhal, near Bethlehem, who were hospitalized for treatment. Israeli media claims the settler unit acted against protocols to attack this community in response to stone-throwing. 

• 8/27 Israeli settlers shot and killed one Palestinian and wounded three others in Bethlehem, the Palestinian Health Ministry said earlier on Tuesday. The IDF said it was investigating the incident.

House demolitions

10/7 to 8/26, Israeli authorities demolished 1,446 Palestinian structures across the West Bank, including East Jerusalem, displacing >3,300 Palestinians (~1,430 children), more than double the number when compared to the same period the year before (displacing 1,339 Palestinians, 626 children). The post-10/7 demolitions include >over 500 inhabited structures, >300 agricultural structures, >100 water, sanitation and hygiene structures, and 200 livelihood structures. 

• 8/20, Israeli Civil Administration and military demolished 2 inhabited residences and a cistern in Khirbet ad Deir in Tuqu', Bethlehem, in Area C. 2 families (11 people, 6 children) were displaced for lacking a building permit after the court rejected their appeal. Their belongings were lost under the rubble. 

• 8/22, Israeli Civil Administration and military demolished a house in Kharbatha Al Misbah, Ramallah. 2 households (7 people, 3 children) were displaced. The basement water cistern and the families’ personal belongings were buried under the rubble. The demolition order was issued in 2021, and the family appointed a lawyer to follow up the case, submitting the proper documents. But that did not prevent the demolition. 

ISRAEL

·       The Israeli military said it had finished a monthlong operation in the Khan Younis and Deir al Balah areas of Gaza, which had forced the evacuation of tens of thousands of Palestinians. The military, which has described the offensive as an effort to target Hamas infrastructure and fighters, said that it had killed >250 militants, destroyed tunnels spanning nearly 4 miles and recovered the bodies of six hostages. The statement did not specify whether troops were leaving those areas of southern and central Gaza, but said that Israeli forces were preparing “for the continuation of operations” in the territory. High Court ordered the government to explain why it has not lifted a ban preventing Red Cross representatives from visiting Palestinian detainees and prisoners from Gaza, and why the organization was not presented with details about those being held.

·       Israeli government informed the High Court of Justice that conditions at the Sde Teiman detention facility would improve starting in mid-September, when a new prison wing will be opened. The state added that inmates will be blindfolded and bound with steel handcuffs upon their arrival for 96 hours and then relieved from these constraints, and will not remain handcuffed and blindfolded for 24 hours a day as has been the custom to date.

·       Letter sent by Shin Bet chief Ronen Bar to the prime minister, cabinet members, and the attorney general warns that Jewish terror is a danger to the state's existence. An editorial in Haaretz declared, “Jewish terror has exploded, and nothing is standing in its way. It may bring Israel down.”

US

·       Vice President Kamala Harris said she would continue President Biden’s policies with regard to the war in Gaza. 

·       Nearly 11 months into Israel’s military campaign in Gaza, 60% of Americans want the United States to keep up its military support for Israel until the hostages held by Hamas are freed, according to new polling from the Chicago Council on Global Affairs that was exclusively provided to CNN.

·       The US has sent nearly 2 shipments of weapons to Israel on average every day since it began its genocide in Gaza on October 7, according to new figures from the Israeli military. Israeli military announced that it received its 500th shipment of weapons from the US via aircraft since October 7, through the countries’ airlift partnership. The US has also sent over 100 shipments of equipment by sea. This represents over 50,000 tons of military equipment, or over 150 tons of equipment per day as Israel relentlessly slaughters Palestinians and their children in Gaza and the occupied West Bank. This includes equipment like armored vehicles, munitions and ammunition. The latest figures are yet another show of the astonishing amount of weapons sent by the Biden administration to aid in Israel’s genocide. The US has sent Israel billions in military assistance and funding to procure U.S.-made weapons; just last week, approved a whopping $20 billion sale of weapons to Israel as it threatens war across the Middle East.

INTERNATIONAL

·       "I was struck to learn that the suffering of the people in Gaza has not generated much empathy among most Israelis – as if everybody in Gaza is guilty so everyone, including women and children, must pay for what Hamas has done. This is a big mistake," said EU foreign policy chief Josep Borrell.

·       German ambassador in Tel Aviv has admitted that he spread fabricated Israeli atrocity propaganda intended to give credence to Israel’s debunked claims of mass rapes by Palestinian fighters on 10/7.

·       Oil spill about 2 miles long has been detected in the Red Sea, according to a letter from the Greek ministry of maritime affairs to the UN agency for shipping. The letter said the spill matched the location of the Sounion, a Greek oil tanker that was targeted by the Houthi militia in Yemen as it passed through the Red Sea last week. The crew of the ship has been rescued, but the vessel remains at sea, on fire, and appears to be leaking, prompting concerns of a potential environmental disaster. The Iran-backed Houthis have been targeting commercial ships in the Red Sea in allegiance with Hamas since the war in Gaza began last year.

SOURCES

OCHAOPT, Haaretz, New York Times, The Guardian, Devex, Electronic Intifada, CNN, Truthout