Urgent health update: Consequences of war on Gaza, West Bank/East Jerusalem, and Lebanon 11/23/24

Israeli air, land, & sea bombardment continue across Gaza, causing further civilian casualties, displacement, & destruction of houses & other civilian infrastructure. The siege of northern Gaza has choked off all humanitarian aid and forcing evacuations as intensified attacks increase casualties.

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.

Podcasts

Electronic Intifada podcast with Dr. Maura Finkelstein, a tenured professor who anthropology at Muhlenberg College in Allentown, Pennsylvania for nine years who was fired in May 2024 over social media posts in support of Palestinian rights and against the political ideology of Zionism.
Electronic Intifada

Report from Gaza: Palestinians feel they are being “slowly exterminated” in Israel’s genocide. Democracy Now

Reports

Euro-Med Human Rights Monitor documented dozens of deliberate killings and new field executions carried out by Israeli occupation forces against numerous civilians in northern Gaza. Euro-Med

A particularly bad thing for organizations in the US

The House of Representatives passed legislation that would give the incoming Trump administration the power to unilaterally designate any nonprofit as a “terrorist supporting organization” and revoke its tax-exempt status, effectively killing the group. Under the bill, which critics describe as a “death penalty” for nonprofits, targeted organizations would have little meaningful process for appeal once labeled as “terrorist supporting,” and no evidence of wrongdoing is required before action is taken.

Detailed description of Dr Al-Bursh, famous Gazan surgeon, killed in Israeli prison.
Sky News

GAZA

(Numbers are cumulative through 11/21/24, per OCHAOPT & Palestinian Ministry of Health. Find more details here.)

Killed: 43,972+ (307 this week)

Injured: 104,008 (932 this week)

Israeli soldiers killed in Gaza: 376 (3 this week)

Israeli soldiers injured in Gaza: 2,440

Hostages in Gaza: 101

Insecurity could bring the humanitarian operation in Gaza to a standstill

Muhannad Hadi, Humanitarian Coordinator for the Occupied Palestinian Territory, denounced (see entire statement) the lack of security around aid deliveries to Gaza:

“The delivery of critical aid across Gaza, including food, water, fuel and medical supplies, is grinding to a halt. The survival of two million people hangs in the balance. Bakeries are closing one after the other for lack of flour or fuel to operate power generators.

“For over six weeks, the Israeli authorities have been banning commercial imports. At the same time, a surge in armed looting targeting humanitarian convoys and truck drivers, fueled by the breakdown in public order and safety, has further crippled our ability to collect supplies from border areas and deliver critical aid…

“In 2024, UN trucks have been looted 75 times – including 15 such attacks since 4 November alone – and armed people have broken into UN facilities on 34 occasions. Just last week, one driver was shot in the head and hospitalized, along with another truck driver. This Saturday, no less than 98 trucks were looted in a single attack with trucks being damaged or stolen…

“The atrocities must end.”

Israeli attacks

Suspension of the Palestinian Civil Defense (PCD) work in North Gaza has left recovering casualties to community responders with minimal training and supplies, and limited success.

• 18 killed (2 children) in various attacks on IDP tents, an internet café and a market in the “safe” Al Mawasi area, Khan Younis.

• 11/12, 15 killed, others injured, corpses remaining under rubble, in Beit Hanoun.

• 11/12, 6 killed (2 children), many injured, near Deir Al Balah.

• 11/13, 6 killed and others injured at Kamal Adwan Hospital.

• 11/16, 10 killed (1 child) and others injured in a school in Beach camp, Gaza City.

• 11/17, 65 killed, many injured under rubble, in 2 attacks on Beit Lahiya.

• 11/19 Israeli attacks killed at least 50 Palestinians and wounded 110 others.

• Medics said that an Israeli strike killed 10 Palestinians and wounded at least 20 others at a former school building in Gaza City's Shati refugee camp currently sheltering displaced families.

Evacuations and displacement

The UN estimates 100-131,000 people have been displaced since 10/6/24 to Gaza City, raising the population from 250,000 to 375,000, in an area of severely limited shelter, water, and health care. Only 65,000 to 75,000 people remain in North Gaza, <20% of the population on 10/7/24.

• 11/17, Israeli air force dropped leaflets in Beit Lahiya ordered immediate evacuation, triggering further displacement.

Prisoners

• 11/15, Israeli forces released 20 North Gaza detainees held since 10/6. Transferred to the European Hospital in Khan Younis, they report that many children, elders, and seriously injured were taken from North Gaza hospitals and remain in custody. Detainees subjected to systematic torture in Israeli prisons-- physical assault, sleep deprivation, prolonged periods in handcuffs and blindfolds, and deprivation of food, water, and medical care. The Palestinian Prisoner’s Society announced the death of a Gaza detainee arrested in good health on 12/12/23, as he was being transferred from a south Israel prison to Soroka Hospital in Beersheba.

• Israel Prison Service (IPS) data provided to the Israeli human rights NGO Hamoked lists 10,091 Palestinians in Israeli custody: 3,443 administrative detainees held without trial, 1,997 sentenced prisoners, and 1,627 “unlawful combatants.” These figures do not include Palestinians from Gaza detained by the military since 10/7/23; their number remains unknown.

Aid

• Between 11/1-18, of 319 aid movements coordinated with Israeli authorities, 41% (132) were facilitated, 33% (105) were denied, 16% (51) were impeded, and 10% (31) were cancelled. Aid to North Gaza was particularly blocked: Between 11/1-18, 85% of 41 coordination requests were either denied (17) or impeded (18), while only 7% (3) were facilitated.

• UNRWA: a convoy of 109 trucks driving from the Kerem Shalom border crossing in southern Gaza was looted. Most of the trucks were lost. Some of the drivers were reportedly shot, and some vehicles sustained extensive damage, the agency said. Only 11 trucks made it to their destination.

• In the southern Gaza Strip, Palestinian security forces shot and killed 20 people accused of an organized effort to loot convoys delivering desperately needed aid into Gaza. The killings came two days after armed gangs violently looted nearly 100 trucks carrying food provided by the United Nations. A spokesperson for the U.N.’s agency for Palestinian refugees said Israeli authorities had instructed the convoy to use an unfamiliar route, on short notice, ahead of the ambush. Drop Site News reports the Israeli military has systematically targeted Palestinian security forces charged with protecting aid shipments, while allowing armed gunmen to attack aid convoys in areas under Israeli control.

• An internal UN memo obtained by the Washington Post concluded in October that the gangs “may be benefiting from a passive if not active benevolence” or “protection” from the Israeli army. The memo said that one gang leader established a “military like compound” in an area “restricted, controlled and patrolled" by the Israeli army.

• These attacks have aggravated already severe scarcities of food, medicine, and aid and caused food prices to soar.

• So far in November, Israel says it has allowed in an average of 88 trucks a day, a fraction of the 600 a day that aid agencies say are necessary to meet basic needs.

Health and Hospitals

• Access to the Kamal Adwan, Al Awda and Indonesian hospitals remains almost completely restricted amid severe shortages of medical supplies, fuel and blood. Health Cluster attempts to send an Emergency Medical Team blocked by Israeli authorities.

• "[The director] told us that the [Israeli army] have full data of all males aged between 14 and 65 at Awda hospital," Dr Obeid said, tearfully. "They told him that if all men do not come down… they will destroy the Awda Hospital with all the women and children in it."

• Director of the besieged Kamal Adwan Hospital in northern Gaza warned 85 injured Palestinians are at imminent risk of death after an Israeli attack damaged the hospital’s upper floors. Dr. Hussam Abu Safiya said the hospital had received a large influx of children with signs of malnutrition and is facing an “extreme catastrophe.”

• 11/17, WHO with OCHA, the UN Mine Action Service, the International Red Cross and the Red Crescent reached the Kamal Adwan Hospital to deliver 10,000 liters of fuel and transfer 17 patients (3 children) to Al Shifa Hospital in Gaza City. The mission was also to deliver food and medical supplies to Kamal Adwan, but Israeli forces compelled aid workers to offload the food at a military checkpoint and only some supplies made it to the hospital, according to Dr. Husam Abu Safiyeh. On the evening of 11/18, the Kamal Adwan facility was again attacked, with shrapnel wounding personnel in the ICU.

• Between 10/1-11/17, WHO planned 10 missions to the Kamal Adwan Hospital but only 5 were allowed to reach the facility.

• ICRC and PRCS reached the Al Awda Hospital in Jabaliya to deliver fuel and medical supplies and transfer 15 patients to Al Shifa Hospital. But Israeli authorities blocked delivery of food and water. Al Awda is operating only 4 hours/ day and is in dire need of food, water, blood, and oxygen.

• WHO expanded in-patient capacity at Nasser Medical Complex in Khan Younis, with 13 specialized tents and 88 beds in the hospital yard to support the ER, enhance trauma care, and better manage mass casualty incidents. The hospital still faces blood shortages.

• Emergency, an international NGO, is providing field clinic services in Al Mawasi, seeing 160 patients/ day. 1/3 are children, and 1 in 10 patients is malnourished.

• 11/14, WHO and partners evacuated 8 children with conflict injuries and metabolic conditions from Gaza to Jordan, for onward travel to the US for treatment. Earlier, MSF reported Israeli authorities blocked without explanation the medical evacuation of 8 children. MSF previously applied for 32 child evacuations, but only 6 were allowed. Since the closure of Rafah Crossing on 5/7, only 329 patients have been evacuated; all regular evacuations of critically ill and injured patients remain suspended.

• Rana Nabeel Baalousha is fighting a rare illness while also struggling to survive the genocide in Gaza. Her only hope of survival is a medical transfer out of Gaza, but Israel won’t allow it. Her story is one of many. Mondoweiss

• The closure of boundary crossings has resulted in severe shortages of medical supplies, including eye drops and surgical equipment. The medical facilities still operating in Gaza prioritize life-saving procedures, leaving eye treatments on the sidelines. Dr. Mohamed Tawfik, an Egyptian ophthalmologist who came to Gaza at the start of October as part of a relief mission, said in an interview, “People here are going blind, not because their conditions are untreatable, but because the treatments are simply unavailable.” “Over half of the necessary eye medications are out of stock, and we are forced to reuse medical instruments due to the shortage.”

Food Security

• Over 1 million people have received no food parcels since July or earlier. Many community kitchens have closed: none are operational in North Gaza, 18 in the Gaza governorate and 120 remain open in central and southern Gaza. These face constant shortages threatening shutdown. As of 11/18, only 8 of 19 WFP bakeries remained operational–4 in Gaza City, 3 in Deir al Balah and 1 in Khan Younis. No cooking gas has entered north Gaza for over 13 months and firewood is scarce, forcing people to burn waste to cook and to search for fuel in high-risk areas.

• Food access to North Gaza is heavily restricted; only 2 missions by Food Security Sector (FSS) partners delivered food aid since 10/6. All Nutrition Cluster activities remain suspended, including treatment of children with acute malnutrition and supplementary feeding for children and pregnant or breastfeeding women.

• Director of the FAO Office of Emergencies and Resilience, Rein Pulsen, stressed that “men, women, boys and girls are effectively starving as the conflict rages, with humanitarian organizations blocked from delivering assistance to those in need.” He explained that people would have already been dying from hunger by the time famine is declared and this would have “irreversible consequences that can last generations.”

• In the northern third of Gaza, where Israeli forces are waging a weeks-long offensive that has killed hundreds of people and displaced tens of thousands, famine conditions may have already set in, experts say.

• 11/15 video, the Director of the Kamal Adwan Hospital noted that signs of famine are evident in North Gaza, with acutely malnourished people arriving at the hospital and 4 children in critical condition.

• 11/16, a UN convoy of 109 trucks of food supplies was violently looted, with 97 trucks lost and drivers forced to unload at gunpoint.

• Wheat flour is extremely scarce. The price of a 25kg bag has skyrocketed to 400 NIS (over US$100), compared with 40 NIS (about $10) prior to 10/2023. The situation is “unbearable,” highlighted UNRWA, with “people fighting over bags of flour and surviving on tinned food.” Protests demanding flour and food supplies are increasingly frequent.

• The International Medical Corps’ Nutrition Stabilization Center in Deir Al Balah reported an increase in admissions of children with edema, a sign of worsening malnutrition.

• A school in Gaza burned down hours after aid arrived. Witnesses said IOF soldiers forced civilians away from the area, preventing them from collecting aid from the first convoy to reach the area in over a month. A video seen on social media, taken by an IoF soldier, showed two Israeli armored vehicles leaving the school as it was engulfed in flames.

Water and Sanitation

• In North Gaza, 65-75,000 people have difficulty accessing clean drinking water. No fuel has been allowed in, shutting down many wells. All requests since 10/6 for delivery of supplies and fuel for WASH facilities were denied by Israeli authorities. Half of Gaza City’s wells are inaccessible; south Gaza also suffers fuel and equipment shortages.

• 11/13, the Coastal Municipalities Water Utility (CMWU) received a UNICEF shipment of 20,000 liters of chlorine for drinking water, sufficient for 1 month of operations of desalination plants and wells in southern Gaza. Destruction of water and sanitation infrastructure has resulted in unprecedented levels of water pollution.

• 11/14, Israeli authorities enabled a single electric line to the UN-supported south Gaza desalination plant. This is the 1st time Israel allowed an electric connection to Gaza since all power was cut off in October 2023.

• The city of Khan Yunis, located in southern Gaza, announced on Saturday that a week-long fuel shortage has left over 1.2 million Palestinian residents and displaced individuals in the area without access to clean water.

WEST BANK AND EAST JERUSALEM

This week, Israeli forces killed 4 Palestinians (1 child) and injured 43 (25 children).

Killed since October 2023: 787+ (including at least 147 children) and injured: >6,533

Find more detail here.

Israeli Attacks

This week, 25 of 43 Palestinians injured (58%) were children. 19 schoolgirls in Bethlehem were treated for tear gas inhalation. 3 boys were shot in Nablus for throwing stones at Israeli forces who fired live ammunition, rubber bullets and tear gas. Since 10/7/2023, 166 West Bank children have been killed, up from 40 killed in the 1st 9 months of 2023 – a 400% increase. Over 60% occurred in Jenin, Tulkarm, Tubas and Nablus during intensified Israeli operations, including 35 killed in airstrikes. 1,132 children have been injured, nearly half (48%) from live ammunition.

• 11/18, Israeli forces shot and killed a child in Nablus after their setting up a checkpoint caused a confrontation, with Palestinians throwing stones and Israeli forces firing tear gas and live ammunition. The military delayed the ambulance, and the child was pronounced DOA at the hospital.

• 11/20, Israeli forces launched a 46-hour attack in and around Jenin, killing 5 and damaging homes, displacing residents, and destroying 4km of roads and underlying infrastructure.

• 11/21, Israeli forces shot and killed a man in Ein Beit el Ma’ refugee camp, Nablus.

• Israeli settlers suspected of torching homes and a car in West Bank village of Beit Furik, east of Nablus

Settler Attacks

This week, settlers carried out 47 attacks against Palestinians, 25 causing injuries and/or property damage. Since 10/7/23, OCHA documented 1,639 attacks by settlers against Palestinians, causing 170 injuries. Settler violence displaced 295 households (1,722 people, 835 children) in Bedouin and herding communities. For more info on casualties, displacement and settler violence since January 2023, see the OCHA West Bank snapshot.

• Since the beginning of the olive harvest, 10/1/24, OCHA has documented 225 incidents involving settlers in 82 communities, 171 which resulted in casualties or property damage: 11 Palestinians injured by Israeli settlers, 55 by Israeli forces, and more than 2,500 mostly olive trees and saplings destroyed, and crops and harvesting tools stolen.

• In a typical attack on 11/17, a Palestinian truck driver was fixing his broken-down truck near Ramallah when Israeli settlers attacked him with metal poles and stones. Israeli forces and police arrived and arrested the Palestinian, prevented an ambulance from treating him, and fined him 1,000 NIS. He later sought attention at a nearby hospital.

Demolitions

This week, Israeli authorities demolished 32 Palestinian-owned structures for lack of Israeli-issued building permits, displacing 21 people (7 children). Since 10/7/23, Israeli authorities destroyed 1,875 Palestinian structures across the West Bank, displacing 4,665 Palestinians (1,965 children). For more on demolitions and displacement, see the OCHA demolition dashboard.

Access Restrictions and Education

• Students in the Israeli-controlled H2 area of Hebron are prevented by intensified access restrictions from attending school. 13,065 H2 students have not attended in-person classes from 10/2023 to 5/2024. Enrollment at Ash Shuhada school, on a street closed to Palestinians, dropped by 1/3. Teachers and students must now detour through an olive grove where they are threatened by settlers. The Ministry of Education in Hebron shifted some schools online, but families have limited or no internet access or electronic devices, resulting in a 75% drop in attendance since 10/2023.

LEBANON

Updated on 11/21 by Lebanese Health Ministry:

Since 10/8/23, Israeli forces killed 3,583 and injured, 15,244.

• >145 health care workers have been killed while on duty in Lebanon since the war began in mid-September according to WHO. 11/15. five medics were killed in Israeli strikes on southern Lebanon, three more were wounded.

• Israel’s war on Hezbollah is taking a terrible toll on Lebanon’s children. At least 231 children have been killed and 1,330 injured, according to the Lebanese Health Ministry. (11/19)

• Lebanese Health Ministry said six people were killed, including three children, and eleven were wounded in an Israeli strike on a village in Lebanon's Baalbek region.

• Israeli military pressed on with its days-long bombing campaign taking place near Beirut in an area dominated by Hezbollah, while in the country’s south two paramedics were killed. Tedros Adhanom Ghebreyesus, the director general of the World Health Organization, also denounced the killings of at least a dozen paramedics this week in a single airstrike on a building used by emergency workers in the village of Douris, in the Baalbek region of northeastern Lebanon.

• Although it appears that all sides, including Iran, are interested in stopping the war in Lebanon, it's not certain that this is an attainable goal in the near future. As for Gaza, Netanyahu is free to pursue an endless war.

ISRAEL

• Over the last year, Israel's National Security Minister Itamar Ben-Gvir has begun implementing a policy of expelling foreign pro-Palestinian activists – many of them Americans – on a variety of pretexts. The result: a spike in the number of activists forced to leave.

• Israeli Finance Minister Belazel Smotrich said that "In order to return the hostages, we [Israel] need to occupy the entire northern Gaza Strip," while informing Hamas "unequivocally that if the hostages don't return, we will exercise our sovereignty and stay there forever. At that moment, Hamas will have the motivation to keep them alive."

• Former Defense Minister Yoav Gallant said that a plan proposed by Israeli ministers to transfer responsibility for aid distribution in Gaza to private companies but secured by the IDF is a euphemism for military rule and "a reckless and dangerous political act.”

• Far-right Finance Minister Bezalel Smotrich said at the Knesset that "the right thing for Israel's economy is to continue the war until all its objectives are fully achieved. Victory will bring security, and security will bring economic growth for many years to come," adding that Israel's security budget "will need to increase."

• Israel’s coalition will consider a bill easing West Bank land purchases for Jews. The bill would abolish an existing Jordanian law and allow anyone to purchase real estate in the West Bank. Another bill considered would imprison and fine those displaying Palestinian flags at state-funded institutions.

US

• 11/19 over 100 activists held a sit-in on Capitol Hill to demand our senators block $20 billion in weapons for genocide and war. Capitol police arrested faith leaders alongside climate, housing, Indigenous, Jewish, and Palestinian activists participating.

• Bernie Sanders: "The United States government is currently in violation of the law, and every member of the U.S. Senate who believes in the rule of law should vote for these resolutions,", pointing to U.S. statutes prohibiting the sale of weaponry to countries violating internationally recognized human rights or obstructing American humanitarian aid.

• The Biden administration is aggressively pushing senators to bless continued U.S. weapons shipments for Israel ahead of a first-of-its-kind vote in Congress on the policy, and administration officials are suggesting lawmakers who vote against the arms are empowering American and Israeli foes from Iran to the militant groups Hamas and Hezbollah, which the U.S. treats as terror organizations.

• U.S. Senate refused to pass joint resolutions of disapproval proposed by Sen. Bernie Sanders that would prevent the sale of certain offensive American weaponry to Israel, which has killed nearly 44,000 Palestinians in Gaza since last fall. S.J. Res. 111, S.J. Res. 113, and S.J. Res. 115 would have respectively blocked the sale of 120mm tank rounds, 120mm high-explosive mortar rounds, Joint Direct Attack Munitions (JDAMs), the guidance kits attached to "dumb bombs."

• United States vetoed a draft UN Security Council resolution calling for a ceasefire in Gaza, marking the 49th time the US has used its veto power against Israel-related UN Security Council draft resolutions. The draft resolution was brought forth by the 10 elected members of the Security Council, and every member except for the US voted in favor of the measure.

• White House said that the U.S. "fundamentally rejects the Court's decision to issue arrest warrants for senior Israeli officials. Incoming U.S. National Security Advisor Michael Waltz said "the ICC has no credibility and these allegations have been refuted by the U.S. government," adding that "you can expect a strong response to the antisemitic bias of the ICC and UN come January." U.S. Sen. Lindsey Graham called on Senate Majority Leader Chuck Schumer to advance a House-passed bill sanctioning the ICC.Top EU Diplomat Josep Borrell said that the warrants issued are not political and must be respected and implemented.

• Medical professionals, especially those who have treated patients in Gaza’s and Lebanon’s hospitals over the past year, have spoken out about atrocities carried out by the Israeli military. Doing so at UCSF, one of the country’s most elite medical institutions, may come at a price. Bridget Rochios is one of nine health care workers at UCSF who spoke with The Intercept about their experiences of censorship and punishment after speaking out about human rights for Palestinians as part of their research and medical work. The Intercept

• UCSF crackdown has been broad, targeting professors, doctors, and medical staff. Doctors have had their lectures mentioning Gaza scrubbed from the internet or canceled outright. They have been accused of antisemitism and creating an unsafe work environment, and banned from lecturing entirely. Staffers, nurses, and students have been suspended for speaking out in solidarity or for acts as simple as wearing a watermelon pin or hanging a pro-Palestine symbol in their offices. Dozens of employees have criticized the ongoing silence from UCSF and its failure to condemn Israel’s war on Gaza, accusing the school of favoring pro-Israel views.

INTERNATIONAL

• A Turkish-American activist who was killed by Israeli fire in the West Bank was laid to rest on Saturday in her hometown in Turkey with thousands lining the streets and anti-Israeli feelings in the country rising from a conflict that threatens to spread across the region. Aysenur Ezgi Eygi, a 26-year-old woman from Seattle, was shot dead Sept. 6 by an Israeli soldier during a demonstration against Israeli West Bank settlements, according to an Israeli protester who witnessed the shooting.

• UN Special Rapporteur on the OPT Francesca Albanese alleged that Palestinian doctor Adnan Al-Bursh was sexually abused until his death while in Israeli detention, according to a post to her X/Twitter. Albanese wrote, "A doctor. A stellar surgeon. The embodiment of Palestinian ethics. Likely raped to death."

• Head of UNRWA, Phillipe Lazzarini, urged the international community to contest Israel’s recent ban of the organization, stressing that no other entity can substitute the work of the UN agency on the ground. The impact of the Israeli decision on UNRWA’s operations is already being felt on the ground.

• International Criminal Court issued arrest warrants for Prime Minister Benjamin Netanyahu and former Defense Minister Yoav Gallant, accusing them of war crimes and crimes against humanity in Israel's offensive in Gaza. An arrest warrant was also issued against late Hamas leader Mohammed Diab Ibrahim Al-Masri (also known as Mohammed Deif).

• Palestine-Global Mental Health Network is now launching an international campaign to demand world governments hold Israel accountable for its war crimes against Palestinian and Lebanese children

SOURCES

OCHAOPT, Mondoweiss, Haaretz, New York Times, Palestine Chronicle, JPost, Washington Report, Campaign for Palestinian Rights, Democracy Now, The Intercept, Portside, Electronic Intifada, Middle East Eye, Huffington Post, The Guardian, The Cradle, Aljazeera