Healthcare crisis threatens to tip Gaza over the edge

While diplomatically, progress is slowly being made, the overwhelmed hospitals in Gaza are in dire need of medicine

Brooklyn Middleton

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The 72-hour Egypt brokered ceasefire between Israel and Hamas that went into effect during the early hours on Tuesday has thus far held without incident. Meanwhile, the Israeli Defense Forces’ (IDF) ground troops pulled out of Gaza Strip territory. However, there is reason to believe that the ceasefire will be extended – chief among them is that the number one military goal of the IDF has apparently been fulfilled. Also, Hamas remains seriously weakened and once again seems to be deterred. The latter point was most clearly demonstrated when Hamas agreed to this latest ceasefire while withholding all of its previous demands for a cessation of hostilities.

If Hamas and or other militant factions in the Strip resume rocket fire targeting Israeli cities, it is likely that Israel – despite reportedly agreeing to an unconditional extension of the ceasefire – will retaliate with limited air strikes. With that said, the latest ceasefire, in addition to the IDF’s stated completion of their tunnel destruction mission, has likely led to a major de-escalation that will bring Israel and Gaza back to a “quiet-for-quiet policy.”

But despite this de-escalation – and lingering threats that Hamas will once again launch its rockets, inevitably triggering an Israeli response - the humanitarian situation in Gaza remains dire and few immediate solutions appear nearing implementation. Nearly one month of fighting has left at least 1,800 Palestinians - the figure includes civilians as well as militants and children - dead. The destruction across Gaza is extensive and surreal, with United Nations officials indicating the coastal territory likely sustained at least $5 billion in damage during the latest conflict. UNRWA spokesperson Chris Gunness reported that at least 169,012 Palestinians remain displaced in 90 different shelters across the Strip. Meanwhile, the U.N. has noted that at least 45,000 pregnant women are in need of access to maternity care – with at least 5,000 of those women remaining in shelters.

While diplomatically, progress is slowly being made – despite Hamas’ demands that no one in any official capacity is giving too much attention to (rightfully so, in my opinion) the overwhelmed hospitals in Gaza and dire shortage of medicine must be more comprehensively and immediately addressed.

Medical crisis

Before Israeli ground troops even put boots on the ground in the Strip, Dr. Mahmoud Daher, head of the World Health Organization (WHO) of the Gaza Strip office, told me in an interview that at least 28% of the essential medical supply list and 50% of general medical supplies were completely out of stock. With upwards of 9,000 Palestinians now injured and Israel’s field hospital set up at the Erez crossing going mostly unused, one shudders when assessing the current status of medical supplies and access to care. I spoke with Karl Schembri, regional media manager in the Middle East with Save the Children, who noted: “The month of conflict has put all the medical facilities under unprecedented strain. A total of 12 hospitals, 14 primary healthcare clinics and 29 ambulances have been damaged or destroyed by missiles, rockets and shrapnel from attacks in their vicinity.”

Meanwhile, Hamas has reportedly refused shipments of medicine from Israel with The Times of Israel reporting that Israeli Health Minister Yael German noted: “They don’t want the world to see us doing anything humanitarian.”

Leaving Gaza

While some reports indicate that Egypt has opened the Rafah crossing to evacuate injured Palestinians, others note periodic closures. Schembri said there are numerous critically injured babies and children “who risk dying of their wounds or remain permanently disabled” unless a swift evacuation for specialized treatment is immediately facilitated. But even among the well, Schembri noted, “there is also a scarcity of baby foods, besides the almost total collapse of the water and sanitation infrastructure that leaves children exposed to public health risks.”

Despite working on the ceasefire, I believe that Israel and Egypt have yet to coordinate efforts to efficiently evacuate Palestinian civilians in need of care through Rafah into Egyptian hospitals. As I wrote last week, the possibility of Israel and Egypt coordinating the deployment of Palestinian Authority security forces to man the Rafah crossing would offer two-fold benefits: as Hamas, Israel, and Egypt continue talking or not, Palestinian civilians desperately in need of care simply unable to be accessed in Gaza could be evacuated. Secondly, this immediate decision would allow for a much needed political gesture to PA President Mahmoud Abbas.

In my view, the fate of the tenuous ceasefire between Israel and Hamas will ultimately be determined by whether rockets once again begin striking Israeli cities in the near term. Meanwhile, it remains unknown whether President Abbas will play a new and crucial role in Gaza affairs by taking control of the Rafah crossing. Despite these two major unknowns, what is clear is the current status of healthcare in Gaza is a catastrophe and I believe that the need for all parties to facilitate the opening of the Rafah crossing for critical, humanitarian transfers is essential.


Brooklyn Middleton is an American Political and Security Risk Analyst reporting from Israel. Her work has appeared in Turkish and Israeli publications including The Times of Israel and Hürriyet Daily News. She has previously written about U.S. President Obama's policy in Syria as well as the emerging geopolitical threats Israel faces as it pursues its energy interests in the Eastern Mediterranean. She is currently researching Ayatollah Khomeini’s influence on Hamas and the Palestinian Islamic Jihad militant groups to complete her MA in Middle Eastern Studies. You can follow her on Twitter here: @BklynMiddleton.

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