Doctors and aid workers in Gaza say they have been abandoned by the international community to a “humanitarian tragedy” as they “fight to survive” after almost four weeks of war between Israel and Hamas.
With widespread destruction in urban areas and basic services collapsing amid continuing airstrikes, artillery bombardments and close-quarters fighting, little remains of the former lives of the 2.3 million inhabitants of the territory, said many of those who spoke to the Guardian.
Israel has placed Gaza under a near-total blockade since it launched its effort to destroy Hamas after the murderous attacks by the Palestinian militants in southern Israel on 7 October that killed 1,400 people, mostly civilians. Hamas also seized more than 240 hostages, including infants and elderly people.
Power, food and clean water has become increasingly difficult to find, while an almost total lack of fuel has emptied Gaza’s usually busy roads and stopped many generators.
At least 9,227 Palestinians have been killed since the Israeli offensive began, including 3,826 children, according to the Hamas-run health ministry in Gaza. It is unclear how many of the dead were combatants.
“It is a terrible situation, a real catastrophe … We feel totally abandoned, left alone, left by ourselves,” said Dr Shawqi Muhaisen, a well-known neurologist in Gaza.
Conditions inside the UN-run schools and compounds where about 700,000 people have sought shelter are deteriorating rapidly. Witnesses report acute overcrowding, the spread of infectious diseases, inadequate washing facilities and limited water.
Healthcare has been particularly badly hit. One UN administrator described hiring a donkey cart to search the few pharmacies that remained open for vital medicine for his sick 76-year-old mother.
“It was dangerous because of the airstrikes, but you do what you have to do for your loved ones,” said the administrator, who was not authorised to talk to the media.
An NGO worker in northern Gaza, where the most intense bombing and fighting has been taking place, described a similar frantic search to find a doctor to treat an elderly relative and then for clean syringes.
“All the hospitals were overflowing with casualties from the airstrikes. I saw appalling scenes. Children with their faces covered in blood, mothers crying as they searched for their children, fathers carrying their daughters and crying like babies,” said Mahmoud Shalabi, a programme manager in Beit Lahiya for the UK-based charity Medical Aid for Palestinians.
More than a third of Gaza’s hospitals are no longer functioning, putting remaining facilities under massive pressure. There are reports of operations carried out by torchlight, without anaesthetic and with vinegar used as a disinfectant.
Muhaisen, 54, said he had abandoned hope of ever treating hundreds of patients who depended on him for vital care as his clinic, equipment and home had all been destroyed. In the compound at Khan Younis, where he was sheltering with his family, 24 toilets served an estimated 22,000 people.
“It is a terrible situation, a real catastrophe, there is a shortage of medicine. We have to queue for hours for the toilet. I am restricting what I eat and drink so I don’t have to go to the bathroom,” he said.
Antony Blinken, the US secretary of state, arrived in Tel Aviv on Friday to meet Israel’s war cabinet and urge greater restraint in its campaign to destroy Hamas.
An Israeli military spokesperson said on Friday that the aim of the offensive was to eradicate the political and military capabilities of Hamas and ensure that no repeat of the 7 October attacks was possible.
“This will take as long as it will take,” said Lt Col Richard Hecht, who accused Hamas of deliberately placing rocket launch sites next to UN-run schools and stockpiling precious fuel.
In an attempt to justify its refusal to allow fuel into Gaza, the Israeli army released a recording of a conversation that it said featured a Hamas health ministry official who admitted that the organisation kept fuel stockpiles beneath Shifa hospital in Gaza City.
Though 68 trucks carrying medical and other supplies entered the enclave on Thursday, conditions across Gaza continued to deteriorate.
Yasmin Sharraf, 37, told the Guardian she had sought shelter three weeks ago at a UN-run vocational training compound outside Khan Younis after fleeing her home in Gaza City.
“It is very horrible. It is a very crowded place. My kids are very sick with chickenpox and some respiratory infection but I cannot get them proper care,” Sharraf said. “We are all sleeping in our car together so now I am sick too.”
Periodic shutdowns by Israel, lack of power and damage from bombing has rendered much of the communications network inoperable, residents said.
“We felt totally isolated. It was really a torture. And I couldn’t connect with the rest of the family. We try to check on each other all the time. When we finally got through, my wife was crying with relief,” said one journalist who moved from Gaza City to Nuseirat refugee camp at the beginning of the conflict.
“We were really worried, we were thinking is this the end, do they want to isolate the place to do what they want without anybody hearing.”
The Israeli army said airstrikes across Gaza had targeted Hamas military command centres hidden in civilian area and that sometimes ambulances were used by Hamas to transport its fighters.
There are widespread concerns over the mental health of children and that of their parents, too. In the compound in Khan Younis, a UN administrator said he had told his young children that they had left home to go camping, hiding the truth that the house he and they had grown up in was in ruins.
“Now they just say they want to sleep in their own beds and cry all the time. I don’t know what to say any more,” said the administrator, who requested anonymity.
Others said they had not told their children about relatives and friends who had been killed or badly injured in an effort to spare them further trauma and fear.
“They ask me when it is going to be over and I tell them all things come to an end,” the UN administrator said. His uncle and several cousins were killed two weeks ago.
Muhaisen, the neurologist, said he dreaded the coming days. “Nobody cares truly about human rights. There is lots of talk but then no one takes any action. No one cares … We have no hope. I think the worst is still to come,” he said.