Fifteen months into Israel's war on Gaza, more than 46,000 Palestinians have been killed, most of them women and children, according to the territory's health ministry. The horror of the situation in Gaza shows no signs of abating as the world looks the other way. Meanwhile, Israeli officials continue to systematically deny the delivery of life-saving aid in flagrant violation of international law.
Israeli security forces have killed more than 46,000 people and wounded more than 109,000 others, most of them civilians, since the war began in October 2023. Estimates suggest that more than 15,000 children are among the dead. More than 10,000 people, including thousands of children, are missing and presumed dead.
A quarter of the injured in Gaza - some 27,000 Palestinians - are believed to require lifelong specialized rehabilitation and supportive care, including those with severe limb injuries, amputations, spinal cord injuries, traumatic brain injuries, and severe burns.
The fatalities include at least 369 aid workers, 267 UN staff, 1057 health workers and 193 journalists. Since October 2023, more than 165,000 people, or nearly 8 percent of Gaza's population, have been killed, wounded or reported missing in Israel's attacks on Gaza.
An unprecedented humanitarian catastrophe has been unfolding in the Gaza Strip for fifteen months, with people dying from widespread attacks, starvation, dehydration, disease and hypothermia. Hostilities continue, with relentless operations by the Israel Defense Forces (IDF) causing mass casualties and widespread destruction.
At least eight newborn babies have died of hypothermia in the past month alone, as the continued lack of basic shelter in winter temperatures poses a serious threat. Infants are unable to regulate their body temperature.
On Thursday, UN Secretary-General António Guterres again strongly condemned the widespread killing and injury of civilians in this conflict. He reiterated his call for all to respect international humanitarian law and demanded the protection of all civilians, his spokesperson said. Civilians must be protected and respected at all times and their basic needs must be met, Guterres said,
Pope Francis, the head of the Catholic Church, also condemned Israel's military campaign in Gaza on Thursday, calling the humanitarian crisis very serious and shameful.
"We cannot accept in any way the bombing of civilians or attacking infrastructure necessary for their survival. We cannot accept seeing children freezing to death because hospitals have been destroyed,” the Pope said in remarks delivered on his behalf by an aide because of health concerns. The remarks were part of an address during an audience with the diplomatic corps.
The conditions for survival are particularly alarming in besieged North Gaza, where the movement of humanitarian personnel is severely restricted. The UN Office for the Coordination of Humanitarian Affairs (OCHA) reported on Friday that Israeli authorities continue to deny UN-led efforts to deliver vital aid to the North Gaza governorate.
At the same time, the hunger crisis across the Gaza Strip continues to worsen amid critical shortages, severe access restrictions and violent armed looting. In central and southern Gaza, OCHA reported on Thursday that humanitarian agencies had exhausted all supplies in their warehouses, while Israeli authorities were continuing to deny most requests to bring food aid from the Erez West crossing to areas south of Wadi Gaza.
The number of aid trucks entering Gaza remains woefully inadequate to meet the most basic needs of families. Meanwhile, some 120,000 metric tons of food assistance - enough to feed the entire population for more than three months - remain stranded outside Gaza.
Aid agencies warn that without additional supplies, the distribution of food parcels to hungry families will remain extremely limited. More than 50 community kitchens, which provide over 200,000 meals a day to people in central and southern Gaza, are also at risk of shutting down in the coming days.
In a separate development, OCHA said on Friday it was deeply concerned about the impact of dwindling fuel supplies on essential services in Gaza. Palestinian telecommunications providers are now warning that their services may be cut off tomorrow due to a lack of fuel, which they need to run the generators that power their equipment.
The UN relief office is also warning that the lack of fuel to power generators is crippling Gaza's health system, putting patients' lives at risk.
OCHA reports that Israeli authorities continue to deny UN-led efforts, including the most recent attempt, to reach the North Gaza governorate. Throughout the territory on Wednesday, out of 15 coordinated humanitarian movements, Israeli authorities facilitated only 5 missions, while 4 were impeded, 3 were denied and another 3 were canceled due to security or logistical challenges.
Across the entire Gaza Strip on Thursday, only 10 of the 21 UN-planned humanitarian movements were facilitated by the Israeli authorities. Seven were denied outright, three were impeded and one was canceled due to security and logistical challenges.
Access to the North Gaza governorate, which has been under a tightened siege since October 6 last year, continues to be largely denied by the Israeli authorities. Since the start of the Israeli offensive until 31 December, the UN has made 165 attempts to access the area, of which 149 were denied and 16 were allowed to proceed but encountered impediments.
Meanwhile, ongoing attacks and hostilities in North Gaza have severely disrupted health services for survivors who remain there. Access to Al Awda Hospital in Jabalya is extremely limited.
The World Health Organization (WHO) said on Friday that Al Awda Hospital, the last partially functioning hospital in the governorate, is critically short of fuel and essential medical supplies.
WHO has been working to gain access to Al Awda to resupply it and to assess the situation at Kamal Adwan Hospital, which is completely out of service. However, damaged roads - as well as insufficient access facilitation by the Israeli authorities - have made it impossible to reach these facilities safely.
The UN agency is urging immediate action to make the roads passable and to allow access to Al Awda Hospital so that it can continue to operate.
Meanwhile, civil order in Gaza has largely collapsed and humanitarian goods are being looted. Attacks on humanitarian workers, convoys and facilities continue, further hampering humanitarian operations and jeopardizing the safety of aid workers.
On Sunday, a World Food Programme (WFP) convoy consisting of three clearly marked vehicles carrying eight staff members was fired upon by Israeli forces. No injuries were reported, but at least 16 bullets hit the vehicles.
According to WFP, the convoy had received all necessary permits from the Israeli authorities.
"Security conditions in Gaza must urgently improve for life-saving humanitarian assistance to continue," WFP said in a statement.
Palestinian civilians are enduring appalling levels of violence as hostilities continue throughout the Gaza Strip. The United Nations Children's Fund (UNICEF) said Wednesday that at least 74 children were reportedly killed in Gaza in the first seven days of this year alone.
“For the children of Gaza, the new year has brought more death and suffering from attacks, deprivation, and increasing exposure to the cold,” said UNICEF Executive Director Catherine Russell.
“A ceasefire is long overdue. Too many children have been killed or lost loved ones in a tragic start to the new year.”
Russell said the continued lack of basic shelter amid winter temperatures poses a serious threat, with more than one million children living in makeshift tents.
UN agencies and their non-governmental partners are doing their utmost with available supplies to provide shelter, food, water and medicine to Gaza's survivors. Despite ongoing challenges, they are working to reach people throughout the Gaza Strip with critical relief supplies.
The humanitarian situation in Gaza has spiraled out of control. Leading UN officials have called the situation in Gaza "apocalyptic," "hell on earth," a "dystopian nightmare," and "beyond catastrophic. They have said that the humanitarian community is "running out of words to describe what is happening in Gaza."
Gaza is on the brink of famine, with more than 2 million people facing severe food shortages amid high rates of disease, inadequate shelter, and limited access to safe water and sanitation. Some 1.9 million people - 90 percent of Gaza's total population - have been displaced by Israeli military attacks or Israeli evacuation orders, including people who have been forced to flee dozens of times.
While the war in Gaza is characterized by serious war crimes and crimes against humanity committed by Israeli forces, a growing number of independent legal experts and international organizations - including Amnesty International - have concluded that Israel's actions in Gaza against Palestinians as a group amount to genocide.
International humanitarian law requires Israel to ensure that the basic needs of the people of Gaza are met. This includes guaranteeing that the people of Gaza have access to sufficient water, food, health care, and other basic necessities for survival. According to the Genocide Convention, acts amounting to genocide include deliberately inflicting on a group or part of a group conditions of life calculated to bring about its physical destruction.
Since Israel imposed a full siege on the Gaza Strip on October 9, the amount of aid entering the enclave has never been sufficient to meet the needs on the ground. For more than a year, Israel has deliberately failed to provide or even facilitate the delivery of critical supplies to the 2.1 million people still surviving in Gaza.
Repeated Israeli military attacks on Palestinian civilians over the past fifteen months, the dismantling of the health system and other essential civilian infrastructure, the siege, and the systematic denial of humanitarian aid are destroying the conditions for survival in Gaza. Ongoing indiscriminate attacks by the IDF continue to kill large numbers of civilians, including children.