Buckling Gaza Health Service Turns to Volunteers

Palestinians walk among the rubble of destroyed residential buildings following Israeli air strikes on Tel al-Hawa neighborhood, in Gaza City, 30 October 2023. (EPA)
Palestinians walk among the rubble of destroyed residential buildings following Israeli air strikes on Tel al-Hawa neighborhood, in Gaza City, 30 October 2023. (EPA)
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Buckling Gaza Health Service Turns to Volunteers

Palestinians walk among the rubble of destroyed residential buildings following Israeli air strikes on Tel al-Hawa neighborhood, in Gaza City, 30 October 2023. (EPA)
Palestinians walk among the rubble of destroyed residential buildings following Israeli air strikes on Tel al-Hawa neighborhood, in Gaza City, 30 October 2023. (EPA)

Gaza medical chiefs are turning to volunteers to help run an emergency service buckling under Israel's offensive as ambulances struggle to reach bomb sites past rubble-strewn roads and with ever-depleting supplies of fuel.

Medical and emergency staff have worked with little rest and are deploying in the most dangerous areas, witnessing the horror of violent death, terrible injuries and grief.

Gaza's health ministry has called on all trained paramedics to help staff hospitals and call-out teams, but though dozens have responded the system is still in dire need of more workers, it said.

"I have not gone home since the first day of the war. I shower here, sleep here and eat here," said Loay al-Astal, a volunteer emergency worker in Khan Younis, in the south of the enclave.

Health authorities in the Hamas-run enclave say Israeli air and artillery strikes have killed more than 8,000 people since Oct. 7 when Hamas fighters rampaged through security barriers to kill more than 1,400 Israelis and take more than 200 hostage.

After Israel began ground operations on Friday, many Gaza residents fear the destruction will intensify.

Israel has ordered civilians to leave the northern half of the Gaza Strip for the south, but has continued an intense bombardment across the enclave and many people are refusing to leave.

Shelling on Gaza's main north-south road on Monday meant the enclave was all but cut in two, with any attempts to flee south risking bombardment.

The health ministry said 116 medical staff had been killed in the bombardment since Oct. 7, along with 18 civil emergency department rescuers.

Astal, the volunteer who had trained at university to be a paramedic but was unemployed when the war began, described an incident in which some of his colleagues had nearly been killed by an air strike that blew out the windows of their ambulance.

"The glass was smashed and some of our volunteers were wounded," he said.

He is haunted by the memory of trying to save a woman who was buried up to her neck in rubble from an air strike. "There was a cut on her head and I rushed to treat the wound," Astal, 33, said.

She asked him to free her from the rubble so she could find her son, but she died minutes later, still trapped, he said. "I felt bad I couldn't save her," he said.

'Where should we go?'

The head of the Khan Younis ambulance service, Naseem Hassan, said the department was overwhelmed and needed trained medics. "We opened the door for volunteers and many young people answered that call and have been on duty since the war began," he said.

Along with the bombardment, Israel has imposed a blockade on the enclave, home to 2.3 million people, cutting supplies of electricity and fuel. Limited food and medical aid deliveries have entered Gaza since last week after international pressure on Israel.

"Ambulances are about to go out of operation because we have very limited fuel left. We have problems with communications. We lose touch with the ambulances that leave here," said volunteer driver Sari al-Najjar.

Phone and internet services in Gaza were cut off for nearly two days over the weekend as Israeli tanks started moving into the enclave. Communications gradually started returning from Sunday.

Without reliable power supplies, many residents were unable to charge phones, adding to the difficulties for ambulance crews trying to locate and coordinate rescues.

Thousands of people have gathered at hospitals in Gaza City, in the north of the enclave, many sheltering in makeshift tents hoping for some safety from the bombardment.

Medical officials said air strikes in the vicinity of the major Gaza City hospitals including al-Shifa, al-Quds and the Turkish Friendship hospital, have caused damage.

Israel has accused Hamas of placing command centers and weaponry near hospitals, which the group denies.

"Where should we go? It is all one death," said Hatem Sultan, sheltering near al-Shifa Hospital, the enclave's biggest medical center, where ambulances were constantly arriving with people injured in air strikes.



'We Will Die from Hunger': Gazans Decry Israel's UNRWA Ban

 Itimad Al-Qanou, a displaced Palestinian mother from Jabalia, eats with her children inside a tent, amid Israel-Gaza conflict, in Deir Al-Balah, central Gaza Strip, November 9, 2024. REUTERS/Ramadan Abed
Itimad Al-Qanou, a displaced Palestinian mother from Jabalia, eats with her children inside a tent, amid Israel-Gaza conflict, in Deir Al-Balah, central Gaza Strip, November 9, 2024. REUTERS/Ramadan Abed
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'We Will Die from Hunger': Gazans Decry Israel's UNRWA Ban

 Itimad Al-Qanou, a displaced Palestinian mother from Jabalia, eats with her children inside a tent, amid Israel-Gaza conflict, in Deir Al-Balah, central Gaza Strip, November 9, 2024. REUTERS/Ramadan Abed
Itimad Al-Qanou, a displaced Palestinian mother from Jabalia, eats with her children inside a tent, amid Israel-Gaza conflict, in Deir Al-Balah, central Gaza Strip, November 9, 2024. REUTERS/Ramadan Abed

After surviving more than a year of war in Gaza, Aisha Khaled is now afraid of dying of hunger if vital aid is cut off next year by a new Israeli law banning the UN Palestinian relief agency from operating in its territory.

The law, which has been widely criticised internationally, is due to come into effect in late January and could deny Khaled and thousands of others their main source of aid at a time when everything around them is being destroyed.

"For me and for a million refugees, if the aid stops, we will end. We will die from hunger not from war," the 31-year-old volunteer teacher told the Thomson Reuters Foundation by phone.

"If the school closes, where do we go? All the aspects of our lives are dependent on the agency: flour, food, water ...(medical) treatment, hospitals," Khaled said from an UNRWA school in Nuseirat in central Gaza.

"We depend on them after God," she said.

UNRWA employs 13,000 people in Gaza, running the enclave's schools, healthcare clinics and other social services, as well as distributing aid.

Now, UNRWA-run buildings, including schools, are home to thousands forced to flee their homes after Israeli airstrikes reduced towns across the strip to wastelands of rubble.

UNRWA shelters have been frequently bombed during the year-long war, and at least 220 UNRWA staff have been killed, Reuters reported.

If the Israeli law as passed last month does come into effect, the consequences would be "catastrophic," said Inas Hamdan, UNRWA's Gaza communications officer.

"There are two million people in Gaza who rely on UNRWA for survival, including food assistance and primary healthcare," she said.

The law banning UNRWA applies to the Israeli-occupied West Bank, Gaza and Arab East Jerusalem, areas Israel captured in 1967 during the Six-Day War.

Israeli lawmakers who drafted the ban cited what they described as the involvement of a handful of UNRWA's thousands of staffers in the attack on southern Israel last year that triggered the war and said some staff were members of Hamas and other armed groups.

FRAGILE LIFELINE

The war in Gaza erupted on Oct. 7, 2023, after Hamas attack. Israel's military campaign has levelled much of Gaza and killed around 43,500 Palestinians, Gaza health officials say. Up to 10,000 people are believed to be dead and uncounted under the rubble, according to Gaza's Civil Emergency Service.

Most of the strip's 2.3 million people have been forced to leave their homes because of the fighting and destruction.

The ban ends Israel's decades-long agreement with UNRWA that covered the protection, movement and diplomatic immunity of the agency in Israel, the West Bank and the Gaza Strip.

For many Palestinians, UNRWA aid is their only lifeline, and it is a fragile one.

Last week, a committee of global food security experts warned there was a strong likelihood of imminent famine in northern Gaza, where Israel renewed an offensive last month.

Israel rejected the famine warning, saying it was based on "partial, biased data".

COGAT, the Israeli military agency that deals with Palestinian civilian affairs, said last week that it was continuing to "facilitate the implementation of humanitarian efforts" in Gaza.

But UN data shows the amount of aid entering Gaza has plummeted to its lowest level in a year and the United Nations has accused Israel of hindering and blocking attempts to deliver aid, particularly to the north.

"The daily average of humanitarian trucks the Israeli authorities allowed into Gaza last month is 30 trucks a day," Hamdan said, adding that the figure represents 6% of the supplies that were allowed into Gaza before this war began.

"More aid must be sent to Gaza, and UNRWA work should be facilitated to manage this aid entering Gaza," she said.

'BACKBONE' OF AID SYSTEM

Many other aid organizations rely on UNRWA to help them deliver aid and UN officials say the agency is the backbone of the humanitarian response in Gaza.

"From our perspective, and I am sure from many of the other humanitarian actors, it's an impossible task (to replace UNRWA)," said Oxfam GB's humanitarian lead Magnus Corfixen in a phone interview with the Thomson Reuters Foundation.

"The priority is to ensure that they will remain ... because they are essential for us," he said.

UNRWA supports other agencies with logistics, helping them source the fuel they need to move staff and power desalination plants, he said.

"Without them, we will struggle with access to warehouses, having access to fuel, having access to trucks, being able to move around, being able to coordinate," Corfixen said, describing UNRWA as "essential".

UNRWA schools also offer rare respite for traumatised children who have lost everything.

Twelve-year-old Lamar Younis Abu Zraid fled her home in Maghazi in central Gaza at the beginning of the war last year.

The UNRWA school she used to attend as a student has become a shelter, and she herself has been living in another school-turned-shelter in Nuseirat for a year.

Despite the upheaval, in the UNRWA shelter she can enjoy some of the things she liked doing before war broke out.

She can see friends, attend classes, do arts and crafts and join singing sessions. Other activities are painfully new but necessary, like mental health support sessions to cope with what is happening.

She too is aware of the fragility of the lifeline she has been given. Now she has to share one copybook with a friend because supplies have run out.

"Before they used to give us books and pens, now they are not available," she said.