Gaza- Since the start of the Israeli aggression on the Gaza Strip, with the first shell and missile, the health sector has been in the “target focus,” and instead of hospitals being a safe haven providing medical service to victims and patients, they themselves, with their staff and stones, have become the target of this aggression.
The memory still bears the major attack on the “Al-Shifa Medical Complex” in Gaza City, which is the largest complex in Palestine, which the occupation forces set as a main goal of their ground operation and their widespread invasion of Gaza City, and promoted many justifications that became clear in the end – according to medical organizations and bodies. And international human rights law – it is a set of lies, and Israel did not provide even a single piece of evidence that this complex departed from the context of its humanitarian health work.
Al-Shifa Complex went out of service, and the systematic targeting operations by the occupation against hospitals did not stop, and they continued to collapse and go out of service one by one, the most recent of which was Kamal Adwan Hospital in the town of Beit Lahia in the northern Gaza Strip. According to the Ministry of Health and local authorities in Gaza, the Israeli goal is “to destroy the health system.” “As a title for life and making Gaza unlivable.”
Systematic targeting
“Early, from the first moments of the war, we realized that we were in the eye of the storm and that we had no immunity from it,” says the General Director of Field Hospitals, Dr. Marwan Al-Hams, to Al-Jazeera Net. He adds: “Even now, with the escalation of the war in its second year, we still cannot protect ourselves from being targeted by killing and wounding.” And arrest.”
The targeting of the health system ranged between direct and indirect, and affected the health infrastructure of staff, facilities, devices and equipment. Of the 37 government, private and private hospitals that were operating before the outbreak of war on October 7, 2023, only 7 hospitals are currently operating with the minimum capabilities and specializations. Medical facilities are facing obstacles and are in danger of collapsing at any moment, whether as a result of threats or direct targeting, as is currently happening with Al Awda Hospital (a civil society association) in The Tal al-Zaatar area in Jabalia, north of the Gaza Strip, or as a result of severe restrictions on the supply of fuel, medicines, and humanitarian supplies, according to Al-Hams.
Official estimates indicate that the size of the health system’s financial losses is estimated at about one billion dollars, and Al-Hams confirms: “We work under extremely complex conditions and with minimal capabilities, and we suffer from a major shortage of specialized personnel, equipment, devices, and fuel (..) The medical device that stops working, we cannot Repair it because the occupation prevents the entry of spare parts.”
The Shifa Complex received the largest share of this major destruction in the health infrastructure. The occupation stormed this complex twice, wreaked havoc and destruction on it, killed 10 medical personnel, and arrested a number of others, led by the complex’s director, Dr. Muhammad Abu Salamiya, who spent months in prison before being released. He was released, and Al-Hams says: “Out of nowhere, we succeeded in the Ministry of Health in reopening the reception and emergency department in the complex, while the rest of the rare departments and specialties cannot be reopened in light of this war and this siege.” “The suffocator.”
Currently, and according to Al-Hams’ confirmation, there is no medical service in Gaza City and the northern Gaza Strip except in the Arab National Hospital known as the Baptist (a civil society association), and it is working with all its capacity despite the lack of cadres and capabilities, in addition to small private hospitals that cannot bear the burden of the war, while the Hospitals in the northern Gaza Strip went out of service, respectively, namely the Indonesian (government) and Kamal Adwan (government). They suffered great destruction, burning of equipment and equipment, and the arrest of medical personnel, most notably Dr. Hossam Abu. Safiya, while Al Awda Hospital is in a state of idleness and the occupation is tightening its siege on it, targeting its buildings and facilities with bombing and gunfire. According to its director, Muhammad Salha, the occupation demanded last week that they evacuate it, otherwise it will bomb it over their heads and the 112 patients in it, including 37 patients.
The reality of the medical situation in the south of the Gaza Strip does not seem much different from its north, and Al-Hams continues to diagnose this bitter reality and says that 3 government hospitals and two private hospitals are still struggling in the south of the Gaza Strip to continue providing medical service to about two million Palestinian residents and displaced people, who represent more than Of the 90% of the population in the small coastal sector.
Hospitals in the south of the Gaza Strip face what their counterparts in the north faced. In the city of Rafah, the far south of the Gaza Strip, which has been subjected to a continuous ground invasion since last May, the occupation forces destroyed all of its small hospitals, the most important of which is the Martyr Abu Youssef al-Najjar Hospital (governmental), which was run by Al-Hams himself. He says: “The occupation completely destroyed Rafah, including its hospitals.”
From time to time, the occupation forces target Al-Aqsa Martyrs Hospital (governmental), which is the only one in the city of Deir al-Balah and serves more than 700,000 people in the Central Governorate.
During their invasion of the city of Khan Yunis, which lasted for 4 months, between last December and April, the occupation forces stormed the Nasser Medical Complex (governmental), which is the second largest complex in the Gaza Strip after Al-Shifa, and arrested a number of its staff, led by the medical director of the complex, Dr. Nahed Abu. Taima, but strenuous efforts succeeded in restarting this complex after the Israeli withdrawal from the city, and it currently serves more than a million of its residents and displaced people.
Al-Hams asserts that the entire health system in the Gaza Strip needs reconstruction after the war stops and the siege is lifted, but before that, approximately two million and 300 thousand people in the Gaza Strip are in dire need of field hospitals to meet the needs until the reconstruction is completed, while there are currently 10 in the Khan Yunis and Central governorates. Field hospitals: The northern Gaza Strip governorate needs 3 field hospitals, the Gaza governorate needs 5 hospitals, and the Rafah governorate needs 3 hospitals.
Assassination and disappearance of specialized personnel
Local authorities in Gaza document that the occupation killed 1,060 members of the medical staff, and arrested 360, of whom 4 were martyred in prison as a result of severe torture, in addition to about 3,500 wounded, including cases of disability and amputation.
The occupation forces did not limit themselves to targeting the doctor, nurse, paramedic, and medical worker, but also expanded the scope of targeting to include the family and the family. Al-Hams says that there are many members of the medical staff whose families and families were deleted from the civil registry.
This is an intensification by the occupation of killing and raising the blood bill, such that there remains no refuge for war victims and the sick. In the opinion of Al-Hams, the occupation has permitted everything and destroyed all immunity for workers in all humanitarian sectors. This is a message that “hospitals are the last factors of Palestinian steadfastness and must be Destroying it with all its human and material resources.”
In conjunction with the targeting of local medical personnel, Al-Hams says that the occupation imposed severe restrictions on the arrival of foreign medical delegations, and further restricted them, by detaining them for long hours and humiliating searches, before allowing them to enter without any equipment, devices or medicines, and each doctor is only allowed two mobile phones. Provided that they are used, and as a result the number of medical delegations decreased from about 50 individuals per month before the outbreak of war to less than 7 currently, and this had an impact It has a major negative impact on the lives of the sick and wounded who need specialized medical interventions that are not available in the Gaza Strip, whether in terms of human staff or financial capabilities. This explains why about 25,000 people are in urgent need of travel and treatment abroad.
The severity of these restrictions imposed on the movement of delegations, the sick, and the wounded increased following the need for the city of Rafah and the occupation of the Rafah land crossing with Egypt, which is the only outlet for Gazans to the outside world. According to the Deputy Commissioner-General of the Independent Palestinian Commission for Human Rights, Amjad Shawa, the occupation controls this movement and only allows it. In the narrowest scope.
During the past few months, the occupation forces allowed a few hundred urgent medical cases to travel according to strict standards and complex security procedures, through the Kerem Shalom crossing, where they also put pressure on medical delegations, which Al-Shawa says the sector is in dire need of to support exhausted local cadres. Providing life-saving services to thousands of sick and wounded people who do not have access to treatment in the remaining hospitals.
The Director General of the Government Media Office, Dr. Ismail Al-Thawabta, believes that the absence of specialized doctors and the obstruction of their arrival among foreign medical delegations had disastrous effects, depriving the sick and wounded of urgent and necessary health care.
The strict Israeli restrictions that prevented international medical teams from reaching the Gaza Strip have led to a severe shortage of medical personnel and relief aid. In addition to the famine that afflicts hundreds of thousands, local medical personnel are facing enormous pressure and are unable to deal with large numbers of casualties. At the same time and with emergency situations that require rare and precise specializations that are not available in the sector, according to Al-Thawabta’s confirmation.
Restrictions and blockades
The restrictions and complications of the occupation extended to include the work of local relief organizations with all their specializations, including health, which, according to the Deputy Commissioner General of the Independent Commission for Human Rights, was “the first responder to confront the repercussions of the humanitarian disaster,” and despite its limited capabilities, this had a prominent role in alleviating the suffering of citizens, especially in relief and health. It has established medical points in many areas, specifically in shelter centers and displacement tents, and has provided supportive medical services that have reduced the burden on hospitals, in addition to psychological support services.
Despite the scope of their humanitarian work, the occupation did not allow these organizations to work in a safe environment, and deliberately targeted their headquarters and workers. Hundreds of workers in these civil relief organizations were martyred, and others were arrested, including doctors, one of whom was the director of Al-Awda Hospital, affiliated with the Al-Awda Community and Health Association, Dr. Ahmed Muhanna, It has been about a year since he was arrested from inside the hospital in Jabalia camp.
The stifling siege also prevented the work of relief organizations, with severe restrictions on the entry of all types of aid, including medical aid, and even assistive devices for people with disabilities and medical rehabilitation, the power outage crisis, and the lack of laboratory materials. Al-Shawa says: “All of these matters affected the ability to diagnose. In addition, the lack of important medications for people with chronic diseases affected their health, and some of them lost their lives as a result.”
At the end of this month, the Israeli decision to ban the work of the United Nations Relief and Works Agency for Palestine Refugees (UNRWA) will come into effect, and its implementation constitutes a real setback, as UNRWA is one of the main providers, whether of relief aid or medical services, according to Shawa.
Ambulance system
Al-Hams describes the workers in the ambulance teams as “fedayeen” working in a dangerous and complex field, and a large number of them paid the price for this humanitarian mission with their blood and freedom, as the occupation forces killed, wounded, and arrested dozens of them, and destroyed the majority of the ambulances and targeted them directly, even though they bore markings. Featured.
The health official says that the occupation has put the entire ambulance system out of service in the northern Gaza Strip, while it faces severe obstacles in Gaza City and the southern Gaza Strip. It is estimated that the health sector is in urgent need of about 60 modern and advanced ambulances, to compensate for the acute shortage, whether due to destruction or the stopping of cars. Service due to lack of spare parts or fuel.
One of these “guerrillas” is Hassan Omran, who has been working as a paramedic for 12 years. He says that he miraculously escaped death several times during his work in the field, while he lost a number of his comrades as martyrs, wounded, and detainees.
This paramedic is certain that the occupation is deliberately obstructing the work of ambulances and their arrival to the targeted locations to retrieve the martyrs and rescue the wounded, and completely prevents their access to areas that have become completely under its military and security control, such as the Rafah and northern Gaza governorates.
The government media office documents that the occupation forces have targeted 136 ambulances since the outbreak of the war, and Imran says: “Every time we go out on a field mission, we think it is the last and we fear death by a missile or shell.”
Medical education
Medical education in all its specialties was affected catastrophically, according to Al-Hams’ description, as a result of the destruction of medical colleges in universities and the destruction of hospitals, and students no longer had places for education and training.
This medical official says that before the war, Gaza had reached a stage of self-sufficiency in various medical specialties, including human medicine, dentistry, and veterinary medicine, as well as nursing, medical analysis, and other specialties taught by local universities. According to Al-Hams, volunteer medical students had a role. Prominent and supportive of doctors in hospitals during the months of war.
The Director General of the Government Information Office agrees with Al-Hams and says that the war has left devastating effects on medical education, which is a vital element for the sustainability of the health sector, as targeting hospitals and destroying health infrastructure has directly affected the training of students in medical specialties, and they no longer have the necessary environment to receive practical education and training. Clinical.
According to Al-Thawabta, approximately 10 universities and colleges offering advanced medical programs were severely damaged, affecting thousands of students seeking medical education, pointing out that this systematic destruction of the educational infrastructure hinders the development of future medical personnel and increases the suffering of the besieged health sector.
The occupation did not limit itself to targeting health and educational infrastructure and staff working in hospitals, but its crimes targeted more than 3,500 male and female students from the medical and nursing specializations who became martyrs, according to local statistics.