Urgent health update: Consequences of war on Gaza, West Bank/East Jerusalem, and Lebanon 11/2/24
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.
JOURNALS & REPORTS
Gaza: Entire population at risk of genocide “executed under our watch,” says UN expert BMJ 2024; 387 doi: https://doi.org/10.1136/bmj.q2386 (Published 28 October 2024)Cite this as: BMJ 2024;387:q2386
A report by the Watson Institute at Brown University gathered previously published data to provide an overview of the human costs that have resulted, and will continue to result, from the Hamas attack and Israeli military operations in one year of war since 10/7/23. It includes U.N. estimates of Israeli and Palestinian direct deaths in Israel, Gaza, and the West Bank. Watson Institute
An article in The New Yorker about aid workers who risk their lives to volunteer in Gaza. As the war grinds on, logistical challenges are compounded by politics, repeated evacuations, and the fear of being killed. New Yorker
Israeli Military Aggression Doubles Cancer Risks for Women and Denies Them Treatment Palestine Centre for Human Rights
Joint Statement: Standing with the UN Special Rapporteur Francesca Albanese in Face of Israeli-Led, Western-Backed, Intensified Attacks Amid Ongoing Genocide, Palestine Centre for Human Rights
Why Israel outlawed UNRWA, and what it could mean for Palestinian refugees: Israel has banned the work of the UN agency for Palestinian refugees as part of an ongoing campaign to erase Palestinian refugee rights. UNRWA's commissioner general said the law would sacrifice "an entire generation of children." Mondoweiss
Report of the Special Rapporteur on the situation of human rights in the Palestinian territories occupied since 1967, Francesca Albanese - Genocide as colonial erasure UN report
Ashlaa’ and the Genocide in Gaza: Livability against Fragmented Flesh, From the Series: Anthropology in a Time of Genocide: On Nakba and Return, By Nadera Shaloub-Kevorkian The Arabic word ashlaa’ refers to scattered body parts and dismembered flesh and bones. Society for Cultural Anthropology
GAZA (Numbers are cumulative through 10/31/24, per OCHAOPT & Palestinian Ministry of Health. Find more details here.)
Killed: 43,204 (>343 this week)
Injured: 101,641 (>914 this week)
Israeli soldiers killed in Gaza: 365 (9 this week)
Israeli soldiers injured in Gaza: 2,373 (11 this week)
Hostages in Gaza: 101
Disregard for humanity must stop
The UN released 3 statements on Gaza in an unusual display of activity, anger, and clarity:
10/26 Statement on North Gaza by Joyce Msuya, Acting Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator:
“What Israeli forces are doing in besieged North Gaza cannot be allowed to continue. Hospitals have been hit and health workers have been detained. Shelters have been emptied and burned down. First responders have been prevented from saving people from under the rubble. Families have been separated and men and boys are being taken away by the truckload. Hundreds of Palestinians have reportedly been killed. Tens of thousands have been forced to flee yet again. The entire population of North Gaza is at risk of dying. Such blatant disregard for basic humanity and for the laws of war must stop.”
10/27 Oct 2024 Statement on North Gaza by UN Secretary-General spokesperson. Excerpts:
“The plight of Palestinian civilians trapped in North Gaza is unbearable... The Secretary-General is shocked by the harrowing levels of death, injury and destruction in the north, with civilians trapped under rubble, the sick and wounded going without life-saving health care, and families lacking food and shelter, amid reports of families being separated and many people detained.
“Repeated efforts to deliver humanitarian supplies essential to survive – food, medicine and shelter – continue to be denied by the Israeli authorities, with few exceptions, putting countless lives in peril…
“This conflict continues to be waged with little regard for the requirements of international humanitarian law.
“In the name of humanity, the Secretary-General reiterates his calls for an immediate ceasefire, the immediate and unconditional release of all hostages, and accountability for crimes under international law.”
11/01 Statement by Inter-Agency Standing Committee, 15 UN Agencies and NGOs. Excerpts:
“We…call on the State of Israel to cease its assault on Gaza and on the humanitarians trying to help. The situation unfolding in North Gaza is apocalyptic. The area has been under siege for almost a month, denied basic aid and life-saving supplies while bombardment and other attacks continue… Hospitals have been almost entirely cut off from supplies and have come under attack, killing patients, destroying vital equipment, and disrupting life-saving services. Health workers and patients have been taken into custody. Fighting has also reportedly taken place inside hospitals…
We have received reports of civilians being targeted while trying to seek safety, and of men and boys being arrested and taken to unknown locations for detention… The entire Palestinian population in North Gaza is at imminent risk of dying from disease, famine and violence…
And this week, the Israeli Parliament adopted legislation that would ban UNRWA…a catastrophe for the humanitarian response in Gaza, diametrically opposed to the UN Charter, with potential dire impacts on the human rights of the millions of Palestinians depending on UNRWA’s assistance, and in violation of Israel’s obligations under international law…
The blatant disregard for basic humanity and for the laws of war must stop…
Attacks against civilians and what remains of civilian infrastructure in Gaza must stop…
Member States must use their leverage to ensure respect for international law. This includes withholding arms transfers where there is a clear risk that such arms will be used in violation of international law.”
Israeli attacks
Over 3 weeks of heavy attacks have displaced >71,000 from North Gaza to Gaza City, with about 100,000 people remaining in the North. The Palestinian Civil Defense (PCD) announced a halt to operations, leaving the North without firefighting, search and rescue, and emergency medical assistance. PCD staff were detained (2 at Kamal Adwan Hospital), 3 injured, their last firetruck was destroyed. The humanitarian crisis in Jabalya is exacerbated by severe shortages of food, water, and medical supplies. All community kitchens and bakeries in the North are closed.
• Between 10/22-29, 7 attacks on Jabalya, An Nuseirat, and Beach refugee camps, and Beit Lahya, Gaza City, and Khan Younis killed >350, with many missing and trapped in rubble.
• 10/29 Scores of Palestinians, including many women and children, have been killed in an Israeli airstrike on a crowded apartment building in the northern Gaza town of Beit Lahiya. Gaza’s civil defense agency said 93 people had been killed and 40 were still missing. Many of the victims were members of the extended Abu Nasr family, as well as Palestinians displaced from elsewhere.
• From 10/1-26, 57 schools were attacked by airstrikes, shelling, and arson.
• Israel’s three-week siege of northern Gaza has killed at least 1,000 Palestinians, most of the dead women and children. While Israel has attempted to justify its renewed focus on the north by claiming it is targeting regrouped Hamas fighters, the intensity of the fighting has caused heavy losses among the 100,000 civilians still living there. Many of them are families who, exhausted by Israel’s multiple forced displacement orders, have chosen to stay in the north.
• Dr. Areej Hijazi, filled with sorrow and grief at the deaths of his mentor and medical colleagues among the many killed by Israel, wrote obituaries for Dr. Nahed al-Harazin, head of Al-Shifa’s gynecology department; Dr. Maisara Alrayyes, a member of Médecins du Monde; and Dr. Inas Mahmoud Yousef, a general practitioner. Electronic Intifada
Health and Hospitals
• Of 5 Northern Gaza hospitals functional prior to October 2023, only Kamal Adwan and Al Awda remain partially operational.
• 10/25, Israeli soldiers invaded Kamal Adwan hospital where 600 people were present, including 195 patients. 3 nurses and a cleaner were injured and 3 ambulances, a transport vehicle and the solar generation system were destroyed. Of the hospital’s 70-member team, 44 males were detained by Israeli military, 30 still in custody, and the others were forced to evacuate south. 10/29, Kamal Adwan Hospital received a mass casualty influx with only the hospital’s director and 1 pediatrician struggling to assist 150 patients; no surgeons, anesthesia or Intensive Care Unit teams.
• 10/26 Israeli forces withdrew from Kamal Adwan Hospital just one day after storming it, with health officials saying that soldiers detained dozens of male medical staffers and some of the patients. This comes as the Israeli government has banned six medical NGOs from entering Gaza despite the dire humanitarian crisis
• 10/28 Only one doctor remains at the Kamal Adwan Hospital in northern Gaza after the facility’s medical staff were either detained or forced out by the Israeli army, according to Gaza’s Health Ministry. “One pediatrician remains.”
• 10/24, WHO supplies managed to deliver fuel, blood, and medicines for ~5,000 patients and trauma supplies to Kamal Adwan. Dr. Richard Peerperkorn reported the team witnessed “thousands of women and children leaving the area, walking, limping with their few belongings towards Salah al Din [road] and Gaza City,” while at Kamal Adwan, they saw “mayhem and chaos,… horrific trauma patients,” overwhelmed and underequipped staff, and hundreds seeking shelter in every corner of the facility.
• 10/24 WHO reported the now-closed Indonesian Hospital boundary wall was demolished, Israeli forces were stationed at all entry points to the hospital, no food or water is available, 4 patients died 10/20-26, and a WHO-led mission to deliver food, water and medical supplies was denied by Israeli authorities.
• Al-Awda Hospital is inaccessible due to damaged roads, with 151 people, including 65 employees, 43 patients, 36 companions and seven children remaining in the facility as of 10/26. The hospital lacks potable water, relying on untreated well water.
• “Children in Gaza are dying, not just from the bombs, bullets and shells that strike them,” but because when they survive, “they are then prevented from leaving Gaza to receive the urgent care that would save their lives,” stressed UNICEF Spokesperson, James Elder. Since the Rafah crossing closed on 5/7, only 127 children–suffering from head trauma, amputations, burns, cancer, and severe malnutrition–have been allowed to evacuate out of Gaza. WHO estimates 14,000 urgently need evacuation from Gaza, but only 39% of evacuation requests were approved by Israeli authorities since 10/2023.
• UNRWA health teams relocated to Gaza City, where a single UNRWA medical point at a school remains functional. The agency’s medical points in North Gaza were destroyed.
• Israel has all but ended medical evacuations from Gaza. For the past 6 months, only 237 patients have been evacuated out of Gaza
• Israel has barred at least six international medical NGOs that had been providing crucial support to Gaza's decimated healthcare sector. Doctors in the banned groups say the move could result in thousands of additional deaths.
Polio
The unending violence in North Gaza compelled the Polio Technical Committee to delay the 3rd and final phase of the vaccination campaign in the North, now rescheduled for 11/2-4. However, the 2nd round polio vaccinations campaign reached 96% of children <10 in central and southern Gaza.
Water and Sanitation
• Israeli attacks on WASH personnel and facilities: killed 4 Coastal Municipalities Water Utility (CMWU) workers in a clearly marked vehicle during a mission approved by Israeli authorities; killed 2 municipal well operators in Gaza City; destroyed water access to 2/3 of households (1.4 million people) who consume less than recommended daily amounts for drinking, cooking, and hygiene. No fuel has been delivered to WASH facilities in North Gaza since 10/1; fuel missions are consistently denied by Israeli authorities.
• After more than a year of war, farmers have lost land, equipment and sometimes their lives. NYT
Food and Nutrition
• Since 10/7, Israeli military attacks have closed all 7 North Gaza supplementary feeding (BSFP) sites, targeting pregnant and breastfeeding women (PBW) as well as children < 5; 1 WFP distributor remains active in Gaza City and supports 50 nutrition sites.
• With the Kamal Adwan Hospital operating at minimum capacity, the services for acutely malnourished children have been disrupted, displacing children under treatment. The Benevolent Society Stabilization Center in Gaza City continues to admit children.
• WFP’s nutrition activities reached 100,000 people in central and southern Gaza during October. WFP has resumed supplementary feeding programs in An Nuseirat and Al Maghazi refugee camps in Deir al Balah after months of restricted access. 1,400 children have been receiving outpatient treatment for malnutrition. Action Against Hunger is supporting 11 new mother and baby-friendly spaces in Deir al Balah and Khan Younis.
• The drop in aid entering Gaza (<100 trucks since 10/1) means people lack adequate food, shelter, and fuel, and already alarming rates of food insecurity and malnutrition will worsen. At the end of October, >1.7 million people (80% of the population) received no monthly food rations. The threat of famine persists as 100,000 metric tons of food--over 2 months of food for the entire population—is barred entry by Israeli authorities. Convoy information is on this dashboard.
Humanitarian Aid
• Since 10/3, 14 aid workers and 4 health workers have been killed and others injured. These include 7 UNRWA and 7 NGO staff. Since 10/2023, at least 322 aid workers (315 Palestinians and 7 foreigners) have been killed.
• In October, of 580 planned aid missions in Gaza requiring coordination with Israeli authorities, 44% (254) were denied, 16% (92) were impeded, 4% (22) were cancelled, and 36% (212) were facilitated. Of the 93 providing assistance in the North, only 8% (7) were facilitated by Israeli authorities.
• The amount of humanitarian aid entering Gaza in October was the lowest of any month this year.
Economy
A UNDP assessment estimates that, by the end of 2024, the Human Development Index (HDI) in Gaza will drop to 0.408, erasing over 69 years of progress. In the West Bank, the HDI is expected to decline to 0.676 and could further worsen if military incursions continue. The poverty rate throughout OPT is projected to rise to 74.3% in 2024, up from 38.8% in 2023. “Projections in this new assessment confirm that amidst the immediate suffering and horrific loss of life, a serious development crisis is also unfolding – one that jeopardizes the future of Palestinians for generations to come,” stressed UNDP.
WEST BANK AND EAST JERUSALEM
This week, Israeli forces killed 4 Palestinians (1 child) and injured 35 (10 children).
Killed: 766+ (including at least 146 children)
Injured: 6,490
Israeli attacks
Israeli forces raiding Nablus and Tulkarm killed 2 Palestinians, including an 11-year-old boy who threw stones at military jeeps as they passed. The military operation in Tulkarm severely damaged a multi-story residential building, displacing 4 households (23 people, 11 children) and damaged 5 nearby houses.
Settler Violence
This week, settlers carried out 70 attacks against Palestinians, resulting in 12 injuries, 11 by settlers and 1 by soldiers, and property damage. Since 10/7/23, OCHA documented 1,600 attacks by settlers against Palestinians, causing 164 injuries, 1,261 cases of property damage, and 158 leading to both. Settler violence displaced 287 households (1,682 people, 816 children) in Bedouin and herding communities. For more info on casualties, displacement and settler violence between January 2023 and October 2024, see the OCHA West Bank snapshot.
• Many attacks target Palestinians harvesting crops. 120 grapevines, 65 guava saplings, and 40 olive trees were vandalized, water tanks were damaged, and agricultural tools were stolen. A 70-year-old woman was injured fleeing from armed Israeli settlers who attacked 4 in Qaryut, Nablus governorate; 10 farmers were attacked harvesting olives near Tulkarm; settlers cut off electricity to Yasuf, Salfit; settlers protected by soldiers attacked 4 families harvesting olives in Beitillu, Ramallah; settlers protected by soldiers damaged greenhouses and crops in Ash Shuykh, Hebron; settlers pepper-sprayed a 73-year-old man and stole his olive harvest in Sabastiya, Nablus.
• The Protection Cluster and the UN Human Rights Office (OHCHR) are delivering protective presence interventions and emergency response training in 70 West Bank communities during the olive harvest season. They also provide legal support, agricultural tool kits, and emergency preparedness trainings on response actions.
Demolitions
This week, Israeli authorities demolished no Palestinian-owned structures. Since 10/7/23, Israeli authorities destroyed 1,829 Palestinian structures across the West Bank, displacing 4,630 Palestinians (1,950 children). For more on demolitions and displacement, see the OCHA demolition dashboard.
Other
• In the West Bank, concerns grew that anti-UNRWA legislation could undermine the UN agency's ability to pay salaries, worsening already high poverty and unemployment rates. In Gaza, where the agency is the sole distributor of humanitarian aid, the law's impact could be even more severe.
• 139 East Jerusalem residents discovered land they live on is registered to the Jewish National Fund (JNF). Residents of the Umm Tuba neighborhood discovered this when one applied to the Jerusalem municipality for a building permit on land he has lived on for decades. Despite the residents holding documents proving land ownership, the JNF could seek their eviction.
ISRAEL
• The Israeli Knesset passed a bill on 10/28, banning the United Nations Relief and Works Agency for Palestinian refugees (UNRWA) in Israel and East Jerusalem. UNRWA's commissioner general said the law would sacrifice "an entire generation of children." World leaders and international aid organizations have voiced fears for the delivery of crucial aid in Gaza. Secretary general, António Guterres, “There is no alternative to UNRWA.”
• The ban is set to take effect in 90 days and lead to the closure of UNRWA’s premises in the occupied Palestinian territory – the West Bank, including occupied East Jerusalem – and Gaza, effectively paralyzing the agency’s ability to fulfil its mandate as set out by the UN General Assembly in 1949.
• The first law, which bans UNRWA from conducting “any activity” or providing any service inside Israel, passed 92-10 following a fiery debate between supporters of the bill and its opponents, primarily members of Arab parliamentary parties.
• The second legislation, which declares UNRWA a “terror” group and bans Israeli officials from any contact with the agency, passed 87-9.
• Palestinian human rights groups say that new Israeli legislation banning a UN agency from providing services to Palestinians under occupation “aligns with a broader pattern of Israel’s genocidal intent.” “The legislation also terminates the 1967 agreement between Israel and UNRWA with immediate effect,” according to three prominent Palestinian human rights groups: Al-Haq, Al Mezan and the Palestinian Center for Human Rights.
• Israeli war minister Yoav Gallant says Israel will have to make “painful compromises” and that “not all goals are achieved through military action.” Head of Mossad meets CIA Director and Qatari foreign minister in Doha to discuss reviving ceasefire negotiations in Gaza and Lebanon.
• Israeli daily Yediot Ahronot reported on 4/24, that some 10,000 Israeli soldiers and officers have been either killed or wounded since 10/7. The head of the Israeli army’s wounded association told Israel’s Channel 12 that the number of wounded Israeli soldiers exceeds 20,000, including at least 8,000 who have been permanently handicapped as of 6/1. Israel’s Channel 7 reported that according to the Israeli war ministry’s rehabilitation service numbers, 8,663 new wounded joined the army’s handicap rehabilitation system since 10/7 and as of 6/18.
LEBANON
Updated on 10/31 by Lebanese Health Ministry, since 10/8/23: 2,822 killed by Israeli forces
12,937 injured by Israeli forces
Israeli soldiers injured: 900
• As of last week, Israel killed over 160 health and rescue workers across Lebanon and damaged over 150 ambulances and 55 hospitals. Meanwhile, the U.N. Interim Force in Lebanon, UNIFIL, says its forces are continuing to come under attack.
• Israel bombed Lebanese towns of Zibqin, Burgholiyeh, Qleileh, Byut al-Sayad, Jabal Blat, Jebal al-Butm, Ramadiyeh, Sheitiyeh, Kufr Kila, Deir Sirian, and Kufr Tebnit, as well as cities of Nabatieh and Tyre in southern Lebanon, the towns of Suhmor, Halaniyeh, Taria, Mashghara, Asireh and Shimstar, and the Beqaa Valley. Hezbollah launched rockets into northern Israel and called on Israelis to evacuate 25 towns in the Galille and Golan Heights
• Hezbollah elects Naim Qassem as new Secretary General. In his inaugural address, Qassem reaffirms that Hezbollah will not negotiate before a ceasefire, says Hezbollah rebuilt its structure and is ready to fight for months.
US
The architects of Project 2025 at the conservative Heritage Foundation have drafted a plan to break the pro-Palestinian movement in the U.S. in anticipation of their desired victory by Donald Trump victory in next week’s presidential election. Dropsite News
INTERNATIONAL
• Democracy Now interviewed U.N. special rapporteur on the occupied Palestinian territory Francesca Albanese, who says Israel is committing genocide on Palestinians in the Gaza Strip. Albanese was in New York to present her report, titled “Genocide as colonial erasure,” which finds that Israel’s genocide is founded on “ideological hatred” and “dehumanization” and “enabled through the various organs of the state,” and recommends that Israel be unseated from the United Nations over its conduct. She argues that Israel’s attacks on U.N. employees, including the killings of at least 230 U.N. staff in Gaza, its flagrant violations of U.N. resolutions and international law and the unique status of “the first settler-colonial genocide to be ever litigated before [an international] court” justify this unprecedented measure. Israel’s continued impunity, Albanese warns, “is the nail in the coffin of the U.N. Charter.” Albanese’s report warns that Israel’s genocide in Gaza could be expanding to the West Bank.
• Human Rights Watch is calling on countries to suspend arms sales to Israel, accusing it of committing war crimes by attacking medical workers and healthcare facilities in Lebanon.
• The small number of cancer patients from Gaza who are receiving care in Jordan’s capital, Amman, bear burdens beyond those of illness — deep feelings of guilt, along with fear and homesickness.
• South Africa Files 750 Pages of 'Overwhelming' Evidence in ICJ Genocide Case Against Israel: "The glaring genocide in Gaza is there for all who are not blinded by prejudice to see."
• Raji Sourani, founder of the Palestinian Centre for Human Rights in Gaza, says evidence of war crimes is extensive but Israel's allies are obstructing path to justice The National News
• Iran’s Supreme Leader Ali Khamenei says country’s specialized authorities will decide proper response to Israel’s attack. Israeli opposition leader Yair Lapid says Israel’s avoidance of striking strategic and economic targets in Iran was “wrong,” other Israeli leadership describe a missed opportunity for more aggressive attacks.
SOURCES
OCHAOPT, British Medical Journal, The Guardian, The New York Times, Haaretz, Democracy Now, Palestine Chronicle, Electronic Intifada, Dropsite News, Mondoweiss, Aljazeera, Common Dreams, Palestine Centre for Human Rights, The National News