Lethal combination of hunger and disease to lead to more deaths in Gaza
21 December 2023 – Hunger is ravaging Gaza, and this is expected to increase illness across the Strip, most acutely among children, pregnant and breastfeeding women, and older people.
In new estimates released today, the Integrated Food Security Phase Classification (IPC) global partnership, which includes WHO, said Gaza is facing “catastrophic levels of food insecurity,” with the risk of famine “increasing each day.”
An unprecedented 93% of the population in Gaza is facing crisis levels of hunger, with insufficient food and high levels of malnutrition. At least 1 in 4 households are facing “catastrophic conditions”: experiencing an extreme lack of food and starvation and having resorted to selling off their possessions and other extreme measures to afford a simple meal. Starvation, destitution and death are evident.
On recent missions to north Gaza, WHO staff say that every single person they spoke to in Gaza is hungry. Wherever they went, including hospitals and emergency wards, people asked them for food. “We move around Gaza delivering medical supplies and people rush to our trucks hoping it’s food,” they said, calling it “an indicator of the desperation.”
Infectious diseases are thriving
Gaza is already experiencing soaring rates of infectious diseases. Over 100 000 cases of diarrhoea have been reported since mid-October. Half of these are among young children under the age of 5 years, case numbers that are 25 times what was reported before the conflict.
Over 150 000 cases of upper respiratory infection, and numerous cases of meningitis, skin rashes, scabies, lice and chickenpox have been reported. Hepatitis is also suspected as many people present with the tell-tale signs of jaundice.
While a healthy body can more easily fight off these diseases, a wasted and weakened body will struggle. Hunger weakens the body’s defences and opens the door to disease.
Malnutrition increases the risk of children dying from illnesses like diarrhoea, pneumonia and measles, especially in a setting where they lack access to life-saving health services.
Even if the child survives, wasting can have life-long impacts as it stunts growth and impairs cognitive development.
Breastfeeding mothers are also at high risk of malnutrition. From 0-6 months of age, a mother’s milk is the best and safest food a baby can get. This protects the child from nutritional deficiencies and catching deadly diseases such as diarrhoea, especially when access to safe drinking water is extremely limited.
Mental health issues, on the rise across the population in Gaza, including among women, could further impact breastfeeding rates.
Lack of sanitation and hygiene, and a collapsing health system, add to the toxic mix
Over 1.9 million people have been displaced from their homes, of whom over 1.4 million are staying in overcrowded shelters. These conditions are ripe for a continued rise in infectious diseases. In Gaza today, on average, there is only one shower for every 4500 people and one toilet for every 220. Clean water remains scarce and there are rising levels of outdoor defecation. These conditions make the spread of infectious diseases inevitable.
Tragically, access to health services across Gaza has plumeted as the war continues to degrade the health system. With the health system on its knees, those facing the deadly combination of hunger and disease are left with few options.
The people of Gaza, who have already suffered enough, now face death from starvation and diseases that could be easily treated with a functioning health system. This must stop. Food and other aid must flow in far greater amounts. WHO reiterates its call for an immediate humanitarian ceasefire.
WHO teams deliver supplies to hospitals in Northern and Southern Gaza
27 December 2023 – Gaza: World Health Organization teams have undertaken high-risk missions to deliver supplies, with partners, to hospitals in Northern and Southern Gaza witnessing intense hostilities in their vicinity, high patient loads and overcrowding caused by people displaced by the conflict seeking refuge.
“Today I repeat my call on the international community to take urgent steps to alleviate the grave peril facing the population of Gaza and jeopardizing the ability of humanitarian workers to help people with terrible injuries, acute hunger, and at severe risk of disease,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
In WHO’s latest high-risk mission, teams visited on Tuesday 26 December two hospitals - Al-Shifa in the north and Al-Amal Palestine Red Crescent Society in the south – to deliver supplies and assess needs on the ground.
Both hospitals also serve as shelters for displaced people seeking relative safety. At Al-Shifa Hospital, a reported 50 000 people are sheltering, while in Al-Amal there are 14 000.
At Al-Shifa, WHO delivered fuel to keep essential health services running. With UNICEF, WHO also delivered medical supplies for the hospital. And in support of NGO partner, the World Central Kitchen, delivered materials to support a kitchen at Al-Shifa. Medical supplies were also delivered to the Gaza Central Drug Store, which will act as a medical supply hub to deliver to other hospitals, and will be supported by WHO and partners.
At Al-Amal, colleagues saw the aftermath of recent strikes that disabled the hospital’s radio tower and impacted the central ambulance dispatch system for the entire Khan Younis area affecting more than 1.5 million people. Of the 9 ambulances the hospital once had, only 5 remain functioning. WHO staff reported finding it impossible to walk inside the hospital without stepping over patients and those seeking refuge. There are only few functioning toilets available in the hospital and adjacent community buildings and PRCS training centres for the people taking refuge there, staff and hospital patients.
While transiting across Gaza, WHO staff witnessed tens of thousands of people fleeing heavy strikes in the Khan Younis and Middle Area, on foot, riding on donkeys, or in cars. Make-shift shelters were being built along the road.
“WHO is extremely concerned this fresh displacement of people will further strain health facilities in the south, which are already struggling to meet the population’s immense needs,” said Dr Rik Peeperkorn, WHO Representative in WHO's office for the West Bank and Gaza. “This forced mass movement of people will also lead to more overcrowding, increased risk of infectious diseases, and make it even harder to deliver humanitarian aid.”
According to the latest WHO assessments, Gaza has 13 partially functioning hospitals, 2 minimally functioning ones, and 21 that are not functioning at all.
Among these is Nasser Medical Complex, which is the most important referral hospital in Southern Gaza, and is partially functioning. Recent reports of residential areas being ordered to evacuate around the hospital are extremely concerning.
“When military activities intensify near the hospital, ambulances, patients, staff, and WHO and partners will be unable to reach the complex, and this key hospital will quickly become barely functional,” said Dr Peeperkorn. “This scenario was witnessed all too often in the North. Gaza can not afford to lose any more hospitals. WHO is working to strengthen and expand the existing struggling health system.”
WHO staff also reported Tuesday that the need for food continues to be acute across the Gaza Strip. Hungry people again stopped our convoys today in the hope of finding food.
WHO’s ability to supply medicines, medical supplies, and fuel to hospitals is being increasingly constrained by the hunger and desperation of people en route to, and within, hospitals we reach.
Dr Tedros said: “The safety of our staff and continuity of operations depends on more food arriving in all of Gaza, immediately. My own colleagues are also being directly and personally affected by the conflict, just like virtually everyone in Gaza. I continue to receive heartbreaking news of the loss of our Gaza staffers’ family members.”
“The recent United Nations Security Council resolution appeared to provide hope of an improvement in humanitarian aid distribution within Gaza,” Dr Tedros added. “However, based on WHO eyewitness accounts on the ground, the resolution is tragically yet to have an impact. What we urgently need, right now, is a ceasefire to spare civilians from further violence and begin the long road towards reconstruction and peace.”
New mass displacement of Palestinians fleeing fighting, health facilities crammed with people seeking refuge, food. Photo credit: WHO 27 December 2023 – Gaza: World Health Organization teams have undertaken high-risk missions to deliver supplies, wi
Cairo, Geneva, Jerusalem, 23 January 2024 – WHO and partners completed another high-risk mission on Monday to resupply fuel to the Al-Shifa Hospital in northern Gaza, where hundreds of thousands of people remain cut off from aid. Across the Gaza Strip, the few remaining hospitals find themselves in ever more dire circumstances, with hostilities often preventing access for patients and supplies, and health workers managing on little rest and scarce supplies.
The mission was carried out along with the Office for the Coordination of Humanitarian Affairs, the United Nations Department of Safety and Security, and Médecins Sans Frontières.
The last humanitarian mission to northern Gaza took place on 12 January.
Yesterday‘s mission, which delivered 19 000 liters of fuel to Al-Shifa Hospital, faced delays at the checkpoint. The roads leading to the hospital were severely damaged, and the desperation in northern Gaza was apparent, as thousands of civilians surrounded the UN vehicles and fuel truck in the hopes of finding food and water, also delaying the mission.
In Al-Shifa Hospital, the mission saw that the functionality has improved since the last visit ten days ago. A significant decrease in the number of displaced people, from 40 000 to 10 000 was observed. There are 120 health and care workers, and 300 patients. The hospital conducts 5-10 surgeries daily, mainly trauma cases that require immediate care.
Essential services such as basic laboratory and radiological facilities remain operational, along with emergency care, a surgical unit with three operation theaters, post-operative care, and a dialysis unit. There are plans to reopen a 9-bed ICU over the coming days.
There are no maternity or pediatric services, and shortages of specialized doctors, medicines, and medical supplies such as orthopedic equipment. These units could become operational again, but will require a consistent supply of fuel, oxygen, medical supplies, and other aid.
The hospital’s primary oxygen plant has been destroyed. They are relying on a smaller plant.
Seven out of 24 hospitals remain open in northern Gaza. These are only partially functioning, without enough specialized medical staff to manage the volume and range of injuries, nor sufficient medicines and medical supplies, fuel, clean water, or food for patients or staff. Additionally, two Ministry of Health primary healthcare centers in northern Gaza are partially functional but lack essential supplies, including syringes and vaccines needed for routine immunization.
Intensified military presence and hostilities in southern Gaza are also placing patients and health workers at risk, and compromising access to health care. They are severely obstructing the movement of health workers, ambulances, and health partners' ability to resupply hospitals, eroding their functionality. WHO staff say the situation for hospitals in Khan Yunis is “catastrophic and indescribable.”
In southern Gaza, which used to have 12 hospitals, only 7 remain partially functional. A further two, Al-Kheir Hospital and Nasser Medical Complex, are only minimally functional and now inaccessible.
WHO is extremely concerned about reports of Al-Kheir Hospital, a small NGO-run hospital with around 30 beds, facing military incursions and several health workers being detained. Communication with the hospital is no longer possible.
Due to evacuation orders in neighborhoods surrounding Nasser Medical Complex--the largest hospital in the south--and continuous hostilities in the vicinity of the hospital, the Ministry of Health reports that large numbers of wounded people are on the hospital grounds.
An international emergency medical team deployed at Nasser says that no one can enter or exit the facility due to ongoing bombardment close by.
Health staff are reported to be digging graves on hospital grounds due to the large numbers of deaths anticipated and the need to manage dead bodies. This horrifying situation should never take place in any hospital.
Hostilities around Al-Amal Hospital are risking the facility becoming non-functional, as ambulances and injured patients reportedly cannot access the facility.
WHO again calls for an immediate ceasefire in Gaza, active protection of civilians and health care, and sustained access for the delivery of critical aid across the Strip.
WHO calls for protection of humanitarian space in Gaza following serious incidents in high-risk mission to transfer patients, deliver health supplies
12 December 2023 – Cairo, Geneva, Jerusalem, WHO reiterates its call for the protection of health care and humanitarian assistance in Gaza, following military checkpoint delays and detention of health partners during a mission to transfer critically-ill patients and deliver supplies to a hospital in northern Gaza. During the mission, a patient reportedly died.
On 9 December 2023, a WHO team, in collaboration with the Palestine Red Crescent Society (PRCS) and the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), and with support from the United Nations Department of Safety and Security (UNDSS), completed a high-risk mission to Al-Ahli Hospital in Gaza City to deliver medical supplies, assess the situation in the hospital, and transfer critically-injured patients to a hospital in the south. The mission delivered trauma and surgical supplies, enough to treat 1500 patients, to the hospital, and transferred 19 critical patients with 14 companions to Nasser Medical Complex in south Gaza, where they can receive a higher level of care.
On the way north, the UN convoy was inspected at the Wadi Gaza checkpoint, and ambulance crew members had to leave the vehicles for identification. Two PRCS staff were detained for over an hour, further delaying the mission. WHO staff saw one of them being made to kneel at gunpoint and then taken out of sight, where he was reportedly harassed, beaten, stripped and searched.
As the mission entered Gaza City, the aid truck carrying the medical supplies and one of the ambulances were hit by bullets.
On the way back towards southern Gaza, with the patients from Al-Ahli Hospital on board, the convoy was again stopped at the Wadi Gaza checkpoint, where PRCS staff and most of the patients had to leave the ambulances for security checks. Critical patients remaining in the ambulances were searched by armed soldiers.
One of the same two PRCS staff temporarily detained earlier on the way in was taken for interrogation a second time. The mission made numerous attempts to coordinate his release, but eventually—after more than two and a half hours—had to make the difficult decision to leave the highly dangerous area and proceed, for the safety and wellbeing of the patients and humanitarian workers. (Three ambulances carrying extremely critical patients had already continued onwards earlier, while three remained with the convoy.) PRCS reported afterwards that during the transfer process, one of the injured patients died, as a result of his untreated wounds.
The PRCS staff member was released later that night after joint UN efforts. Yesterday, the WHO team met him, as well as his father, supervisor, and colleagues. He said he was harassed, beaten, threatened, stripped of his clothes, and blindfolded. His hands were tied behind his back and he was treated in a degrading and humiliating manner. Once released, he was left to walk towards the south with his hands still tied behind his back, and without clothes or shoes.
Detentions have happened previously during humanitarian missions in Gaza.
On 22 November, six people from the Ministry of Health and PRCS were detained during a WHO-led mission to move patients from Al-Shifa Hospital. Four people–three from the Ministry of Health and one PRCS staff—are still in detention, more than three weeks later. There is no information on their wellbeing or whereabouts. This is unacceptable. WHO, along with their family, colleagues and loved ones, is deeply concerned about their wellbeing. We reiterate our call for their legal and human rights to be respected.
Obstructing ambulances and attacks on humanitarian and health workers are unconscionable. Healthcare, including ambulances, are protected under international law. They must be respected and protected in all circumstances.
The difficulties faced by this mission illustrate the shrinking space for humanitarian actors to provide aid within Gaza, even though access is desperately needed to alleviate the catastrophic humanitarian situation, as called for in the resolution adopted by the WHO Executive Board members on 10 December.
WHO and partners remain firmly committed to staying in Gaza and assisting the population. But as hostilities increase across Gaza, and aid falls short of needs, the humanitarian support system is on the verge of falling apart.
The only viable solution is a sustained ceasefire, so WHO and partners can work safely and unhindered to strengthen a deteriorating health system, replenish critical supplies of fuel, medicines, and other essential aid, and prevent disease, hunger, and further suffering in the Gaza Strip.
Note to editors on Al-Ahli Hospital
During the above mission to the heavily destroyed Gaza City, WHO staff saw hundreds of people, including women, elderly people, youth, and children, who seemed surprised to see aid workers in the area given the highly volatile situation and insecurity.
WHO staff described Al-Ahli Hospital as in a state of “utter chaos and a humanitarian disaster zone.” It is extremely congested with many displaced people and over 200 patients, while it only has enough resources to support 40 beds – half of its original bed capacity. The building has sustained substantial damage because of the hostilities.
Doctors said the situation is “beyond control” as they face shortages of fuel, oxygen, and essential medical supplies, as well as a lack of food and water for patients and themselves. Health staff capacity is minimal, nursing care is extremely limited, and the hospital is relying heavily on volunteers.
Faced with vast numbers of trauma patients inside the hospital, and outside on the street, doctors are forced to prioritize who receives care and who does not. They are treating many serious cases in the hospital’s corridors, on the floor, in the hospital chapel, and even in the street. The hospital is severely short-staffed, and it is lacking the ability to perform vascular operations. Limb amputations are decided as the last resort to save lives.