Palestinian girl Rahaf Sa’ad, who lost her legs in an Israeli strike, sits on a bed next to her mother Israa at Al-Bureij, in the central Gaza Strip on September 12, 2024.
| Photo Credit: Reuters

On February 10, 2024, Abdul was hoping to find food for his family amid the devastation in northern Gaza. “I wanted to surprise my mum with some salt or flour,” he recounted later to my colleagues. But as the 15-year-old scoured abandoned homes, he was grievously injured during an Israeli airstrike. His leg shattered, Abdul crawled for more than an hour through the chaos, missiles falling around him. Alone and terrified, his cries for help went unanswered until someone finally carried his fragile wounded body to the nearest functioning hospital. Even there, his suffering did not end. With hospitals overwhelmed with casualties and critical supplies lacking, doctors were forced to perform surgery on Abdul without anaesthesia.

After receiving emergency surgery in Gaza, Abdul was one of the very few Palestinian patients who was allowed to be evacuated from the war zone for medical reasons: first to Egypt, and then to a reconstructive surgery hospital of MSF (Médecins Sans Frontières/Doctors Without Borders) in Amman, Jordan. Seven months later, he is learning to walk again with crutches.

Unfortunately, Abdul’s story is just one among thousands. More than 10 children per day on average lost one or both legs during the first three months of Israel’s assault on Gaza, according to Save the Children. As devastating and distressing as Abdul’s story is, it is one of the very few stories with a hopeful ending: he is alive and getting access to treatment.

The grim reality in Gaza

Israel’s blockade, which has suffocated Gaza for 16 years, has turned into an outright nightmare during the past 12 months. Since October 2023, more than 41,000 people have been killed, and according to the World Health Organization, an estimated 12,000 are in desperate need of medical evacuation. Yet, only 41% of medical evacuation requests have been approved by Israel. This is not just a logistical challenge; it is a denial of the basic human right to healthcare. For those lucky enough to be evacuated, as Abdul was, survival often means months of painful recovery — a luxury many still trapped in Gaza cannot afford. Thousands of displaced people are unable to access medical care due to destroyed health facilities, restricted movement, and the extremely dangerous conditions on the ground.

We have borne witness to the devastation this violence has wrought on Gaza’s health infrastructure. Of Gaza’s 36 hospitals, 17 are now out of service. Over 500 attacks have targeted healthcare facilities, crippling the capacity to provide essential care. Our teams have watched patients die on hospital floors as overwhelmed staff struggle to cope with the flood of the wounded. Essential supplies, such as oxygen concentrators for anaesthesia, vital surgical equipment, and generators, have been delayed or blocked by Israeli authorities repeatedly. Without these vital resources, life-saving surgeries have become nearly impossible, leading to thousands of otherwise preventable deaths.

Psychological wounds

The war’s toll extends beyond physical injuries — it has inflicted deep psychological wounds on Gaza’s population. Children like Abdul and Karam, a 17-year-old who suffered severe burns in an airstrike that killed 13 members of his family, are physically and emotionally scarred. According to UNICEF, over one million children in Gaza now need urgent mental health and psychosocial support. Even as aid and healthcare workers tirelessly support these children, the trauma of living through constant bombardment, witnessing death, destruction, and enduring displacement will affect them for decades to come, if they are fortunate enough to survive the brutality of the aggressions.

Violation of international humanitarian law

The ongoing violence and the Israeli blockade represent a gross violation of international humanitarian law, its principles completely disregarded and violated. An immediate and sustained ceasefire is the only viable solution to meet Gaza’s overwhelming medical and humanitarian needs. Without this, more lives will be lost, and this war will leave yet another indelible stain on our collective conscience.

All parties need to guarantee safe passage for humanitarian assistance inside Gaza, which requires the opening of essential land borders, including the Rafah crossing. Equally crucially, there should be immediate medical evacuation of those whose lives depend on it, along with their caregivers. Safe, voluntary, and dignified return to Gaza for all patients and their caregivers must be ensured.

Abdul’s story is not just a statistic— it is a harrowing reminder of the real human cost of this war. No child should have to crawl through the rubble for survival, yet thousands of Palestinian children face this unimaginable horror. The suffering in Gaza needs to end. Governments must act now to secure a ceasefire, ensuring displaced populations have access to the healthcare they desperately need to survive and rebuild their lives. This is not just a humanitarian issue. It is a global moral imperative.

Farhat Mantoo is Executive Director at Médecins Sans Frontières (MSF)/Doctors Without Borders, South Asia

The United Nations agency for Palestinian refugees warned on October 25 that without immediate deliveries of fuel it will soon have to sharply cut back relief operations across the Gaza Strip, which has been blockaded and hit by devastating Israeli airstrikes since Hamas militants launched an attack on Israel more than two weeks ago.

The warning came as hospitals in Gaza struggled to treat masses of wounded with dwindling resources, and health officials in the Hamas-ruled territory said the death toll was soaring as Israeli jets continued striking the territory overnight into Wednesday.

The Israeli military said its strikes had killed militants and destroyed tunnels, command centres, weapons storehouses and other military targets, which it has accused Hamas of hiding among Gaza’s civilian population. Gaza-based militants have been launching unrelenting rocket barrages into Israel since the conflict started.

The Hamas-run Gaza Health Ministry said the airstrikes killed at least 704 people between Monday and Tuesday, mostly women and children. The Associated Press could not independently verify the death tolls cited by Hamas, which says it tallies figures from hospital directors.

The death toll was unprecedented in the decades-long Israeli-Palestinian conflict. Even greater loss of life could come when Israel launches an expected ground offensive aimed at crushing Hamas militants.

In Washington, White House National Security Council spokesman John Kirby told reporters the U.S. could not verify the one-day death toll. “The Ministry of Health is run by Hamas, and I think that all needs to be factored into anything that they put out publicly.”

Israel said on Tuesday it had launched 400 airstrikes over the past day, an increase from the 320 strikes the day before. The U.N. says about 1.4 million of Gaza’s 2.3 million residents are now internally displaced, with almost 6,00,000 crowded into U.N. shelters.

Gaza’s residents have been running out of food, water and medicine since Israel sealed off the territory following the attack on southern Israel by Hamas, which is sworn to Israel’s destruction.

In recent days, Israel allowed a small number of trucks filled with aid to come over the border with Egypt but barred deliveries of fuel — needed to power hospital generators — to keep it out of Hamas’ hands.

The U.N. said it had managed to deliver some of the aid in recent days to hospitals treating the wounded. But the U.N. agency for Palestinian refugees, the largest provider of humanitarian services in Gaza, said it was running out of fuel.

Officials said they were forced to reduce their operations as they rationed what little fuel they had.

“Without fuel our trucks cannot go around to further places in the strip for distribution,” said Lily Esposito, a spokesperson for the agency. “We will have to make decisions on what activities we keep or not with little fuel.”

Meanwhile, more than half of Gaza’s primary healthcare facilities, and roughly a third of its hospitals, have stopped functioning, the World Health Organization said.

Overwhelmed hospital staff struggled to triage cases as constant waves of wounded were brought in. The Health Ministry said many wounded are laid on the ground without even simple medical aid and others wait for days for surgeries because there are so many critical cases.

The Health Ministry says more than 5,700 Palestinians have been killed in the war, including some 2,300 minors. The figure includes the disputed toll from an explosion at a hospital last week.

The fighting has killed more than 1,400 people in Israel — mostly civilians slain during the initial Hamas attack, according to the Israeli government. Hamas is also holding some 222 people that it captured and brought back to Gaza.

The conflict threatened to spread across the region, as Israeli airstrikes hit Syrian military sites in the south on Wednesday, killing eight soldiers and wounding seven, according to Syria’s state-run SANA news agency.

The Israeli military said in a post on X, formerly known as Twitter, its jets had struck Syrian military infrastructure and mortar systems in response to rocket launches from Syria.

Israel has launched several strikes on Syria in recent days, including strikes that put the Damascus and Aleppo airports out of service, in an apparent attempt to prevent arms shipments from Iran to militant groups, including Lebanon’s Hezbollah. Israel has been fighting the Iranian-backed group Hezbollah across the Lebanese border in recent weeks.

Hezbollah leader Hassan Nasrallah met on Wednesday with top Hamas and Palestinian Islamic Jihad officials in their first reported meeting since the war started. Such a meeting could signal coordination between the groups, as Hezbollah officials warned Israel against launching a ground offensive in Gaza.

Israeli military spokesman Rear Adm. Daniel Hagari said Iran was helping Hamas, with intelligence and by “whipping up incitement against Israel across the world.” He said Iranian proxies were also operating against Israel from Iraq, Yemen and Lebanon. Fighting also erupted in the West Bank, which has seen a major spike in violence.

Islamic Jihad militants said they fought with Israeli forces in Jenin overnight. The Palestinian Health Ministry in the West Bank said Israel killed four Palestinians in Jenin, including a 15-year-old, and two others in other towns. That brought the total number of those killed in the occupied West Bank since October 7 to 102.

Across central and south Gaza, where Israel told civilians to take shelter, there were multiple scenes of rescuers pulling the dead and wounded out of large piles of rubble from collapsed buildings. Graphic photos and video shot by the AP showed rescuers unearthing bodies of children from multiple ruins.

A father knelt on the floor of the Al-Aqsa Hospital in Deir Al-Balah next to the bodies of three lifeless children cocooned in bloodied sheets. Later, at the nearby morgue, workers prayed over 24 dead wrapped in body bags, several of them the size of small children.

“Buildings that collapsed on residents killed dozens at a time in several cases, witnesses said. Two families lost 47 members in a levelled home in Rafah,” the Health Ministry said.

In Gaza City, at least 19 people were killed when an airstrike hit the house of the Bahloul family, according to survivors, who said dozens more remained buried. The legs of a dead woman and another person, both still half buried, dangled out of the wreckage where workers dug through the dirt, concrete and rebar.

Israeli Foreign Minister Eli Cohen told the U.N. Security Council on Tuesday that the proportionate response to the October 7 attack is “a total destruction” of the militants. “It is not only Israel’s right to destroy Hamas. It’s our duty,” he said.

On Wednesday, Israel’s U.N. ambassador, Gilad Erdan, said his country will stop issuing visas to U.N. personnel after U.N. Secretary-General Antonio Guterres said that Hamas’ attack “did not happen in a vacuum.” It was unclear what the action, if followed through with, would mean for U.N. aid personnel working in Gaza and the West Bank.

“It’s time to teach them a lesson,” Erdan told Army Radio, accusing the U.N. chief of justifying a slaughter.

The U.N. chief told the Security Council on Tuesday that “the Palestinian people have been subjected to 56 years of suffocating occupation.” Mr. Guterres also said “the grievances of the Palestinian people cannot justify the appalling attacks by Hamas. And those appalling attacks cannot justify the collective punishment of the Palestinian people.”