The UN and European Union issued a joint warning on Monday that human development across Gaza has been set back by a staggering 77 years, with $71.4 billion needed over the next decade for recovery and reconstruction.
The assessment says $26.3 billion will be needed in the first 18 months to restore essential services, rebuild critical infrastructure and support economic recovery.
Since full-scale war erupted in Gaza following the Hamas-led attacks on southern Israel in October 2023, the physical damage in the Strip is estimated at $35.2 billion, with a further $22.7 billion in economic and social losses.
Entire sectors have been devastated, including housing, health, education, commerce, and agriculture.
Over 371,888 housing units have been destroyed or damaged, more than 50 per cent of hospitals are non-functional, and nearly all schools have been destroyed or damaged. The economy has contracted by 84 per cent.
Devastating human toll
The impact on the lives of Gazans is just as devastating: more than 60 per cent of the population having lost their homes and 1.9 million people displaced, often multiple times. Women, children, persons with disabilities, and those with pre-existing vulnerabilities bear the greatest burden.
Over two years of conflict has resulted in more than 71,000 Palestinian fatalities and over 171,000 injured, according to local authorities, with many still missing under the rubble.
Framework for reconstruction
The report provides the foundation for early recovery planning and reconstruction, stressing it must must run in parallel with humanitarian action to ensure an effective transition from emergency relief toward reconstruction at scale in both the Gaza Strip and West Bank.
The assessment is framed in line with Security Council adopted resolution 2803 (2025) of the US-backed Comprehensive Plan to End the Gaza Conflict, which welcomed establishment of the Board of Peace led by President Trump as a transitional administration to set the framework for redevelopment and authorised the mechanism to set up a temporary International Stabilisation Force (ISF).
The EU and UN emphasise that recovery and reconstruction should be Palestinian-led and should support the transition of governance to the Palestinian Authority, while advancing a durable political settlement based on the two-State solution.
Planning and implementation should be inclusive, transparent, and accountable, with particular attention to the needs of women, children, elderly, and persons with disabilities.
Conditions needed
The assessment recognises that a set of enabling conditions are essential for recovery, reconstruction, and implementation of the broader political framework:
A sustained ceasefire and adequate security
Unimpeded humanitarian access and immediate restoration of essential services
Free movement of people, goods, and reconstruction materials, within and between Gaza and the West Bank, and a functional, transparent financial system
Clear, accountable governance, including defined mandates and establishment of conditions for the transitional administrative bodies in coordination with the Palestinian Authority (PA)
A credible pathway for the PA’s future governance across the entire Occupied Palestinian territory, including Gaza, the West Bank and East Jerusalem, is essential
Debris clearance, explosive ordnance management, and resolution of housing, land, and property rights are prerequisites for reconstruction.
The international community must mobilise resources in a targeted, sequenced, coordinated manner
All obstacles to the deployment of expertise and equipment must be removed rapidly
The Palestinian Red Crescent Society stated, Sunday, that only 700 patients were able to depart the Gaza Strip, to receive outside health care as of last 2 February, 2026 when the Rafah Crossing was partially opened.
The PRCS added that more than 18,000 patients and those that are injured are still waiting for permission to leave for medical reasons, amidst tight Israeli restrictions.
Raed Al Nims, PRCS spokesman told “Sawt Falestine” the current pace of evacuation is “very slow and does not match the growing needs,” whilst warning that the health crisis in the sector is worsening.
He added about 700 patients left the Gaza Strip for treatment, while more than 18,000 wounded and sick individuals are awaiting urgent medical care.
Al-Nims explained thousands of critical cases are at risk of death due to the lack of medical resources, adding: “Lives are at stake, and some patients have already died while waiting on long waiting lists due to the absence of life-saving medical services.”
He clarified that patient selection is based on medical criteria that takes into account the severity of their condition, but procedures related to security approvals delay their departure, exacerbating their health problems.
This comes amidst Israel’s control over the Gaza Strip crossings, including the Rafah crossing on the Palestinian side, while it continues to occupy more than 50 percent of the Strip’s area. This further restricts the movement of patients and limits their access to treatment outside Gaza.
Al-Nims called on the international community to intervene urgently to ensure the permanent opening of the crossings and to keep medical cases separate from any political or security considerations, while also stressing the need to provide safe and sustainable corridors for medical evacuations.
Since the reopening of the Rafah Crossing, Palestinians returning to Gaza have reported as being subjected to Israeli mistreatment, including detention and harsh interrogations lasting for hours, before being allowed to continue their journey into the Strip.
Before the war, hundreds of Palestinians left Gaza daily through the crossing, and hundreds more returned to the Strip in a normal flow of traffic. The crossing’s operations were managed by the Gaza Interior Ministry and the Egyptian authorities, without Israeli interference.
With American support, Israel launched a two-year war of genocide against Gaza on October 8, 2013, leaving more than 72,000 Palestinians dead and over 172,000 wounded, most of them children and women, and destroying 90 percent of the civilian infrastructure.
Despite the ceasefire agreement in effect since October 10, Israel continues its campaign of genocide through a persistent siege and daily bombardments, resulting in the deaths of 773 Palestinians and injuries to 2,171 others, mostly children and women, in addition to widespread material destruction. Israel is also preventing the entry of agreed-upon quantities of food, medicine, medical supplies, shelter materials, and prefabricated homes into Gaza, where some 2.4 million Palestinians, including 1.5 million displaced people, live in catastrophic conditions. Anadolu
An official with Doctors Without Borders (MSF) said about 60 percent of the cases treated at the organization’s facilities in the Gaza Strip over the past six months were direct injuries. She explained that the situation for Palestinians has not changed significantly since the ceasefire signed at the end of last year.
Shaimaa Awda, head of the organization’s mental health support department, described the health situation in the Gaza Strip to Anadolu Agency as “suffocating.”
Despite the ceasefire agreement in Gaza coming into effect on 10 October, 2025, living and health conditions remain dire for the 2.4 million Palestinians in Gaza, including for the 1.4 million internally displaced persons.
Israel continues to renege on its commitments under the ceasefire agreement, including opening the crossings and allowing the entry of the agreed-upon quantities of food, relief supplies, medical aid, and shelter materials.
It also continues to commit daily violations of the ceasefire agreement, resulting in the deaths of 765 Palestinians and injuries to 2,140 others, according to a Gaza Ministry of Health statement.
A Dire Health Situation
Awda says that the organization’s teams have treated hundreds of dead and thousands of wounded, noting that injuries continue to arrive daily at its hospitals in Deir al-Balah and Gaza City.
She adds: “The violence continues, and the Gaza Strip is witnessing repeated incidents, the latest of which occurred in al-Maghazi camp, where medical teams received dozens of wounded, including critical cases.”
On 6 April, approximately 10 Palestinians were killed and others wounded by Israeli drone strikes and gunfire targeting a gathering of civilians east of al-Maghazi camp in the central Gaza Strip.
Awda explains that restrictions on the entry of medical supplies have severely impacted health services, pointing to the difficulty in providing essential medications, especially for chronic diseases such as insulin.
She also notes a severe shortage of surgical instruments, sterilization materials, and infection control supplies, which has negatively affected the quality of medical care and the teams’ ability to treat patients.
Diseases Spreading
Awda warns of outbreaks of diseases linked to deteriorating living conditions, such as skin diseases, diarrhea, and respiratory illnesses, resulting from the scarcity of clean water and inadequate sanitation services.
She emphasizes that diseases like scabies have become more prevalent, especially among children in shelters and tents, due to the lack of hygiene and adequate healthcare.
These statements coincide with warnings issued by the WHO Regional Director for the Eastern Mediterranean, Hanan Balkhi, in an interview with Anadolu Agency on Monday, that the spread of diseases in Gaza threatens the entire region due to ongoing Israeli restrictions on the entry of medical aid, which hinders the health response.
Increasing Cases
Awda points out that children are the most vulnerable group, with medical facilities receiving increasing cases of respiratory illnesses and infections, including meningitis, in addition to worsening skin diseases.
She adds that some families delay seeking treatment due to the social stigma associated with skin diseases, which exacerbates the children’s health conditions.
She stressed the need for “real political pressure” on Israeli authorities to allow the urgent entry of medical and food supplies, warning that the continuation of the current situation threatens dire humanitarian consequences.
She affirmed that “the suffering of the population continues despite talk of a truce, amid a severe shortage of resources and a decline in basic services,” calling for immediate international action to save what remains of the health sector in Gaza.
The ceasefire agreement was reached after two years of a genocidal war launched by Israel in Gaza on October 8, 2013, with US support. The war continued in various forms afterward, leaving more than 72,000 Palestinians dead and over 172,000 wounded, and causing widespread destruction affecting 90 percent of the civilian infrastructure.
KHAN YOUNIS, GAZA—Ahmed Al-Harsh waited outside Nasser Hospital in Khan Younis on Monday to meet his son, a toddler and the only other survivor of his entire family.
“I’m waiting for my son Mahmoud. I haven’t seen him in two and a half years except once, before he was transferred to Egypt. I’ve been waiting for two and a half years,” Al-Harsh, 31, told Drop Site News.
Mahmoud is one of 28 Palestinian infants who were evacuated to Egypt as premature babies in November 2023 from the neonatal intensive care unit in Al-Shifa Hospital in Gaza City, as the Israeli military laid siege to the medical complex and raided it. Mahmoud and seven other children were returned to Gaza on Monday to be reunited with their families, or what was left of them.
On October 14, 2023, one week into Israel’s genocidal assault on Gaza, the Israeli military bombed the Al-Harsh’s family home in the Jabaliya refugee camp. Al-Harsh’s entire family was killed in the attack—his four-year-old daughter, his father, mother, brother, sisters-in-law, nephews, and nieces. Al-Harsh initially thought his wife, who was eight months pregnant at the time, had also been killed. He only later learned that she had been gravely injured and had given birth to their son, Mahmoud, in hospital before succumbing to her injuries.
(Left) Ahmed Al-Harsh outside Nasser Hospital in Khan Younis as he waits for his son, Mahmoud, to arrive after 2.5 years in Egypt. (Right) Ahmed Al-Harsh holds up a photo of his son Mahmoud on his phone. March 30, 2026. Screenshots of video provided by Abdel Qader Sabbah.
Al-Harsh was able to see Mahmoud only once before he was taken to the neonatal intensive care unit in Al-Shifa’s hospital for care. He had been staying in Beit Lahia, unable to move amid the escalating Israeli assault. In November, Israel laid siege to Al-Shifa hospital, surrounding the medical complex and cutting it off from the rest of Gaza City before raiding it on November 15. Doctors inside scrambled to keep their patients alive, including the nearly 40 premature babies in the hospital’s neonatal intensive care unit, Mahmoud among them. There was no electricity and incubators were failing. The World Health Organization, which was able to coordinate a one-hour visit to Al-Shifa at the time, described the hospital as a “death zone.”
After much negotiation, 31 premature babies were evacuated from Al-Shifa on November 19 and taken to Rafah. UNICEF said the conditions of the babies had been “rapidly deteriorating” inside the besieged hospital. Five died before they could be evacuated. The next day, 28 of the babies were transported across the border to Egypt for treatment. None were accompanied by family members.
For the past two and a half years, Al-Harsh has seen his son only in photos or videos sent to him from Egypt—first as an infant, then a toddler. “The feeling is indescribable. What can I tell you about this feeling?” he said. “These two years felt like forty, even more—a lifetime. During this time, I was a body without a soul. I couldn’t work or do anything.”
Video of the convoy arriving at Nasser Hospital in Khan Younis bringing eight children who were evacuated from Gaza to Egypt in November 2023. March 30, 2026. Video provided by Abdel Qader Sabbah.
By early afternoon on Monday, the convoy from Egypt finally arrived. A Red Crescent ambulance and UN vehicles escorted a large bus carrying the children. Families crowded around the doors as they pulled up outside Nasser Hospital. The children were passed into the waiting arms of family members, most of them meeting for the first time, in scenes of joy. Al-Harsh appeared overwhelmed with emotion as he held Mahmoud, chubby, bespectacled and crying, in his arms. When Mahmoud grabbed a bottle of water and drank thirstily, Al-Harsh broke down and wept.
“Every human being needs the love of a mother and father. I am 31, I lost my mother and father, and I’m still suffering,” Al-Harsh said. “This boy—where do I find him a mother? Where do I find him his mother? When he grows up and asks about his mother, what do I tell him?”
At least four of the babies who were evacuated to Egypt died while there, Dr. Ahmed Al-Farra, the director of the pediatric department at Nasser Hospital, told Drop Site. He added that the children who returned to Gaza, while healthy, would require additional medical and psychiatric evaluation.
Gaza’s health care system has been systematically destroyed by the Israeli military since October 2023. Every single hospital was attacked and 25 were completely shut down while 13 remain partially functioning, according to Gaza’s Health Ministry. Despite a “ceasefire” that went into effect in October, Israel has continued near daily attacks in Gaza, killing over 700 Palestinians since then. Israel has also continued to severely restrict the amount of humanitarian aid, fuel, medicine and other essentials, allowing in an average of only 200 trucks daily instead of the 600 agreed upon in the deal.
At the onset of the U.S.-Israeli war against Iran on February 28, Israel reinforced a total siege on Gaza, citing “security concerns.” The Kerem Shalom crossing was partially reopened three days later. The Rafah Crossing between Gaza and Egypt—which had only opened in early February for medical evacuations and for Palestinians returning to Gaza—was also closed at the onset of the Iran war and only reopened on March 18. Roughly 20,000 people are on waiting lists for medical evacuation abroad, 4,000 of them children, according to the Health Ministry.
The Gaza Health Ministry this week warned of a severe shortage of generator fuel that threatened hospital operations. The Ministry said that remaining generators are “worn out and prone to repeated breakdowns,” placing critical departments such as intensive care, surgery, neonatal units, and dialysis at risk of shutting down. Israeli forces have allowed the entry of only 1,240 fuel trucks out of the 8,350 that were supposed to enter over the 167 days since the ceasefire agreement took effect—a compliance rate of just 14.8%—according to the latest statistics from officials in Gaza shared with mediators and obtained by Drop Site. The Health Ministry warned that 90 generators are already out of service, while 11 are running on limited supplies. All hospitals in Gaza remain fully dependent on emergency back-up generators, according to OCHA.
Regardless of the continued Israeli siege and daily military assaults, the families who were finally reunited with their children in Gaza on Monday after nearly two and a half years of separation, described the moment as nothing short of miraculous.
Sundus Al-Kurd was among them. She was badly wounded in an Israeli airstrike on her family home in Beit Lahia on October 22, 2023. Her daughter Habibat Al-Rahman was killed in the attack. Eight months pregnant, Al-Kurd was rushed to hospital where doctors operated on her to save her life and conducted an emergency delivery to save her unborn daughter, Bissan.
“On the day I gave birth to my daughter, I lost her only sister,” Al Kurd said.
“When I woke up, I asked, ‘Where is my daughter?’ They told me, ‘Your daughter is fine and doing well,’” she added. “They told me she was in an incubator and that due to my health condition I wouldn’t be able to care for her.”
Al-Kurd continued to recover from her injuries and was unable to see her daughter before the Israeli military attacked Al-Shifa in November 2023.
“I was evacuated from the hospital with difficulty and I asked to take my daughter with me, but they said I wouldn’t be able to care for her due to my medical condition,” she said.
Having lost her other daughter, parents, and two siblings during the war, Al-Kurd said she could not bear the thought of losing Bissan, whom she described as “a gift and compensation from God.” Al-Kurd did not know what had happened to her daughter until much later when she found out she had been among the 28 premature babies evacuated to Egypt.
Sundus Al-Kurd holds up a traditional Palestinian dress she brought for her daughter Bissan, who returned to Gaza after being evacuated to Egypt 2.5 years ago for medical treatment. Khan Younis. March 30, 2026. Screenshot of video by Abdel Qader Sabbah.
“Today, after two and a half years, God willing, we will be reunited with our daughter,” Al-Kurd said. She brought a traditional Palestinian dress for Bissan to wear. When her daughter finally arrived in the convoy to Nasser hospital, Al-Kurd held her tightly before dressing her in the white and red dress as relatives took turns embracing her.
“I am meeting my daughter for the first time,” she said. “It’s as if today is the day of her birth. I can’t describe my feelings.” Drop Site
General Dan Kaine, Chairman of the Joint Chiefs of Staff, delivered a confidential warning to President Trump with the utmost candor—the kind of candor that democracies rely on and empires routinely ignore. He said: “We don’t have enough ammunition to win this war. It’s not going to be pretty.” This warning wasn’t born of cowardice; it was the last vestige of institutional integrity that still flickers within the halls of American military power.
Trump’s response was that of a circus clown, not a commander-in-chief. Through his “Truth Social” platform—that distorted mirror of American political life—he dismissed the warning with the arrogance of a street vendor, saying: “Oh, no, no, no. If we do it, we’ll win easily.” Thus, a sober assessment became mere publicity, and caution a lie.
But the biggest lie came later. When Kaine’s warning leaked, Trump not only rejected it but completely reversed it. With the confidence of a man who has never been held accountable for anything, he told the American public the general had said the exact opposite—that the United States had plenty of missiles, munitions, and everything else. “That’s not what he said at all,” Trump declared, putting words of false victory in the mouth of a man who had offered only warnings.
And General Cain remained silent
This silence is not just a footnote in this story; it is the story itself. By remaining silent, Cain allowed the American public to absorb the falsehood as truth. He did not say: “No, Mr. President, that’s not what I said.” He did not invoke his oath, nor the soldiers who would pay with their lives for the gap between political rhetoric and logistical reality. He chose the safety of silence over the danger of truth, and in doing so, he betrayed not only himself but the Republic. This is the rot at the heart of American militarism.
As historian Andrew Bacevich has long warned, the professional military has become more of an instrument of imperial ambition than a defender of democratic values, with senior officers more concerned with their next post than with the Constitution they swore to uphold. Kaine’s silence was not a mere slip of the tongue; it was a symptom of a deeper malaise.
The logistical picture Kaine described in private was not theoretical; the calculations were unforgiving.
Current stockpiles of interceptor missiles and precision munitions could not sustain a prolonged air campaign against a country three times the size of Iraq. The Wall Street Journal documented a “worrying gap” in U.S. missile stockpiles, noting that reserves were “far below” the requirements of intensive and sustained operations. Pentagon contractors were instructed to “double or even quadruple” production of Patriot, SM-6, and precision-strike missiles—a tacit admission that the arsenal built for Cold War scenarios is inadequate for the war being fought today.
Consider Gaza: Israel, the most heavily armed military power in the Middle East, with complete air and naval dominance, has turned a tiny coastal strip into a moon-like landscape of devastation over two and a half years, yet it has not broken Hamas. Gaza is only 37 kilometers long. Iran, on the other hand, is a nation of 90 million people, with mountainous terrain, strategic depth, fortified infrastructure, and a combat-hardened Revolutionary Guard. The idea that it will collapse under a few weeks of American airstrikes is not strategy; it is wishful thinking. “God help us if this continues, if it gets to four weeks,” Colonel Daniel Davis warned on the Deep Dive podcast. He was speaking in military terms, and the same prayer applies. Politically.
When Trump now raises the prospect of sending ground troops, he is not escalating from a position of strength, but rather improvising from a position of denial. Admitting that air power and missiles alone cannot achieve the political objective is an admission that the original objective was never honestly assessed. This is the pattern of American wars at the end of an empire: Glittering promises, disastrous calculations, and then a grim and horrific reckoning paid in blood by those who had no seat at the table where the lies were told.
The costs are already piling up—not just in the currency of munitions and riches, but in the currency that empires always ultimately spend and regret most: credibility. America’s word, already devalued by two decades of contrived justifications for war, is getting cheaper by the day.
Democracies can tolerate miscalculations, and they can tolerate bad presidents, but what they cannot long tolerate is the institutionalization of a culture where the truth is whispered behind closed doors and swallowed whole in front of cameras. When the chairman of the Joint Chiefs of Staff allows his words to be weaponized for propaganda — when the man in charge of counting missiles refuses to correct a president who pretends they are plentiful — something far greater than military credibility collapses.
What is crumbling is the social contract between the governed and those who send them to their deaths.
Caine’s silence was not cautious; it was complicity. And in an imperial machine suffering from a shortage of ammunition and a shortage of truth, complicity is the only resource that seems inexhaustible, because when the missiles finally run out, slogans won’t replace them.
Reality will.
Al-Azzawi is an Iraqi writer who contributed this piece to Al Rai Al Youm which was translated and appeared in crossfire.com
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