‘I am terrified of losing my daughter’
‘I am terrified of losing my daughter’
As people of Gaza face catastrophic hunger, WHO, with support from European Union, is ensuring that nutrition stabilization centers are equipped to treat cases of severe acute malnutrition.
GAZA, OCCUPIED PALESTINIAN TERRITORY, 19 APRIL 2024 -“My daughter is my life; she was like a flower. Now I can see her ribs and her spine. She can’t even sit, I have to carry her to the toilet,” says Nesma Ayyad, mother of seven-year-old Jana.
Nesma has been alone in Gaza since the war began in October. Her husband had left the Strip for medical treatment and was unable to return home as borders closed and the conflict worsened. With their family home destroyed during a bombing, she has struggled to provide for her four children and keep them safe.
Jana, whom she describes as an active young girl full of life, began suffering from stomach aches, diarrhea, and weight loss due to dire shortages of food and safe water. By February, her condition had deteriorated to the point where she was admitted to Kamal Adwan Hospital in north Gaza due to complications arising from dehydration and severe acute malnutrition.
"The doctor told me she needs nutritious food that I could not provide. I am terrified of losing my Jana,” says Nesma.
Jana’s story is tragically all too familiar. With famine looming, more than half of all Palestinians in Gaza – 1.1 million people – and are facing catastrophic hunger. Twenty-eight patients have reportedly died due to malnutrition, and many are fighting for their life.
Since the onset of hostilities, agricultural and agrifood production in Gaza has collapsed. Currently, about 81% of Gaza households lack access to clean and safe water, with internally displaced persons among the most affected.
Gaza has been reduced to rubble and urgently requires the revival of its local food production to help prevent famine and malnutrition – and this needs the entry of food production and agricultural inputs. With traditional food sources disrupted, humanitarian assistance has become the primary means of survival. To address the population's dire needs, an immediate humanitarian ceasefire, opening of all border crossings, and sustained aid access are crucial, along with the availability of basic goods from the private sector.
WHO, together with its partners, is racing against time to save lives.
Three WHO-supported nutrition stabilization centers are currently operational in hospitals and medical centers in Gaza - two in the south and one in the north of the Strip. With crucial support from the European Union, WHO has supplied these centers with medical supplies for the treatment of up to 1250 children with severe acute malnutrition. Additionally, WHO has trained health workers to identify and treat malnutrition with complications.
Jana’s condition is still critical. After receiving initial treatment at the nutrition stabilization center at Kamal Adwan, she has been transferred by WHO with assistance from CADUS, an international emergency team, to a field hospital in Rafah. She is currently awaiting approval for medical evacuation outside Gaza to continue her treatment.
"I am truly happy that she’s finally going to be able to receive treatment abroad. I hope that day comes soon, says Nesma. “I hope my child comes back healthy as she was before.”
Famine in Gaza is imminent, with immediate and long-term health consequences
18 March 2024, The latest analysis from the Integrated Food Security Phase Classification (IPC) partnership released today warns that the situation in Gaza is catastrophic, with northern Gaza facing imminent famine and the rest of the Strip at risk as well.
"The IPC announcement reflects the dire situation that the people of Gaza are facing," said WHO Director-General Dr Tedros Adhanom Ghebreyesus. "Before this crisis, there was enough food in Gaza to feed the population. Malnutrition was a rare occurrence. Now, people are dying, and many more are sick. Over a million people are expected to face catastrophic hunger unless significantly more food is allowed to enter Gaza."
Before the recent months’ hostilities, 0.8% of children under 5 years of age were acutely malnourished. Today’s report shows that as of February in the northern governorates, that figure is between 12.4 and 16.5%.
Without a significant and immediate increase in deliveries of food, water and other essential supplies, conditions will continue deteriorating. Virtually all households are already skipping meals every day and adults are reducing their meals so that children can eat.
The current situation will have long-term effects on the lives and health of thousands. Right now, children are dying from the combined effects of malnutrition and disease. Malnutrition makes people more vulnerable to getting severely ill, experiencing slow recovery, or dying when they are infected with a disease. The long-term effects of malnutrition, low consumption of nutrient-rich foods, repeated infections, and lack of hygiene and sanitation services slow children’s overall growth. This compromises the health and well-being of an entire future generation.
WHO and partners have been carrying out high-risk missions to deliver medicines, fuel and food for health workers and their patients, but our requests to deliver supplies are often blocked or refused. Damaged roads and continuous fighting, including in and close to hospitals, mean deliveries are few and slow.
The IPC report confirms what we, our UN partners and nongovernmental organizations (NGOs) have been witnessing and reporting for months. When our missions reach hospitals, we meet exhausted and hungry health workers who ask us for food and water. We see patients trying to recover from life-saving surgeries and losses of limbs, or sick with cancer or diabetes, mothers who have just given birth, or newborn babies, all suffering from hunger and the diseases that stalk it.
WHO, as a partner of the Nutrition Cluster, is currently supporting a nutrition stabilization center in Rafah to treat children with severe acute malnutrition with medical complications, who are at the highest risk of imminent death if not urgently treated. We are supporting the establishment of two additional centres: one in the north of Gaza at Kamal Adwan hospital and one at the International Medical Corps field hospital in Rafah. WHO is supporting the pediatric wards of Al-Aqsa and Al-Najjar hospitals through the provision of nutrition supplies and medicines as well as training of medical personnel, and the promotion of appropriate infant and young child feeding practices, including breastfeeding.
WHO has trained health workers on how to recognize and treat malnutrition with complications. WHO is supporting hospitals and the centers with medical supplies for the children being treated.
Further nutrition and stabilization centres need to be added in all key hospitals in Gaza. Communities themselves will need the support to scale up the management of malnutrition locally.
WHO and other UN partners again ask Israel to open more crossings and accelerate the entry and delivery of water, food, medical supplies and other humanitarian aid into and within Gaza. As the occupying force, it is their responsibility under international law to allow for the passage of supplies including food. Recent efforts to deliver by air and sea are welcome, but only the expansion of land-crossings will enable large-scale deliveries to prevent famine. The time to act is now.
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Note to editors
The Integrated Food Security Phase Classification (IPC) is a multi-partner initiative for improving food security and nutrition analysis and decision-making. By using the IPC classification and analytical approach, governments, UN Agencies, NGOs, civil society and other relevant actors, work together to determine the severity and magnitude of acute and chronic food insecurity, and acute malnutrition situations in a country, according to internationally recognized standards.
As a member of the IPC partnership, WHO provided technical expertise and information on the health situation for this evaluation. The conflict is posing extreme limitations to the ability to deliver life-saving health assistance to the population. In February 2024, attacks against health-care facilities, infrastructures and services continued, resulting in 58% of the hospitals not functioning in Gaza, especially in the Northern governorates (75% of the hospitals not functioning). According to the Health Cluster, as of 5 March 2024, only 2 hospitals and no Primary Health Care Centres were fully functioning. Acute respiratory infections and diarrheal diseases are rampant among children under five, exposing them to high-risk nutritional deterioration.
The full recommendations from the IPC
Famine can be halted—both in the immediate term and it requires urgent and proactive measures from parties to the conflict and the international community. They must immediately curb the rapidly escalating hunger crisis in the Gaza Strip, garner political support to put an end to the hostilities, mobilize necessary resources and ensure the safe delivery of humanitarian aid to the people of Gaza.
Overall recommendations
- Restore humanitarian access to the entire Gaza Strip.
- Stop the fast-paced deterioration of the food security, health and nutrition situation leading to excess mortality through: the restoration of health, nutrition, and WASH services and the protection of civilians; and the provision of safe, nutritious, and sufficient food to all the population in need.
- The sustained supply of sufficient aid commodities, including but not limited to food, medicines, specialist nutrition products, fuel, and other necessities should be allowed to enter and move throughout the entire Gaza Strip by road. Traffic of commercial goods should also be fully resumed to meet the volume of commodities required.
Six months of war leave Al-Shifa hospital in ruins, WHO mission reports
6 April 2024 - A WHO-led multi-agency mission accessed Al-Shifa Hospital in north Gaza on 5 April to conduct a preliminary assessment of the extent of destruction and identify needs to guide future efforts to restore the facility. The highly complex mission was conducted in close partnership with the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), United Nations Mine Action Service (UNMAS), United Nations Department for Safety and Security (UNDSS), and in collaboration with the acting Hospital Director.
Prior to the mission, WHO’s efforts to reach the hospital to medically evacuate patients and staff and conduct an assessment were denied, delayed or impeded 6 times between 25 March and 1 April.
Like the majority of the north, Al-Shifa Hospital – once the largest and most important referral hospital in Gaza – is now an empty shell after the latest siege. No patients remain at the facility. Most of the buildings are extensively damaged or destroyed and the majority of equipment is unusable or reduced to ashes. The WHO team said that the scale of devastation has left the facility completely non-functional, further reducing access to life-saving health care in Gaza. Restoring even minimal functionality in the short term seems implausible and will require substantial efforts to assess and clear the grounds for unexploded ordnance to ensure safety and accessibility for partners to bring in equipment and supplies.
The hospital’s emergency department, surgical, and maternity ward buildings are extensively damaged due to explosives and fire. The western wall of the emergency department and northern wall of the neonatal intensive care department (NICU) have been torn down. At least 115 beds in what once was the emergency department have been burnt and 14 incubators in the NICU destroyed, among other assets. An in-depth assessment by a team of engineers is needed to determine if these buildings are safe for future use.
The hospital's oxygen plant has been destroyed, leaving Kamal Adwan Hospital as the only source of medical oxygen production in the north. Further comprehensive assessment is essential to evaluate the functionality of vital equipment such as CT scanners, ventilators, sterilization devices, and surgical equipment, including surgical tools and anaesthesia devices. The current situation has left north Gaza without CT scanning capabilities and significantly diminished laboratory capacity, severely compromising effective diagnosis, which will increase avoidable deaths.
Numerous shallow graves have been dug just outside the emergency department, and the administrative and surgical buildings. In the same area, many dead bodies were partially buried with their limbs visible. During the visit, WHO staff witnessed at least 5 bodies lying partially covered on the ground, exposed to the heat. The team reported a pungent smell of decomposing bodies engulfing the hospital compound. Safeguarding dignity, even in death, is an indispensable act of humanity.
According to the acting Hospital Director, patients were held in abysmal conditions during the siege. They endured severe lack of food, water, health care, hygiene and sanitation, and were forced to relocate between buildings at gun point. At least 20 patients have reportedly died due to the lack of access to care and limited movement authorized for health personnel.
Despite deconfliction, yesterday’s mission faced significant delays at the military checkpoint en route to Al-Shifa Hospital. On the same day, another WHO-led mission bound for Al-Awda and Kamal Adwan hospitals in northern Gaza – to deliver medical supplies, fuel, deploy emergency medical teams, and support referral of critical patients – encountered unnecessary delays, including the detention of a supply truck driver who was part of the convoy. He was detained for over an hour at a separate location, out of view of the mission team. Eventually this mission was aborted due to safety concerns as the delays left insufficient time for safe completion and return before nightfall.
Between mid-October and end March, over half of all WHO missions have been denied, delayed, impeded or postponed. As health needs soar, the lack of a functional deconfliction system is a major obstacle in delivering humanitarian aid – including medical supplies, fuel, food and water to hospitals – anywhere close to the scale needed.
Six months – half a year – into the war, the destruction of Al-Shifa Hospital and Nasser Medical Complex has broken the backbone of the already ailing health system. Prior to the latest siege, WHO and partners had supported the revival of basic services at Al-Shifa Hospital, and Nasser Medical Complex was regularly supplied to continue serving as the main hospital in south Gaza. These efforts are now lost.
As WHO marks World Health Day tomorrow, under the theme “My health, my right”, this basic right is utterly out of reach for the civilians of Gaza. Access to health care in Gaza has become totally inadequate, and the ability of WHO and partners to help is constantly disrupted and impeded.
Of the 36 main hospitals that used to serve over 2 million Gazans, only 10 remain somewhat functional, with severe limitations on the types of services they can deliver. The proposed military incursion into Rafah can only result in further diminution of access to health care and would have unimaginable health consequences. The systematic dismantling of health care must end.
WHO repeats its calls for the protection of patients, health and humanitarian workers, health infrastructure, and civilians. Hospitals must not be militarized, misused, or attacked. WHO demands an effective, transparent and workable deconfliction mechanism, and safety guarantees, ensuring that the movement of aid within Gaza, including through checkpoints, is safe, predictable and expedited. WHO calls for additional land crossings to allow access into and across Gaza more safely and directly.
As famine looms, disease outbreaks spread, and traumatic injuries increase, WHO calls for unimpeded access of humanitarian aid into and across the Gaza Strip, and a lasting ceasefire.
France and the UN join hands to strengthen maternal and neonatal health services in the Gaza Strip and the West Bank
In the framework of France’s efforts to support the civilian population in Gaza and more particularly women and children, who are the first victims of this conflict.
EAST JERUSALEM, 16 April 2024 – France, through the French Development Agency (AFD), UNICEF, UNFPA and WHO will continue supporting the health system in the State of Palestine, with a particular focus on addressing the acute crisis in the Gaza Strip caused by the ongoing hostilities. The agreement, signed today in the Prime Minister Office in Ramallah by the General Consul of France in Jerusalem, M. Nicolas Kassianides, AFD Country Director, Mrs. Véronique Sauvat, and the UNICEF Special Representative to the State of Palestine, Ms. Jean Gough, increases the support already received from France, through AFD, of € 9 million, for a total of € 19,9 million.
This is a concrete translation of the 100 million euros support that was announced by France during the Paris humanitarian conference on 9 November 2023, convened by the French President. The delivery of health services, in particular to women and children who are the first victims of the conflict, is at the core of this effort. Indeed, the ongoing escalation of hostilities in the Gaza Strip continues to have severe health consequences, especially for women and children. Access to healthcare remains disrupted, leading to malnutrition among children. Women face challenges in accessing maternal health services and limited access to food, medicines, water and sanitation services amplify health risks. This programme is a continuation of an existing initiative, supported by AFD, which focused on restoring and strengthening sexual, reproductive, maternal, neonatal, children and adolescents' health (SRMNCH) services, while also strengthening emergency response mechanisms, providing maternity equipment and replenishing stocks of medicines and supplies vital to the operation of health centers, particularly in the Gaza Strip. Additionally, the programme focuses on further supporting and strengthening health centers and reproductive, maternal, neonatal, and infant (RMNI) services by supporting healthcare staff including midwives. The programme aims at reducing gender inequalities in health care provision and addressing specific needs of women and girls in accessing services, particularly in crisis and post-crisis contexts. While most activities will support children in the Gaza Strip, the West Bank will also be included in the programme to address the consequences of the crisis in the Gaza Strip.
This collaboration aims at improving access to health services for the population reaching more than 145,000 people both in the context of the crisis and in the long-term striving to deliver on transformative changes for the benefit of the most vulnerable groups and particularly now where the population faces unprecedented and unparalleled challenges.
In the framework of the previous phase of this project, 504,700 women (108,500) and children (396,200) in the Gaza Strip were provided with improved access to gender sensitive SRMNCH services, through the renovation of six hospitals and primary centers in Khan Younes and health training of around 7.000 persons. In the framework of the conflict, the emergency component of the project was used to provide medical supplies to treat 1,600 trauma patients, postpartum kits for around 600 women, hygiene kits to 1,000 pregnant women, 26 incubators and 30 oxygen pumps.
About AFD
The Agence Française de Développement (AFD) Group is a public entity which finances, supports and expedites transitions toward a more just and sustainable world. As a French overseas aid platform for sustainable development and investment, we and our partners create shared solutions, with and for the people of the global South.
Active in more than 4,000 projects in the French overseas departments and some 115 countries, our teams strive to promote health, education and gender equality, and are working to protect our common resources — peace, education, health, biodiversity and a stable climate.
It’s our way of honoring the commitment France and the French people have made to fulfill the Sustainable Development Goals. Towards a world in common.
About WHO
Dedicated to the well-being of all people and guided by science, the World Health Organization leads and champions global efforts to give everyone, everywhere an equal chance at a safe and healthy life. We are the UN agency for health that connects nations, partners and people on the front lines in 150+ locations – leading the world’s response to health emergencies, preventing disease, addressing the root causes of health issues and expanding access to medicines and health care. Our mission is to promote health, keep the world safe and serve the vulnerable. www.who.int
About UNFPA
UNFPA is the United Nations sexual and reproductive health agency. Our mission is to deliver a world where every pregnancy is wanted, every childbirth is safe and every young person's potential is fulfilled. Our goal is ending unmet need for family planning, preventable maternal death, and gender-based violence and harmful practices including child marriage and female genital mutilation by 2030.
About UNICEF
UNICEF promotes the rights and wellbeing of every child, in everything we do. Together with our partners, we work in 190 countries and territories to translate that commitment into practical action, focusing special effort on reaching the most vulnerable and excluded children, to the benefit of all children, everywhere.
WHO and Dubai’s International Humanitarian City to send life-saving health supplies to Gaza Strip
21 February, Dubai, United Arab Emirates – Amid a worsening health emergency, the World Health Organization (WHO) logistics hub in Dubai, in partnership with Dubai’s International Humanitarian City, will be delivering critical health supplies worth over US$ 1.7 million to the Gaza Strip.
In total, 80 metric tonnes of life-saving medicines, including insulin, are being delivered through a temporary air bridge between the United Arab Emirates and Egypt. Several air rotations are anticipated to deliver the supplies, which will support about 2 million people in the Gaza Strip.
“WHO’s logistics hub in Dubai provides a lifeline to countries affected by health emergencies across the WHO Eastern Mediterranean Region and beyond. As the health crisis in the Gaza Strip unfolds and as hostilities in Rafah escalate, these medicines are critical for people whose access to medical care has been severely restricted owing to shortages facing the health system as a whole,” said Dr Hanan Balkhy, WHO Regional Director for the Eastern Mediterranean.
“WHO is grateful for the support of Dubai’s International Humanitarian City, the Government of Dubai and the Government of the United Arab Emirates to deliver life-saving supplies to the world’s most vulnerable populations in their greatest time of need,” Dr Balkhy added.
Rafah’s population has increased five-fold to 1.5 million as it now houses half of Gaza’s displaced people. Still more families continue to arrive in Rafah as violence intensifies in the southern Gaza Strip.
“Since 2018, the logistics hub at Dubai’s IHC has been at the forefront of WHO’s humanitarian response, reaching over 100 million people with humanitarian health supplies. Our coordination for the response to the humanitarian emergency in Gaza began in October. Today, we continue to closely coordinate with WHO and all our partners to address the pressing needs for humanitarian health assistance in Gaza, with the ongoing airbridge and at least four additional airlifts,” Giuseppe Saba, CEO of Dubai’s International Humanitarian City said.
Through its logistics hub in Dubai, WHO has delivered enough medicines to reach over 1 million people in Gaza since October 2023. Yet the needs continue to grow, and the delivery of supplies continues to be impeded by denials of access for humanitarian aid.
WHO has persevered to deliver vital medical supplies and to support health services in Gaza, navigating complex logistical and security obstacles to do so. The needs, however, far exceed the aid, and the sustained delivery of health supplies from Egypt into the southern Gaza Strip is vital to WHO’s ongoing operations to address severe medicine shortages and to bolster an ailing health system.
WHO transfers critical patients out of Nasser Medical Complex, fears for safety of remaining patients
20 February 2024 – WHO led two life-saving missions to transfer 32 critical patients, including two children, from Nasser Medical Complex in southern Gaza on 18 and 19 February, amid ongoing hostilities and access restrictions. The high-risk missions were conducted in close partnership with the Palestine Red Crescent Society (PRCS) and the United Nations Office for the Coordination of Humanitarian Affairs (OCHA). The team also provided limited supplies of essential medicines and food for the remaining patients and staff who are otherwise cut off from aid.
Four PRCS ambulances ensured the safe transportation of the patients, who underwent medical assessment and triage under the coordination of the hospital director. Patients were moved to the European Gaza Hospital in Khan Younis, Al-Aqsa hospital in Gaza’s middle area, and the International Medical Corps, UAE and Indonesia field hospitals in Rafah.
The transfer of patients was requested by the hospital staff after the facility became non-functional following a military raid on 14 February, after a week-long siege. Weak and frail patients were transferred amidst active conflict near the aid convoy. Road conditions hindered the swift movement of ambulances, placing the health of patients at further risk. Patients transferred during the missions included three suffering from paralysis - two of them with tracheostomy - and several others with external fixators for severe orthopedic injuries. Two of the paralyzed patients required continuous manual ventilation throughout the journey, due to the lack of portable ventilators. A patient with a spinal fracture, previously referred to Nasser by WHO during a mission to Al-Ahli Hospital in northern Gaza, had to be transferred again despite his condition.
Nasser Hospital has no electricity or running water, and medical waste and garbage are creating a breeding ground for disease. WHO staff said the destruction around the hospital was ‘indescribable.’ The area was surrounded by burnt and destroyed buildings, heavy layers of debris, with no stretch of intact road.
An estimated 130 sick and injured patients and at least 15 doctors and nurses remain inside the hospital. As the ICU was no longer functioning, WHO staff transferred the only remaining ICU patient to a different part of the complex where other patients are receiving basic care.
WHO fears for the safety and well-being of the patients and health workers remaining in the hospital and warns that further disruption to lifesaving care for the sick and injured would lead to more deaths. Efforts to facilitate further patient referrals amidst the ongoing hostilities are in process.
Prior to the missions, WHO received two consecutive denials to access the hospital for medical assessment, causing delays in urgently needed patient referral. Reportedly, at least five patients died in the Intensive Care Unit before any missions or transfers were possible.
On 17 February, an UNRWA-led mission, which included WHO staff, delivered 24,000 liters of fuel and limited food and water supplies to the hospital, after not being able to reach it on 16 February due to unforgiving road conditions, including a deep, muddy, impassable ditch 50 meters from the hospital. That day, despite the risks, WHO staff, accompanied by an engineer, managed to reach Nasser Medical Complex on foot. However, they were only permitted to examine the generator, which had ceased functioning after running out of fuel. During both missions, senior WHO staff clearly identified themselves upon entering the hospital compound and requested approval to assess patients and evaluate hospital functionality. These requests were denied.
As the raid continues, any further damage to Nasser Medical Complex will mean even more delays in restoring functionality. The hospital’s large medical warehouse, along with supplies provided by WHO and partners, has burnt down, and the warehouse for day-to-day medical supplies is partly damaged. The WHO-supported limb reconstruction center, housed within the hospital, is no longer operational. These are tragic developments that will further limit access to health care in a context where needs continue to soar.
The dismantling and degradation of the Nasser Medical Complex is a massive blow to Gaza’s health system. Facilities in the south are already operating well beyond maximum capacity and are barely able to receive more patients.
WHO repeats its calls for the protection of patients, health workers, health infrastructure, and civilians. Hospitals must not be militarized, misused, or attacked.
WHO reiterates its calls for all parties to uphold international humanitarian law and the principles of precaution, distinction, and proportionality, and to ensure sustained access so hospitals can continue providing lifesaving care.
Photos: https://photos.emro.who.int/category/93/israelipalestinian-conflict-oct-2023-feb-2024?tab=categories
UNIFEED b-roll: https://www.unmultimedia.org/tv/unifeed/asset/3175/3175146/
Statement: WHO transfer critical patients out of Nasser Medical Complex, fears for safety of remaining patients
WHO led two life-saving missions to transfer 32 critical patients, including two children, from Nasser Medical Complex in southern Gaza on 18 and 19 February, amid ongoing hostilities and access restrictions. The high-risk missions were conducted in close partnership with the Palestine Red Crescent society (PRCS) and the United Nations OCHA occupied Palestinian territory.
The team also provided limited supplies of essential medicines and food for the remaining patients and staff who are otherwise cut off from aid.
Four PRCS ambulances ensured the safe transportation of the patients, who underwent medical assessment and triage under the coordination of the hospital director. Patients were moved to the European Gaza Hospital in Khan Younis, Al-Aqsa hospital in Gaza’s middle area, and the International Medical Corps, UAE and Indonesia field hospitals in Rafah.
The transfer of patients was requested by the hospital staff after the facility became non-functional following a military raid on 14 February, after a week-long siege. Weak and frail patients were transferred amidst active conflict near the aid convoy. Road conditions hindered the swift movement of ambulances, placing the health of patients at further risk. Patients transferred during the missions included three suffering from paralysis - two of them with tracheostomy - and several others with external fixators for severe orthopedic injuries. Two of the paralyzed patients required continuous manual ventilation throughout the journey, due to the lack of portable ventilators. A patient with a spinal fracture, previously referred to Nasser by WHO during a mission to Al-Ahli Hospital in northern Gaza, had to be transferred again despite his condition.
Nasser Hospital has no electricity or running water, and medical waste and garbage are creating a breeding ground for disease. WHO staff said the destruction around the hospital was ‘indescribable.’ The area was surrounded by burnt and destroyed buildings, heavy layers of debris, with no stretch of intact road.
An estimated 130 sick and injured patients and at least 15 doctors and nurses remain inside the hospital. As the ICU was no longer functioning, WHO staff transferred the only remaining ICU patient to a different part of the complex where other patients are receiving basic care.
WHO fears for the safety and well-being of the patients and health workers remaining in the hospital and warns that further disruption to lifesaving care for the sick and injured would lead to more deaths. Efforts to facilitate further patient referrals amidst the ongoing hostilities are in process.
Prior to the missions, WHO received two consecutive denials to access the hospital for medical assessment, causing delays in urgently needed patient referral. Reportedly, at least five patients died in the Intensive Care Unit before any missions or transfers were possible.
On 17 February, an UNRWA-led mission, which included WHO staff, delivered 24,000 liters of fuel and limited food and water supplies to the hospital, after not being able to reach it on 16 February due to unforgiving road conditions, including a deep, muddy, impassable ditch 50 meters from the hospital. That day, despite the risks, WHO staff, accompanied by an engineer, managed to reach Nasser Medical Complex on foot. However, they were only permitted to examine the generator, which had ceased functioning after running out of fuel. During both missions, senior WHO staff clearly identified themselves upon entering the hospital compound and requested approval to assess patients and evaluate hospital functionality. These requests were denied.
As the raid continues, any further damage to Nasser Medical Complex will mean even more delays in restoring functionality. The hospital’s large medical warehouse, along with supplies provided by WHO and partners, has burnt down, and the warehouse for day-to-day medical supplies is partly damaged. The WHO-supported limb reconstruction center, housed within the hospital, is no longer operational. These are tragic developments that will further limit access to health care in a context where needs continue to soar.
The dismantling and degradation of the Nasser Medical Complex is a massive blow to Gaza’s health system. Facilities in the south are already operating well beyond maximum capacity and are barely able to receive more patients.
WHO repeats its calls for the protection of patients, health workers, health infrastructure, and civilians. Hospitals must not be militarized, misused, or attacked.
WHO reiterates its calls for all parties to uphold international humanitarian law and the principles of precaution, distinction, and proportionality, and to ensure sustained access so hospitals can continue providing lifesaving care.
Children’s lives threatened by rising malnutrition in the Gaza Strip
The situation is especially serious in the north, where 1 in 6 children under the age of 2 is acutely malnourished
19 February 2024, A steep rise in malnutrition among children and pregnant and breastfeeding women in the Gaza strip poses grave threats to their health, according to a comprehensive new analysis released by the Global Nutrition Cluster.
As the ongoing conflict in the Gaza Strip enters its 20th week, food and safe water have become incredibly scarce and diseases are rife, compromising women and children’s nutrition and immunity and resulting in a surge of acute malnutrition.
The report “Nutrition Vulnerability and Situation Analysis - Gaza” – finds that the situation is particularly extreme in the Northern Gaza Strip, which has been almost completely cut off from aid for weeks. Nutrition screenings conducted at shelters and health centres in the north found that 15.6 per cent – or 1 in 6 children under 2 years of age – are acutely malnourished. Of these, almost 3 per cent suffer from severe wasting, the most life-threatening form of malnutrition, which puts young children at highest risk of medical complications and death unless they receive urgent treatment. As the data were collected in January, the situation is likely to be even graver today.
Similar screenings in the Southern Gaza Strip, in Rafah, where aid has been more available, found 5 per cent of children under 2 years are acutely malnourished. This is clear evidence that access to humanitarian aid is needed and can help prevent the worst outcomes. It also reinforces agencies’ calls to protect Rafah from the threat of intensified military operations.
“The Gaza Strip is poised to witness an explosion in preventable child deaths which would compound the already unbearable level of child deaths in Gaza,” said UNICEF Deputy Executive Director for Humanitarian Action and Supply Operations, Ted Chaiban. “We’ve been warning for weeks that the Gaza Strip is on the brink of a nutrition crisis. If the conflict doesn’t end now, children’s nutrition will continue to plummet, leading to preventable deaths or health issues which will affect the children of Gaza for the rest of their lives and have potential intergenerational consequences.”
Before the recent months’ hostilities, wasting in the Gaza Strip was rare with just 0.8 per cent of children under 5 years of age acutely malnourished. The rate of 15.6 percent of wasting among children under 2 in Northern Gaza suggests a serious and rapid decline. Such a decline in a population’s nutritional status in three months is unprecedented globally.
There is a high risk that malnutrition will continue to rise across the Gaza Strip due to the alarming lack of food, water and health and nutrition services:
- 90 per cent of children under the age of 2 and 95 per cent of pregnant and breastfeeding women face severe food poverty – meaning they have consumed two or less food groups in the previous day – and the food they do have access to is of the lowest nutritional value.
- 95 per cent of households are limiting meals and portion sizes, with 64 per cent of households eating only one meal a day.
- Over 95 per cent of households said they had restricted the amount of food adults received in order to ensure small children had food to eat.
“The steep rise in malnutrition that we are seeing in Gaza is dangerous and entirely preventable”, said WFP Assistant Executive Director for Programme Operations, Valerie Guarnieri. “Children and women, in particular, need continuous access to healthy foods, clean water and health and nutrition services. For that to happen, we need decisive improvements on security and humanitarian access, and additional entry points for aid to enter Gaza.”
Inadequate safe drinking water, as well as insufficient water for cooking and hygiene purposes, are compounding poor nutrition. On average, households surveyed had access to less than one litre of safe water per person per day. According to humanitarian standards, the minimum amount of safe water needed in an emergency is 3 litres per person per day, while the overall standard is 15 litres per person, which includes sufficient quantities for drinking, washing and cooking.
Hungry, thirsty and weak, more Gazans are falling sick. The report finds at least 90 per cent of children under 5 are affected by one or more infectious disease. Seventy per cent had diarrhoea in the past two weeks, a 23-fold increase compared with the 2022 baseline.
“Hunger and disease are a deadly combination,” said Dr Mike Ryan, Executive Director of WHO’s Health Emergencies Programme. ”Hungry, weakened and deeply traumatised children are more likely to get sick, and children who are sick, especially with diarrhea, cannot absorb nutrients well. It’s dangerous, and tragic, and happening before our eyes.”
Without more humanitarian assistance, the nutritional situation is likely to continue to deteriorate rapidly and at scale across the Gaza Strip. With the majority of health, water and sanitation services severely degraded, it is essential that those that remain functional are protected and reinforced to stem the spread of diseases and stop malnutrition from worsening.
UNICEF, WFP and WHO call for safe, unimpeded and sustained access to urgently deliver multi-sectoral humanitarian assistance throughout the Gaza Strip. This includes nutritious foods, nutrition supplies and essential services for malnourished and at-risk children and women to safely access health and nutrition care and treatment services, particularly infants and young children under 5. Hospitals and health workers must be protected from attack so they can safely provide critical treatment and care. An immediate humanitarian ceasefire continues to provide the best chance to save lives and end suffering.
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Note to the editor
Due to security and access challenges throughout the Gaza Strip, it is nearly impossible to collect anthropometric data to measure rates of acute malnutrition. Collection of anthropometric data (MUAC) was only possible in two areas (North Gaza and Rafah) among children under 2 years of age. The report therefore used an innovative method of analysis to support this data and determine that acute malnutrition is rising throughout the Gaza Strip. This method analyzed data on the drivers of malnutrition – lack of food, rates of disease, lack of access to clean water and lack of available health services – which was collected through telephone and SMS questionnaires. From analyzing the key causes, we can conclude that acute malnutrition is rising throughout Gaza at speed.
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Dedicated to the well-being of all people and guided by science, the World Health Organization leads and champions global efforts to give everyone, everywhere an equal chance at a safe and healthy life. We are the UN agency for health that connects nations, partners and people on the front lines in 150+ locations – leading the world’s response to health emergencies, preventing disease, addressing the root causes of health issues and expanding access to medicines and health care. Our mission is to promote health, keep the world safe and serve the vulnerable.
WHO, KSrelief sign new agreement to support over one million people in Gaza
6 February 2024, Cairo, Egypt – A US$ 10 million agreement signed today by the World Health Organization (WHO) and the King Salman Humanitarian Aid and Relief Centre (KSrelief) will provide more than one million people in Gaza with access to emergency life-saving health services.
“The collaboration between WHO and KSrelief signifies a strategic, coordinated response to addressing urgent health needs in Gaza,” said Dr Hanan Balkhy, WHO Regional Director for the Eastern Mediterranean. “KSrelief’s generous commitment will enable WHO to continue bolstering the health system, ensuring that people displaced by ongoing violence have access to lifesaving health care.”
The project, which will be implemented over a 12-month period, will support 30 primary health care centers and 10 hospitals and ambulances across Gaza with essential medicines, medical supplies and disposables, and fuel. Approximately one million internally displaced people and those living within the catchment area of the targeted health facilities stand to benefit from this project.
Recent hostilities in Gaza have strained the health system and exacerbated challenges such as shortages in essential services, clean water, food, and fuel. In just four months, almost 28,000 people have been killed, and almost 67,000 people injured. More than 1.7 million people have been displaced, the majority living in overcrowded shelters. Ambulance access is hindered, disease surveillance disrupted, and inadequate water and sanitation have increased the spread of infectious disease outbreaks.
“KSrelief is committed to alleviating the suffering of people affected by emergencies across the Region. The deterioration of the humanitarian and health situation in Gaza has reached unprecedented levels,” said Dr Abdullah Al Rabeeah, KSrelief Supervisor General. “The Kingdom of Saudi Arabia, represented by KSrelief, will continue to support WHO in its tireless efforts to help people in need of urgent health services in Gaza.” Representing KSrelief at the signing event with WHO were Eng. Ahmed Albaiz, Assistant Supervisor of KSrelief’s General Operations and Programmes, and Dr Abdullah Al Moallem, Director of KSrelief’s Health Department.
WHO’s operational plan for Gaza focuses on sustaining essential health services, supporting hospitals and primary health centers through medical supplies, coordinating deployment of emergency medical teams, establishing temporary field hospitals, strengthening referral pathways, and supporting public health surveillance, disease prevention and control. Aligned with the United Nations Flash Appeal, the plan targets priority areas of the Health and Nutrition component. Immediate attention is essential for procuring and distributing essential health supplies to address the crisis in Gaza.
As Health Cluster Lead Agency, WHO collaborates with partners, including health authorities and UNRWA, to maintain health services through effective supply chain management. Leveraging established systems, WHO facilitates the procurement, storage, and delivery of medical supplies to vulnerable communities.
“Despite a severely shrinking space for the humanitarian and health response in Gaza, WHO and partners remain committed to reaching all people with the aid they desperately need,” added Dr Balkhy. “Ultimately, what is needed is sustained access into and across the Strip for the urgent delivery of aid, and an end to the hostilities, so that together with all people in Gaza, we can embark on the long road to wellbeing and recovery.”
WHO and KSrelief have a long-standing partnership responding to crises in WHO’s Eastern Mediterranean Region. In 2022-23, WHO implemented KSrelief-funded projects in three emergency-affected countries (Yemen, Iraq, and Somalia) with contributions of over US$ 26 million.
WHO delivers health supplies to Al-Shifa Hospital, appeals for continued access to address urgent needs in north Gaza
17 December 2023 — WHO staff participated in a joint UN mission to Al-Shifa Hospital in north Gaza on 16 December to deliver health supplies and assess the situation in the facility. Partners on today’s mission included OCHA, UNDSS, and UNMAS. The team delivered medicines and surgical supplies, orthopedic surgery equipment, and anesthesia materials and drugs to the hospital.
Al-Shifa Hospital, currently minimally functional, needs to urgently resume at least basic operations to continue serving the thousands in need of lifesaving health care.
Once the most important and largest referral hospital in Gaza, Al-Shifa now houses only a handful of doctors and a few nurses, together with 70 volunteers, working under what WHO staff described as “unbelievably challenging circumstances,” and calling it a “hospital in need of resuscitation.” The operating theatres and other major services remain nonfunctional due to lack of fuel, oxygen, specialized medical staff, and supplies. The hospital is only able to provide basic trauma stabilization, has no blood for transfusion, and hardly any staff to care for the constant flow of patients. Dialysis is being provided to approximately 30 patients a day, with the dialysis machines operating 24 hours a day, seven days a week, using a small generator.
The team described the emergency department as a “bloodbath”, with hundreds of injured patients inside, and new patients arriving every minute. Patients with trauma injuries were being sutured on the floor, and limited to no pain management is available at the hospital. WHO staff said that the emergency department is so full that care must be exercised to not step on patients on the floor. Critical patients are being transferred to Al-Ahli Arab Hospital for surgeries.
Tens of thousands of displaced people are using the hospital building and grounds for shelter. A multi-pronged humanitarian response is needed to provide them with food, water and shelter.
Many of them asked our team to tell the world what is happening in the hope that their suffering might soon be eased. Al-Shifa Hospital continues to experience a severe shortage of food and safe water for health workers, patients, and displaced people. This reflects grave and growing concerns around persistent hunger across the Gaza Strip, and the consequences of malnutrition on people’s health and susceptibility to infectious diseases.
WHO is committed to strengthening Al-Shifa Hospital in the coming weeks, so that it can resume at least basic functionality and continue to provide the lifesaving services that are needed at this critical time. Up to 20 operating theatres in the hospital, as well as post-operative care services, can be activated if provided with regular supplies of fuel, oxygen, medicines, food, and water. Substantial additional specialized medical, nursing and support staff, including emergency medical teams are also urgently needed.
Currently, Al-Ahli Arab Hospital remains the only partially functional hospital in north Gaza along with three minimally functional hospitals – Al-Shifa, Al Awda and Al Sahaba Medical Complex - down from 24 before the conflict. WHO is also gravely concerned at the unfolding situation at Kamal Adwan Hospital and is gathering information urgently.
As hostilities continue and health needs across the Gaza Strip increase, Al-Shifa Hospital, a cornerstone of Gaza’s health system, must be urgently restored so that it can serve a besieged people trapped in a cycle of death, destruction, hunger, and disease.