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Aid groups struggle to prepare in Rafah, as Israel expands its evacuation orders

NY Times: https://www.nytimes.com/2024/05/10/world/middleeast/gaza-aid-border-crossing.html

Rafah hospital is the only crossing in the U.S. for humanitarian aid right now, and why we’ve never seen a worse health crisis

“[A ceasefire]s will enable us to finish our mission, enable new help to come in, new supplies to come in, and eventually enable our safe return home,” she said.

Everyone was hoping for a cease-fire. Israel says it needs to eliminate Hamas’s military capability so it is rejecting a sustained ceasefire.

“We’re running out of pain medicine, running out of blood pressure medicine. These people are no longer alive or comfortable. She said it’s horrifying what they’re seeing.

The burn nurse from Portland, Ore., was in the intensive care unit at the hospital on Thursday, only partially recovered from a gastrointestinal illness.

“Every day that that crossing is not available and usable for humanitarian assistance, there’s going to be more suffering, and that’s of deep concern to us,” he told reporters. “And so once again, we urge the Israelis to open up that crossing to humanitarian assistance immediately, that aid is desperately needed.”

White House national security spokesman John Kirby on Friday said the U.S. wants the Rafah crossing, the only one able to handle large numbers of fuel trucks, opened immediately.

Source: [U.S. medical volunteers in Rafah hospital](https://tech.newsweekshowcase.com/medical-volunteers-in-the-hospital-say-theyve-never-seen-a-worse-health-crisis/) say they’ve never seen a worse health crisis

Dr. Usman Shah: “They tried to suture up the hole in the heart – they couldn’t” for a Gazan wounded patient

The U.N.’s relief operations need a certain amount of fuel each day to maintain operations, according to the head of the organization.

The Israeli military on Friday in an apparent response to the concerns said it had transferred more than 52,000 gallons of fuel to be made available to international organizations in Gaza through Kerem Shalom crossing into southern Gaza.

Jeremy Konyndyk, President of Refugees International said the aid operation runs on fuel. That means water cannot be pumped, lights cannot be kept on and vehicles cannot distribute aid. If fuel is cut off the operation collapses quickly.

UNRWA, the main U.N. agency overseeing aid for Palestinians, says no food or medical supplies have entered Gaza from the territory’s two main crossings since Sunday. Only a few trucks have entered Gaza from a northern border crossing, far short of the amount needed to stave off hunger and starvation, according to aid groups.

The damage to the Gaza infrastructure, lack of clean water, ongoing attacks and increasing starvation have caused humanitarian operations to the brink of collapse, warned aid workers who were either in Rafah or who had recently left at a press conference this week.

“They tried to suture up the hole in the heart — they couldn’t,” Dr. Usman Shah, from California, explains to Dr. Ammar Ghanem about a patient wounded in an explosion. He made a video of his conversation with Shah on Friday, and he is the vice president of the Syrian American Medical Society.

A group of doctors from the US and Israel arrived in Rafah 10 days ago on a medical mission. Now, nearing the end of the mission, with Israel closing the main border crossing, they are unable to leave.

Shah was dressed in blue scrubs and talked in an even voice about how his patient’s jaw fell under his hand when he touched him. He is in the middle of telling a story and he closes his eyes to give himself time to get better.

The Gaza Strip is not a safe place for medical missions: Dr. Nick Maynard, a Gaza surgeon, says he is frustrated by the lack of humanitarian assistance

Many of the local physicians and nurses were unable to come to work because they had to leave their families when the border was closed.

“Unfortunately here I have to prioritize patient lives. When I say ‘prioritizing patient lives’ I mean I know that term He said in an interview that he had never used it before, but he came here to use it.

One of the videos sent to NPR was about an 18-year-old women who had a skull fracture so severe that brain material was visible. He said they did not have drugs strong enough to keep her sedated.

He said they stopped treatment for a woman suffering from acute pancreatitis after two days because she required continued oxygen that might support several other patients.

Ghanem, who did not want the hospital identified for security reasons, estimated that two to three patients a day die in the intensive care unit because of lack of supplies or equipment.

items critical for hospitals are banned by Israel because they can be used for military purpose, thus making the problem worse. The list of items it considers dual-use include some water disinfection materials.

There are items that the list does not cover. Save the Children has said it has had shipments rejected by Israel because they contained sleeping bags with zippers. An Israeli legal center called Geisha has compiled a list of items which have been rejected, including fishing rods and plastic sheets.

Israel promised to allow in more aid after seven World Central Kitchen workers were killed in the Gaza Strip last month.

A statement issued this week by seven major international aid organizations, including Save the Children and Care, said those pledges have not been fulfilled.

Humanitarian actors see no improvement in the situation for Gaza’s 2.3 million residents.

People are being squeezed into smaller areas of the Gaza Strip along its Mediterranean coast as the UN says most of the Strip has been ordered to be evacuated.

Ghada al-Haddad, a Gaza-based communications officer for Oxfam, said families were pitching makeshift tents on sidewalks and in graveyards. The beach has no clean water and no sanitation, and she claims that others have moved to it.

Oxford professor Dr. Nick Maynard, a surgeon from England who traveled to Gaza three times on medical missions since the start of the war, said most of his time over Christmas was spent operating on major explosive injuries to the chest and abdomen. He said on his last voyage that there had been an increase in trauma cases where there had been malnutrition.

“I operated on many patients in the last two weeks who had awful complications from their abdominal surgery related to inadequate nutrition and particularly those with the abdominal wall breaking down,” he said. Their bowels end up hanging outside.

The deaths last week of two patients who had survivable injuries but died from being too hungry is the direct result of malnutrition, Maynard said.

“We’re in the middle of a major shift in our approach to medical aid,” said Dr. John Kahler, who is the co- founder of MedGlobal. He said Palestinian children before the war were getting only about 80% of the calories they needed. The effects of consistent deprivation are showing up now after seven months of war.

“It’s at that time that the immunological system begins to break down,” he said. “It’s at that time where infections and complications of malnutrition will start.”

The Israeli-Israel War, Hamas, and the Security Situation in Gaza, according to the Israel-Israel Counterattack on the Oct. 7 Attack

Several Western and Israeli officials say that Egypt is complicating matters by refusing to send aid trucks to Kerem Shalom, which is a way of facilitating aid collection and delivery.

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The Israeli military described its actions as “precise operations in specific areas of eastern Rafah” and accused Hamas of using Gaza’s residents as “human shields for its terrorist activities and infrastructure.” In leaflets and messages, the military told people to head to areas of al-Mawasi and Khan Younis.

The military launched its ground assault into Rafah Monday night, erecting Israeli flags along Gaza’s border with Egypt. The operation effectively closed Gaza’s main crossing for aid and fuel, and means severely wounded Palestinians and foreign aid workers can’t leave.

Hamas, which carried out the Oct. 7 attack on Israel that sparked the war, says cease-fire talks that took place in Cairo this week have come to a standstill. The group accused Israeli Prime Minister Benjamin Netanyahu of wanting the war to continue in order “to achieve his personal goals and political ambitions.”

If we don’t get any food soon, we will run out on Sunday. “It means there’s nothing left in the warehouses to distribute,” says Scott Anderson, senior deputy director for UNRWA in Gaza.

Rafeek el-Madhoun, program manager for Rebuilding Alliance in Gaza, which partners with the WFP to distribute hot meals, says they’ve reduced the number of cooking stations in Rafah and are racing to set up new ones in areas of Gaza where people are fleeing to.

He said that they contacted the WFP to let them know that they could manage for two to three weeks.

The needs of people have gone up this week, and El- Madhoun says they are now preparing between 60,000 and 60,000 meals a day. Meanwhile, the price of food for basics like potatoes in the market is skyrocketing and vegetables and fruits are in short supply, he says.

Aid groups are rushing to establish field clinics and kitchens in the area of al-Mawasi, which the Israeli military identified as an “expanded humanitarian zone.” Aid groups say they are still trying to build health care services in this area.

“Life in Rafah right now is a nightmare. Project Hope’s field clinic in Gaza is being moved to Khan Younas due to the constant bombing and shelling.

Dozens of people have been killed in the last few days in Rafah, Gaza’s health ministry and survivors tell NPR.

Israel’s alleged afghanistan behavior “violating international humanitarian law” is consistent with the US-State Department’s counterexample

The US State Department said Friday that it was reasonable to suspect that Israel had acted in a way that was in violation of international humanitarian law.

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