With the brief "humanitarian pause" between Israel and Hamas so far failing to result in the delivery of sufficient aid in Gaza, United Nations officials on Tuesday warned that the spread of disease could soon begin killing more Palestinian people than Israel's bombs and raids.
Humanitarian groups have warned for weeks that Israel's total blockade of Gaza—cutting off deliveries of fuel, water, food, and electricity access—quickly fueled outbreaks of gastrointestinal illnesses as sanitation and water treatment services ground to a halt.
The World Health Organization (WHO) has now recorded more than 44,000 cases of diarrhea and 70,000 acute respiratory infections in Gaza since Israel began its latest bombardment of the enclave on October 7, with cases of gastrointestinal illness for those aged five and older rising to more than 100 times the normal level earlier this month.
"Everybody everywhere has dire health needs now because they are starving, because they lack clean water and they're crowded together," said Margaret Harris, a spokesperson for WHO, at a briefing in Geneva on Tuesday. "Basically, if you're sick, if your child has diarrhea, if you've got a respiratory infection, you're not going to get any [help]."
"Eventually we will see more people dying from disease than from bombardment if we are not able to put back together this health system," she added.
On social media, WHO reiterated its call for a permanent negotiated cease-fire and sustained aid access in Gaza to allow health officials to rebuild the decimated medical system.
Out of 36 hospitals in Gaza, about 26—or three-quarters—have entirely shut down due to damage from bombings and an inability to provide care to patients. Without fuel shipments and reliable electricity, doctors have been unable to run machinery needed to properly sterilize medical equipment, among other necessities.
Although the current truce has been in place for four days and was extended by two days on Tuesday, the Palestinian Ministry of Health reported that no fuel has arrived in northern Gaza for hospitals to run generators.
One doctor from al-Shifa Hospital, which was raided by the Israel Defense Forces (IDF) earlier this month, told the United Nations Children's Fund (UNICEF) that primary threats to children's safety were previously "very much from the air and now very much on the ground," as gastrointestinal and respiratory infections continue spreading.
"He was terrified as a medical professional in terms of the disease outbreak that is that is lurking here and how that will devastate children whose immune systems and lack of food…is making them perilously weak," UNICEF spokesperson James Elder said Tuesday.
At hospitals throughout Gaza, Elder said in a video briefing, "I met a lot of parents... They know exactly what their children need. They don't have access to safe water and it's crippling them."
Since last month, United Nations agencies and groups including Oxfam have warned that, cut off from access to clean water, Palestinians face an even more dire public health threat than the diseases that are already spreading: a potential cholera outbreak like the one that killed at least 97 people in 2022 in Syria and Lebanon.
"It's conceivable that the bacterium has been brought in and the conditions are now ripe for its spread," Richard Brennan, regional emergency director for WHO, told Al Jazeera in October.
The Palestine Red Crescent Society (PRCS) told the BBC Tuesday that about 200 aid trucks per day have been allowed into Gaza since the humanitarian pause began last week—an improvement over the roughly 45 trucks that entered the enclave each day before the truce, but only half the amount that brought aid to Gaza's 2.3 million residents daily before October 7.
"The situation has become more than dire and this aid is urgently and critically needed," PRCS spokesperson Nebal Farsakh told the BBC.
Amnesty International warned that Palestinian civil society groups are struggling to serve injured, ill, displaced, and traumatized residents as a number of European countries and the European Commission have suspended or restricted aid funding due to "unfounded allegations that funding has been diverted to 'terrorist organizations' or used for 'incitement to hatred and violence'."
The European Commission introduced "anti-incitement" clauses in all new contracts with Palestinian NGOs, subjecting them to third-party monitoring, even as it announced on November 21 that "no evidence has been found to date that money has been diverted for unintended purposes."
"Restricting the funding of Palestinian organizations only is discriminatory and would silence them by hampering their vital work and would further deprive victims of any prospect of protection," said Eve Geddie, director of Amnesty International's European Institutions Office.
"The credibility of European states who claim to champion human rights has already been already weakened by their failure to call for a cease-fire and by continuing to arm Israel as it kills thousands of Palestinians with impunity," added Geddie. "These discriminatory funding restrictions are damaging their credibility even further."