Hunger is ravaging Gaza, rates of infectious diseases are soaring, and the health system is on its knees, says the World Health Organization

WHO, Médecins Sans Frontières (MSF) and UNICEF, the United Nations children’s agency, have sounded the alarm bells about the lethal health situation in Gaza, with “catastrophic levels of food insecurity” and “a lack of sanitation and hygiene and a collapsing health system” creating a toxic mix.

WHO says Gaza faces crisis levels of hunger, with insufficient food and high levels of malnutrition. “Gaza is already experiencing soaring rates of infectious diseases. Over 100,000 cases of diarrhoea have been reported since mid-October (to the end of 2023). Half of these are among young children under the age of five years; case numbers that are 25 times what was reported before the conflict,” it said.

“Over 150,000 cases of upper respiratory infection, and numerous cases of meningitis, skin rashes, scabies, lice and chickenpox have Image credit: UNICEF ‘The near total breakdown and attacks on medical and healthcare services across Gaza threatens the lives of every child in the Strip.’ — UNICEF Executive Director, Catherine Russell been reported.

“Hepatitis is also suspected, as many people present with the tell-tale signs of jaundice.”

A WAR ON CHILDREN – UNICEF

More than a million children in the Gaza Strip are caught in a devastating situation marked by widespread destruction, relentless attacks, displacement, and severe shortages of essential necessities such as food, water and medicine, says UNICEF. The Gaza Strip is the “most dangerous place in the world to be a child”, Catherine Russell, Executive Director of UNICEF told the UN Security Council. By the end of 2023, the Palestinian death toll in Gaza had passed 20,000, including about 8000 children and 6200 women, while more than 52,000 people had been injured, according to the territory’s government. UN officials and human rights groups say these numbers are reliable. An article in The Lancet medical journal said there was “no evidence of inflated rates”.

“In Gaza, the effects of the violence perpetrated on children have been catastrophic, indiscriminate and disproportionate,” said Ms Russell. She said the near total breakdown and attacks on medical and healthcare services across Gaza threatens the lives of every child in the Strip.

UNDER FIRE, THE HEALTH SYSTEM HAS COLLAPSED

Gaza’s hospitals are barely operating, says WHO. Al-Shifa, the largest referral hospital in Gaza, now houses only a handful of doctors and a few nurses, working under what WHO staff describe as “unbelievably challenging circumstances,” and calling it a “hospital in need of resuscitation”. The operating theatres and other major services remain non- functional due to lack of fuel, oxygen, specialised medical staff, and supplies. The first major assault on a hospital by the Israeli army (IDF) was on al-Shifa.

The IDF said five of the hospital’s buildings were directly involved in Hamas activities, directed from tunnels underneath the hospital. A subsequent investigation by The Washington Post discredited the army’s claims that Hamas had been using the hospital as a command-and-control centre after analysing open-source visuals, satellite imagery and all the publicly released IDF materials

The Post’s analysis showed that:

• the rooms connected to the tunnel network discovered by IDF troops showed no immediate evidence of military use by Hamas

• none of the five hospital buildings identified by the IDF appeared to be connected to the tunnel network

• there was no evidence the tunnels could be accessed from inside hospital wards.

Dr Natalie Thurtle, an Australian doctor who coordinated medical aid for MSF in Gaza, told The Guardian it was “very confronting for colleagues trying to provide health care when it’s possible to be shot through the window of the hospital”. Thurtle said it was “impossible to set up a meaningful response to this catastrophe because of the ongoing military activity”. She said clinicians were operating in an “incredibly chaotic environment” that was “extremely difficult to manage”.

Thurtle said healthcare infrastructure had been “systematically targeted”. She said between 150 and 200 patients were arriving at al-Aqsa hospital in central Gaza each day, but “about a third of those patients are dead on arrival, which is very hard because many of them are children”.

“Certainly, from speaking to colleagues and seeing the images that they’re seeing, the volume of children killed or mutilated in this conflict is very extreme,” she said. “Unfortunately, there’s a lot of misinformation around that, but that is certainly what we’re witnessing on the ground – that there’s a huge proportion of children being killed or maimed for life in this conflict.

“ Nothing can excuse the consistent and relentless targeting and decimation of healthcare infrastructure in Gaza,” she said. Thurtle said MSF was speaking up because it felt it had a responsibility to explain what its staff were seeing and experiencing, given that “there’s a huge volume of commentary from people who are not directly witnessing what’s happening on the ground”.