Urgent Health Update: Consequences of the war on Gaza-March 31, 2024

The Jewish Voice for Peace Health Advisory Council is sharing information on the health implications of the attacks.  We will update in a week.  Please use this information to organize & educate. As the Israeli government threatens an all out assault on Rafah, increasing the risk of further massacres & genocide, starvation is rising & multiple countries move to defund & destroy UNRWA, this is a time to make your voices heard. In particular, current attack on Al-Shifa Hospital requires immediate calls to elected officials and media.

Intense Israeli bombardment & ground operations as well as heavy fighting between Israeli forces & Palestinian armed groups continue to be reported across much of the Gaza Strip, resulting in further civilian casualties, displacement, & destruction of houses & other civilian infrastructure, in particular, health care facilities. Israeli and US disregard for international law and repeated calls from UN bodies for a cease-fire and humanitarian aid, threatens basic agreements about world order and standards of behavior developed post WW 2.

DAY 177

Recommended articles

Article in Mondoweiss: We study America’s biggest public health crisis. This is why we speak out against the Gaza genocide.

Article in Mondoweiss: A volunteer doctor in Gaza faces her patients’ traumas along with her own

Report on the assault on Gaza medical facilities in the Journal of Public Health and Emergency, led by our Italian comrade Paola Manduca and co-authored by Alice Rothchild, Rachel Rubin, and Alan Myers who are all on the JVP HAC. On the Duty to Protect the People of Gaza https://jphe.amegroups.org/article/view/9883/pdf

Editorial by JVP HAC steering committee member Maxine Fookson and others at: https://www.socialmedicine.info/index.php/medicinasocial/article/view/1701/2809

Rapid Response in The British Medical Journal by Derek Summerfield, MD. Gaza: BMA calls for urgent investigation into mistreatment of doctors

New Yorker, The Children Who Lost Limbs in Gaza  

Situation update

GAZA

Al-Shifa Hospital

3/31/24 DESPERATE REPORT FROM DOCTOR,  DAY 14 OF SIEGE AT AL-SHIFA HOSPITAL: “107 PATIENTS, MOST OF THEM FROM ICU & 60 MEDICAL STAFF HAVE BEEN INCARCERATED IN AN OLD BUILDING IN THE HOSPITAL THAT DOES NOT HAVE CAPACITY TO HOST SUCH NUMBER OF PATIENTS NOR THE EQUIPMENT. THE SITUATION AS REPORTED BY MANY OF THE STAFF IS HORRIFIC & INHUMANE; NO VENTILATION, CLEANING CONDITIONS, WATER, NOR MINIMUM MEDICATION HAS BEEN PROVIDED LEADING TO SEPTIC WOUNDS INFESTED WITH WHITE FLIES. DOCTORS RAN OUT OF GLOVES SO STARTED USING PLASTIC BAGS WHEN CHANGING WOUNDS WHICH RAN OUT AS WELL. REPORTED LACK OF ELDERLY DIAPERS, 30 PATIENTS ARE BED RIDDEN & USE DIAPERS & REQUIRE INTENSIVE MEDICAL & NURSING CARE, LIMITED NUMBER OF STAFF IS INCAPABLE OF PROVIDING. PATIENTS' COMPANIONS ARE EITHER EXECUTED, ARRESTED OR DISPLACED TO THE SOUTH BY THE MILITARY WHICH ADD ANOTHER BURDEN ON THE STAFF. MILITARY IS STARVING THE BESIEGED PATIENTS & STAFF WITH NO FOOD OR DRINKABLE WATER PROVIDED FOR DAYS. STAFF REPRESENTATIVE TRIED MULTIPLE TIMES TO CONVEY THEIR NEEDS TO THE MILITARY LEADERSHIP, HOWEVER; HE WAS MET BY VIOLATION &  MISTREATMENT.  PRIOR TO EVERY NEGOTIATION, SOLDIERS UNDRESS HIM & LEAVE HIM HALF NAKED FOR 3 HOURS AT LEAST BEFORE MEETING THE CONCERNED OFFICER WITH 'WE WILL LOOK INTO THE MATTER & COME BACK TO YOU' RESPONSE, BUT THEY NEVER DID. IN LIGHT OF THESE HORRIFIC CONDITIONS, OUR ALREADY EXHAUSTED MEDICAL STAFF STARTED SHOWING SYMPTOMS OF FATIGUE & ALLERGY. IF NO SOLUTION IS PURSUED AS SOON AS POSSIBLE, THE PLACE WILL TURN INTO A GRAVEYARD OF PATIENTS & STAFF IF IT IS NOT ALREADY THE CASE.”

 Cummulative statistics

·       Killed: >32,623, includes > 9,000 women, >13,000 children, plus >7,000 missing under rubble

·       174 UN staff killed

·       348 health workers killed

·       48 civil defense killed on duty

·       15 Palestinian Red Crescent Society killed, 30 injured, 8 detained

·       Injured: >75,092

·       Israeli soldiers in Gaza: 252 killed, 1,523 injured

·       134 hostages

·       10 of 36 hospitals partially functional, 4 in north, 6 in south, overwhelmed with patients, critical shortages of fuel, medicines, medical supplies, & health personnel.

·       2 of 3 field hospitals fully functional

·       24% of primary health care facilities functional

·       33% of UNRWA health centers operational

·       17 emergency teams operational

·       As of 3/12, > 400 health attacks affecting ~126 ambulances & almost 100 health facilities, health personnel repeatedly detained, tortured

·       Hospitals under direct attack in past week: Al-Shifa, al-Amal, Nasser

·       Israeli forces ordered Palestinians inside al-Amal Hospital in Khan Younis to leave “naked” while survivors of the al-Shifa Hospital raid witnessed numerous atrocities committed by the Israeli army. Palestinians described days of heavy fighting, mass arrests, forced marches past dead bodies. Doctors without Borders expressed deep concern for medical staff arrested at al-Shifa & heavy air strikes. Tanks crushed bodies & ambulances at al-Shifa.

·       Palestine Red Crescent Society (PRCS) staff & wounded patients arrived in Rafah after being trapped inside ambulances outside al-Amal Hospital for 20 hours.

·       UN special rapporteurs decry underreporting of sexual violence against Palestinians.

·       >500,000 cases acute respiratory infections

·       >290,000 cases diarrhea

·       Between 3/23 & 3/29, 42% of humanitarian aid missions to northern Gaza were denied access by Israeli authorities, 7% of missions to southern Gaza were withdrawn. Lack of water & electricity, closed crossings, repeated inspections, off loading & reloading in Egypt & Israel, crowded, impassable roads, risk of unexploded ordinance, & repeated attacks has severely compromised humanitarian supply chains & access

·       In north, 70% face catastrophic hunger predicted between March & July, 2024

·       Famine is already probably present in at least some areas of northern Gaza, while other areas are in danger of falling into conditions of starvation, US state department said after the world’s top court ordered Israel to admit food aid into the territory.

·       ~40% of school buildings in Gaza (212 of 563 school buildings) have been directly hit, according to satellite imagery. 67% will need full reconstruction or major rehabilitation. Among the 122 directly hit schools, 58% (112) are public schools, 29% (62) are UNRWA schools, 13% (28) are private schools. 59% of school buildings used as IDP shelters have been either directly hit or damaged.  Schools are being used for military operations by Israeli Security Forces including use as detention, interrogation centers, & military bases

·       ~346,000 children <5 are at greatest risk of malnutrition & preventable mortality, of whom about 50,400 children are estimated to be acutely malnourished at present (compared to 7,685 prior to the onset of hostilities). Condition is especially dire for ~135,000 children <2 years of age, who are the most vulnerable to severe acute malnutrition. 

·       1 in 3 children <2 years of age in northern Gaza are now estimated to be suffering from wasting, the most severe form of malnutrition, compared to 1 in 6 children in January. 1/2 the population is experiencing catastrophic levels of food insecurity

·       31 people died of malnutrition & dehydration

·       60-70% of meat & dairy producing livestock killed or prematurely slaughtered

·       12 Palestinians drowned while trying to reach airdropped aid that fell in the sea.

·       1 out of 3 water pipelines coming from Israel operational at 70% of its full capacity; 2 of 3 main desalination plants are partially functional

·       83% of ground wells not operating

·       All waste water treatment systems are nonoperational (1 partially working), 2 of 3 water desalination plants partially functional

·       54% of WASH facilities damaged or destroyed

·       ~1.7 million internally displaced, average space per person in IDP shelters, 1 square meter, 41% lack sufficient ventilation, 57% affected by rain and water infiltration

·       >1 million children in need of mental health & psycho-social support

·       ~17,000 children unaccompanied or separated

·       ~125 journalists & media workers killed

·       >8,000 patients are on waiting list for medical referral

·       2,613 medical referrals abroad, including 1,690 wounded, 915 ill, 1,785 companions

·       Israeli military started to use facial recognition technology in Gaza according to 3 senior Israeli intel officers. Hundreds of Palestinians have been arrested due to the use of an AI-based system partially operated by the Military Intelligence unit 8200. System relies on technology from Corsight, a private Israeli company & they also use Google Photos. Combined, the technologies enable Israel to pick faces out of crowds & grainy drone footage In the West Bank & East Jerusalem, Israelis have a homegrown facial recognition system called Blue Wolf. Surveillance of Hamas in Gaza was instead conducted by tapping phone lines, interrogating Palestinian prisoners, harvesting drone footage, getting access to private social media accounts & hacking into telecommunications systems.

·       Israeli army released 102 Palestinians who were detained from Gaza & held in Israeli custody for several days to weeks. According to Palestinian Red Crescent Society, 9 of the released are paramedics who work for the society & who were detained for 46 days. 3 of the released were taken to some of the few remaining operating hospitals in Gaza to be treated from the effects of torture.

·       The human cost of Israel’s invasion of Gaza, launched after the Hamas attack is being compounded by an environmental crisis. Analysis of satellite imagery shows destruction of ~38-48% of tree cover and farmland, with olive groves & farms reduced to packed earth. Soil & groundwater contaminated by munitions & toxins & the air polluted by smoke & particulate matter. The sea is choked with sewage & waste.

WEST BANK & EAST JERUSALEM

·       >450 killed

·       Israeli settlers stormed Al Aqsa on 5th day of Sukkot & attempted to perform “Talmudic rituals” Thousands of settlers have been carrying out provocative tours of the mosque complex following calls by ultranationalist Jewish groups.

·       Israel is accelerating land theft in West Bank, approving seizure of one of the largest areas since the Oslo Accords. Bezalel Smotrich, ultra-far-right Israeli finance minister, declared nearly 2,000 acres of Palestinian land in the West Bank as so-called “state lands.”

·        Israel raided Nablus & the refugee camps of Shu’fat & Qalandia north of Jerusalem.

ISRAEL

·       Israel pressed on with strikes in Gaza after UN ceasefire resolution, striking over 60 targets.

·       UNRWA Commissioner General Philippe Lazzarini said Israeli Authorities informed the UN they will no longer approve any UNRWA food convoys to north of Gaza, adding that this was done “to obstruct lifesaving assistance during a man-made famine.”

·       Thousands protesting in Israel for a ceasefire and release of hostages.

·       New video surfaced that undercuts the account of an Israeli military paramedic who said 2 teenagers killed in the Hamas-led terrorist attack on Oct. 7 were sexually assaulted, raising further doubts about reports of widespread sexual violence.

·       >9,000 Palestinians imprisoned under Israel’s military and national security laws are being held in Israeli detention facilities, the highest figure in more than a decade, according HaMoked, an Israeli human rights group, who says that many of the detainees are being held without charges and have been abused while in custody. >3,500 are held in administrative detention

US

·       US officially barred UNRWA funding through March 2025. The bipartisan bill, which Biden signed into law, also cuts funding to the UN Human Rights Council unless the administration can certify that it is taking “significant steps to remove Israel as a permanent agenda item”; & banning funding for the UN Commission of Inquiry on Israel. Bill includes $3.8 billion in US funding to Israel and limits aid to Palestinian Authority if they initiate or support investigations in the ICC into Israeli crimes against Palestinians.

·       55% of Americans disapprove of Israeli military action in Gaza, according to a new Gallup poll. This marks the first time the survey has found a majority disapproves, a rise of 10% since November 2023.

·       US State Department official working on human rights in the Middle East, Annelle Sheline, resigned in protest against the Biden administration’s policies on the Gaza war, the third US official to publicly cite such reasons for their departure.

INTERNATIONAL

• At least 40 Syrian soldiers and Hezbollah fighters killed in Israeli strikes on Aleppo, Syria.

• Israel launched multiple strikes on Lebanon, targeting Hezbollah which has launched rocket barrages along the southern Lebanon border region

• Gaza truce talks set to resume in Cairo

·       UN Secretary General Antonio Guterres called for immediate ceasefire while visiting Rafah border crossing, calling conditions morally unacceptable.

·       On 3/25 the UN Security Council adopted a resolution calling for an immediate Gaza cease-fire during Ramadan & immediate release of all hostages. US abstained. Following the vote, National Security Council spokesperson John Kirby said the abstention does “not represent a shift in our policy.” US also described the resolution as “non-binding,” although it is binding.

·       UN Human Rights Council published a draft report that found “reasonable grounds to believe” that Israel is committing genocide in Gaza. The advance unedited version of the report—entitled Anatomy of a Genocide—concludes that Israel’s far-right government and military “have intentionally distorted jus in bello principles, subverting their protective functions, in an attempt to legitimize genocidal violence against the Palestinian people.” "Israel's genocide on the Palestinians in Gaza is an escalatory stage of a long-standing settler-colonial process of erasure."

·       UN Special Rapporteur on Human Rights in the Occupied Territories Francesca Albanese told UN Human Rights Council that she believed that Israel’s military campaign in Gaza since 10/7 amounted to genocide, & called on countries to immediately impose sanctions & an arms embargo on Israel.

·       International Court of Justice imposed new provisional measures in South Africa’s case against Israel for its genocide in Gaza, ordering Israel to ensure the entry of food and other supplies to stop the spreading famine. “Palestinians in Gaza are no longer facing only a risk of famine, as noted in the Order of 26 January 2024, but that famine is setting in, with at least 31 people, including 27 children, having already died of malnutrition and dehydration”.

·       Colombian President Gustavo Petro called on international community to sever diplomatic relations with Israel if it does not comply with the UN Security Council’s resolution calling for a cease-fire in Gaza.

·       Dublin joined South Africa’s case in the International Court of Justice, arguing that stopping delivery of essentials may constitute ‘genocidal intent.’

·       French, Egyptian and Jordanian foreign ministers called for an “immediate and permanent ceasefire” in Gaza and the release of all captives held by Palestinian armed groups.

·       Germany, long a staunch ally of Israel as a way of atoning for the Nazi Holocaust, & its second-largest arms supplier started to question uncritical support of Israel in the face of the high costs of the war and threat of Rafah invasion.

·       Israel lobbyists (UK Lawyers for Israel) targeted a sold-out event on Palestine at London’s Freud Museum earlier this month, but ultimately failed to stop the discussionof mental health  from going ahead in an important moment for Palestine solidarity within a divided discipline. 

SOURCES

OCHA, WHO, Mondoweiss, Haaretz, The Guardian, New York Times, The Intercept, Portside, Electronic Intifada, Gallup, Aljazeera, Common Dreams, UN News, Novara Media, personal communication on whatsapp.