Hospitals in Gaza on verge of total shutdown

Hospitals in Gaza are on the verge of total shutdown as more have come under intense bombardment. Almost two thirds of all hospitals in Gaza are now completely out of service, and the rest are struggling to keep functioning while civilian casualties continue to rise. Bombardments and armed clashes around the Al Shifa hospital in Gaza City have intensified since Saturday afternoon.

Al Shifa hospital, the largest medical complex in Gaza, is reporting a complete lack of electricity and strikes impacting key facilities. According to its Medical Director, Al Shifa was hosting more than 10,000 internally displaced persons (IDPs), patients and medical staff, including those in critical medical conditions.

The UN Office for the Coordination of Humanitarian Affairs (OCHA) says that critical infrastructure, including the oxygen station, water tanks and a well, the cardiovascular facility, and the maternity ward, was damaged, and three nurses killed due to bombardments and armed clashes around the hospital. While many IDPs and some staff members and patients have reportedly managed to flee, others are trapped inside, fearing to leave or physically unable to do so.

At Al Shifa hospital, at least two premature babies and ten other patients have died since the power outage that started on November 11, compounded by the lack of medical equipment. Another 36 babies in incubators as well as kidney dialysis patients are at heightened risk of death because of the lack of power. On Sunday, the World Health Organization (WHO) indicated that it had lost communication with its contacts in Al Shifa.

The international humanitarian organization Médecins Sans Frontières (MSF) still has staff in the hospital.

"We don’t have electricity. There’s no water in the hospital. There’s no food. People will die in a few hours without functioning ventilators. In front of the main gate, there are many bodies, there are also injured patients, we can’t bring them inside," a voice note from an MSF surgeon in Al Shifa hospital said today.

“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”, he added.

In a statement Sunday, the UN Office of the High Commissioner for Human Rights (OHCHR) informed about allegations that those attempting to leave the complex have been shot at. OHCHR said these “are serious allegations that should be independently investigated”.

“There’s also a sniper who attacked patients, they have gunshot wounds, we operated on three of them. (..) We need a guarantee that there is a safe corridor because we saw some people trying to leave Al Shifa, they killed them, they bombed them, the sniper killed them,” the MSF surgeon said.

Also on Sunday, the Palestine Red Crescent Society (PRCS) announced that the Al Quds Hospital in Gaza City was no longer operational due to the depletion of available fuel and power outage.

Escalated attacks on hospitals in the Gaza Strip have gravely endangered medical staff and civilians, and caused casualties and significant damage. Medical centers across northern Gaza and Gaza City are being directly hit and shuttered as a result of the fighting and depleted fuel. 

“Words fail us to describe the grave existential threats and harm facing medics, staff, patients, and displaced persons at medical centers across Gaza,” OHCHR said.

Hospitals and medical personnel are specifically protected under international humanitarian law (IHL). Any military operation around or within hospitals must take steps to spare and protect the patients, medical staff, and other civilians. All feasible precautions must be taken, including effective warnings, which consider the ability of patients, medical staff and other civilians to evacuate safely. 

Evacuations of hospitals in northern Gaza is, as the World Health Organization has warned, a “death sentence” in a context where the entire medical system is collapsing and hospitals in southern Gaza have no capacity to absorb more patients.

The UN Human Rights Office warned that already weakened telecommunications and internet services could completely cease in less than four days due to a lack of fuel and power, further adding to the immense difficulties faced by the people in Gaza.

"A further and extended blackout of telecommunications and internet connection would deepen the already catastrophic humanitarian crisis. Desperate Palestinians will be unable to request emergency, rescue, and relief services," the OHCHR statement said.

Meanwhile, Israeli bombardments from the air, sea, and land continue across the Gaza Strip, killing hundreds of civilians every day; the majority of them are children and women. 

Indiscriminate and disproportionate attacks by the Israeli Defense Forces (IDF) have killed more than 11,200 Palestinians and wounded more than 27,000 since October 7. While two thirds of the fatalities are reportedly children and women, the dead include more than 4,600 children and at least 667 elderly persons. 

Among those killed are at least 101 UN staff, 195 health workers and 47 journalists. More than 2,700 people - including 1,500 children - have been reported missing and may be still trapped dead or alive under the rubble.

More than a month ago, the humanitarian situation of Palestinians in the Gaza Strip drastically deteriorated following attacks by the Israeli military due to atrocities committed by Palestinian armed groups in Israel, that killed over 1,200 Israelis and foreign nationals.  The increasing escalation of violence and the complete blockade imposed on Gaza by the Israeli government has led to a humanitarian catastrophe for the people of the tiny enclave.

Almost 1.6 million people – more than two thirds of the total population of Gaza - have been displaced due to the attacks by the Israeli military or the Israeli evacuation order. More than 778,000 civilians are sheltering in 154 UN installations in increasingly dire conditions.

The flight of tens of thousands of IDPs southwards from the north of Gaza through a “corridor” opened by the Israeli military, continued on Sunday. However, hundreds of thousands of people remaining in the north are struggling to survive.

Further information

Full text: OHCHR oPt - Hospitals Statement (12 Nov 2023), Office of the High Commissioner for Human Rights (OHCHR), published November 12, 2023
https://reliefweb.int/report/occupied-palestinian-territory/ohchr-opt-hospitals-statement-12-nov-2023

Full text: Hostilities in the Gaza Strip and Israel - reported impact, Day 37, UN Office for the Coordination of Humanitarian Affairs (OCHA), published November 12, 2023
https://www.ochaopt.org/content/hostilities-gaza-strip-and-israel-flash-update-37