Gaza’s crumbling health services are now matched by parallel Rafah meltdown

Gaza faces its deepest crisis as Palestinians, mourning their dead and injured, marked Wednesday’s 76th anniversary of the Nakba, Israel’s 1948 war which has defined their lives. During that war, 750,000 Palestinians were driven from their homes. The majority settled in United Nations refugee camps in Gaza, East Jerusalem, the West Bank, Jordan, Lebanon and Syria. Registered refugees now number 5.9 million out of a global Palestinian population of 14.3 million.

According to the UN, Gazans fleeing the southern Rafah governorate comprise 450,000-500,000 of the 1.4 million sheltering there before Israel began its Rafah offensive on May 6th. Some 100,000 have been displaced in northern Gaza, raising the total of Gazans on the move to almost a quarter of Gaza’s 2.3 million population. They face war, wounding and illness at a time when the UN has reported that 24 of the 36 hospitals in Gaza are out of service.

One of the spurs driving flight from Rafah is fear of injury and illness as medical care has dwindled during the seven months of war. Relief agencies have said the situation has become catastrophic since aid supplies to the south halted after the Rafah-Egypt crossing closed when Israel opened its Rafah offensive.

Rafah’s surviving hospitals have been functioning partially, due to damage and the lack of medicine, fuel, water and food. The largest, Abu Youssef Al-Najar, was abandoned after the Israeli military ordered the evacuation of eastern Rafah. The Emirati maternity hospital continues to deliver babies and the Kuwaiti hospital, with only four intensive care units, struggles to treat the wounded. The European Hospital north of Rafah, which took referrals, ceased operations on Wednesday after its generators stopped when fuel ran out.

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[ Explainer: What is the Nakba? ]

To make up for the absence of fully functioning established hospitals, the field variety has proliferated. They provide emergency surgery for severe injuries and treatment for communicable diseases and complications from untreated chronic ailments.

As Israeli tanks and troops advanced toward the centre of Rafah this week, the Red Cross opened a 60-bed field hospital, staffed by Australian medics, to provide emergency care to 200 patients a day.

However, the aid agency Médecins Sans Frontières (MSF) has warned that such “structures will not be able to cope with a large influx of wounded civilians, on top of overwhelming medical needs. They can in no way replace a functional health system”.

MSF halted operations at Rafah’s Indonesian field hospital and its 22 patients were transported to other facilities as their safety could not be guaranteed.

“We have had to leave 12 different health structures and have endured 26 violent incidents, which include air strikes damaging hospitals, tanks being fired at deconflicted shelters, ground offensives into medical centres and convoys fired upon,” said MSF emergency operations head Michel-Olivier Lacharité.