Gaza health system collapses amid nonstop Israeli bombardment

With Israel’s resumption of the assault on Gaza with “maximum force,” the genocidal campaign against the Palestinians is driving a majority of the population out of their homes and into shelters and refugee camps in the south.

In the course of the last few days, hundreds more innocent civilians, the majority women and children, have been killed in the incessant bombing, which, as one commentator on the ground noted, turns “the sky grey and the ground red.”

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In northern Gaza, Kamal Adwan Hospital has been surrounded by the Israel Defense Forces (IDF), trapping hundreds of people who have sought treatment or refuge in the buildings and adjacent compounds. On Tuesday, the health ministry told reporters that more than 100 people had been killed close to the facility. The overnight bombing in Beit Lahiya around the hospital sent terror into the hearts of the thousands sheltering there. No one can grow accustomed to such violence, both in anticipation of the next attack and the subsequent carnage.

Munir al-Bursh, director-general of the health ministry in Gaza, speaking from inside the hospital, said, “The Israeli occupation forces have laid siege to the hospital from all sides. We are targeted by gunfire and artillery shells. We fear a massacre inside Kamal Adwan Hospital, as happened in Al-Shifa and Indonesian hospitals.” Anyone venturing outside is shot on sight.

Of the 24 hospitals that existed north of the Wadi Gaza before October 7, only three are functioning, and only in the most rudimentary capacity, said the World Health Organization (WHO) during the pause in the conflict last week. Without fuel, water or food, the situation for the remaining patients and those providing care is bleak.

Meanwhile, in the southern Gaza district of Khan Younis, home to approximately 170,000 Gazans, Israeli troops have crossed into the heart of the city. Leaflets directed at residents of six districts of Khan Younis, amounting to a quarter of the population, are warning them to shelter inside or at the hospitals. “Don’t go out,” it reads. “Going out is dangerous. You have been warned.”

A team of physicians with Doctors Without Borders (Medecins Sans Frontieres, or MSF) working at the Nasser Medical Complex located in Khan Younis told Al Jazeera that the number of displaced people arriving at their facility was increasing, necessitating building shelters for them in the car parks, with many simply sleeping on the ground in the open. The inured were also arriving in droves.

Chris Hook, the MSF medical coordinator, said, “The hospital has been receiving multiple severely injured patients nearly every hour. With the situation as it is in the hospital—there is no available space anymore. It really is a terrible situation. Everyone is genuinely worried about what will come next.”

Dr. Richard Peeperkorn, WHO representative in Gaza, told reporters by video link, “The situation is getting worse by the hour. There’s intensified bombing going all around, including here in the southern areas, Khan Younis and even in Rafah.” After explaining how concerned he was about the vulnerability of the densely populated enclave, as people escaped to the south to avoid the shelling, he dejectedly noted, “We will witness [here] the same pattern of what happened in the north. That cannot happen. … I want to make this point very clear, that we are looking at an increasing humanitarian disaster.”

Already more than 80 percent of Gaza’s population has fled to the south, which means that the population density in that region is the highest across any urban center. Rafah, which normally has a population of 280,000, is hosting close to one-half million people.

Dr. Mike Ryan, executive director of WHO’s health emergencies program, recently explained, “There are now almost two million people internally displaced, so many people are living within shelters, living within family homes, three, four or five families now per apartment, living in other types of shelter, mosques and schools, community halls. Everywhere is packed. The weather has deteriorated. The rain is falling. Children are getting colder. Nutritional status is dropping rapidly … all the conditions are there for a deterioration of the situation.”

Since hostilities commenced on October 7, close to 500 healthcare facilities have been targeted by the IDF. The experiences at Al-Shifa and Indonesian hospitals only confirm that even these “privileged” facilities are not safe for those seeking shelter and protection. Indeed, the decimation of the entire healthcare system is vital to Israel’s plan for genocide and ethnic cleansing.

One must understand that Gaza’s healthcare system was already teetering on the brink before the genocidal campaign. It had only 36 hospitals with a total capacity of 3,412 beds, which were treating the 2.3 million people that lived there. While the need for access to emergency health services has jumped by several orders of magnitude, the overall bed capacity that remains has plummeted to 1,500. Only 15 hospitls are now functioning, partially, almost all (12) in the south, and all are completely overwhelmed.

At the World Health Organization’s (WHO) press briefing on November 29, much of the discussion was on the state of healthcare and the health crisis in Gaza. Officials warned several times that the singular most important task in the crisis was “to preserve the existing capacity in the health system in Gaza.”

Speaking to this, Dr. Ryan said, “The one thing I will say is that if we use [immunization rates] as a marker, and this is often used as a marker of the effectiveness of health systems, the immunization rates in Gaza prior to the conflict were some of the highest in the world, which means regardless of the government situation, the reality is that primary prevention and basic care to individuals was being carried out beforehand; and in fact, we’re in many ways relying on that residual protection that exists for that population.”

The panel warned that these conditions will drive outbreaks of serious epidemics that for children, elderly people, malnourished people and pregnant women can lead to severe disease if not death without immediate access to medical facilities, where close monitoring and intravenous fluids can be administered.

Dr. Ryan, in response to a query, said that besides the rise in infectious and diarrheal diseases, the WHO was seeing an uptick in the signal for Acute Jaundice Syndrome—caused by infectious pathogens that attack the liver (acute viral hepatitis E, A, B and C)—common in densely populated refugee camps without adequate provisions or general hygiene standards.

Dr. Peeperkorn, who had attended the press briefing before leaving for Gaza, listed 111,000 cases of acute respiratory infections, 12,000 cases of scabies, and 11,000 cases of lice. Among those under the age of five there were 36,000 cases of diarrhea, and for those five and over, 40,000. More than 24,000 people had developed skin rashes. There were also 1,100 people with jaundice and 2,500 with chickenpox. There were 111 cases of meningitis, of which 74 were in the last two weeks. Meanwhile, at one of their UNRWA schools that was housing 19,000 people, there were only eight functioning toilets.

According to Gaza health officials, as of December 5, the death toll was, conservatively, 16,248 Palestinians confirmed killed. Of these, 7,112 were children and 4,885 women, accounting for nearly three-quarters of all killed. More than 43,616 wee wounded. Some 7,600 remained unaccounted for.

Al-Bursh, speaking with the Palestinian news agency Shehab, said, “The Israeli occupation wants to kill hope, it wants to kill our youths, our children and women. The Israeli forces do not differentiate between a child and the elderly.”

At the time of the temporary pause, according to Salama Maarouf, head of the media office, more than 40,000 tons of explosives (equivalent to three nuclear bombs the size of the bomb used on Hiroshima) had been dropped on Gazans, who live in one of the most densely populated regions of the world.

The destruction wrought on northern Gaza, in particular, is comparable to the Allied bombing of major German cities during World War II.

Maarouf noted, “The bombs recently used by the occupation (forces) have never been used before, and hundreds of martyrs are buried in the places where they died. The devastation by the occupation reflects its intent to make Gaza uninhabitable.”

As of last week, the IDF boasted that it had fired over 90,000 shells on Gaza, or around 1,800 per day. A recent report from WION stated that since the commencement of hostilities, the United States had given Israel 15,000 bombs, including 100 2,000-pound bunker busters, and 57,000 artillery shells. The bunker busters can penetrate more than six feet of reinforced concrete.

The purpose of using such armaments in the manner they are being deployed is not to flush out Hamas, but to eradicate the entire population by first destroying the social infrastructure of Gaza and then overseeing the slow death brought on by starvation, dehydration and infections from contamination of injuries. This is all to ensure that each and every Palestinian meets a violent cruel death.

The comments by Giora Eiland, the former head of the Israeli National Security Council, supporting the destruction of hospital systems because “severe epidemics in the south of the Gaza Strip will bring victory closer,” are not simply the ravings of a sick mind, but rather a pre-planned strategy that is now being executed.

Washington’s verbal cautions that Israel do more to limit civilian deaths are belied by its deeds--continuing to supply Israel with weapons of mass destruction and support its genocidal actions.