Urgent health update: Consequences of war on Gaza, West Bank/East Jerusalem, and Lebanon 11/8/24
Please read, share with colleagues, family, elected officials, political groups, medical organizations...every week is more horrifying than the last...
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 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
This 28-page report covers the challenges and inter-sectoral responses of meeting the humanitarian needs in Gaza during the first half of this year. OCHAOPT
GAZA
(Numbers are cumulative through 11/05/24, per OCHAOPT & Palestinian Ministry of Health. Find more details here.)
Killed: 43,391 (330 this week)
Injured: 102,347 (1,124 this week)
Israeli soldiers killed in Gaza: 368 (3 this week)
Israeli soldiers injured in Gaza: 2,394 (21 this week)
Hostages in Gaza: 101
UNRWA: The 10/28 Israeli Knesset approval of 2 laws prohibiting Israel from any contact with UNRWA and banning the agency will go into effect in 3 months. In Gaza, UNRWA is the backbone of humanitarian services, including health care services, education, food and shelter. UNRWA is “the last remaining lifeline” for people, and the only entity able to re-start education for >660,000 children. The legislation would suffocate efforts to ease human suffering in Gaza and be an enormous setback to sustainable peace efforts.
Israeli attacks
Many more than 42 people killed and others injured in multiple attacks on homes and IDP shelters in Beit Lahiya. Cadavers and wounded remain trapped under the rubble or in the street.
Dozens killed in Jabalya Refugee Camp and Tal Az Za’tar area.
58 killed (4 children) and dozens injured in houses and schools hit in and around An Nuseirat. Medical and civil defense (PCD) responding to an attack were targeted, injuring >30 people, including a medic and 2 journalists. Caritas Jerusalem reported 2 team members injured by intense shelling on 11/1. Al Awda Hospital received 42 fatalities and 150 injured on 11/2.
A UNICEF vehicle was fired on near a polio vaccination clinic in Gaza governorate, wounding several children. UNICEF Executive Director Catherine Russell deplored these “further examples of the grave consequences of the indiscriminate strikes on civilians in Gaza.” Save the Children warned: if “the international community does not intervene soon, an entire generation of children in Gaza will be erased, along with their futures.”
Health & Hospitals
Kamal Adwan Hospital “has been reduced from a hospital helping hundreds of patients with dozens of health workers, to a shell of itself,” reported WHO Director-General, Tedros Ghebreyesus. The hospital’s 3rd floor was hit on 10/31, destroying newly-delivered WHO supplies and dialysis equipment, and injuring 4 medical staff manually extinguishing the fire. A 11/3 attack injured 6 hospitalized children, killing one and damaging water tanks. WHO: It is “appalling that hospitals in Gaza continue to be attacked, patients continue to be harmed, and health workers and humanitarians continue to work under life-threatening conditions.” Even the New York Times was compelled to cover the attack.
0n 10/31, MSF confirmed their orthopedic surgeon at Kamal Adwan Hospital was detained with other medical staff by Israeli forces in a 10/26 raid.
Israeli authorities have refused to allow delivery of supplies to Al Awda Hospital. Hospital administration warned that fuel, medicines, medical consumables, blood units, food and water were desperately needed, and noted 6 employees were injured in attacks, 1 losing a limb, and all ambulances were out of service.
Indonesian Hospital resumed partial functionality and received patients on 10/29. However, no fuel or medical supplies could be delivered.
On 11/5, Humanitarian Coordinator (HC) for the Occupied Palestinian Territory (OPT) Muhannad Hadi visited an UNRWA school in Gaza City sheltering hundreds of refugee families from the north. He said conditions were unbearable-- the facility lacks food, water and functioning toilets, sewage is running everywhere. “This is not a place for humans to survive. This is beyond imagination.”
In Gaza City, the newly rehabilitated “mini hospital” at Al Shifa (destroyed in April) is an “example of resilience,” stressed WHO Representative in OPT, Dr. Richard Peeperkorn. The facility has an emergency ward, operating theaters and an ICU, averaging 9 operations daily. Its 25-machine dialysis unit supports 63 kidney patients. Al Rantisi Pediatric Hospital in Gaza City is also expected to reopen next week; Israeli attacks forced its closure in November 2023.
The War on Hospitals is a War on Civilians. “1,047 Palestinian medical personnel have been killed, and 310 have been arrested... Thousands of the over 100,000 wounded have had their limbs amputated at a time in which the Gaza Strip does not have crutches or wheelchairs, let alone prosthetic limbs.” Hospitals face “severe shortages of soap and detergents.” Surgeries, including cesarean sections and amputations, are performed without anesthesia.
Polio
The 3rd area of the vaccination campaign began 11/2 in northern Gaza, with a total of 105,261 children < 10 vaccinated. 216 vaccination teams deployed to 106 fixed sites and 209 social mobilizers raised popular awareness. WHO reports the humanitarian pause was limited to Gaza City, but their Polio Technical Committee decided to mitigate the risk of a long delay and vaccinate children recently displaced from northern Gaza to Gaza City. WHO reported Israel attacked the Sheikh Radwan primary health center on 11/2 as parents were bringing their children to be vaccinated, injuring 6 (4 children).
Food & Nutrition
The FAO reports 95% of cows have died and only 43% of sheep, 37% of goats, and 1% of poultry sector remain alive. Coupled with large-scale damage of agricultural infrastructure and Israeli denial of entry to agricultural inputs, this represents enormous impediments to rebuilding local food systems. The latest FAO/WFP Hunger Hotspots report places Gaza as “the most intense” (according to the WFP) among the 5 “highest alert” territories worldwide of catastrophic food insecurity.
The WFP warns that as winter approaches, the lack of food and vital humanitarian supplies entering Gaza could soon escalate into famine.
While the Erez West crossing re-opened on 10/14, delays and multiple inspections limit aid actually entering, and supplies have only been allowed to reach Gaza City, not the besieged areas of north Gaza.
Dangers of war contamination
Mine Action staff and the Protection Cluster paint an alarming picture of the EO (Explosive Ordinance) risk in Gaza: in all 5 Gaza governorates, Explosive Remnants of War (ERW) are on the surface and underground, including ammunition (projectiles, mortars, rockets, missiles, grenades and landmines) and buried bombs, weapons and ammunition caches. Satellite analysis shows 66% of all structures damaged or destroyed, creating more than 42 million tons of rubble (UNDP) containing explosive hazards. Beyond ERW, carcinogenic asbestos and other contaminants have been widely scattered by the destruction and will affect Gaza long into the future.
Israeli authorities continue to deny the entry of specialized personnel and equipment, and prevent disposal activities. Disposal teams are only allowed to mark and report ERW, not move or dispose of them. Mine removal activities are routinely impeded, denied or canceled. In September, for example, 31 requests were denied. Israeli authorities also refuse to provide data regarding ordinance use and deployment.
Aid Activities
During October, of 644 planned aid movements requiring coordination with Israeli authorities, 37% (241) were facilitated, 43% (278) were denied, 15% (99) were impeded, and 4% (26) were canceled. The denied aid activities included 77 related to water, sanitation and hygiene (WASH), 42 to health, and 27 to food. Compared to September, denials have risen by over 100%; for northern Gaza denials increased by 115%. Of 183 coordinated efforts in the north, only 29% (53) were facilitated, while 44% (81) were denied, 21% (39) were impeded and 5% (10) were canceled.
The Aid Workers Who Risk Their Lives to Bring Relief to Gaza
As the war grinds on, logistical challenges are compounded by politics, repeated evacuations, and the fear of being killed. The New Yorker:
Journalism
The Palestinian Journalists Syndicate reported 174 killed—10% of Gaza’s working journalists—101 injured and 30 detained since October 2023. They also documented 514 family members of journalists killed in airstrikes on homes or shelters. The UN Secretary-General called the Israeli refusal to allow international journalists into Gaza “unacceptable” and stated: “Journalists in Gaza have been killed at a level unseen in any conflict in modern times… [T]he voices of journalists must be protected and press freedom must be safeguarded.”
WEST BANK AND EAST JERUSALEM
This week, Israeli forces killed 5 Palestinians (1 child) and injured 22 (4 children).
Killed: 766+ (including at least 146 children)
Injured: >6,490
Israeli attacks
On 10/30 in Tulkarm, undercover Israeli agents entered a store and shot and killed a man wanted by the army. Hours later, Israeli forces raided and carried out an airstrike on Tulkarm’s Nur Shams refugee camp, killing 2, displacing 4 families (23 people), and damaging at least 100 structures. Later, they bulldozed the area, damaging water, electricity and telecommunication and destroying the UNRWA office in the camp. Another Palestinian was killed inside his house by a sniper.
On 11/3, Israeli forces near Hebron, shot and killed a 14-year-old boy. His body was taken by Israeli soldiers and later delivered to the Red Crescent at the Efrata settlement.
On 11/5, 8 killed and 4 injured during 4 operations by Israeli forces in Jenin, Tubas, and Tulkarm. These included airstrikes and other lethal war tactics. In Qabatiya, Israeli forces delayed a Red Crescent (PRCS) team trying to evacuate casualties, including a man left bleeding for nearly an hour who later died.
Settler violence
This week, settlers carried out 61 attacks against Palestinians, resulting in 4 injuries, 3 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 290 households (1,697 people, 823 children) in Bedouin and herding communities, 3 this week. For more info on casualties, displacement and settler violence since January 2023, see the OCHA West Bank snapshot.
Since 10/1, OCHA has documented 177 settler incidents related to the olive harvest in 73 West Bank communities, 129 of which caused casualties or property damage. During the same period, 63 Palestinians were injured by Israeli settlers, 13 by Israeli forces, and more than 1,200 mostly olive trees burnt, sawed-off or otherwise vandalized, and many crops and harvesting tools stolen.
Demolitions
This week, Israeli authorities demolished 14 Palestinian-owned structures. Since 10/7/23, Israeli authorities destroyed 1,843 Palestinian structures across the West Bank, displacing 4,644 Palestinians (1,958 children). For more on demolitions and displacement, see the OCHA demolition dashboard.
Approximately 15 families (140 people) in Umm Tuba, East Jerusalem face imminent displacement due to land title claims. While applying for a building permit, 70-year residents discovered their land had been registered under ownership of the Jewish National Fund (JNF) in May 2024 without notifying them. They petitioned the Israeli High Court of Justice, which has scheduled a 12/8 hearing.
On 11/5, Israeli authorities demolished 4 residences in Al Bustan, Silwan (East Jerusalem), displacing 42 people, half of them children. Al Bustan is the target of an Israeli settlement-related plan to demolish dozens of Palestinian homes.
Access to health
Movement restrictions and Israeli military operations have restricted access to health care across the West Bank, particularly in refugee camps and Area C. In response, Health Cluster partners: delivered first-aid training sessions and equipped 600 volunteers with 1st aid kits; distributed emergency trauma supplies to primary health-care centers and provided surgical equipment to Jenin Hospital; and conducted over 36,000 primary care consults in refugee camps and mobile health clinics. MSF is also providing psychological 1st aid to mitigate mental health impacts, especially for children. Mobile health teams, operated by the Palestinian Medical Relief Society and UNFPA, offer services to >30,000 Palestinians across the Hebron, Bethlehem, Qalqilya, and Tulkarm governorates.
The 10/28 Israeli Knesset approval of 2 laws prohibiting Israel from contact with UNRWA and banning the agency will enter into effect in 3 months. This would end UNRWA operations in the West Bank, including East Jerusalem. It would collapse operation of 96 schools (47,000 students), 3 vocational training centers, 43 health centers, and end cash assistance and other support to Palestinians. The legislation would suffocate efforts to ease human suffering in the entire OPT and be an enormous setback to peace efforts.
Israel
Exterminate, Expel, Resettle: Israel’s Endgame in Northern Gaza
Debates over the details of the ‘Generals’ Plan’ distract from the true brutality of Israel’s latest operation — one that drops the veneer of humanitarian considerations and lays the groundwork for settlements. Portside
Israel admits it is depopulating north Gaza, says it will expand offensive to Beit Lahia
Spokesperson Yitzhak Cohen said the Israel army is close to the complete “evacuation” of north Gaza, and Palestinians will not be allowed back. This marks the first official admission of the intent to permanently expel Palestinians. Military operations will expand from Jabalia refugee camp (carpet-bombing the infrastructure, deploying quadcopter drones among civilian population) to Beit Lahia. Mondoweiss
The consequences of Israel’s law of incitement and the painful price of being a “citizen stranger.” New York Times
Israel's Knesset approved a bill to allow the deportation of relatives of terrorists from Israel for up to 20 years. A temporary 5-year provision was also passed, enabling imprisonment of minors under 14 convicted of homicide as part of a terror act. Haaretz
Lebanon
Updated on 11/7 by Lebanese Health Ministry: Since 10/8/23, 3,102 killed by Israeli forces (185 children), 13,819 injured
United States
US security assistance may not be provided to foreign security forces credibly alleged to be involved in gross violations of human rights. Despite indisputable evidence of gross human rights violations committed by Israeli army units, US assistance continues to flow. Other laws are being violated as well: The Arms Export Control Act, the Foreign Assistance Act, Section 620i, and others. Secretary Antony Blinken’s continued insistence that “Israel has a right to defend itself” ignores the fact that US arms have been used to enforce an occupation, violate international humanitarian law, and escalate the conflict, both in the West Bank and Lebanon. New Lines Institute
SOURCES: OCHAOPT, Haaretz, Middle East Eye, Mondoweiss, New Lines Instititute, New Yorker, The New York Times, 972Magazine, Portside