Gaza is not getting enough aid to meet even basic emergency needs, the UN has warned, and the population is so ravaged by hunger, bombing and the lack of clean water that deaths from disease could outstrip those from war.
“All this aid is triage, and it’s not even enough for triage,” a Unicef spokesperson, James Elder, told a press conference in Geneva, speaking by video link from inside Gaza. “Everything here is emergency care.”
Aid workers in Gaza are racing to assess needs and provide aid during a brief truce, the terms of which included allowing more food, medicine and other humanitarian supplies into the enclave.
Elder’s comments came as US and Israeli spy bosses flew to Qatar for talks on how to extend it further in exchange for the release of more hostages by Hamas.
The World Health Organization also said that only a “trickle” of aid was reaching Gaza, even during the pause in fighting. “It’s barely registering,” said Margaret Harris, spokesperson for the organisation. The scale of displacement meant needs were growing daily, even when there were no new war injuries.
The UN estimates 1.8 million people in Gaza have fled their homes, nearly four in five residents, with children making up half of those crowded into shelters, given shelter by relatives, or living in tents or cars.
“It is not just the hospitals, everybody everywhere has dire health needs now, because they are starving, because they lack clean water, they are crowded together, they are in terror so they have massive mental health needs. And there is a continuing rise in outbreaks of infections disease,” Harris said.
“Eventually, we will see more people dying from disease than we are even seeing from the bombardment, if we are not able to put back this health system and provide the basics of life. Food, water, medicines and of course fuel to operate hospitals.”
Diarrhoea increased by 45 times compared with the same period last year, and other communicable diseases, from respiratory infections to hygiene issues such as lice, have risen, she said, but people had little hope of getting treatment.
Almost three-quarters of hospitals in Gaza and two-thirds of primary health care clinics have shut down because of damage from hostilities or lack of fuel, the WHO says. The north of Gaza is even more critical, with hospitals “almost entirely shut down”.
Even with simple illnesses where parents understood how to protect their children, such as providing hydration to those with diarrhoea, they were powerless because of a lack of food or clean water.
Elder said the four-day truce – now extended by two days – had provided a brief respite to get aid into the territory and to allow people to search for and bury their loved ones. But it was not enough time to repair vital civilian infrastructure such as water treatment systems and hospitals, he said.
The humanitarian crisis would deepen fast if Israel started bombing Gaza again because people had been so weakened by two months of attacks, he added. “Gazans have told me here, they are starting [a new round of fighting] from a position of a nightmare,” he said. “With families having lost everything, with living outside, with rain coming, disease threatening and threats from the air.”
He described seeing scenes of devastation and deprivation. Teenage girls, queueing for two or three hours to use a toilet, told him”: “We have lost everything; why are we being denied our dignity.”.
At one aid delivery point in northern Gaza, people were so thirsty they drank water rations as soon as they were handed out. People queued for almost a mile waiting for cooking gas supplies.
Elder described evidence of trauma among children, including a boy who had lost both parents and his twin brother when their home was bombed. “He would perpetually close his eyes,” Elder said. “He’s picturing them. He’s terrified he will forget what they look like, he is terrified he will lose them in his mind.”
Unicef is working on creating safe spaces for children, but they need a longer break in fighting to heal. “This is not a place where children are going to recover, particularly when they wait, biting finger nails, to see if there will be another pause.”
A senior US official said the Biden administration was putting pressure on Israel to improve water supplies to prevent a health crisis. “The real key to preventing the kind of outbreaks – typhoid, cholera – which tend to occur in situations like this, is increasing the supply of potable water and sanitation,” said the official, who spoke on condition of anonymity.
“That is why we have placed such emphasis since the beginning of this engagement on moving as much fuel as possible in order to power everything from sewerage pumps, to the desalination system in the south. The fuel that is being provided now has made a big difference. More fuel needs to continue to come.”
Hamas’s attack on 7 October killed 1,200 Israelis, most of them civilians. Israel’s military response has led to the deaths of more than 15,000 Palestinians in Gaza, more than two-thirds of them women and children, according to data from Gaza’s health ministry.
