In Gaza, the dead go uncounted as medical infrastructure disintegrates

BEIRUT - A line of medical workers in scrubs, young men with bewildered expressions and a boy walk hurriedly through a door, each gingerly cradling the tiny form of a swaddled premature baby brought from the nursery of Gaza’s al-Shifa Hospital.

The video, aired by Al Jazeera on Tuesday, gave a rare glimpse inside Gaza’s largest hospital, where fuel reserves went dry on Friday and power was cut off from incubators and the lifesaving machines in the intensive care unit. The babies were being relocated from the nursery to an operating room that still had some power.

As Israeli forces push into the heart of Gaza City to pursue their mission to destroy the militant Hamas movement, civilians are bearing the brunt, and the hospitals that once provided succor are shutting down as communications break down and fuel for generators runs out.

Gaza’s hospitals have been caught in the crossfire of the fighting, with Shifa emerging as a focal point. Israel alleges that Hamas uses hospitals — including Shifa — to conceal its bases, while the injured and displaced living on the grounds act as human shields. Hamas accuses Israel of targeting health facilities to cut off a lifeline for residents.

The United States backed Israel’s allegations on Tuesday. “We have information that Hamas and the Palestinian Islamic Jihad used some hospitals in the Gaza Strip, including al-Shifa, and tunnels underneath them, to conceal and support their military operations and to hold hostages,” said National Security Council spokesman John Kirby, citing “a variety of intelligence sourcing.”

The disintegration of the Gaza infrastructure also means that information about what is happening and the numbers of those affected is scarce.

[Civilian buildings increasingly at center of Israeli operation in Gaza]

“There is no ministry basically to put out a number,” said Medhat Abbas, one of the Health Ministry’s directors. He said he had been unable to speak with his colleagues, many of whom are at Shifa. “The corpses are in the street, so we can’t say any number right now,” he said. “The bombardment is ongoing.”

The lack of fuel, in hospitals both in the north and in the south, has led to a breakdown in communication and made tallying the dead impossible. Damage from the fighting has also severely degraded the mobile network.

The ministry stopped updating its tally on Friday at 11,078 but estimates that thousands more have died since then. There have been strikes on the Jabalya refugee camp and in Khan Younis since the counting stopped.

Israel launched its operation in Gaza in response to the Hamas attack on southern Israel on Oct. 7, during which more than 1,200 people in Israel were killed and about 240 hostages were taken.

U.S. National Security Council spokesman John Kirby said Tuesday that the Biden administration was “in active discussion as we speak right now with counterparts in the region” about a potential agreement for the release of some of the Israeli and foreign hostages. Brett McGurk, the NSC coordinator for Middle Eastern affairs, was traveling to the region to continue talks among the United States, Israel and Qatar, which serves as a go-between with Hamas, Kirby said.

Amid its push deeper into Gaza, the Israel Defense Forces announced it had taken over the building of the legislature and other government facilities, a police headquarters and an engineering faculty that it said produced weapons.

[Israeli military seizes broader control of northern Gaza and captures key government buildings]

Basem Naim, a Hamas official, told The Washington Post that government headquarters had been destroyed by Israeli bombardment and that the police headquarters was empty. “This is an attempt to create a fictitious victory,” he said. The legislative council had been “destroyed more than once before, and there are no forces in it even if they entered it.”

Since Friday, no ambulances have been allowed to reach Shifa hospital, which is now host to approximately 10,000 patients, staff and displaced people. Health Ministry spokesman Ashraf al-Qudra said the hospital director and Israeli officials are communicating about evacuation but have not reached a resolution.

“We are trapped inside the buildings. We can’t step outside,” Qudra said Tuesday in a rare phone call from Shifa. “Nothing is available inside the hospital — water, food or medical supplies. That’s why we lose patients.”

He said three babies, born premature, died as a direct result of the lack of electricity and basic necessities such as water; 37 other people have died since Friday, he said.

By Tuesday, Shifa’s unlit nursery had been completely emptied: Al Jazeera showed a room full of empty incubators. In an operating room that still had some power, the 34 remaining infants were placed side-by-side on three beds wrapped in teal blankets, their tiny limbs flailing as they mewled softly. Four were born to dead mothers, Al Jazeera reported.

The accounts and footage could not be independently verified by The Post.

“We have no objection to evacuate the patients,” Qudra said, “but we need a safe passage. There is yet no place to house 650 patients.”

Nowhere in northern Gaza is safe to evacuate to: The U.N. Development Program said Tuesday it had received reports that its compound in Gaza City was struck by a shell fired by a tank, but reported no casualties. The hit was the “second such incident in two days,” the agency said, after a separate shelling against the compound on Saturday. Israel did not immediately respond to queries about the attack.

The United Nations estimates that hundreds of thousands remain in the north, unable or unwilling to leave. The World Food Program has expressed concern about malnutrition and starvation. Medical workers have echoed those worries for weeks.

The United States has recently raised pressure on Israel to address the dire humanitarian effect of its Gaza invasion. The operations have sparked protests worldwide calling for a cease-fire.

President Biden, speaking at an Oval Office news conference on Monday, said he was in contact with Israel about the safety of Gaza’s hospitals. “It’s my hope and expectation that there will be less intrusive action” around them, he said.

Foreign Minister Eli Cohen, speaking to Israeli journalists on Monday, estimated that the army had another two or three weeks to complete its mission before international pressure would force a cease-fire.

Israel agreed last week to daily pauses to allow civilians to evacuate along routes it decided on. But medical workers and humanitarian groups have said evacuations are not possible because of the fighting around hospitals.

Human Rights Watch said Israel’s repeated attacks on medical facilities, personnel and transport “should be investigated as war crimes.” In a report Tuesday, the New York-based group said concerns about “disproportionate attacks are magnified for hospitals. Even the threat of an attack or minor damage can have massive life-or-death implications for patients and caregivers.”

Since the pauses, an estimated 200,000 more people have fled the fighting raging in northern Gaza for the south via a corridor opened by the Israeli military, the U.N. humanitarian office said Tuesday. The Israeli military calls southern Gaza a “safer zone.” It does not call it a “safe zone.”

Conditions in the south, in fact, are far from safe: Bombardment has continued, hospital generators there, too, have stopped working and potable water is in short supply.

The U.N. agency for Palestinian refugees said Monday that it expected its humanitarian operations to halt within 48 hours, when it will have exhausted its fuel reserves. Its two primary water distribution contractors ceased operations Monday, cutting off 200,000 people from access to potable water.

The Palestinian Red Crescent Society announced that the power generator at its affiliated al-Amal Hospital in Khan Younis in the south had gone offline, threatening the lives of 90 patients receiving treatment and the 9,000 displaced people who had sought refuge on the premises.

Sporadic violence continued in the occupied West Bank, with clashes in the town of Tulkarm. At least seven Palestinians there were killed, Reuters reported.

The IDF said that it was carrying out “counterterrorism activities” there and that “a number of the assailants were killed.” The Palestine Red Crescent Society tweeted that an ambulance “was surrounded, inspected, and a wounded person inside was detained” by Israeli forces near the camp.

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Balousha reported from Amman, and Berger from Jerusalem.