Urgent health update: Consequences of war on Gaza and West Bank/East Jerusalem-June 16, 2024

Israeli air, land, & sea bombardment continue to cause civilian casualties, displacement, destruction of houses & other infrastructure. Ground fighting continues, particularly in the central Gaza An Nuseirat Refugee Camp, near Deir al Balah; Beit Hanoun, south of Gaza city, in Khan Younis, and in Rafah. 

JOURNAL ARTICLES
Psychological and Social Suffering of Another Generation of Palestinian Children Living under Occupation: An Urgent Call to Advocate (Health and Human Rights Journal) 

In case you missed this: The Columbia Law Review website was temporarily shut down after it published a Palestinian human rights lawyer’s article proposing a new way to understand Palestinian life under Israeli rule. Here is the article published elsewhere.

REPORT

UN: both Hamas and Israel have committed war crimes. UN Commission of Inquiry (COI) report covers the period from 10/7 to 10/31, findings based on interviews with victims & witnesses, hundreds of submissions, satellite imagery, medical reports & verified open-source information. Findings will be discussed by the UN Human Rights Council in Geneva. Report is available to download here, accuses Israel of using starvation as a method of warfare, forcible transfer & intentionally directing attacks against civilians

PRESENTATION

One Month into the Rafah Offensive-Gaza: The Human Toll. Center for Strategic and International Studies event 6/10/24

Numbers are cumulative since 10/7/23

GAZA

·       Killed: 37,266 (535 this week)

·       Injured: 85,102 (1,578 this week)

·       Israeli soldiers killed in Gaza: 299 (5 this week)

·       Israeli soldiers injured in Gaza: 1,940 (32 this week)

Hospitals

·       17 of Gaza’s 36 hospitals are partially functional (3 in North Gaza, 7 in Gaza City, 3 in Deir al Balah & 4 in Khan Younis). Of these, 14 are only partially accessible due to insecurity & damage to patient & ambulance entrances & surrounding roads. No hospitals are operational in Rafah, leaving people dependent on the ICRC field hospital & the UAE field hospital, only partially functional with limited access.

·       Al Khair Hospital in Khan Younis resumed partial functionality, & Nasser Medical Complex received 15 dialysis machines. In North Gaza, access to the Al-Awda, Kamal Adwan & Indonesian hospitals has been partially restored. The Indonesian Hospital offers only basic emergency services, inpatient services have resumed at both Kamal Adwan (144 beds) & Al Awda (40 beds), & Al-Awda provides critical maternal care. 6/9, WHO delivered fuel & supplies to these hospitals as well as 2 tents to Al-Awda.  

·       Palestine Red Crescent Society is setting up medical tents at Al Amal Hospital in Khan Younis to increase capacity & better respond to emergencies. 

·       6/7 WHO reported a truck with medicines for chronic conditions (hypertension, cardiac issues, diabetes, & respiratory illnesses) arrived in Gaza via the Kerem Shalom Crossing 5/30. These supplies, supporting treatment for up to 44,000 people, “given the scale of needs…is simply not enough.” 

·       Gaza MoH warned that a shortage of generators places the lives of the sick & injured at risk. Many generators have been destroyed, maintenance has been hampered by restrictions on the entry of spare parts into Gaza, & fuel shortages threaten the medical infrastructure that does function. There is only 1 oxygen production facility in Gaza; it could cease functioning due to the shortage of fuel.  

·       WHO reported there are no international EMTs deployed in Rafah nor in northern Gaza due to lack of security. Medical evacuations also remain suspended.

·       Gaza’s only oxygen generator on the brink of stopping, says health ministry.

An Nuseirat Refugee Camp attack

·       6/8, Israeli forces, disguised as displaced Palestinians & Hamas militants using an aid truck & civilian car, launched a daytime attack on Nuseirat refugee camp to rescue 4 Israeli hostages. Death toll: 274 Palestinians with 698 injured in heavy bombardment. Among fatalities: 64 children, 57 women & 37 elderly; among the wounded: 153 children, 161 women & 54 elderly. US provided some intelligence. 1 Israeli officer killed. IDF states civilian casualties were <100.  Streets were filled by a swarm of quadcopter drones equipped with small arms. Tanks could be heard. US-made Apache attack helicopters hovered. Nearby homes were hit with missiles. “The street was filled with civilian body parts…many injuries bleeding out without ambulances being able to reach them.” 89 inhabited homes or residential buildings were bombed without previous notification.

·       Top EU diplomat says “bloodbath must end”, calling it a “massacre”.  UN’s aid chief described in graphic detail scenes of “shredded bodies on the ground”. “Nuseirat refugee camp is the epicentre of the seismic trauma that civilians in Gaza continue to suffer,” called for a ceasefire, release of all hostages. “Seeing bloodied patients being treated on hospital floors, we are reminded that health care in Gaza is hanging by a thread…even as 4 hostages are reunited with their families, we are reminded that scores are still being held captive. All of them must be released. All civilians must be protected. This collective agony can and must end now.” 

·       The floating pier appears to have served as a joint command center for both Israeli and US forces during the invasion and massacre at Nuseirat refugee camp. Israeli captives were evacuated from US pier.

Other attacks

·       UNRWA reports 435 attacks since October on its facilities (including schools) sheltering displaced families, killing at least 456 refugees, injuring 1,478 people, & damaging or destroying 186 UNRWA installations. ~3 Palestinians were killed & 15 injured this week when Israel bombed UNRWA’s Asmaa School in the Ash Shati’ Refugee Camp.

·       Israeli bombing of the Deir al Balah municipal building killed the mayor of An Nuseirat & 4 others. Bombing of homes in the An Nuseirat & Al Bureij refugee camps killed 10 people.

·       In and around Khan Younis, Israeli bombing of 2 houses & an apartment building killed 27 people.

·       In and around Gaza City, bombings of 4 homes & apartment buildings killed 36 people. Heavy fighting reported between Israeli forces & Palestinian resistance in the Zeitoun neighborhood in Gaza City.

·       Israel launched strikes on Al-Mawasi in southern Gaza, bombarding an area it had previously designated as a "safe zone" by land, sea & air

·       6/9 Hamas launched rockets at central Israel, first time in months that air-raid sirens went off in Tel Aviv, Israel retaliated dropping 2 250-pound bombs on temporary structures in the Rafah camp. Lethal shrapnel hurtled in every direction, soon a fire was raging. Israel bombed targets inside a camp that had existed for months, sheltering hundreds of people displaced by the war.
Analysis raised questions about assessment Israeli military said it made before launching the strike that it was unlikely to harm civilians. The 2 250-pound American-made GBU-39 “small diameter” bombs, carried 37 pounds of explosive. GPS-guided bombs have wings & tail fins that pop out once they are dropped, allowing them to glide long distances & steer to their targets. Maker, Boeing, bills the GBU-39 as a “low collateral damage” precision weapon.
Combination of weapon, location & timing caused destruction well beyond the target. The explosions blasted the bombs’ steel casing into shards that could cause death & injury up to around 570 feet away. 45 killed and 249 injured

·       6/13 Israeli tanks rolled into western Rafah as  city came under intense helicopter, drone & artillery fire. Assault on Rafah has driven out >1 million Palestinians who had been sheltering there, forcing them into areas with little or no access to food, water or shelter. UN has warned >1 million people are expected to “face death and starvation by the middle of July”.

·       8 Israeli soldiers killed while riding in an armored vehicle in southern Gaza ambush; deadliest day in months. Hamas says it carried out “a complex ambush against enemy vehicles” using anti-tank missiles in Tal as-Sultan district of southern Rafah city.

·       2/3 of the roads in Gaza damaged or destroyed as of the end of May, based on a satellite image analysis. ~680 miles of roads destroyed, 220 miles severely affected, >900 miles moderately affected, per UN.

Public Health

·       In past month, Israeli military operations forced displacement of 1 million people from Rafah & >100,000 people in northern Gaza. Majority from Rafah sought refuge in the already overcrowded & resource-depleted areas of Khan Younis & Deir al Balah. Displaced people and families face dire conditions, including destroyed housing & lack of access to food, water, sanitation, & basic services.

·       Lack of sanitation infrastructure led to skin diseases, hepatitis A, gastroenteritis, & respiratory illness. Domestic violence & mental health issues are common, children have no access to play spaces or educational activities. Average water availability per person/day was <2 liters at Abo Dalal displacement site & 0.7 liters at Ard Al Ghusain displacement site. (Internationally recognized minimum requirement for survival: 3 liters/day, significantly lower than the 15 liters/day needed in an emergency for drinking, washing & cooking.) 

·       Recent military operations destroyed 5 wells in Jabalya, 2 wells in Rafah, & supply line from the Egyptian desalination plant & two desalination plants in Rafah. ~67% of water & sanitation infrastructure has been destroyed or damaged, including 194 wells, 40 reservoirs, 55 sewage stations, 76 municipal desalination plants, 4 wastewater treatment plants, & 9 warehouses. Many more facilities are non-operational due to insecurity, limited access, lack of power & fuel for generators, & low to no availability of spare parts, consumables, building materials & equipment.  Water production declined to 28% of what it was prior to 10/23 & is further limited by leaks due to war damage.

·       Accumulation of “mountains of waste and rubble” poses “significant health and environmental risks." Inaccessibility of 2 large landfills, exacerbated by fuel shortages, damaged infrastructure, & destruction of waste collection machinery, has severely compromised waste management. UN Development Program recently helped collect 47,000 tons of waste from Deir al Balah, Khan Younis, & Rafah, & distributed fuel to waste management operations. As of 6/9 ~330,400 tons of solid waste have so far accumulated in or near populated areas. 

·       Among the dangers the agency highlighted is hepatitis A, a virus, often transmitted through person-to-person contact or contaminated food, that may cause liver disease. Those infected can suffer debilitating fatigue, nausea, vomiting, abdominal pain, jaundice, etc. Lack of fuel for waste-removal vehicles has compounded sanitation problems, UNRWA accuses Israel of blocking UNRWA members from accessing landfills. Many of the agency’s sanitation centers, machinery & trucks for removing trash have been destroyed.

·       6/12, WHO Director-General, Tedros Adhanom Ghebreyesus: a “significant proportion of Gaza’s population is now facing catastrophic hunger and famine-like conditions.” >8,000 children < 5 years old have acute malnutrition. Treatment for 3,000 children has been stopped due to displacement & shrinking capacity; 2 stabilization centers for severely malnourished children remain functional, 1 in North Gaza, 1 in Deir al Balah. “Our warnings of mounting child deaths from a preventable combination of malnutrition, dehydration and disease should have mobilized immediate action to save children’s lives, and yet, this devastation continues,” stated UNICEF. 32 Palestinians have died of starvation in Gaza since October, including 28 children <5.

Humanitarian Aid

·       In May, humanitarian aid to Gaza  severely hindered by intense military activities, closure of crossings, insecurity, unexploded ordnance, complex & inconsistent notification procedures, damaged & overcrowded roads, & inconsistent checkpoint procedures. Of planned humanitarian missions, 48% in the north and 29% in the south were denied, impeded, or cancelled by Israel. Many missions classified as “impeded” experienced extended delays imposed by the Israeli army. Aid convoy was held for >9 hours at a northern Gaza checkpoint, preventing the delivery of medicines & nutrition for more than 10,000 children. Another mission to northern Gaza, delivering medical supplies to hospitals & the transfer of a patient, faced a 5-hour checkpoint delay.  

·       6/11, World Food Program: operations severely affected by escalation in fighting; it needs “regular access, the ability to transport aid safely, & fighting to stop.” The WFP temporarily halted operations at the floating dock, pending a security assessment to ensure the safety of their staff & partners. 

·       6/12, Humanity and Inclusion: Israeli army bulldozed their Rafah warehouse, “where nearly 200 pallets of humanitarian equipment were stored.” 

·       ~ 80 truckloads of humanitarian aid were delivered/day during the first week in June. ~500 truckloads were allowed into Gaza daily before current war began. >96% of women are not meeting their nutrient requirements.

·       273 aid workers  killed in Gaza, including 197 UN staff members, 33 PRCS staff & volunteers, 43 others. In addition, MoH and Palestinian Civil Defense report that 498 health workers & 70 Civil Defense staff have also been killed. 

·       The Trident, US-built “floating pier” off Gaza’s coast, expected to deliver >150 trucks’ worth of humanitarian aid into Gaza, has been out of service for weeks. Port damaged to its infrastructure in unclear weather-related circumstances, on 6/15 US Central Command said “the temporary pier will be removed from its anchored position in Gaza & towed back to Ashdod, Israel” due to expected high seas.

Other issues

·       Hamas accepted a US-drafted UN Security Council resolution calling for a cease-fire in Gaza & release of all hostages, is ready to negotiate over its details. Hamas & Palestinian Islamic Jihad: ready to "deal positively to arrive at an agreement," their priority is to bring a "complete stop" to the war. While Hamas earlier said its "positive" response opened a "wide pathway" to reach an agreement, Israel said the reply was tantamount to a rejection. White House National Security Adviser Jake Sullivan said that Hamas' proposed changes are minor, the US will work with Egypt & Qatar to bridge gapsl.

·       76% of Gaza schools require full reconstruction or major rehabilitation; a “continuous spike in the direct targeting of schools,” with 23 already damaged facilities affected by additional direct hits in April. ~54% of schools “directly hit,” 22% “damaged,” & 15% “likely or possibly damaged.” 96% of all directly hit schools are in areas subject to Israeli evacuation orders. Gaza's outsized literacy rate & high university attendance have come under attack. Some are launching makeshift alternatives to regular schooling, but rebuilding Gaza's destroyed schools could take years.

WEST BANK & EAST JERUSALEM

·       Palestinians killed: >544 including 126 children

·       Palestinians injured: >5,200 including 800 children

·       12 Israelis, including 7 soldiers & 5 settlers, were killed by Palestinians & >105 Israelis, including 70 soldiers, were injured.

·       183 Palestinians from Jerusalem have been displaced since January (55 this week).

·       Yoa’d Ghanadry-Hakim, clinical psychologist, Palestinian Counseling Center in Beit Hanina: term PTSD is inappropriate in Palestinian context since there is nothing “post” about Palestinian trauma. It is individual & collective, direct & indirect, continuous & cross- and inter-generational. Even the therapeutic vocabulary imposed by often well-meaning experts to try to diagnose, treat & encompass Palestinian lived experiences is determined by Western mindsets; once again, Palestinian truth is diminished, silenced and denied.

·       Between 10/7 & 5/28, WHO documented 480 attacks on West Bank health care. 16 people have been killed & 95 injured, as well as affecting 319 ambulances, 54 health facilities & 20 mobile clinics.

·       Thousands of Israelis, including settlers, marched through the Old City of Jerusalem on 6/5. They attacked Palestinians, damaged property, forced shops to close. Hundreds went to the Al Aqsa Mosque where, with the aid of Israeli forces, they prevented Palestinians from entering the Mosque. Marchers assaulted 2 Palestinian journalists, an Israeli journalist, & a foreign journalist. Israeli forces accompanying the march arrested 20 Palestinians. 

·       Other recent army & settler (often deadly) incidents include attacks near a military gate located at the Barrier, West of Tulkarm City, Jenin Refugee Camp, Ya’bad (Jenin), Anabta (Tulkarm), El Far'a Refugee Camp, near Tubas, Tulkarm City, Kafr Ni’ma west of Ramallah, Urif near Nablus, Kurf Dan northwest of Jenin, Kufr Ni’mah west of Ramallah, main roads south of Nablus, Huwarra, northern entrance of Ramallah & farmland in Nahalin south of Bethlehem. Palestinian Red Crescent Society medics were repeatedly denied access by Israeli forces.  

·       Settler attacks increased from average of 3/day to 7 since war started 10/7. Between 10/7 & 6/10: 968 settler attacks leading to casualties (98 incidents), damage to Palestinian property (767 incidents), or both (103 incidents). Settlers killed 10 Palestinians, injured 237, destroyed or damaged >43,600 Palestinian-owned trees.

·       Tens of thousands of US citizens are among the 700,000 Jewish residents of illegal settlements in the West Bank. 

·       During the past week, Israeli authorities demolished  50 Palestinian structures due to the lack of Israeli-issued building permits, displacing 88 people, including 43 children. 

·       10/7 to 6/10 Israeli authorities demolished 990 Palestinian structures, 34% (366) were homes displacing,2,155 people, including 1,036 children.

·       Palestinians report water supply was available for only 2 days over the past week in East Jerusalem's Kafr Aqab, as the local water company says Israel diminished water supply to the area.

ISRAEL

·       Israel intends to “phase out” the Sde Teiman facility. Several hundred detainees already transferred from Sde Teiman to other detention centers, including Ofer military prison in the West Bank. Hundreds more will be transferred. Israel will still use the military camp for its “initial screening of detainees,” according to the Association for Civil Rights in Israel, one of the groups that initiated legal proceedings to shut down Sde Teiman.

·       Israel’s expansion of the Gaza war to West Bank refugee camps can be explained as Israel seeking to eradicate the right of return.

·       Israeli universities suspended classes to demand prisoners’ exchange deal with Hamas.

·       Israel’s ambassador to the UN Gilad Erdan says Israel will study deporting UN staff & re-evaluate membership in the UN.

·       Israeli finance minister Bezalel Smotrich ordered deduction from Palestinian customs money equivalent to social-aid salaries of Palestinian martyrs’ & detainees’ families, transferred to families of slain Israelis.

·       Palestinian Professor Nadera Shalhoub-Kevorkian of Hebrew University spoke out against the Gaza War, Israel detained her. The investigation of Shalhoub-Kevorkian has prompted a debate inside Israel about repression of free speech & academic freedoms. “I have been persecuted & defamed, my academic production of knowledge flattened & my home & even my own bedroom invaded.” She is now under investigation for incitement to terrorism — a crime punishable by up to 5 years in prison.

·       Hezbollah launched >200 rockets in addition to drones on Galilee & Golan heights, causing widespread fires, in response to Israel’s killing of senior Hezbollah commander Taleb Abdallah & 3 more operatives in a strike in southern Lebanon.

US

·       6/9 thousands surrounded the White House with a red banner meant to evoke a "red line" that the Biden administration allegedly set & overlooked on Israel's actions in Rafah.

·       Interview with Hashem Amireh, president of the Graduate Student Union at University of North Carolina Chapel Hill, banned from campus & suspended from UNC on disciplinary charges related to his participation in pro-Palestinian activities on campus.

·       6/13 Biden said he doesn’t expect to seal a Gaza cease-fire deal in the near future, as a US-backed proposal with global support has not been fully embraced by Israel or Hamas.

·       US sanctions Israeli group, Tzav 9, for attacking Gaza aid convoys, a group whose stated aim is to prevent any assistance from entering Gaza. US accused the group of looting & setting fire to aid trucks. Administration says the Israeli government has a “responsibility” to protect humanitarian trucks heading to Gaza. For months, right-wing Israelis have been protesting and blocking roads to prevent aid shipments from reaching Gaza. Israel Police Commissioner Kobi Shabtai: far-right National Security Minister Itamar Ben-Gvir pushed to prevent law enforcement from protecting aid convoys to Gaza.

·       Jewish US Army Major Harrison Mann: first military & intelligence officer to publicly resign over the Biden administration’s support for Israel’s war on Gaza. Mann left his role at the Defense Intelligence Agency after 13-year career, saying “nearly unqualified support for the government of Israel … has enabled & empowered the killing & starvation of tens of thousands of innocent Palestinians.” It was “impossible” not to see echoes of the Holocaust in the devastation of Gaza. 

·       US Defense Secretary Lloyd Austin congratulated Israel’s military chief over raid on Nuseirat refugee camp, which freed 4 Israeli hostages.

INTERNATIONAL

·       UN added Israel to its blacklist of nations & groups that violate the rights of children in armed conflicts. Other nations on the UN list include Russia, Democratic Republic of Congo, Somalia, Syria, Burma, Afghanistan & Haiti. UN also added Hamas & Islamic Jihad to the list.

·       UN Security Council adopted a US-backed cease-fire plan for Gaza with only Russia abstaining, a sign of the growing frustration among the world’s major powers over the war & the desire to bring it to an end.

SOURCES

OCHAOPT, CNN, Washington Post, The Guardian, Haaretz, The Hill, Democracy Now, New York Times, Electronic Intifada, Indy Week, Middle East Eye, Yahoo News, Aljazeera, Mondoweiss, Democracy Now, The Intercept, Center for Strategic and International Studies, Social Change NYU, Palestine Chronicle, Reuters