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Aid Group Calls for Safe Passage for Medical Missions as Gaza Hospital Conditions Worsen
"The humanitarian situation... continues to deteriorate rapidly and dramatically," the Palestine Red Crescent Society said.
Nov 13, 2023
As the humanitarian situation at hospitals in northern Gaza continues to deteriorate, the Palestine Red Crescent Society put out a call Monday to the international community, pleading with its Red Cross and Red Crescent partners and United Nations agencies to ensure safe passage for medical missions in Gaza, especially in the north.
The call comes after shelling prevented an attempt by PRCS and the International Committee of the Red Cross to send an evacuation team to al-Quds hospital, which has ceased to function entirely due to lack of fuel.
"The medical team, patients, and their families remain besieged in the hospital with no food, water, or electricity," the group wrote on social media.
PRCS said the convoy had left Khan Younis to reach al-Quds in Tel Al-Hawa, but was forced to turn back due to "relentless bombardment."
In its appeal statement, PRCS said that it was receiving hundreds of calls on the 101 emergency number from people in northern Gaza asking for ambulances to assist the wounded, retrieve the dead, or help them evacuate.
"A lot of phone calls received informed PRCS teams about a huge number of people stuck under the rubble, and tens of injured who need emergency medical care," the group wrote.
PRCS said that the Israeli army prevented ambulances from traveling in the north, and would target anyone who tried to move, meaning people were forced to abandon bodies in the streets.
"The humanitarian situation [in] Gaza and the northern governorates of the strip continues to deteriorate rapidly and dramatically," PRCS said. "Civilians in these areas are left behind, without emergency medical services due to the inability of ambulances to reach the injured."
The PRCS also said that any ambulances would have no hospitals to transport the injured to, since they were all either "besieged or out of service."
In response to the news that the convoy to al-Quds had to turn back, the U.N. Human Rights Office in Palestine also said there was an "urgent need for humanitarian access to northern Gaza and Gaza City." The office called for hospitals and their staff and patients to be protected.
Another struggling hospital in Gaza's north is al-Shifa Hospital, where staff continue to report harrowing conditions amid an ongoing siege by Israeli military.
"We don't have electricity," a surgeon with Doctors Without Borders/Médecins Sans Frontières (MSF) told the humanitarian group via phone on Monday. "There's no water in the hospital. There's no food. People will die in a few hours without functioning ventilators."
Over the weekend, hospital staff had to remove 39 premature babies from incubators due to lack of electricity and place them together in a bed. Since then, three have died, pediatrics head Dr. Mohamed Tabasha toldReuters Monday.
"The situation is very bad, it is inhuman."
"Yesterday I had 39 babies and today they have become 36," Tabasha said. "I cannot say how long they can last. I can lose another two babies today, or in an hour."
Tabasha said that fuel shortages also meant it wasn't possible to maintain the proper temperature for the infants, and that the hospital had no way to sterilize their milk or bottle teats. Because of this, some of the infants had become infected with gastritis, putting them at risk of dehydration.
"Unfortunately, this situation means that we are waiting for them to die one by one," Ahmad Mukhallati, who leads al-Shifa's plastic surgery department, toldMiddle East Eye on Monday.
The hospital is under siege by the Israeli military because it claims that Hamas operates a command center from the hospital and underground, The Associated Press reported. Both Hamas and the hospital staff deny this, and Israel has not supplied any evidence. It is considered a war crime to target a hospital.
The MSF surgeon said that the staff there would only evacuate if they received a guarantee that their patients, including the premature babies, would be evacuated safely first.
Mohammed Zaqout, the director of hospitals in Gaza, told AP that there were around 650 patients, 500 staff, and 2,500 displaced people still inside the hospital.
The MSF surgeon said that Israeli forces had bombed or shot at people who had attempted to leave the hospital, and also prevented hospital staff from bringing the injured in.
"When we sent the ambulance to bring the patients, a few meters away, they attacked the ambulance. There are injured people around the hospital, they are looking for medical care, we can't bring them inside," the surgeon said. "There's also a sniper who attacked patients, they have gunshot wounds, we operated on three of them. The situation is very bad, it is inhuman."
The Israeli military presence also means that staff have not been able to retrieve or bury the bodies of the dead outside the hospital.
Health ministry official Munir al-Bursh choked up while speaking to Al Jazeera Monday as he described seeing stray dogs eat the bodies left in the hospital's courtyard and being unable to stop them.
The European Union's humanitarian aid chief called for "meaningful" pauses in the fighting Monday so that fuel could be delivered to hospitals, as Agence France-Pressereported.
"First of all, they have to be announced well in advance of the implementation so organizations can prepare to exploit them. Second, they have to be clearly defined time-wise," Janez Lenarcic, European commissioner for crisis management, said during a meeting in Brussels.
So far, at least 1,200 Israelis and more than 11,000 Palestinians in Gaza have been killed since Hamas' October 7 attack on Israel and Israel's retaliatory bombardment and invasion of Gaza. Gaza's Health Ministry said that 32 patients had died at al-Shifa since it lost fuel on Saturday, according to AP.
On Sunday, World Health Organization Director-General Tedros Adhanom Ghebreyesus put out a call for an immediate cease-fire in response to conditions at al-Shifa.
"The world cannot stand silent while hospitals, which should be safe havens, are transformed into scenes of death, devastation, and despair," Tedros said on social media.
In response to growing calls for a cease-fire from humanitarian organizations and civil society, both Israeli Prime Minister Benjamin Netanhayu and U.S. President Joe Biden have refused.
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Human Rights Watch Sounds Alarm as Israeli Forces Close In On Gaza's Largest Hospital
"Hospitals must always be protected. No area is a free-fire zone," said one HRW director. "World leaders should urgently act to prevent further mass atrocities."
Nov 09, 2023
As Israeli forces moved toward the largest hospital in the Gaza Strip on Thursday, a leading human rights group expressed concern about the patients, medical staff, and sheltering civilians there, along with Israel's recent calls to evacuate the facility.
The Israeli bombardment of Gaza, launched in response to a Hamas-led attack on southern Israel on October 7, has killed more than 10,800 Palestinians, including over 4,400 children, and displaced an estimated 70% of the strip's 2.3 million residents.
Israel—which is now also conducting ground operations—has bombed homes, schools, religious buildings, medical facilities, and even an ambulance convoy outside Gaza City's al-Shifa Hospital, where an estimated 50,000 to 60,000 people are sheltering.
As Israeli troops neared the hospital on Thursday, Human Rights Watch (HRW) said on social media that "with ongoing strikes and fighting nearby, we are gravely concerned about the well-being of thousands of civilians there, many children among them, seeking medical care and shelter, including people on life support, those who lost limbs in air strikes, and burn victims."
"Videos from inside al-Shifa's compound, verified by HRW, show hundreds of people in a courtyard next to the [emergency room], including sheltering civilians, medics tending to patients, emergency workers collecting dead bodies, and journalists. Satellite imagery shows many tents there," the group said. "Videos and photos taken in recent days show civilians and emergency workers bringing hundreds of injured and dead people to the hospital day and night, by ambulance, by car, on foot, and by donkey cart. People regularly walk in and out of the hospital's main entrance."
The Israel Defense Forces (IDF) has alleged that Hamas' main base of operations is under hospital. Taking credit for the ambulance attack on November 3, the military said that "a Hamas terrorist cell was identified using an ambulance. In response, an IDF aircraft struck and neutralized the Hamas terrorists, who were operating within the ambulance. We emphasize that this area in Gaza is a war zone. Civilians are repeatedly called upon to evacuate southward for their own safety."
HRW highlighted Thursday that Israel has not made public any proof to support it claims about the ambulance attack—which critics have pointed to as yet another war crime in what experts around the world have called a "genocidal" assault of Gaza.
"Al-Shifa and the surrounding area continue to come under fire," HRW noted. "Hospitals have special protection under the laws of war, which they only lose if they are being used to commit 'acts harmful to the enemy' and after due warning. Evacuation of hospital patients and staff should only be a last resort."
"Israel's military has called for the evacuation of al-Shifa Hospital, and said on November 8 that 'time is running out' for civilians to evacuate Gaza's north via Salah al-Din Road, which Israel's military says it keeps 'open' for a few hours at a time," the group continued, sharing a map of the region that shows fires along the evacuation route.
HRW declared that "Israel's evacuation orders raise grave concerns. Warring parties should issue effective warnings when conditions permit. But calls suggesting all civilian structures are targets or alerting civilians to flee without a safe passage or safe place to go does not suffice."
"Civilians who remain in place after an evacuation warning—including those who can't leave, fear moving, or don't want to be displaced—don't lose their protections as civilians under the laws of war. No area is a free-fire zone," HRW stressed, using a term popularized by the "shoot anything that moves" approach of U.S. soldiers during the Vietnam War. "All parties to the conflict have an obligation to take constant care to protect civilians in their military operations, and take all feasible precautions to protect them from the effects of attack."
"World leaders should call on Israel to protect civilians and civilian infrastructure and to not carry out unlawful attacks," the organization concluded. "They should urgently act to prevent further mass atrocities."
Al Jazeera reported Thursday evening that a Palestinian Health Ministry spokesperson "says an Israeli attack hit a car in the yard of al-Shifa Hospital" and "exact casualties are not yet known."
While some political leaders around the world have joined growing global demands for a cease-fire, U.S. President Joe Biden—who recently asked Congress for $14.3 billion to support Israel's war effort, on top of the $3.8 billion in military aid the nation already gets annually—told reporters on Thursday that there is "no possibility" of a cease-fire.
That came after the White House said earlier Thursday that Israel has agreed to daily four-hour pauses for civilians to flee northern Gaza—though, as Reuters later reported, "there was no sign of a let-up in the fighting that has killed thousands and laid waste to the seaside enclave."
While staff at al-Shifa Hospital continues to treat patients despite dwindling supplies, some Gaza facilities have had to scale back services or fully shut down over the past month—leading to warnings that the strip's healthcare system is on the brink of collapse.
The Palestine Red Crescent Society announced on social media Thursday that "a PRCS paramedic volunteer was injured and two ambulances went out of service during the occupation forces' targeting of the area of the al-Awda Hospital in northern Gaza."
The PRCS also runs al-Quds Hospital in Gaza City, which has had to cease most operations this week "to ration fuel use and ensure a minimum level of services in the coming days," according to Al Jazeera.
"We're talking about shelling about 15 metesr [16 yards] from the hospital building," PRCS spokesperson Nebal Farsakh told the outlet Wednesday. "Most of the buildings around [the] hospital have been almost completely destroyed. The bombings are getting closer and closer to the hospital, and we fear a direct hit to the hospital."
"We have about 500 patients inside the hospital. We have 15 patients in the [intensive care unit]," she added. "They are wounded and on respirators. We have newborns in incubators. We have 14,000 displaced people, the majority of whom are women and children."
Mohammed Abu Msbeh of PRCS warned Thursday that al-Quds Hospital only has around 24 hours of fuel for its generator, and if it is not replenished, there will be "a total shutdown of all hospital services."
The World Health Organization said Thursday that lack of fuel in Gaza has also "led to the shutting down of desalination plants, significantly increasing the risk of bacterial infections like diarrhea," and "disrupted all solid waste collection, creating an environment conducive to the rapid and widespread proliferation of insects [and] rodents that can carry and transit diseases."
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WHO Chief Calls Report of Israeli Forces Threatening Gaza Hospital 'Deeply Concerning'
"We reiterate—it's impossible to evacuate hospitals full of patients without endangering their lives," said Tedros Adhanom Ghebreyesus.
Oct 29, 2023
The World Health Organization Director-General Tedros Adhanom Ghebreyesus on Sunday expressed alarm after a Palestinian humanitarian group announced that Israeli forces have ordered the immediate evacuation of Al-Quds Hospital in the Gaza Strip.
The report from Palestine Red Crescent Society (PRCS) "is deeply concerning," the WHO chief said on social media. "We reiterate it's impossible to evacuate hospitals full of patients without endangering their lives. Under international humanitarian law, healthcare must always be protected."
The humanitarian group explained in a statement Sunday that "two phone calls were received, with a clear and direct threat, that the hospital must be evacuated at once, otherwise PRCS holds full responsibility for the lives of everyone inside the hospital."
PRCS highlighted that along with its staff, the hospital "has hundreds of wounded and patients receiving medical care," including in the intensive care unit and children in incubators, along with approximately 12,000 internally displaced civilians sheltering there.
The group called for International Committee of the Red Cross (ICRC) intervention to ensure the protection of civilians and PRCS' teams and facilities in accordance with international humanitarian law, and for the global community, including the United Nations system, "to act immediately" to prevent the targeting of all Gaza hospitals and "a humanitarian catastrophe from unfolding."
Israel launched a three-week bombardment of Gaza in response to a Hamas-led attack that killed 1,400 Israelis—with about 200 others taken hostage—and has now moved to a "second stage" of what some legal scholars are calling genocide, stepping up ground operations in the Palestinian territory as people around the world demand a cease-fire.
Israel's war on Hamas-controlled Gaza—which has been under an Israeli blockade for 16 years—has killed over 8,000 people, including more than 3,300 children, displaced the majority of the 2.3 million population, knocked out internet and communication services, and devastated civilian infrastructure, including homes, schools, religious buildings, and medical facilitates.
Israeli forces—backed by billions in U.S. military support—previously threatened the Al-Quds Hospital and demanded an evacuation earlier this month, according to PRCS. As BBC reported at the time:
A doctors' group, Physicians for Human Rights Israel, said it filed a petition to Israel's Supreme Court warning that Al-Quds Hospital could not be evacuated.
"In its response, the state announced that it would not attack the hospital for the time being," the group said, as it warned against harming civilians during combat, violating international law, and damaging medical services.
Dr. Ghassan Abu-Sittah, who recently left his London home to treat patients at Al-Shifa Hospital in Gaza, toldDemocracy in Exile this week that "basically, there's just no possibility of evacuating any of the hospitals. First, it's a war crime to even target hospitals, and threatening to do it, to evacuate people, does not make it less than a crime. It's just not possible. Shifa Hospital has around 1,700 critically wounded patients. What are we going to do with them? Where are we going to take them?"
"We're looking at days for the hospital to run out of fuel. If it does, then effectively the hospital becomes a mass grave," the surgeon added. "We have 150 patients ventilated. You have a neonatal intensive care unit. You have anesthetic machines that can no longer work to do the surgeries. Without electricity, this is just a mass grave."
ICRC president Mirjana Spoljaric said in a statement Saturday that "I am shocked by the intolerable level of human suffering and urge the parties to the conflict to de-escalate now. The tragic loss of so many civilian lives is deplorable. It is unacceptable that civilians have no safe place to go in Gaza amid the massive bombardments, and with a military siege in place there is also no adequate humanitarian response currently possible. This is a catastrophic failing that the world must not tolerate."
"In the face of this dramatic armed conflict, what is critically needed now is adherence to international humanitarian law by all parties," Spoljaric continued. "An unhindered flow of humanitarian relief and personnel into Gaza is vital, as is the capacity to get basic services on their feet again. Sustained humanitarian access is imperative, and aid workers must be able to operate in a safe environment."
Dr. Christos Christou, international president of Doctors Without Borders or Médecins Sans Frontières, similarly stressed in a statement that that "helpless people are being subjected to horrific bombing."
"Families have nowhere to run or to hide, as hell is unleashed on them," he said. "Water, food, fuel, medical supplies, and humanitarian aid in Gaza need to be urgently restored. We need a cease-fire now."
"We are ready to increase our aid capacity in Gaza," Christou added. "We have teams on standby ready to send medical supplies and to enter Gaza to support the emergency medical response, as soon as the situation allows it. But as long as the bombing continues with the current intensity, any effort to increase medical aid will inevitably fall short."
This post has been updated with comment from Dr. Ghassan Abu-Sittah.
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