Marie McInerney writes:
“The nightmare in Gaza is now entering an atrocious, abominable second year,” United Nations Secretary-General António Guterres said this week in an address marking the conflict’s anniversary, as fears grow about a wider crisis involving Lebanon, Iran and Yemen.
“Over the last year – following the horrific terror attacks perpetrated by Hamas on 7 October – Gaza has become ground zero to a level of human suffering that is hard to fathom,” Guterres said, counting the cost on the civilian population, journalists and humanitarian workers.
“Virtually the entire population has been displaced – no part of Gaza has been spared,” Guterres said.
In a powerful article published this week at the ABC, three members of Healthworkers 4 Palestine wrote that health workers have a moral and professional obligation to call for medical neutrality in Gaza.
Doctors have described being forced to practise “medieval medicine” while they also deal with “eighteenth-century illnesses”, said Melbourne palliative care physiotherapist Dr Rachel Coghlan, Oxford University consultant obstetrician Dr Brenda Kelly and Dr Muath Alser, a Gazan doctor who cofounded the group.
“When a doctor adopts an ethical code rooted in the values of the Hippocratic Oath and the Declaration of Geneva, they never imagine having to amputate the leg of a child without anaesthetic or dousing wounds with vinegar instead of antiseptic,” they write.
“Yet that is what is happening in Gaza.”
Their article said that apathy by the medical and health establishment – or worse, censorship or collusion – “can perpetuate power imbalances and grant cover to egregious injustices and the dehumanisation of the people for whom physicians have pledged to care”.
“By contrast, there is strength in solidarity. That is the conviction that underpins our collective determination to unite as a global health movement to fight for justice, accountability and the protection of health systems and workers.”
Health and humanitarian concerns
UN Secretary-General Guterres’ speech this week, marking the anniversary of the attacks on Israel, came amid desperate and urgent negotiations for a ceasefire in Gaza that would allow the rollout of a second phase of polio vaccination.
World Health Organization Secretary-General Dr Tedros Adhanom Ghebreyesus also urged Israel to facilitate critical humanitarian missions, and ultimately, to work for a ceasefire, saying WHO missions to evacuate critical patients from hospitals in northern Gaza were impeded this week.
Costs of war
The Costs of War Project at Brown University in the US released two new reports to mark this week’s anniversary.
They estimate the likely number of people killed so far at more than 100,000, say the cost to US taxpayers sits at nearly $23 billion, and conclude that disease, infection, starvation, and death are “at catastrophically high rates for the people living in Gaza”.
The report on indirect causes of death canvases the devastation of Gaza in compelling detail, painting a graphic picture of the dire conditions, including looking at the drivers of wholesale hunger and malnutrition.
Israel has destroyed or damaged the infrastructure that provide residents of Gaza with food, including bakeries and food shops, farmland, irrigation works, artisanal fishing boats and fishing equipment, and over half of tree crops and greenhouses, it said.
The report cites UN data that, as at May 2024, Israel had blocked access to farmland and the sea, damaged over 57 percent of Gaza’s cropland, destroyed over 70 percent of its fishing fleet, and damaged more than 46 percent of agricultural wells and 33 percent of greenhouses.
“What olive groves remained could not be harvested during the fall harvesting season because of constant Israeli bombardment,” it said.
“Livestock (for example, chickens, cattle, sheep, goats) that have not been killed or injured in direct attacks have become emaciated or otherwise sick.”
On the verge
Guterres said he had warned for months of the risks of the conflict spreading – the Middle East is “a powder keg with many parties holding the match”.
“We are on the verge of an all-out war in Lebanon – with already devastating consequences,” he said.
The death toll has already surpassed that of the 2006 war, with 1,500 reported deaths in the past two weeks alone, and Lebanese authorities report over one million people have been displaced in Lebanon – 300,000 people fleeing into Syria. 
The UN is also worried about draft Israeli legislation aimed at the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) agency that would “suffocate efforts” to ease human suffering in Gaza and the wider occupied Palestinian territory.
“It would be a catastrophe in what is already an unmitigated disaster” if Israel banned UNRWA’s presence and operations in its territory and revoked its privileges and immunities, Guterres said.
“If approved, such legislation would be diametrically opposed to the UN Charter and in violation of Israel’s obligations under international law.”
See also this statement from Philippe Lazzarini, Commissioner-General of UNRWA, at the UN Security Council about the risks.
The UN chief said Gaza is in “a death spiral”, amid new Israeli evacuation orders for parts of northern Gaza that are being targeted by airstrikes and a ground offensive and have forced up to 400,000 people to once again flee.
He gave the example of a family in the Jabalya refugee camp: “They were ordered to leave their homes in October 2023. Active operations subsided, and they returned.
“They were once again ordered to evacuate in December 2023. Active operations subsided, and they returned. They were ordered again to evacuate in May 2024. Active operations subsided, and they returned. And just this month, they were once again ordered to evacuate.”
Guterres said the conclusion is clear. “There is something fundamentally wrong in the way this war is being conducted. Ordering civilians to evacuate does not keep them safe if they have no safe place to go and no shelter, food, medicine or water.”
• Croakey thanks photographer Tom Lewendon for permission to publish the feature image on this article. He is planning to publish a book, ‘Children of Gaza, The Kites Still Fly’, raising funds through GoFundMe.
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