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UPDATED: Gazans struggle for survival; aid reaches stricken hospital

Hundreds of thousands of Palestinians still in northern Gaza face unprecedented hardship after being isolated by Israeli military operations, while a medical convoy sent by the UN and partners was fired on in Gaza City, the Organization’s humanitarians said on Wednesday.

The development came as foreign ministers from the G7 group of countries joined international calls on Wednesday for humanitarian pauses in the fighting to protect civilians, help bring in aid and support the release of the more than 240 hostages held captive in Gaza by Hamas since 7 October.

No bakeries are functioning in the north because of a lack of fuel, water and flour and no food or bottled water has been distributed there in a week, according to UN humanitarian affairs coordination office OCHA.

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Convoy under fire

Due to the lack of medical supplies, hospitals in the north now conduct surgery without anaesthesia, UN health agency WHO said.

Adding to the dire healthcare picture, OCHA reported that a convoy of five trucks from WHO and the UN agency for Palestine refugees (UNRWA), escorted by two vehicles of the International Committee of the Red Cross (ICRC) came under fire on its way to deliver lifesaving medical supplies to the Shifa and Al Quds hospitals in Gaza city on Tuesday.

Two trucks were damaged and a driver was injured, but the convoy ultimately reached Al-Shifa hospital and made its delivery, OCHA said.

‘Disastrous’ conditions, UN chiefs warn

UNRWA confirmed on Wednesday night local time the delivery of WHO’s much needed emergency medical supplies and medicines to Al-Shifa hospital in Gaza City, “despite huge risks to our staff and health partners”.

In a statement, the head of UNRWA, Phillipe Lazzarini, together with WHO chief Tedros Adhanom Ghebreyesus, said this was only the second delivery of lifesaving supplies to the hospital since Israel’s total siege of Gaza began.

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“While welcome, the quantities we delivered are far from sufficient to respond to the immense needs in the Gaza Strip. The medical conditions at Al-Shifa - the largest hospital in the Gaza Strip and one of the oldest Palestinian health institutions - are disastrous”, said the heads of WHO and UNRWA. 

“There are currently almost two patients for every bed available.  The emergency department and wards are overflowing, requiring doctors and medical workers to treat wounded and sick patients in the corridors, on the floor, and outdoors”, they added.

Tens of thousands of displaced people have sought shelter in the hospital’s parking lots and yards.  

“Al-Shifa Hospital has traditionally been the most important health facility in Gaza.  Its doctors, nurses and other workers have responded heroically to the current desperate situation.  But they need more support.

"The northern areas of Gaza cannot and should not be isolated nor deprived of the delivery of humanitarian assistance. Patients there cannot be denied the healthcare to which they are entitled and urgently need.  Aid should reach the whole of Gaza”, the top UN officials said.

99 UNRWA staffers killed

Briefing journalists in New York after noon local time, the UN Spokesperson Stéphane Dujarric said the the number of UN Palestine refugee agency (UNRWA) staff who have been killed during the continuing Israeli bombardment, has reached 99.

Answering questions from correspondents, Mr. Dujarric said that "when this conflict ends there will need to be accountability" for the deaths.

Risk of disease spreading soars: WHO

As deaths and injuries in Gaza continue rising, intense overcrowding and disrupted health, water, and sanitation systems pose an added danger: the rapid spread of infectious diseases, said the UN health agency in a statement, adding that "worrying trends are already emerging."

"Lack of fuel has led to the shutting down of desalination plants, significantly increasing the risk of bacterial infections like diarrhea spreading as people consume contaminated water. Lack of fuel has also disrupted all solid waste collection, creating an environment conducive to the rapid and widespread proliferation of insects, rodents that can carry and transit diseases."

The situation is particularly concerning for almost 1.5 million displaced people across Gaza, especially those living in severely overcrowded shelters with poor access to hygiene facilities and safe water, increasing risk of infectious diseases transmission, WHO noted. 

Evacuation continues

Meanwhile, Israeli bombardments continued across the Gaza Strip while Palestinian armed groups continued launching projectiles toward Israel.

Israeli troops are reportedly inside Gaza City in pursuit of Hamas fighters responsible for the deadly 7 October attacks in southern Israel.

OCHA said that the Israeli military reiterated its evacuation orders to residents in the north and on Tuesday, for the fourth consecutive day, opened a “corridor” along a main traffic artery, giving residents a four-hour window to move southwards.

UN monitors estimate that up to 15,000 people may have used this route. OCHA stressed that “the majority, including children, elderly people and people with disabilities, arrived on foot with minimal belongings”.

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Children on life support at risk

On Tuesday the Israeli army also renewed its evacuation orders for the Rantisi hospital in Gaza City, the only paediatric facility in the north, “claiming that armed groups were using its premises and surroundings”, OCHA said.

According to Gaza’s health authorities, such an evacuation would endanger the lives of dozens of children who are either on life support, undergoing kidney dialysis or relying on respirators.

War crime warning

As many as a third of all buildings in northern Gaza have reportedly been destroyed or damaged, and a UN-appointed independent rights expert warned on Wednesday that systematic or widespread bombardment of housing, civilian objects and infrastructure are strictly prohibited by international humanitarian law, criminal law and human rights law.

Balakrishnan Rajagopal, the UN Special Rapporteur on the right to adequate housing, said that carrying out hostilities “with the knowledge that they will systematically destroy and damage civilian housing and infrastructure, rendering an entire city – such as Gaza city - uninhabitable for civilians is a war crime”.

UN Special Rapporteurs are independent experts appointed by the UN Human Rights Council. They are not employees of the UN and do not receive a salary from the UN for their work.

Chronic water shortage

In southern Gaza, finding food and water remains challenging, OCHA said. Eleven bakeries have been hit and destroyed since 7 October and “the only operative mill in Gaza” is at a standstill due to a lack of electricity and fuel.

OCHA said that bread is provided to bakeries “intermittently” and people queue for long hours in front of the functioning bakeries, where they risk being hit by airstrikes.

Water entering from Egypt in bottles and jerry cans is “addressing only four per cent of the residents’ water needs per day”, OCHA warned, based on an allocation of three litres per person per day for all purposes, including cooking and hygiene.

Aid ‘a drop in the ocean’

On Tuesday, 81 trucks carrying food, medicines, health supplies, bottled water and hygiene products entered Gaza from Egypt through the Rafah crossing. In total, 650 aid trucks have entered Gaza since deliveries resumed on 21 October.

OCHA recalled that prior to the start of hostilities, an average of 500 truckloads entered Gaza every working day; WHO has called the amount of aid it has been able to provide so far “a drop in the ocean” compared to the vast needs.

The UN has repeatedly called for more aid access to the enclave. On Thursday, UN relief chief Martin Griffiths will represent Secretary-General António Guterres at an international conference on humanitarian aid for Gaza’s civilians hosted by French President Emmanuel Macron in Paris.