Jason Staines and Melissa Sweet write:
Calls for a ceasefire in Gaza are intensifying as the traumatic toll on civilians sees thousands of children being killed, many health and aid workers and journalists dying on the job, the destruction of health services, surgery taking place without anaesthetic, and civilians unable to access necessities, including life-saving healthcare, food and water.
The most recent news is that the Turkish-Palestinian Friendship Hospital, the main cancer centre in the Gaza Strip, is no longer functional because of lack of fuel and damage due to airstrikes in its vicinity over the past 48 hours.
“No words can describe our concern for the patients who have just lost the only possibility to receive lifesaving cancer treatment or palliative care,” World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus said today.
Since 7 October, the WHO has documented 200 attacks on healthcare in the occupied Palestinian territory, with 494 people killed in health attacks, including 16 health workers on duty.
The WHO has welcomed Egypt’s decision to accept 81 injured and sick people from the Gaza Strip for treatment, but noted that those who remain in serious need include thousands of seriously injured civilians including many children, more than 1,000 people who need kidney dialysis to stay alive, more than 2,000 patients on cancer therapy, 45,000 people with cardiovascular diseases; and more than 60,000 people with diabetes.
“These patients must be able to have sustained access to healthcare inside Gaza. Hospitals and other health facilities must be protected from bombardment and military use,” said the WHO statement.
The crisis in Gaza is also having a devastating impact on access to healthcare for patients with long-term needs, said the WHO.
Patients with cancer, diabetes, heart disease and mental ill health are unable to access medicines and have been cut off from health services. Just a third of primary care facilities are functioning, while the 66 percent of hospitals remaining open have substantially reduced services to cope with massive casualties. Before 7 October, around 100 patients each day needed health care outside Gaza because of lack of availability of health care.
A living hell
The ongoing bombardment of Gaza is turning the territory into a “graveyard for thousands of children,” according to UNICEF Spokesperson, James Elder, who added that it was becoming “a living hell for everyone else”
An Australian doctor who has previously worked in Gaza has expressed her horror at the toll, especially for children, and added her voice to wide-ranging calls for a ceasefire.

Dr Natalie Thurtle, an emergency physician who was medical coordinator for Palestine between 2020 and 2021 and is now working in Tasmania, says the impacts will last for years, if not generations.
“I would say that this particular situation in Gaza is probably the worst humanitarian situation I’ve been connected to,” Thurtle, who has worked with Médecins Sans Frontières (MSF) since 2008, told Croakey in an interview this week.
What makes the current situation so horrific, according to Thurtle, is its impact on children. “I think the nature of this is primarily a paediatric impact and I think that’s horrific for everyone concerned, and I think the minimisation of that is an affront,” she said.
UNICEF’s Executive Director, Catherine Russell, recently told the United Nations Security Council that more than 3,400 children had been killed in Gaza since 7 October, with several thousand more injured. Save the Children International said the number of children reported killed in Gaza had now surpassed the annual number of children killed in conflict zones since 2019.
Thurtle said the lack of supplies into the area — which was already limited before the current conflict — meant hospitals were operating in unimaginable circumstances.
“A huge percentage of the victims in this bombardment are children and that’s very confronting for the medical professionals who are striving to continue treating patients. We’ve got such limited access to pain relief and anaesthetics that operations are being done with very limited sedation, no analgesia,” she said.
Thurtle said she understood a small “trickle” of supplies was being allowed into Gaza, but this was nowhere near enough to treat not only those who had been wounded in the bombardment, but patients with existing health conditions.
“With the increased massive need created by the wounded, and also people who haven’t got any other access to healthcare for chronic diseases and just regular illness, they are getting more and more sick. So with that increased need, certainly what’s making it into Gaza doesn’t meet the requirements,” said Thurtle.
Media reporting from the region notes that fuel shortages and blocked roads are hampering the distribution of what little aid makes it into Gaza. Thurtle said those same conditions were making it impossible for people to escape the bombardment.
“There’s no possibly to leave Gaza, there’s no possibility to shelter because nowhere is safe,” she said.
The WHO has highlighted the plight of hospitals in Gaza, saying they “are already operating at maximum capacity due to the injuries sustained in weeks of unrelenting bombardment, and are unable to absorb a dramatic rise in the number of patients, while sheltering thousands of civilians”.
Long-term impact
Beyond the current crisis, Thurtle said there will be a host of issues that will need to be treated, although the destruction of Gaza’s healthcare system will make that almost impossible.
“A lot of the injuries that are happening now are life-changing. Certainly … our long-term projects there do try to address that. We have long-term reconstructive surgery and multi-disciplinary post-operative management programs for weapon-wounded. People can be in those programs for years and years and years. They do physiotherapy, psychological support, re-operations,” she said.
“Then you’ve got the complete collapse of the health infrastructure in Gaza, which is already precarious. For over two million people, there’s going to be no services providing for health needs outside of that. So, people are still getting appendicitis, people have still got diabetes, and those things are just not getting better and the whole system is going to be on its knees for the foreseeable future,” she added.
That will also involve treating the mental trauma of survivors — particularly children — many of whom have been orphaned by the conflict. According to Thurtle, the region’s ability to meet people’s mental healthcare needs was already extremely limited before the current bombardment.
Unprecedented
With people unable to leave, hospitals overwhelmed, and limited amounts of food, water and medical supplies making their way into Gaza, Thurtle said the only solution was an immediate ceasefire.
Her call echoes that of Philippe Lazzarini, the head of the UN’s agency for Palestinian refugees, UNRWA, who told the Security Council that “an immediate humanitarian ceasefire has become a matter of life and death for millions”.
On 1 November, Lazzarini issued a statement after his first visit to the Gaza Strip since the war began almost four weeks ago.
“The scale of the tragedy is unprecedented,” he said.
“I met with displaced Palestinians sheltered in one of the UNRWA schools in Rafah. They showed me where it was damaged during bombardments. One person was killed and more than 80 were injured. The place was overcrowded.
“The levels of distress and the unsanitary living conditions were beyond comprehension. Everyone was just asking for water and food. Instead of being at school, learning, children were asking for a sip of water and a piece of bread. It was heart wrenching. Above all, people were asking for a ceasefire. They want this tragedy to end.
“It was one of the saddest days in my humanitarian work.”
Global crisis
Following a two-day visit to Israel and the Occupied Palestinian Territory, a UN agency chief Martin Griffiths urged a ceasefire, warning that the crisis in Israel and the Occupied Palestinian Territory is a global crisis.
“October 7th and its aftermath will leave indelible scars on the lives of millions,” he said in a statement on 1 November.
“In Israel, a nation was left in shock after the brutal and graphic killing of some 1,400 people. The families of more than 200 hostages continue to live in anguish, unsure about the fate, wellbeing and whereabouts of their loved ones.
“In Gaza, women, children and men are being starved, traumatised and bombed to death. They have lost all faith in humanity and all hope of a future. Their despair is palpable.
“In the West Bank, the death toll is rising. Violence and the closure of checkpoints mean that people cannot access food, jobs, healthcare and other essential services.
“Meanwhile, the world seems unable, or unwilling, to act. This cannot go on. Failure to act now will have consequences far beyond the region, because this is a global crisis.”
Leading global organisations, including MSF, the UN, the WHO, Amnesty International, Oxfam International and UNICEF, have also urgently called for a ceasefire in Gaza.
The Australian Nursing and Midwifery Federation (ANMF) said it “condemned the escalating conflict and suffering in the Middle East and expresses hope and solidarity for all Palestinian and Israeli nurses and midwives who continue to carry out their duties under such dangerous and extraordinary circumstances”.
Elsewhere, the People’s Health Movement (PHM) said it reaffirmed its support and solidarity to the Palestinian people, and called for a ceasefire, and end to the siege, “including allowing a safe humanitarian corridor to Gaza”.
As recently reported by Croakey, the Medical Association for the Prevention of War (Australia) has called Australia’s recent abstention from a UN vote calling for a humanitarian truce a “profound, and lasting shame for our nation”.
“Generations to come will know that the Australian Government did not have the courage, when it was desperately needed, to support this critical UN call for civilians to be protected and the rule of law to be upheld,” the Association’s President, Dr Sue Wareham, wrote in an open letter to Foreign Affairs Minister, Senator Penny Wong
She urged Senator Wong to explain “Australia’s plan whereby this war can be brought to an end before further catastrophe mounts upon existing catastrophe”.
Online concerns
Meanwhile, Amnesty International has urged social media companies to urgently address the fanning of online hate and racism against Palestinian and Jewish communities.
Amnesty said it had found an alarming rise in advocacy of hatred that constitutes incitement to violence, hostility, and discrimination on social media platforms, which is prohibited under international human rights law, and other harmful content against Palestinian and Jewish people.
A significant number of social media posts glorify Israel’s attacks on civilians in Gaza, support the destruction of Gaza and advocate violence against Palestinians. Many posts use dehumanising and racist language against Palestinians, a number of which also draw on language used by the Israeli authorities.
Amnesty International also documented concerning reports that content posted by Palestinians and advocates of Palestinian rights are being subject to potentially discriminatory content moderation by different social media platforms.
“Social media can play a vital role in times of crisis for communication – as such, major social media companies need to urgently step-up measures to protect human rights,” said said Rasha Abdul-Rahim, Director of Amnesty Tech.
“The companies must ensure their platforms are not broadcasting messages of hatred and violence, or they risk contributing to gross human rights violations and serious violations of international humanitarian law. This includes war crimes, which have marked this conflict, and caused unprecedented levels of civilian casualties and a catastrophic humanitarian crisis.”
From X/Twitter
Listen to the MSF team in Gaza here.