World leaders including UK Prime Minister Rishi Sunak have joined urgent calls for temporary “pauses” in the fighting to allow delivery of aid and for foreign citizens to evacuate, as hospitals across Gaza shut down due to critical shortages. The health ministry in the besieged enclave – run by Hamas – has said the healthcare system has "collapsed".
Speaking to The Independent, Tamara el-Rifae, a spokesperson for UNRWA, the UN’s Palestinian refugee agency, said that unless fuel arrives imminently their critical support across many facets of life in Gaza may stop.
“There has to be a way to get the fuel in otherwise everything can stop tomorrow, or we have to make extremely hard choices,” she said.
“We will have to decide whether to direct [the last rations of] fuel to generators in hospitals, or to bakeries to make bread for people’s survival or to trucks to deliver aid or to desalination plants for clean water so that people aren’t forced to drink contaminated water,“ she added.
Gaza is buckling under a total siege imposed by Israel that has unleashed its heaviest bombardment ever, in retaliation for the 7 October attack on south Israel by Hamas militants who killed 1,400 people and took around 200 hostage.
Just 54 trucks of aid have been permitted to enter the strip since then, which rights groups say is just “a drop in the ocean of need”. Israel is blocking delivery of fuel it says it would be used by Hamas to fire rockets at Israel.
The lack of fuel is threatening thousands of lives of civilians. The World Health Organisation (WHO) said that 130 premature babies in incubators, 1,000 patients in need of dialysis and hundreds more on life support machines will die instantly if generators give out.
More than 6,500 people, including 2,700 children have been killed in Israel’s bombardment, according to the Gaza health ministry.
Currently one third of Gaza’s hospitals and nearly two-thirds of the primary health care clinics have stopped working in the bombing and siege, which UN experts and rights groups say amounts to collective punishment and so is a violation of international law.
More hospitals, including Al-Awda, the main maternity provider in north Gaza, will close down “in hours”, according to international rights group ActionAid.
Dr Ashraf al-Qudra, a spokesperson for the health ministry announced that the health system has completely collapsed due to a lack of supplies and fuel.
In a statement the ministry said twelve hospitals and 32 health care centres are now out of service due to direct and indirect Israeli targeting and a lack of fuel due to the ongoing siege.
The WHO together with UNRWA is responsible for delivering fuel to four hospitals in south Gaza and the Palestinian Red Crescent for ambulances. In a statement to The Independent WHO officials said “without fuel, there is no health care, without health care vulnerable patients will die.”
Doctors in Gaza said that they have been reduced to using shop bought vinegar and washing up liquid to wash wounds as medical antiseptics were in short supply. For days they have had to ration the use of anaesthesia in surgery.
“We are now making compromises at every level,“ said Dr Ghassan Abu Sitta, a British Palestinian surgeon who was working with Doctors without Borders at Gaza’s largest hospital Al-Shifa in Gaza City.
“There are now 150 critical ventilated patients in makeshift intensive care units all around the hospital,. They are completely depended on the electricity like the operating machines are, like the neonatal intensive care unit are. If the generators stops Shifa hospital will become a mass grave,” he said.
Khaled, a doctor in al-Awda Hospital, the main maternity provider in Northern Gaza and a partner of ActionAid, said the situation was so critical the medical centre was on the verge of shutting down.
“We will have to stop the activities if we do not receive more fuel. We are working on two generators alternatively. There has been no electricity at all for 17 days in Gaza,” he said in a statement shared by the group.
“We cannot evacuate. We have patients, critical patients.”
Mr Sunak has backed "specific pauses" in the conflict between Israel and Hamas to allow British nationals to escape Gaza and let aid in but rejected calls for a ceasefire.
The prime minister said breaks in fighting as Israel pummels the small territory, which is home to more than two million Palestinians, are necessary to get hostages released as well. Aid trucks have been permitted to reach Palestinians only in the past days.
British aid charity Oxfam said starvation was being used "as a weapon of war" as it repeated its call for more aid to be allowed into the bombarded 42-km long Strip.