Urgent health update: Consequences of war on Gaza, West Bank/East Jerusalem, and Lebanon 11/30/24

Israeli air, land, & sea bombardment continues across Gaza, causing further civilian casualties, displacement, & destruction of houses & other civilian infrastructure. The siege of northern Gaza has choked off all humanitarian aid and forced evacuations as intensified attacks increase casualties. While hoping that the ceasefire in Lebanon will take hold, the expansion of the war to the West Bank, Syria and Yemen remains a health and human rights emergency.

REPORTS

Dr. Areej Hijazi, an obstetrician and gynecologist, describes her experiences and describes how pregnant women are the hidden victims of the war. She worked al-Shifa Medical Complex in Gaza for a month during the war, and then her work was transferred to Al-Helou International Hospital due to the large number of injured people. Al-Shifa’s maternity building was converted into a building for the wounded and injured of the war. Mondoweiss

Researchers are trying to understand why resistant pathogens are so prevalent in the war-torn nations of the Middle East. By 2050, The Lancet predicts that antimicrobial resistance will kill 8.22 million people per year, more than the number currently killed by cancer. And a growing body of research suggests that the 21st-century way of warfare has become a major driver of that spread. New York Times , The Lancet

Of the tens of thousands killed in the Israeli bombardment and invasion, Gazan health officials estimate about 15,000 were children. Many Gazans have suffered horrific wounds, but few have been able to leave for treatment. When some met with us in Qatar, they lamented those they left behind, the living and the dead alike. New York Times

Israel blocks entry of blankets, clothes and shoes amid cold weather, intensifying Gaza’s catastrophic humanitarian crisis.
euromed monitor, Portside

RADIO & TV

NPR has been collecting eyewitness accounts from Gaza that indicate Israel is using a new type of drone. One that has a gun attached that can shoot people remotely. We hear how Israel is using it in Gaza and what this technology could mean for the future of warfare. NPR

The northern Gaza Strip has become an epicenter of a devastating humanitarian crisis, particularly in the towns of Beit Lahia and Jabalia, according to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA). Despite the evacuation orders from the Israel Defense Forces, tens of thousands of residents -- between 50,000 and 75,000, according to OCHA -- have refused to evacuate. These residents are now trapped under unimaginable conditions. ABC News

GAZA

(Numbers are cumulative through 11/28/24, per OCHAOPT & Palestinian Ministry of Health. Find more details here.)

Killed: 44,249+ (277 this week)

Injured: 104,746 (738 this week)

Israeli soldiers killed in Gaza: 378 (2 this week)

Israeli soldiers injured in Gaza: 2,456

Hostages in Gaza: 101

Israeli Attacks

Since October 2023, 337 aid workers (330 Palestinians and 7 foreigners) have been killed, including 251 UN staff (247 UNRWA), 33 Red Crescent (PRCS) staff and volunteers, and 53 national and international NGO workers.

• 11/20, 66 killed (including children) and others injured around Kamal Adwan Hospital in Beit Lahiya. Lack of ambulances, tools and Civil Defense crews hampered volunteer efforts to recover victims from the rubble.

• 37 killed (8 children) and many injured in attacks in and around Gaza City, including a PCD member killed while trying to rescue people under rubble. The PCD noted this was the 18th attack on them, with 87 PCD members killed to date. As of 11/21, 304 PCD members have been injured, 21 detained, and 17 centers damaged or destroyed, including 56 firetrucks and ambulances. Civil Defense activities are suspended in North Gaza and all 5 of their remaining vehicles are inoperative due to lack of fuel.

• 18 killed (7 children) and others injured in 2 attacks on the “safe” Al Mawasi zone.

• 11/20, 12 killed and others injured in a house hit in Jabalya Al Balad, North Gaza.

• 11/20 & 23, 14 killed (2 children) and many injured when Israel bombed a school sheltering 200 people and homes in An Nuseirat refugee camp, Deir al Balah.

• 11/21, 7 killed in Rafah City.

• 11/22, 6 killed (3 children) a home in western Khan Younis.

• Earlier this month, UN Secretary-General Antonio Guterres condemned the killings of journalists in Gaza as “unacceptable.” Another Palestinian journalist has been killed in an Israeli airstrike, increasing the death toll to 190 since October last year. Gaza’s government media office identified the journalist as Alaa Barhoum, an editor for several media outlets.

• UNRWA warns conditions for survival are ‘diminishing’ for Palestinians in north Gaza. Israeli bombings erased 1410 Palestinian families from the civil registry, reports the Palestinian health ministry.

Evacuation and displacement

• 11/23, the Israeli military issued an evacuation order for 1.9 sq.km in Gaza City. About 79% of Gaza is under active evacuation orders. See more details here.

• The winter rains began 11/25, worsening vulnerability for 1.6 million people in makeshift shelters, including thousands of families in tents affected by flooding and rising seas, including in the Al Mawasi “safe” area, with several hundred thousands of displaced people. In Deir al Balah, 60 shelters were destroyed and 120 damaged. Flooded roads create additional challenges and further displacement. At Al Qarara seaport in Khan Younis, >600 tents were flooded by high tides. There is an urgent need for tents, clothing, and food. In general, displaced families face “appalling conditions,” with no safe place to seek shelter and lack everything from clothes, shoes, blankets and mattresses, highlights UNRWA.

• 11/25, the Government Media Office (GMO) estimated that 10,000 tents had been “washed away or damaged by the winter storm.”

• Between 11/9-12, the UN conducted a needs assessment in Gaza City, where >100,000 people have been displaced from the north since October. They visited 9 IDP centers hosting 2,094 households and an additional 698 families sheltering outside. They found a severe lack of shelter and belongings necessary for daily life, overcrowding, insufficient access to potable water, dire hygiene, lack of food and means to cook, and a shortage of medication and health supplies.

Hospitals and Health Care

• Kamal Adwan Hospital in North Gaza was attacked 7 times in the past 6 weeks. 11/21, a drone damaged its generator and water tank, injuring 4 staff and 2 patients and destroying access to water. WHO urged “an immediate end to hostilities in the vicinity of the hospital and sustained access for humanitarian missions to provide lifesaving support.” 11/23, an attack injured hospital director Dr. Hussam Abu Safiya, and 3 others, and destroyed the oxygen system.

• 11/20, MSF reported an Israeli drone strike on 5 Palestinian and international MSF staff travelling from Nasser Medical Complex (Khan Younis) in a clearly-marked vehicle cleared with the Israeli military. The MSF team survived but the attack killed 20 people and injured 10 others.

• WHO reported the rebuilding of the warehouse at the Nasser Medical Complex after its near destruction in April, improving storage capacity for medical supplies in the south.

• As medical evacuation from Gaza remains suspended, 11/21 WHO evacuated 6 patients with cancer or conflict-related injuries (3 children) to Jordan. Only 335 patients have been evacuated since the closure of Rafah crossing in May.

• Hunger and malnutrition continue to weaken people’s immune systems and spread disease, especially among women, children, the elderly and people with disabilities or chronic medical conditions.

• Just as the Israeli army is destroying the healthcare system of the Strip, it has also decimated the system of care that used to exist for people with disabilities, killing many professionals who worked in the field. On May 13, Hashem Ghazal, the founder of the Atfaluna Society for Deaf Children and also known as the “spiritual father of deaf people in Gaza”, was killed in an Israeli air strike along with his wife.

• More than 1,000 doctors and nurses are among at least 44,211 people killed in Israel's 13-month assault on the Gaza Strip, officials in the Palestinian enclave said Sunday."Over 310 other medical personnel were arrested, tortured, and executed in prisons," Gaza's Government Media Office also said in a statement, according to Turkey's Anadolu Agency. "The Israeli army also prevented the entry of medical supplies, health delegations, and hundreds of surgeons into Gaza."

Children

• MSF reports it treated 3,421 children June-October at the inpatient pediatric ward of Nasser hospital: 22% for diarrhea-related illness and 9% for meningitis. 1,294 children were admitted for lower respiratory tract infections, including pneumonia; >10,800 children and 168 newborns were treated in the ER for upper respiratory tract infections. The Red Cross (ICRC) reports 31% of all patients at its southern Gaza field hospital are children with respiratory infections, injuries or burns.

• Between 11/1-23, 3,410 children were admitted for outpatient treatment of acute malnutrition; an average of 4,700 children/month were admitted for outpatient treatment of acute malnutrition between July and October. From 10/10- 31, there was a significant increase in children suffering from Severe Acute Malnutrition (SAM) with nutritional edema--where patients show swelling from tissue fluid retention, caused by a lack of protein. In Deir al Balah, cases surged from 10 to 74% in its 2 stabilization centers.

• WHO and Relief International opened a new SAM treatment center in Deir al Balah. 4 are now operational: 1 in Khan Younis, 1 in Gaza City, and 2 in Deir al Balah. Cases increased by 50% since October.

• Between 11/9-23, 13 schools were attacked, 11 by airstrikes. These cause fear among parents, children, and teachers, hampering education-in-emergency programs.

Water and Sanitation

• Cold temperatures, heavy rains and rising tides exacerbate sewage problems, disease spread, and building collapse reports the Norwegian Refugee Council (NRC). The recent weather has intensified the distress with the tents of some two million refugees flooding from either rainwater or sewage. 'It can be summed up in two words: despair and catastrophe,' said a Gaza resident.

• WASH Cluster partners received only 12% of the fuel needed to meet public health needs, including water production and distribution, sewage and waste management.

• Since October, the Israeli siege of North Gaza has prevented delivery of fuel to produce water and manage solid waste and sewage with a catastrophic impact on public health.

Food and Nutrition

• As of mid-November, 440,000 cooked meals prepared in 140 kitchens were distributed daily, representing a 25% decrease compared to late September.

• As of 11/25, only 4 of 19 WFP bakeries remain open due to lack of flour and fuel.

• UNRWA says the amount of food aid being allowed into Gaza meets less than 6% of the need.

Aid

• Between 11/1-25, of 456 aid movements coordinated with Israeli authorities, 40% (184) were facilitated, 35% (158) denied, 16% (73) impeded, and 9% (41) cancelled. Of the 41 missions to North Gaza, 37 were denied and the other 4 approved but so impeded that aid could not be delivered. Since early October, no UN attempt to support the north has been fully facilitated. Similarly, missions to areas in Rafah, where intense Israeli operations began in May: of 28 requests, Israeli authorities denied 24, cancelled 1, impeded 1, allowing only 2 to occur. Find aid convoy information here.

• As of 11/21, 933 UN and International NGO trucks (60% loaded with food) were on standby in Al Arish, ready for dispatch into Gaza, but prevented by Israeli authorities.

WEST BANK AND EAST JERUSALEM

This week, Israeli forces killed 9 Palestinians (1 child) and injured 37 (12 children).

Killed since October 2023: 796+ (including at least 148 children) and injured: >6,570

Find more detail here.

Israeli Attacks

• From 11/19-25, Israeli forces killed 7 Palestinians (1 child) during a 48-hour military operation in Jenin. Near Jenin, Israeli forces shot and killed 3 Palestinians and injured 2 in Ash Shuhada village; and in Kafr Dan, an airstrike killed 2, after which ground troops killed another Palestinian. In both operations, victims’ bodies were withheld. The UN Human Rights Office (OHCHR) denounced severe human rights violations in Jenin: “serious violations of international law including extrajudicial killings, the use of Palestinians to shield Israeli security forces, damage to infrastructure such as water tanks, sewage systems, electricity and roads, the desecration of bodies, and the withholding of the bodies of Palestinians who were killed. There also needs to be an immediate halt to all similar militarized operations in the occupied West Bank, which have applied military means and tactics during law enforcement operations. These operations have violated international human rights law’s strict limitations on the use of force, leading to the unlawful killing and injury of so many Palestinians.”

• 11/19, Israeli forces shot and injured a known-to-them disabled child for disobedience at the Shu’fat refugee camp checkpoint. They then left him bleeding on the ground before finally allowing an ambulance to take him to hospital.

• 11/21, Israeli forces shot and killed a man in Ein Beit el Mai camp, near Nablus.

Settler Attacks

This week, settlers carried out 15 attacks against Palestinians, causing injuries and/or property damage. Since 10/7/23, OCHA documented 1,654 attacks by settlers against Palestinians, causing 177 injuries. For more info on casualties, displacement and settler violence since January 2023, see the OCHA West Bank snapshot.

• Settler attacks on Palestinians during the 2024 olive harvest tripled compared to the preceding 3 years. 57 Palestinians have been injured by settlers, 11 by Israeli forces, over 2,800 mostly olive trees destroyed or damaged, and significant theft of crops and harvesting tools. Nearly 60% of the attacks were in the northern West Bank, especially the Nablus governorate; 25% in the central West Bank, mainly Ramallah; and 15% in the south, Bethlehem and Hebron governorates.

Demolitions

This week, Israeli authorities demolished 28 Palestinian-owned structures for lack of Israeli-issued building permits, displacing 27 people (15 children). Since 10/7/23, Israeli authorities destroyed 1,903 Palestinian West Bank structures, displacing 4,692 Palestinians (1,980 children).

• 4 structures were demolished belonging to an East Jerusalem family trying to obtain building permits, but repeatedly rejected by Israeli courts. Israeli forces threatened to fine them if they did not complete demolition quickly. As the family was demolishing their home, Israeli forces stormed the site and destroyed what remained of the house, including most of their furniture and personal belongings.

LEBANON

Updated on 11/28 by Lebanese Health Ministry:

Since 10/8/23, Israeli forces killed 3,961 and injured, 16,520.

• At least 11 people were killed and 63 wounded in a series of Israeli airstrikes on an apartment block in the densely populated Basta neighborhood of central Beirut. At least four bombs hit an eight-story apartment building at about 4 a.m. on 11/23, without warning, producing blasts heard around the Lebanese capital. The strike leveled the building and destroyed seven smaller residential buildings in the surroundings, leaving meters-deep craters of rubble where the structures once stood.

• A Guardian investigation has found that Israel used a US munition to target and kill three journalists and wound three more in an 10/25 attack in south Lebanon which legal experts have called a potential war crime.

• Early 11/26, a ceasefire came into effect between the Lebanese resistance and Israeli forces, following a deal that President Biden said is intended to bring about a “permanent cessation of hostilities.” The ceasefire provides enormous relief for the people of Lebanon, who have endured death, injury, loss, suffering and displacement on a massive scale from Israel’s indiscriminate bombing targeting villages and civilian neighborhoods.

The deal also raises many questions about the course of the confrontation between Israel and the resistance across the region, sparking concerns that Gaza faces a more difficult struggle without the support front in the north. Netanyahu and US leaders have said that the deal will allow them to focus on destroying Hamas and isolating Iran, although Biden has vowed a new effort to achieve a ceasefire for Gaza.

In accordance with the cease-fire agreement, a 60-day period will be set for the truce's full implementation, during which Israel will gradually withdraw its forces as Lebanon's army takes control of land near its southern border to ensure Hezbollah does not rebuild its infrastructure there.

• Alongside the ceasefire agreement, a letter from the United States to Israel affirms American support for Israel to “act in self-defense,” a term Israel has historically stretched beyond all recognition. The letter also commits the US to provide Israel with intelligence on Iranian efforts to send weapons to Hezbollah or influence politics in Lebanon, and on any attempt by Hezbollah to “infiltrate” the Lebanese army.

• Hours after a ceasefire between Israel and Hezbollah took effect, at 4 a.m. on 11/27, an Israeli drone was still buzzing over the Lebanese capital of Beirut, flying higher than usual, before finally disappearing. Neither the drone nor a warning issued by the Israeli military, telling residents not to return to the hundreds of towns and villages that it had ordered emptied, dissuaded people from making the trek back to their homes. Despite the danger of unexploded ordnance and the remaining presence of Israeli troops in parts of Lebanon, the pull of home is its own powerful force.

The IOF believes that firm enforcement of the cease-fire will be needed to ensure Hezbollah and Lebanon adhere to its terms. Reports in Lebanon indicate several have been killed and wounded since the truce took effect.

ISRAEL

• Decision by new Defense Minister Israel Katz to halt the use of detention without trial against Jewish settlers living in the West Bank is apartheid by all accounts: One law for Jews and another for Palestinians.

• In response to a petition filed by human rights organizations, the Prison Service has admitted that about a quarter of Palestinian prisoners in Israeli jails have been infected with scabies in recent months. The petition, which will be heard by the High Court, states that the Prison Service has not taken the required actions to prevent the disease from spreading.

• Far-right National Security Minister Itamar Ben-Gvir said that an agreement with Lebanon is "a big mistake" and represents a "historic missed opportunity to eradicate Hezbollah."

• Israeli officials are in discussions with their American counterparts about involving the U.S. in a new mechanism for visits to Palestinian prisoners from the West Bank and Gaza held in Israel. This would replace the International Red Cross visits that had been taking place until the war began, according to the Israeli government.

• A bill sponsored by Knesset member Hanoch Milwidsky (Likud), which limits the right of Israel's Arab citizens to vote and be elected in municipal elections, passed its preliminary vote in the Knesset. This legislation joins its ugly twin, which is also advancing, concerning the expansion of the justifications for disqualifying Arab parties and candidates in the Knesset elections as part of an amendment to the Basic Law on the Knesset.

US

• Project Esther proposes a public-private plan for dismantling any domestic group that supports Palestinian rights — which they call the “Hamas Support Network.” The plan’s first targets are pro-Palestinian organizations like Students for Justice in Palestine, American Muslims for Palestine and Jewish Voice for Peace. But that’s just the start.

• The White House condemned the ICC's arrest warrants for Netanyahu and Gallant, joining lawmakers across both parties. Senator Tom Cotton went as far as to imply the U.S. should take military action against the court over the warrants.

• As first reported by Financial Times, which cited people familiar with the sale, the administration has notified Congress that it is moving forward with a $680 million arms sale that includes thousands of JDAMs and 615 small diameter bombs — both of which Israel has used extensively in attacks against Palestinians in Gaza that experts have said are war crimes.

INTERNATIONAL

• In Egypt, Gazans endure ‘unbearable life with little support. Over 100,000 Palestinians fled to Egypt during the war. Feeling stranded by the state and the PA, they describe a precarious existence in legal limbo. +972

• As countries negotiated over climate finance, Palestinian officials and advocates came to Cop29 in Baku to highlight global heating’s intersection with another crisis: Israel’s siege on Gaza. “The Cop [meetings] are very keen to protect the environment, but for whom?” said Ahmed Abu Thaher, director of projects and international relations at Palestine’s Environment Quality Authority, who had travelled to Cop29 from Ramallah. “If you are killing the people there, for whom are you keen to protect the environment and to minimize the effects of climate change?” Despite the suffering of its people, Palestine was “doing its homework” on UN climate agreements, Thaher said. Palestine signed the Paris climate agreement and has submitted decarbonization plans to the UN’s climate body.

• Spanish lawmaker Jorge Pueyo has announced his participation in a multi-day hunger strike in support of the Palestinian people. “There are times in life and politics when words are not enough, and setting an example becomes important,” he told a press conference in the parliament .

• ICC rejected Israel’s challenges to its jurisdiction and also issued a warrant for a top Hamas official, Muhammad Deif. Its chief prosecutor is seeking the arrests for war crimes in Israel and Gaza.

• An ICC spokesman said warrants against Netanyahu and former defense minister Gallant could be rescinded if Israel convinced the court that it would open a thorough investigation into the events of the Gaza war.

SOURCES

OCHAOPT, Aljazeera, The Guardian, Palestine Chronicle, Haaretz, Forward, Common Dreams, Mondoweiss, The New Yorker, NPR, New York Times, Euromed Monitor, Portside, Financial Times, Truthout, ABC News