Rebuilding Gaza is a Massive Task

The rebuilding process in the Gaza Strip following 15 months of Israeli bombardment will “take an awful lot of time” despite the promised surge in humanitarian deliveries, a UN official in Gaza has warned.

“We’re not just talking about food, healthcare, buildings, roads, infrastructure. We’ve got individuals, families, communities that need to be rebuilt,” Sam Rose, acting director of the UN agency for Palestinian refugees (UNRWA) in Gaza, told the BBC.

“We’re expecting a major uptick in the volume of aid that’s coming in, and of course it’s far easier for us to go and collect that aid because many of the problems that we have faced so far in the war go away when the fighting stops,” Rose said.

But he also stressed that “we have to get away from thinking of people’s needs in Gaza as a function of the volume of aid”.

“Every person in Gaza has been traumatised by what’s gone on. Everyone has lost something. Most of those homes are now destroyed, most of the roads are now destroyed,” he added. “It’s going to be a long, long process of rehabilitation and rebuilding.”

The World Health Organization’s regional director, Hanan Balkhy, meanwhile said it had a 60-day plan to get Gaza’s health system back on its feet to meet the population’s urgent needs and prioritize care for the thousands of people with life-changing injuries.

The plan includes repairing Gaza’s hospitals – half of which are out of service and the others are only partially functional – setting up temporary clinics in the hardest-hit areas, addressing malnutrition and controlling disease outbreaks.

Most of Gaza’s 2.3 million population has also been displaced multiple times, 60% of buildings are estimated to be damaged or destroyed, the healthcare, water, sanitation and hygiene systems have collapsed, and there are severe shortages of food, fuel, medicine and shelter.

In October, the UN-backed Integrated Food Security Phase Classification (IPC) estimated 1.84 million people across Gaza were experiencing high levels of acute food insecurity, and that 133,000 people were facing catastrophic levels, which can lead to starvation and death.

The following month, an IPC committee warned that there was a strong likelihood that famine was “imminent” in some areas of northern Gaza.

Before the ceasefire, the UN said the besieged northern towns of Jabalia, Beit Lahiya and Beit Hanoun had been largely cut off from food assistance since the Israeli military launched a ground offensive and siege in October according to the Quds News Network.

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Gaza: Israeli Army, Strewn Bodies and Stray Dogs

Gaza’s Civil Defense reported, Saturday, Israeli forces are killing Palestinians and leaving their bodies in the streets where stray dogs are feeding on them as a clear violation of international law.

In a statement, the Civil Defense explained Israeli forces have repeatedly targeted rescue teams and ambulances, specifically when they attempt to approach the bodies of those killed.

It emphasized that Israel has also obstructed efforts to recover the bodies of thousands of Palestinians who have died under the rubble of homes destroyed in Israeli airstrikes.

It added that it had found several Palestinian bodies that had been reduced to skeletons according to Anadolu.

In other instances, it described seeing stray dogs feeding on the bodies in several neighborhoods, including Zeitoun, Shujaiya, Tel al-Hawa, the Jabalia area, Tal al-Zaatar, Beit Hanoun, and parts of the eastern areas of Khan Younis and Rafah.

Stressing that these actions by Israel constitute violations of the Geneva Conventions, it called on the signatory countries to “take immediate action to ensure Israel’s compliance with international law.”

They urged the international community, including the International Committee of the Red Cross (ICRC) and the World Health Organization (WHO), to “pressure Israel to follow proper protocols for handling the bodies of the deceased during wartime.”

Israel launched a genocidal war on Gaza that has killed more than 45,200 people, mostly women and children, since a cross-border attack by the Palestinian group Hamas on Oct. 7, 2023.

The International Criminal Court issued arrest warrants last month for Israeli Prime Minister Benjamin Netanyahu and his former Defense Minister Yoav Gallant for war crimes and crimes against humanity in Gaza.

Israel also faces a genocide case at the International Court of Justice for its war on Gaza.

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Ruined Lives: 22,500 Injured in Gaza Permanent

At least one quarter or 22 500 of those injured in Gaza by 23 July are estimated to have life-changing injuries that require rehabilitation services now and for years to come, according to a World Health Organization (WHO) analysis of the types of injuries resulting from the ongoing conflict in Gaza: Estimating Trauma Rehabilitation Needs in Gaza using Injury Data from Emergency Medical Teams.

The analysis found that severe limb injuries, estimated to be between 13 455 to 17 550, are the main driver of the need for rehabilitation. Many of those injured have more than one injury. According to the report, between 3105 and 4050 limb amputations have also occurred. Large surges in spinal cord injury, traumatic brain injury and major burn injuries all contribute to the overall number of life-changing injuries, which includes many thousands of women and children.

“The huge surge in rehabilitation needs occurs in parallel with the ongoing decimation of the health system,” said Dr Richard Peeperkorn, WHO Representative in the occupied Palestinian territory. “Patients can’t get the care they need. Acute rehabilitation services are severely disrupted and specialized care for complex injuries is not available, placing patients’ lives at risk. Immediate and long-term support is urgently needed to address the enormous rehabilitation needs.”

Currently, only 17 of 36 hospitals remain partially functional in Gaza, while primary health care and community-level services are frequently suspended or rendered inaccessible due to insecurity, attacks, and repeated evacuation orders. Gaza’s only limb reconstruction and rehabilitation center, located in Nasser Medical Complex and supported by WHO, became non-functional in December 2023 due to lack of supplies and specialized health workers being forced to leave in search of safety, and was later left damaged following a raid in February 2024. Tragically, much of the rehabilitation workforce in Gaza is now displaced. Reports indicate 39 physiotherapists have been killed as of 10 May. In-patient rehabilitation and prosthetic services are no longer available and the number of people with injuries requiring assistive products far exceeds the equipment available within Gaza. Partners report that stocks of essential assistive products such as wheelchairs and crutches have run out and it is difficult to replenish supplies due to the restricted flow of aid into Gaza.

The analysis focuses solely on new injuries sustained since the escalation of hostilities in October 2023. However, tens of thousands of Palestinians in Gaza were already living with pre-existing chronic conditions and impairments before this, putting them at significant risk due to the lack of appropriate services.

The estimates in the analysis will be used by WHO and partners to plan for a surge in rehabilitation-related services and contribute to long-term health planning and policymaking.

Amidst the ongoing hostilities, it is critical to ensure access to all essential health services, including rehabilitation to prevent illness and death. WHO reiterates its call for a ceasefire, which is critical for rebuilding the health system to cope with escalating needs.

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10% of Gazans Killed, Injured, Under The Rubble

About 10% of the Gaza Strip’s population has been killed, injured, or is missing due to the 293-day genocide carried out by Israel in the Strip, ongoing since 7 October 2023 according to the Euro-Med Human Rights Monitor.

Euro-Med Monitor’s preliminary statistics indicate that about 50,000 Palestinians have been killed. This number includes those reportedly trapped under the rubble of destroyed buildings, or whose bodies are either stuck on roads or in border areas that have been completely destroyed, and thus cannot be recovered. More than about 100,000 others, meanwhile, have been injured. The majority of these victims were civilians, mostly women and children, while about 3,000 additional Palestinians have simply disappeared after being arrested from the Gaza Strip, with their fate remaining unknown.

The estimates provided by Euro-Med Monitor are based on data and statistics gathered by its field teams in neighbourhoods and camps located in the Gaza Strip, as well as from information received from relevant authorities and institutions, including several hospitals and medical teams. These indicate that at least 51,000 people have died as a result of the Israeli blockade of the entire Strip; denial of medical care; collapse of the health sector due to Israel’s targeting and blockade; insufficient ambulance services due to said targeting and blockade, as well as a severe shortage of basic medicines, particularly for patients with chronic illnesses and cancer; prevention of the ability to travel abroad for treatment; and the spread of infectious diseases and epidemics.

Accordingly, the natural death rate increased from an estimated 3.5 per 1,000 people prior to the start of the genocide to 22 per 1,000 people during the genocide.

The number of beds available in operating hospitals and field hospitals across the Gaza Strip is down to less than 1,500, which is insufficient to accommodate the needs of over two million people. This is in contrast to the 3,500 beds that were available prior to 7 October. The scarcity of medical supplies and equipment is making the bed shortage worse, as is the Israeli army’s ongoing, systematic, and widespread destruction of hospitals and health facilities. Additionally, there has been a notable rise in the number of wounded and sick, which has resulted in a weak medical response and serious health complications for these individuals, as well as avoidable deaths among the elderly.

The lack of clean water, extreme overcrowding, breakdown of sanitation infrastructure, build-up of waste, scarcity of cleaning and sterilisation supplies, and the frequent forced evacuations all contribute to the rapid spread of infectious diseases.

According to World Health Organisation (WHO) data, 990,000 cases of acute respiratory infections—574,000 of acute watery diarrhoea, 107,000 of jaundice syndrome, and 12,000 of bloody diarrhoea—were recorded as of 7 July 2024, with the actual number of infections likely much higher. Rashes and skin infections, particularly among children, are also on the rise. This trend correlates with a drop in routine vaccination rates and a higher chance of vaccine-preventable illnesses like the poliovirus, which was recently found to be present in the Gaza Strip’s wastewater.

Since Israel started its genocide more than 10 months ago, the people living in the Gaza Strip have endured constant bombardment; shooting; tank shelling; methodical and extensive destruction of houses and other civilian property, as well as essential infrastructure; and frequent attacks on makeshift shelters and tents for the displaced.

Israel is continuing to commit genocide against civilians in Palestine, with the intention of eradicating and destroying them by all possible means, including starvation, denial of medical attention and humanitarian aid, systematic evacuation, torture, and the imposition of living conditions that will eventually cause their destruction.

Israel’s fierce military assaults have caused over 70% of the Gaza Strip’s buildings to be destroyed or severely damaged, forcing over two million Palestinians (out of roughly 2.3 million) to evacuate. The majority of these people have been forced to relocate multiple times, leaving them to live in filthy, uncomfortable temporary tents that are susceptible to the elements, and rendering them especially vulnerable to infectious diseases that spread quickly in crowded areas.

The hardship faced by hundreds of thousands of forcibly displaced people across the Gaza Strip is extreme. This is particularly true inside United Nations shelter centres, where there is severe overcrowding—up to five or six families crammed into a single classroom—and exceptional danger due to the Israeli military’s frequent attacks on these facilities, the damage they cause, and the potential for contamination from explosive ordnance.

This is coupled with a lack of supplies for making adequate shelters, a shortage of drinkable water, and storage issues, plus deteriorating sanitation conditions which have resulted in sewage seeping into the streets in many displacement sites. Additionally, families are frequently forced to rely on extremely salted water for drinking, and deal with a lack of personal hygiene due to the absence of privacy, personal space, water, and hygiene supplies.

The intense heat and accumulation of solid waste also attract insects such as mosquitoes. Communities often burn waste piles in an effort to stop the spread of insects and diseases, but the release of toxic fumes poses additional health risks.

Furthermore, a great deal of food insecurity exists as a result of Israel’s persistent efforts to obstruct the entry of aid supplies. In addition to a lack of infant formulae, few tests available to identify malnutrition, and uneven distribution of nutritional supplements, women struggle to breastfeed their babies as a result of psychological trauma, stress, and malnourishment.

As a form of retaliation and collective punishment against the people of the Gaza Strip, Israel has steadily targeted civilians, civilan objects, and UN-flagged shelter centres in an effort to cause as many casualties as possible. This constitutes full-fledged war crimes and crimes against humanity under the Rome Statute, which governs the International Criminal Court, as well as violations of international humanitarian law and the 1949 Geneva Conventions.

Ensuring the health and dignity of the populace through access to water and sanitation is a fundamental human right that has gained international recognition. However, granting this right to Palestinians in the Gaza Strip will require ending Israel’s genocide, lifting the siege, and salvaging what remains in the enclave, which is not currently viable for life. Delays will either cause all sectors in the Strip to completely collapse, or incur further significant costs in terms of civilian lives and health.

The international community is responsible for ensuring that humanitarian aid reaches the Gaza Strip, including the northern part of the Strip, in a timely, safe, and efficient manner. This aid must include all of the basic food and non-food items needed to address the dire circumstances that the entire Strip’s population is experiencing. 

Pressure must be applied to Israel to reopen the main pipelines that typically supply water to the Gaza Strip, particularly those that enter the north of the Strip, as well as to guarantee the safety of technicians who need to repair and restore the water lines and their various sources while also maintaining sanitation facilities and services. Pressure should also be applied to Israel to ensure that enough fuel is imported to run the Strip’s water and sanitation infrastructure, which includes stations, water desalination plants, water wells, and mobile water cycles, and to facilitate the entry of the necessary supplies for repair and rehabilitation work on such infrastructure. These services are essential to the civilian population in the Gaza Strip, and protect them from the risk of health disasters.

An immediate and urgent ceasefire in the Gaza Strip is necessary and critical, and must be accompanied by measures designed to enable the distribution of medical supplies, food, clean water, and other resources to meet people’s basic humanitarian needs. All nations must fulfil their international obligations by ensuring Israel’s compliance with the rules of international law and the decisions of the International Court of Justice, enacting strong sanctions against Israel, and severing all political, financial, and military support and cooperation with it. This should include immediately halting arms transfers to Israel, including export permits and military aid.

Nations that provide Israel with weapons, military technology, and other forms of support, despite the presumed knowledge that this support is being used to commit international crimes against the Palestinians, must be held accountable for the crimes that have been committed in the Gaza Strip, including genocide.

This article is reprinted from the Euro-Med Human Rights Monitor.

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