Many of those injured suffered terrible burns, according to the World Health Organization (WHO), which will require intensive treatment, electricity and high-level medical services, all of which are scarce after nearly eight months of war.

Massive medical challenge

It is just another massive challenge for all the medical teams in the enclave, WHO spokesperson Margaret Harris told journalists in Geneva.

“This is one of the hardest things for a doctor or nurse as you want to help, but you don’t have what it takes,” Dr. Harris said.

“You are watching people who shouldn’t die, die in front of you because you simply either lack the tools, the skills, or the supplies to do what needs to be done.”

The Israeli incursion in Rafah displaced medical staff while essential fuel stocks continue to dwindle as the UN humanitarian operation has been all but shut down in the latest escalation that began three weeks ago, sparked by a deadly Hamas rocket attack on the Kerem Shalom border crossing.

Fuel in short supply

WHO confirmed that three of its supply trucks managed to cross the Kerem Shalom border since the incursion began, but 60 are stuck in Egypt owing to the closure of the border.

Although some 200,000 litres of fuel are required each day, Dr. Harris said WHO has been able to access only about 70,000 litres per day at best – but some days, absolutely none.

“All the hospitals are really struggling and making decisions about what they can do,” she added.

Fuel is critical to power hospital generators, but it is also needed by bakeries and water desalination plants, which have received only 10 per cent of the supply they require in the past week, according to the UN Children’s Fund (UNICEF).

In condemning the attack, WHO Director-General Tedros Adhanom Ghebreyesus noted that only a third of hospitals in Gaza “remain even partially functional”.

Dire conditions, difficult decisions

The dire conditions mean that medical staff are not able to carry out the surgery needed to save a limb.

“Decisions are having to be made by doctors to remove a limb to save a life and again, that’s a horrible, horrible decision to have to take,” said Dr. Harris.

UNICEF spokesperson James Elder noted that many children who suffered single or double amputations are sitting in tents in Rafah with immense psychological stress.

“What do we say of those countless children who have had arms and legs amputated? Or the thousands who have been orphaned? And what is the language used to describe the unprecedented devastation to homes and schools, to the uncharted territory of trauma of children?” he warned.

“I think then surely the question that needs to be asked is, ‘How many more mistakes is the world going to tolerate?’”

Threat of further displacement

Around one million people have fled Rafah, in southern Gaza, since the start of the Israeli military operation there on 6 May, which continues to intensify.

Humanitarian agencies now fear further displacement following Sunday’s deadly raid, that has been widely condemned, while Israeli tanks incursions have been reported in central Rafah.

The Commissioner-General of UN Palestine refugee agency, UNRWA, Philippe Lazzarini on Tuesday said that heavy bombardment continued overnight in Rafah, including in Tal Al Sultan where the main UN offices in Gaza are located.

“Most of our staff could not make it to work. They are packing up and moving. They are terrified,” he said in a post on the social media platform X, formerly Twitter.

Disease on the rise

Meanwhile, the flow of aid into Gaza has shrunk so much in May that humanitarian officials warn the threat of widespread starvation is more acute than ever.

Additionally, the ongoing lack of clean water and sanitation has also triggered a very high rate of acute respiratory infections, diarrhoea, including bloody diarrhea, as well as hepatitis A, said Dr. Akihiro Seita, UNRWA Director of Health, speaking in Geneva.

“What we need now is ceasefire. We continue to do whatever we can do, but without ceasefire, without peace on the ground, peace in mind, we continue to suffer, and I am sorry to say that the people in Gaza may continue to suffer.”

Annual health report

UNRWA also published its annual report on delivering health services to Palestine refugees across five locations in the Middle East: Jordan, Lebanon, Syria, the Gaza Strip and the West Bank, including East Jerusalem.

Despite challenges to its operations, the agency delivered nearly seven million primary healthcare consultations across the region in 2023.

Some two million Palestine refugees used its services, including 300,000 people with diabetes and hypertension, and roughly 70,000 pregnant women.

UNRWA maintained high levels of immunization, including in Gaza, which has played a crucial role in preventing outbreaks of vaccine-preventable diseases.

Gaza health emergency

Palestinians there are facing an unprecedented health emergency caused by the most devastating war in their history, the report said.

The conflict has severely impacted people’s health and well-being, with increased levels of injury, trauma, and mental health disorders.

Destruction of infrastructure and transportation has further complicated healthcare delivery, while overcrowded living conditions and limited access to clean water have heightened the risk of infectious diseases.

Malnutrition also has worsened, with one in three children under the age of two in northern Gaza suffering from acute malnutrition.

Healthcare access declined during the last quarter of 2023, as 14 of 22 health centres had to cease operating and power outages crippled telehealth systems.

In response, UNRWA opened 155 emergency shelters and deployed 108 mobile medical units, coordinated the shipment of essential medicines, and implemented disease outbreak surveillance.

UNRWA has remained on the frontline amid the war and the agency has lost over 191 staff members, including 11 healthcare professionals.