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Continuity: WHO Press Conference: Gaza Health Update - 21 December 2023
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Press Conferences , Edited News | WHO
WHO Press Conference: Update on health situation in Gaza - 21 December 2023
STORY: Gaza healthcare update – WHO
TRT: 3:09”
SOURCE: UNTV CH
LANGUAGE: ENGLISH
ASPECT RATIO: 16:9
DATELINE: 21 December 2023 - GENEVA, SWITZERLAND
SHOTLIST
- Exterior wide shot: UN building with UN flag, UN Geneva.
- SOUNDBITE (ENGLISH) – Sean Casey, WHO Emergency Medical Teams coordinator: “It's pretty unbearable to see people who are already victims of conflicts who are in what should be a safe place where they should be able to access care, where they're sitting, waiting to die unless something dramatically changes that will allow them to survive. And that required safe movement, it requires a huge uplift of fuel, it requires medicine, medical supplies, human resources. They're starving. They're dying of thirst.”
- Cutaway: Medium shot, UN building with UN flag
- SOUNDBITE (ENGLISH) – Sean Casey, WHO Emergency Medical Teams coordinator: “Patients were crying out in pain, but they were also crying out for us to give them water. It's pretty unbearable to see somebody with casts on multiple limbs, external fixator on multiple limbs, without drinking water and almost no IV fluids available.”
- Cutaway: Medium shot UN entrance at Place des Nations
- SOUNDBITE (ENGLISH) – Dr. Richard Peeperkorn, WHO Representative in the Occupied Palestinian Territory: “Over 20,000 people now have been killed in the hostilities in Gaza. This is actually almost one per cent of the entire population. WHO calls again for a humanitarian ceasefire. This is needed now to reinforce and restock remaining health facilities, deliver medical services needed by thousands of injured people and those needing essential care, and above all, stop the bloodshed and death.”
- Cutaway: Wide shot, Ariana Park at UN Geneva
- SOUNDBITE (ENGLISH) - Sean Casey, WHO Emergency Medical Teams coordinator: “We went through the courtyard where we stepped over a hole from shelling that had happened just a couple of days before, passed a row of bodies that had been wrapped in white, in plastic sheeting,”
- Cutaway: Wide shot, UN flag with ICRC building in background
- SOUNDBITE (ENGLISH) – Sean Casey, WHO Emergency Medical Teams coordinator: “What would be considered unnecessary amputations in the rest of the world where there is capability to save limbs, where there's orthopedic capability, where there is vascular capability, that's not there. There's no surgery happening right now in northern Gaza. And so actually, many of the patients that I saw yesterday will need amputation if and when they're able to access surgical care.”
- Cutaway: Wide shot, UN building
- SOUNDBITE (ENGLISH) – Sean Casey, WHO Emergency Medical Teams coordinator: “It's too late. We’re behind. There is not enough food. Every single person I speak to, everywhere I go in Gaza, is hungry. The time is now. We are dealing with starving people now, adults, children. It's unbearable. Everywhere we go, people are asking even in the hospital, I walk around in the emergency department, somebody with an open bleeding wound, with an open fracture, they ask for food.”
- Cutaway: Wide shot, UN flag alley
Injured patients ‘waiting to die’ in northern Gaza as last hospital shuts down: WHO
There are no functioning hospitals in the north of Gaza and injured patients who need surgery and cannot be moved are “waiting to die”, the UN health agency said on Thursday, in a plea for a ceasefire to allow more aid into the shattered enclave.
The latest grave assessment from the World Health Organization (WHO) came after UN teams reached Al Ahli Arab hospital and Al Shifa hospital on Wednesday, amid reports of intensifying ground operations by Israeli Defense Forces and continuing airstrikes in the Gaza Strip, in response to Hamas’s 7 October terror attacks on southern Israel.
“Patients were crying out in pain, but they were also crying out for us to give them water,” said WHO Emergency Medical Teams coordinator Sean Casey, describing the scene at Al Ahli Arab hospital, where medical staff were struggling to cope with “no food, no fuel, no water”.
“It looks more like a hospice now than a hospital. But a hospice implies a level of care that the doctors and nurses are unable to provide…. It's pretty unbearable to see somebody with casts on multiple limbs, external fixator on multiple limbs, without drinking water and almost no IV fluids available.
“At the moment, it's a place where people are waiting to die unless we are able to move them to a safer location where they can receive care.”
Guterres aid call
Highlighting the need to relieve the deteriorating humanitarian crisis in Gaza, UN Secretary-General António Guterres on Thursday said that “intense fighting, lack of electricity, limited fuel and disrupted telecommunications” had severely restricted the UN’s efforts to provide life-saving aid to people in the enclave.
“Conditions to allow for large-scale humanitarian operations need to be re-established immediately,” the UN chief insisted in a tweet.
Growing hunger
The high-risk mission to northern Gaza involving the WHO, the UN aid coordination office, OCHA, the UN Mine Action Service (UNMAS) and the UN Department of Safety and Security (UNDSS) ensured the delivery of seven pallets of urgently needed medicines, intravenous fluids and supplies for surgery and to treat the wounded, along with equipment to support women giving birth.
Important though the delivery of medical supplies to the north is to provide some relief to patients, much more worrying is the growing and already widespread shortage of food and water.
“We are behind. There is not enough food, every single person I speak to everywhere I go in Gaza is hungry,” Mr. Casey said, speaking to journalists in Geneva. “The time is now. We are dealing with starving people now, adults, children, it's unbearable. Everywhere we go, people are asking us for food even in the hospital, I walked around in the emergency department, somebody with an open bleeding wound, an open fracture; they asked for food. If that's not an indicator of the desperation, I don't know what is.”
Crippling shortages
According to the UN health agency, only nine out of 36 health facilities in Gaza are partially functional; all of them are located in the south.
“There are no operating theatres (in the north) anymore due to the lack of fuel, power, medical supplies and health workers, including surgeons and other specialists,” said Dr Richard Peeperkorn, WHO Representative and now acting UN humanitarian coordinator in the Occupied Palestinian Territory, speaking from Jerusalem.
At Al Ahli Arab hospital approximately 10 staff – “all junior doctors and nurses” – have continued to provide basic first aid to some 80 patients now sheltering in a church within the hospital grounds, Dr. Peeperkorn explained. “Some of them are severely injured and have been waiting for surgery for two weeks or have been operated on but are now at risk of post-operation infection due to lack of antibiotics and other drugs. All these patients cannot move and need to be transferred urgently, to have a chance to survive.”
Heavy bombing and clashes
According to the UN aid office OCHA’s latest update on the crisis, “heavy Israeli bombardments from air, land and sea”, continued across Gaza on Wednesday.
The most intense shelling was reported in Beit Lahiya and multiple areas in Gaza city (north), eastern Khan Younis in the south and the eastern and western areas of Rafah city, also in the south.
OCHA also reported “intense ground operations” and continuing clashes between Israeli forces and Palestinian armed groups in northern Gaza, Gaza City, the Middle Area, and Khan Younis, along with the firing of rockets by Palestinian armed groups into Israel.
Latest casualty figures from Gaza’s health authorities from Tuesday shared by OCHA indicated that 19,667 Palestinians have killed in Gaza since 7 October, about 70 per cent are believed to be women and children. More than 52,586 people have been injured, according to the same source, which reported that many more were missing, likely buried under the rubble.
The UN update also noted that two Israeli soldiers were reported killed in Gaza between 19 and 20 December. “Since the start of the ground operations, 134 soldiers have been killed in Gaza, and 740 soldiers have been injured, according to the Israeli military,” OCHA said.
New evacuation order
The update also flagged a 20 December immediate evacuation order from the Israeli military covering about 20 per cent of central and south of Khan Younis city. The area was marked in an online map published on social media. Before the 7 October escalation, the area was home to nearly 111,542 people, according to OCHA, which noted that it also included 32 shelters housing about 141,451 internally displaced persons - the vast majority having been previously displaced from the north.
Teleprompter
So good morning everyone.
Thank you very much for for joining us on a very short notice and also thanks to our colleagues in the UN Information Service for facilitating this press briefing.
Some of you have seen the post from our Director General, Doctor Tadros last evening on different platforms about the visit that WHO made to two hospitals in north of Gaza and, and what they have seen.
So what what we wanted really is to share with you exclusively this morning what what our teams have have seen and what's the current situation.
So as you have seen in the in the media advisory, we have Doctor Rick Beeperkorn that you know very well by by now who is joining and he's also joined by by Sean Casey, who was in the in the in the WTO team visiting hospitals yesterday.
He is leading emergency medical teams for for Gaza.
So let's start immediately with Doctor people Korna and and then we will hear also from Sean.
Doctor people Korna, thank you very much.
[Other language spoken]
[Other language spoken]
[Other language spoken]
[Other language spoken]
So let me start with this.
So yesterday, on 20 December, in another **** risk joint mission, A-Team from the World Health Organisation, all the UN partners, the UN, the United Nations Office for the Coordination of Unitarian Affairs, OCHSHA and the United Mine Action Service, UMAS and the United Nations Department of Safety and Security, UNDSS reached Al Akhi Arab Hospital and Al Shifa Hospitals in the north of Gaza.
So the initial plan was to deliver fuel to both facilities, but we had to shift to supplies due to a lack of safety guarantees in place and clearance issues.
Our teams delivered 7 pallets of medical supplies for surgery, wound treatment, supplies to support women, your birth delivery, IV fluids and medicines.
And they witnessed the impact of the recent attacks on both health facilities and the level of destructions.
So our staff are running, you will hear later from them are running out of words to describe the beyond catastrophic situation facing remaining patients and health workers.
So WHO and and actually I just come back from Gaza.
I spent more than two weeks and I was part of that mission.
We visited our Akhi hospital over a week ago and then and I think I reported on that it already looked like it was utter chaos.
It was completely con congested and we described it as a disaster zone.
But it was still operational, partly operational but it happened.
Working operation theatre and and and some medical two medical specialists and and constantly busy with trauma and trauma surgery.
Now Al Ahli is a shell of hospital.
Until 2 days ago it was the only hospital where injured people could get surgery in Northern Gas and that was overwhelmed the patient needing emergency care.
There are no operating theatres anymore due to the lack of fuel, power, medical supplies and health workers including surgeons and other specialists.
It completely stopped functioning and and is only operating as a Hospice currently with no or very little care.
Only 9 out of 36 health facilities are partly functional in the whole of Gaza, all of these in the South.
There are actually no functional hospitals left in the north.
Al Ahli was the last one but is now minimal functional and still treating patient but not admitting new ones along with Al Shiba, Al Ada and Al Sahaba hospital.
So these hospitals are still sheltering.
Also thousands of displaced people at the lastly about currently about 10 staff, all junior doctors and nurses continue to provide basic first aid, pain management as much as possible, wound care and trauma stabilisation services.
80 injured patients so that a week more than a week ago there were still 250 patients.
There are 80 injured patients, including elderly, women and small children are sheltering in a church and and and as well and on the wards within the hospital grounds and it's orthopaedic section.
Many of these patients have lost family members and don't have anyone to bring them water or food.
Some of them are severely injured and have been waiting for surgery for two weeks.
Order have been operated on but are now at risk of post operation infection due to lack of antibiotics and other drugs.
All these patients cannot move and need to be transferred urgently to have a chance to survive.
Bodies from recent attacks are lined up in a courtyard and they can't be given safe and dignified burials.
More than 20 Al Akhi hospitals were arrested on 18 December 6 were released and forced to go Styles from the other 14.
There's no information currently regarding their detention.
And WHO reiterates his call for all parties to the conflict to respect international Unitarian law and for the protection of health workers, patients, health facilities and ambulances at all times.
WHO will keep striving to supply health facilities in the northern Gaza, but without fuel, staff and other essential needs medicines it won't make Yeah, medicines will make a difference and all patients will die slowly and painfully.
Over 20,000 people now have been killed in the hostilities in Gaza.
This is actually one, almost 1% of the entire population WHO calls again for a humanitarian ceasefire.
Is it needed now to reinforce and restock remaining health facilities, the liver, medical services needed by thousands of injured people and those needing order, essential care and above all, to stop the bloodshed and death?
I would like to hand over now to my colleague Sean Casey, WHO was the team lead of the mission yesterday to Al Ahli and Al Shifa Hospitals.
Thank you, Doctor Peppercorn.
And just before we hear from Sean, we will share remarks of Doctor Peppercorn.
I I also put in a chat the for those who have not seen the, the comments by Director General last night on this visit.
Sean, please, the floor is yours.
Thanks very much.
[Other language spoken]
I'm currently in Rafa.
In the past few days, we've undertaken 2 missions to the north, one on Saturday to Al Shifa Medical Complex, which is the largest referral hospital in, in the Gaza Strip and saw really unbelievable conditions in the emergency department and a hospital full of internally replaced persons.
And what we were told then was that the hospital was running out of fuel.
It had almost no staff, hundreds of patients and they were sending their, their surgical cases to Ahly Arab Hospital, which instigated our mission there yesterday.
So we, we, we planned this mission initially to take fuel to several hospitals.
The security situation did not allow for that and instead we dispatched trauma kits, trauma supplies, surgical supplies, IV fluids, other medicines, clean delivery kits from UNFPA as well to the and we had hoped to go to the Harbour Maternity Hospital, but there was active conflict in that area and so we redirected the mission to return to Al Shifa Hospital, Bilingad the city.
So we travelled N for about two hours to reach Alafali Hospital.
When we arrived, it was very different from what Doctor Rishi Prakorn had seen just a few days before.
It was mostly empty.
When we pulled up in front of the hospital.
The largest building in the building at the front had been blown out.
I believe that was from activity, military activity that happened in October, and there was a lot of debris blocking, blocking the entrance.
A number of people came out and helped us to unload the truck and and do a chain of passing boxes to bring these medical supplies into the hospital grounds.
We met with a couple of the doctors and nurses outside who told us that they only had five doctors and five nurses remaining on site and that they had 80 patients who were sheltering or admitted, if you can use that term in the in the church on on site and the new orthopaedic building.
There was a lot of damage to the hospital itself, but the church was still intact and the orthopaedic building was still intact.
So we went through the courtyard where we stepped over a hole from chilling that had happened just a couple of days before, past a row of bodies in that have been wrapped in wipes, plastic sheeting that the doctors told us had been there for four days because it was so unsafe to move.
And actually, I should say, as we were pulling up to the hospital, there was gunfire, automatic gunfire and small arms fire in the area where the crowd dispersing maybe a few 100 metres from from where we pulled up to the hospital.
We walked through the courtyard and into the church where we found a really unbearable scene.
And you can see the pain in the eyes of the doctors and nurses who are trying to care for these patients.
But a church with 30 or so patients, almost none of them ambulatory, so bedridden in patients, some of them with serious trauma wounds.
Some of them had had been lucky to have surgery before the operating theatre went down.
We're struggling with post operating infections.
Some of them had been injured days or weeks ago with no surgery to save the limbs and and suffering enormously.
We saw a young girl who had been agitated with both her own family and she lost her her legs above her knee or sorry below her knee.
We saw many patients who had said they hadn't bathed or changed their clothes in weeks.
The hospital staff told us that many of their colleagues have been taken to taken away two days before that they were struggling to maintain these agitations with no, no food, no food, no water.
Patients were crying out in pain, but they were also crying out for us to to give them water.
It's it's pretty unbearable to see somebody with, you know, cast on multiple limbs, external fixators on multiple limbs who were just asking for a drink of water, Almost no IV fluids available.
It, it's a place that, like Rick said, looks more like a Hospice now than a hospital.
But it's, it's a Hospice implies a level of care that the the five doctors and five nurses are simply unable to provide given the circumstances and what they have at their SO at the moment, it's a place where people are waiting to die unless we are able to move them to a safer location where they can receive care.
We visited the orthopaedic ward, which is where other patients are being held there.
The building is intact.
One man was in a stretcher under the stairs.
Inside the ward there were beds, one next to the other with people crying out, actually desperate for us to hear their stories.
They really wanted to tell us what had happened to them, how they struggled to receive care.
Many of them were women and children.
The woman told us that her whole family had been killed and and he couldn't get out of bed.
He had nobody to bring her food.
An elderly man started weeping when I spoke to him.
He had been shot in the in the chest, in the right chest several weeks ago and has still not received surgery.
So he he's he was shot and is still only bandaged.
A really horrifying scene in the health workers are mostly young, those that I saw in their 20s or early 30s, some of them junior doctors.
They said that there is no specialist left.
They, they can't perform surgery and they have no place to send these people at this, at this moment in time.
So we, we delivered supplies there.
But it, it was an unbearable theme, a huge amount of suffering.
And we're now looking into how we can help try to evacuate these patients to another facility.
But there's no place to evacuate them to in Gaza City.
So the only option is to bring them South.
And even here in the South, the hospitals are, are very, very full and of both patients and Idps.
And the, the, the method of doing that is very challenging.
We've, we've tried to do that in the past.
We've done it in the past and had paramedics, ambulance drivers detained and and and faced challenges doing that.
So a number of barriers in order to overcome.
We then proceeded to Al Shifa hospital after delivering the supplies to Alafli where we saw a situation not unlike what we had seen a few days before on Saturday.
A very, very full hospital with hundreds of patients screaming in every day, many of them with severe trauma being brought in in ambulances.
There are a few ambulances operating in gun cities, but mostly self preventing.
If they can walk, they come on foot.
If they can't walk, they're brought by dancing cart.
Some of them are brought in on trolleys and wheelchairs, carried in by family members on budget or sometimes carried in on people's baths.
The emergency department, as I, as I said on Saturday and Doctor Pedros tweeted, it's really a bloodbath.
It's got so few staff, almost the same numbers as the hospital, caring for hundreds of patients and the the hospital grounds are sheltering thousands of internally displaced persons.
So the surgical building, most of the wards are occupied by Idps.
While we were at Shifa this time, we delivered medicines and supplies, including clean delivery kits that we had hoped to take to Sahaba Maternity Hospital, which we weren't able to access.
The good news is that the chief of medical staff said that they would be able to transfer those clean delivery kits to the maternity hospital when it's safe to do so.
So we hope that they'll reach there.
But there are also deliveries happening at our depot, so they will be used there.
The the, we talked about the deployment of emergency medical teams, which will we hope will help to support health service delivery and resumption of surgery in hospital and also help to relieve the pressure on the emergency department.
We have some teams that are willing to go, but the hospital leadership did indicate that bringing medicine, bringing doctors and nurses will not be enormously helpful if they don't have fuel to run the generators and if they don't have water and food for their patients.
So we need the full package.
We need an interagency and larger scale effort to get Shifa functioning again to resuscitate Shifa.
As one of the doctors from Shifa said on Saturday, it's a hospital in need of resuscitation so it needs a different human resources which are working to mobilise.
We're providing medicines, fluid and surgical supplies, but we really need to get fuel in there.
It uses 10,000 litres of fuel per day, so it requires a huge uplift of fuel and there are thousands of people there who are in need of food and water.
What we also saw on Shifa on this trip was a surgical building that had been that had come under attack two days before.
The 12 people lost their lives on the grounds of the hospital 2 days before our visit.
And I walked through the building, I stepped on the rubble in the third floor, on the third level of the surgical ward myself and saw where some of those people lost their lives and, and where part of the building is now inoperable.
There were bullet holes in the surgical building and the bridge that connects the city.
And we were also told that a person was killed in the courtyard of the hospital yesterday morning before our arrival by a sniper.
So obviously, health facilities are coming under attack.
There's a huge level of suffering within the health facilities.
The health workers themselves are suffering.
And what we're doing right now is trying to provide some level of relief to this suffering with the provision of supplies by surging an additional support.
We hope to do fuel delivery in the coming days and also to support some of the other hospitals that have ceased functioning for the most part or completely and see how we can help to, to restart services in some of those locations after they are no longer seeing military activity close by or fighting in the area.
But what we really need is a ceasefire.
We need a, a cessation of hostilities.
Health, health facilities need to be safe places.
It's, it's pretty unbearable to see people who are, are already victims of conflict who are, are in what should be a safe place where they should be able to access care, where they're sitting waiting to die unless something dramatically changes that will allow them to survive that.
And that requires safe movements, requires a huge uplift of fuel, requires medicines, medical supplies, human resources.
They're starving.
They're dying of thirst.
One woman wanted to cry out to me and speak to me yesterday and she was unable to because she was so dehydrated.
I've never seen suffering like just particularly avoidable suffering like this.
So we need urgent action.
We need to stop these children and women and elderly people from dying in a place where they should be safe and where they should be cared for.
We're we're trying our best as WHO and as the United Nations community and the community of non governmental organisations to provide some relief, but it's not enough.
I'll stop there if I can come back to you.
Thank you, Sean for sharing this.
It's it's even difficult just to listen to everything what what you are saying.
[Other language spoken]
Thanks for being the witness.
We are sending you the the the the remarks of Doctor Piperkorn shortly.
You will have it in your e-mail.
Doctor Piperkorn he's speaking from Jerusalem and Sean is speaking from Rapha.
[Other language spoken]
He's just like really telling us what he has seen, not something that has been prepared.
So let's go for questions now starting with Imogen from BBC.
Imogen Yeah, thank you very much both of you for for sharing that You said that you wanted to take fuel over the weekend and this wasn't possible for the for security reasons that basically you were told.
[Other language spoken]
Fuel or it's too dangerous to carry fuel.
I I just want to were you just told that can't be as in part of your convoy?
That's my question.
[Other language spoken]
I think Sean might want to add this is Rick speaking from Jerusalem.
So just coming back from Gaza, I think the decision was made because there was a lot of military activities just north of that.
And this mission was also supposed to go to our Altwa, sorry, Sabaha Hospital, the NCH hospital and, and Al Sabaha Hospital.
And they didn't go there because there were a lot of military activities.
And of course, then bringing fuel, you know, you run additional risks.
So that was the reason fuel was not taken and and the focus was on medical supplies.
Maybe Sean wants to add on this.
[Other language spoken]
So yes, thanks.
So we, we had planned a fuel delivery following our previous mission to Shifa, but we decided well, the mission to deliver the fuel was aborted for several reasons.
1 is that we didn't have assurances and time to be able to get up to, from the from the from the parties to the complex, to be able to get up to the hospitals and back within the time that is available within daylight hours and clearing checkpoints and, and proceeding through very challenging road conditions.
So I must say when, when I travelled up to Saturday, it took 4 1/2 hours to go about 40 kilometres and that was with a flatbed truck.
It's not a huge amount of supplies on it.
[Other language spoken]
So we needed it to be a coordinated movement with the parties to the conflict and also ensure that we had a safe route to pass with 20,000 metres of fuel, which is obviously a volatile commodity and and we haven't done fuel deliveries to the north in the last three weeks since the since the pause.
There were also concerns that it's a **** value item in a population that's very, very desperate and that there could be potential for some kind of engagement along the route.
So it was decided that we needed to validate the route a bit more, which we did yesterday.
We provided those supplies and we hope to deliver fuel on in the coming days.
The fuel needs are enormous.
[Other language spoken]
The truck that we were planning to take is 20,000 litres.
So even if we had made that drip that would be two days worth of fuel for the one referral hospital.
And then and then the other facilities that we were targeting, we've been able to access we can activity in the area, fighting in the area.
So a number of challenges, but we think that we've been able to mitigate some of those and we'll give it another try in the coming days over.
[Other language spoken]
[Other language spoken]
So next question, Mohammed from Anadolu News Agency.
Mohammed, that Tariq, thank you so much for taking my question.
Yesterday, Minister of Health in Gaza announced that the Israeli army tortured Kamal Edwin hospital director El Kahlot and detained him.
Hundreds of healthcare workers have died in Israeli attack since 7 October and Israel is detaining now as 8093 healthcare workers in inhumane conditions.
My question is as WHO, what do you plan to do to protect healthcare workers from Israeli attacks?
[Other language spoken]
Thank you very much, Mohammed.
As as you know, we have been always calling for healthcare to be protected.
But doctor people, would you like to speak about this?
[Other language spoken]
One of the roles WHO, when it comes to attacks on healthcare, and it is a mandate for WHO, provided by the World Health Assembly, by all the member states.
So WHO in every conflict, an active conflict, an acute conflict, a chronic long conflict, WHO is obligated to monitor and analyse and report on attacks on healthcare?
And that's what we're trying to do.
So we, we always try to verify.
When we cannot verify, we will always say like who reported those attacks?
And then we will verify as as as good as possible.
What Of course, the VHL makes a point that that, that any detention of health workers, arrest of health workers is an attack on healthcare.
And we expect that anyone who gets arrested and detained, including health workers, has treated us according to international humanitarian law and, and, and, and, and families, their well, their partners should be of course informed on this.
We are extremely worried that we have seen numbers of health workers and I just want to also remind you that WHO is leading a mission to Al Shifa that is now weeks ago and that's six health workers were detained on that mission.
Two were released.
There are still three health workers, 3 for the Ministry of Health and 1 PRCS colleague were detained and we know nothing about their whereabouts.
The family of course is extremely worried, their colleagues are extremely concerned and and also we in WHO are very concerned.
So the not so in, in, in, in in that sense.
Yeah, WHO has a system in place on attacks on health care and regularly reports on, on, on this, including anybody.
And we will keep doing this and we will keep raising this.
And just to give you some figures, since the 7th of October, so we have documented 493 attacks on healthcare IT occupied Palestinian territory office 246 in Gaza Strip and they resulted in 582 fatalities and 77148 injuries.
So the attacks have also affected 61 healthcare facilities, including 26 hospital damage out of 36.
It affected also 76 ambulances, including 38 with sustained with sustained damage.
Over to you.
Thank you very much people Coron, I just shared in a in a chat the link to our portal on attacks on healthcare where you can look for the period and the country and and have have latest numbers on on on what the people can always just explaining what is the role of WTO.
Next question, Nina Larson from AFP Nina yes, hi, thank you for taking my question.
First, I just wanted to clarify something.
You just said Doctor Peppercorn on the health workers that were detained last month.
You you said two were released and then you said 3 remained in detention.
[Other language spoken]
I wasn't quite clear on the numbers.
Is it 3 or 4 who remain detained?
And I saw that Amnesty yesterday was asking for for investigations into.
Enforced disappearances in Gaza?
Would you consider these enforced disappearances?
Sorry that was that was my clarification and I have a question but you can answer that first if you want.
Or I can, Yeah, I can.
So I, I mentioned on that mission, which is now almost a month ago, so 6 Initially on the way back from Shiva to the South, six health workers were detained.
There were three from the Ministry of Health and three from PRCS.
Two were released from PRCS, 4 remain detained, SO3 from the Ministry of Health and one PRCS colleagues.
So four people remain detained and there's we their families, their colleagues, including us WHO we have, we don't know anything about their whereabouts and of course are extremely concerned.
That applies of course to all the health workers and, and, and we're trying to to get a better overview of that health works which get detained.
And when there's no information about us, we will constantly raise that over to you.
[Other language spoken]
[Other language spoken]
Yes, thank you very much.
[Other language spoken]
About Israel as accused.
People have turning a blind eye to the use of the hospitals by Hamas and some hostages have also said that they were detained in or near the hospitals.
Is that something that you've seen on the ground?
Do you think they're that's credible?
And if so, why haven't you condemned that?
[Other language spoken]
No, I think we and our missions have not seen anything of this on the ground.
But we cannot verify.
We are not in a position to to asserting how any hospitals being used other than a health facility.
We cannot verify that.
And I want to make the point as well.
It's always comes back on attacks on healthcare.
So attacks on healthcare, again, I say the role of WHO is to monitor, analyse and report.
We are not attributing the attacks on healthcare.
We are not a crime investigating organisation.
I think that should be very clear.
[Other language spoken]
Over to you.
Thank you very much.
[Other language spoken]
Do we have any more questions from, from reporters here?
We we have a Nick coming, Bruce from New York Times.
[Other language spoken]
[Other language spoken]
I wanted to check you.
You've indicated that water is in a crucial supply.
I mean, what is, is any water at all reaching any of our athlete or Al Shifa and you know, this must be one of perhaps one of the most critical shortages.
Is there any emergency deliveries that you can foresee in in the coming days that can alleviate that?
And then a question that my colleague John Zaracostas has often asked and I just wondered, wanted to check if you had any update on it and that is on the scale of amputations that is being conducted and perhaps whether you can provide that in relation to one hospital or in relation to many that that would be useful?
[Other language spoken]
[Other language spoken]
Have you let me start and I'm sure that Sean will want to complement all this as well, because they're discussing this, of course, with the one UN, Yeah, the one UN in Gaza and parts of Gaza.
On your last question, Nick, on the level of amputations, no, we don't have an old view of that.
The only thing I could say it's it's everywhere.
When I was there for more than two weeks and visited on most hospitals in the South and specifically also the larger one, the, the European Gaza Hospital, the, the national Complex, but, but actually all the hospitals including Al Ashley.
And when I visited Al Ashley, the, the, the incredibly sad thing was there were then still 2 medical specialists, an orthopaedic surgeon and, and a general surgeon, which we both work with as WHO we did training together.
We know them very well.
But they left and I reported on that they left a vascular surgeon.
So they, they indicated they occasionally had to do amputations, which normally would not be needed if there would be a vascular surgeon.
We see a lot of we everywhere around a lot of amputees, men, women, children as well.
Lots of children, lots of children.
And we don't have an overview.
[Other language spoken]
We're working, trying to work on that.
I also want to make a point on what you said about water and Sean will get in on that.
Currently, and this is I think is also a current and real problem.
We talk about getting more aid in humanitarian aid into Gaza and there's a little bit of good news with the opening of Carriage Shalom, but it's still not enough.
It's absolutely not enough.
The big problem is getting it.
Then specifically to the north, these missions, as Sean already described, they, they need a lot of planning, they need a lot of de conflicting.
And even then it's not completely de conflicted.
They need constantly to change routes and, and, and, and, and roads and very bad roads going over 40 kilometres and sometimes taking 4-5 hours.
That's, that's right, that's reality checkpoints, etcetera.
So it's very difficult to organise this, this missions.
And that is why, why of course, a humanitarian ceasefire is incredibly important, but also to make sure that those missions can take place not once a day or once every two days, but there will be multiple missions to the north.
That's that warehouses can be set up in the north that the storage facilities can be set.
And from there you can distribute foods, water and, and, and, and, and other supplies that's not there at the moment.
So it's all haphazard and and I would say the UN doing what they what they can do.
Maybe Sean, you want to add on this a little bit, how you currently discussing this?
[Other language spoken]
[Other language spoken]
Thanks, Rick.
Yes, so first on the water, I'll speak about water and food because even within the hospitals, patients who were severely injured are crying out to us for water and food.
So, and, and even as we walk on the streets, we're, we're up, you know, in the hospital yard, everybody's asking for water and food.
And, and yesterday when I was in El Shiba, I was asked, they said, oh, you're back again, Sean, by the people who happen to be in the courtyard.
And they said, it's great that you're bringing medical suppliers, but we need food and water.
The challenge, the challenges are many.
1 is that the level of desperation is huge and the numbers of people in need are huge.
And so doing orderly distributions of food or water is very challenging.
There's lots of security concerns around treating that.
The planning that Rick mentioned is the complex and the scale is, is enormous.
And so we can bring tanker trucks and water, but it will be a drop in the bucket relative to the need.
Now one of the efforts that's underway by UN colleagues is to support fuel delivery to the desalin ocean plans in the north so that some water flow can be established.
The potable water flow can be established there through that.
Also working to address the sewer system in the north so that the water sources can avoid being contaminated.
On a on a related point on water in Gaza, a lot of the groundwater is has **** salinity of salty.
So even with filtration systems it's not portable.
And so there's there's an issue in terms of the water sources here and in terms of the scale and complexity of delivering particularly to places like northern Gaza.
On amputations, I think what Rick said is correct.
We see amputees everywhere we go and unfortunately many of them are really unnecessary.
What would be considered unnecessary amputations in the rest of the world.
And where there's capability to save limbs, where there's orthoplastic, there's vascular surgical capability that's not there.
But there's no surgery happening right now in in northern Gaza.
And so actually many of the patients that I saw yesterday will need amputation when they are if and when they are able to access surgical care.
But we saw limbs that are not knowledgeable and people may die of the infections that they have because their limbs are infected.
And we saw patients who are subject and dealing with serious complex infections.
So there are a huge number.
We don't have a clear tally.
Many of them, unfortunately, are last resort amputations to save a life.
[Other language spoken]
And it, just as Rick said, speaks to the need to have the humanitarian pause so that we can bring in the teams and the supplies and the fuel to make surgery possible, evacuate these cases to a place where they can be safe and hopefully save some of these lives and save some of these limbs.
But this is not, it's not just about the number of amputations, it's also that we're talking about small children who have lost their legs, who lost both of their legs.
We're talking about elderly people who have lost them.
We will have nobody to care for them.
They can't move.
They're they're really bound to their beds and they can't.
Even if there was a lot of distribution, even if there was a food distribution, they would struggle to get to it.
So there's, there's really layers to this, but it's a, it's a horrible theme where there's lots of amputations, There's lots of amputations that are becoming infected because there isn't even water to, to manage the post op, post operative care.
I'll stop there.
Thank you very much.
I'll just go in order of hands that we have.
[Other language spoken]
Lisa Schlein, Voice, Voice of America.
[Other language spoken]
Thank you to you and to you gentlemen.
[Other language spoken]
One, there have been increasing warnings about people at risk of starving to death because of lack of food and water.
And also that it's likely that more people will die from disease then from bombs the longer the conflict goes on.
I'd like to ask for your response to that, whether you believe that, sorry to use this phrase, but whether this is a ticking time bomb, how much time actually is available is left to respond to the needs of the people before it does reach a point of, well, horrible, no return.
[Other language spoken]
[Other language spoken]
Yeah, let me start and then maybe Sean might also add to this, you know, like already just coming back to Jerusalem and, and what I witnessed.
And I want to make that point very clear.
So Gaza before this crisis had a reasonably functioning health system and I told that as well.
We'd had wells indicates, targeted neighbours.
Also when you looked at nutrition, yes, there were some, some, some groups of the population with what we call food insecure, but it was limited.
We mainly talked from the health point of view.
We talked about micronutrients deficiency in some areas, iron etcetera, pregnant women iron deficiency, etcetera.
But they were very limited and already what I saw over the last couple of weeks, you could see that that the food insecurity was becoming a major, is becoming a major topic.
I understand that the IPC and FRC will will actually raise much more and much more detailed information about that.
And hopefully today or at least in the coming days, they're your experts on that.
But what we already see that and and you can you've seen it also on the on news from WP.
They conducted this rapid food security assessments following the significant deterioration of food security situation in the South of Gaza and also the large influx of IDP's.
1.95 million people are IDP's and and with resumption of hostilities and very, very **** levels of hunger levels and were reported so on, on let's say extreme and and large part of population, extreme food is insecure and we will get more data on on this.
Now the and the proportion of of IDP households, not only IDP households, also normally P households.
I say going to sleep hungry or maybe have access to 1 small meal a day is increasing and it's increasing from the IDP from was already increasing 34 to 50%.
[Other language spoken]
And that's in combination what you, what you actually said with the, the, the huge number of like not only in the Unrun shelters, but also in this makeshift shelters harbouring 1.95 million people.
The water sanitation conditions are, are completely below par and the water consumptions, I mean like an unsafe sources, etcetera persist and even more in the north as just described by Sean and myself and where the water desalination plans are not working etcetera.
So what we, what we also see and we try to monitor and I must say Unrung LVA is trying to assist as good as possible.
It's difficult to monitor, but what we have seen is lots of acute respiratory infections.
We're talking about 170,000 cases, a lot of scabies and lies, 50,000 cases of diarrhoea, over 125 thousand and under 560-160-2000 which is way, way more than normal.
This time skin rash, chicken pox, jaundice close to 4500, which is actually very worth system for hepatitis.
Something like is it habitat A or is it E, which is much more great.
No lab capacity to actually because it's all destroyed, not non functional.
So WHL has just got in some, some lab case, that testing case and we'll try with unright to set up an early warning and response system.
So the routine surveillance system, which was working pretty well in Gaza has been completely Hanford, it's not working currently.
And and many of these people of the people with no access will go undiagnosed.
So the situation is probably worse than it seems.
An area of vaccine vaccination, routine vaccination.
Gaza had a fantastic poverty, routine vaccination, better than most countries around the world, close to 100% now.
So at the moment that's maybe not a risk, but very quickly that will become a risk.
And think about measles epidemics, what you get and when, when this is not not addressed.
So yes, we are very concerned.
We have not yet seen major outbreaks, but of course we are.
We are actually simply waiting for them.
If this doesn't change, if the excess is not improving, if the supplies are not improving, if the the the shelter conditions are not improving, if the water and sanitation conditions are not improving, if the access to health services and Healthcare is not improving.
I don't like the phrase what you mentioned.
Yeah, taking time home, yes, But it definitely is over to you.
Maybe Sean, do you want to add something from the field correctly?
I'll add 1 brief point which addresses the question of when is when is it too late?
And I think it's too late.
[Other language spoken]
There is not enough food.
Every single person I speak to everywhere I go in Gaza is hungry.
It's the time is now.
We, we, we are dealing with starving people now, adults, children.
And it's, it's unbearable.
Everywhere we go, people are asking us for food.
Even even in the hospitals, as I said, I walk around in the emergency department, somebody with an open bleeding wound, open fracture, they ask for food.
If that's not an indicator of the desperation, and I mean, I don't know what is.
We, we, we move around Gaza to deliver medical supplies and people rush towards our trucks hoping that it's food.
And when we say that it's medical supplies, actually they clear the way for us.
They, they help move debris out of the road.
But everybody's just constantly on the lookout for, for food.
So there's efforts underway with the one UN to look at cash options in some parts of God where there is food on the market, but nobody has money to buy it.
In other parts, there's really nothing on the market and there's an urgent need to bring in flour and, and basic food stuff.
So, yeah, I, I think we're, we're behind on a lot of things here in Gaza and there are trucks, there are hundreds of trucks sitting in Rafa.
Rick said it is good that parential loan is open, but we need more food to come in the private sector.
The commercial trucks also need to come in.
Cash needs to be put in people's hands and that will address some of the food prices.
But we're seeing the consequences of it already in the hospitals and and in our daily interactions with people across across the Gaza Strip.
[Other language spoken]
I mean, and I want to add on that, there's what Sean said, there's no economy going.
So the private sector is of course key to get that reactivated again.
And and we've raised this by the way, many times over the last couple of weeks.
I mean, if this is not a real big indicator, every hospital you go, so there's a lack of food for patients, but there's also a lack of foods for health workers.
So health workers, they have to scavenge around and they have to, to, to, to spend their time.
At the moment, probably we estimate that less than 30% of the of the 25,000 health workers in Gaza is actually operational because everyone, and that's including from our own staff, The Who staff, we have 1/3 who is still incredibly operational.
But a lot of other people are just say they are, they're in a mode of, of, of surviving.
They're focusing on surviving and focusing on what can we get from the market.
There's no money around.
So there's even, there are still some farming done.
I've seen some farming in the middle area and in southern area, et cetera.
But of course, and there is no economy people cannot access.
So it's everywhere there's talk about foods and people ask for food and water and and every time we broken the truck of of medical supplies up north, in the South, etcetera, we had to protect those trucks and pulsively raise out our voice.
Hey, these are Dawa.
These are medicines.
These are medical supplies for hospital X or hospital Y because people jumped on those trucks to see if we were not, if we were not lying, if we were, you know, if there maybe was water and supply and and that truck would be empty in no time.
That is the reality in the ground.
And I think sometimes I feel that it's voices are not heard enough.
The misery is so much large, larger than than I think what people what people think over to you.
[Other language spoken]
Let's we have three more questions for your hands.
[Other language spoken]
Thank you very much.
[Other language spoken]
You thank you very much for all the detail about the food and and water situation.
Could do you have?
Any numbers about the people that have actually been treated for malnutrition?
Is there any sort of metric or gauge that could indicate we did it?
And, and if, if it does bear repeating the numbers that that WFP is provided, of course, which you know, the other day saying that, you know, 90% regularly an entire day without a meal and and half of Gazans are starving, you know, is there are we getting close to a famine like situation there?
I mean, that sounds like it could be in the often with those kinds of numbers.
So, so basically my question for you really is just about the, about the, the, the treatment for, for malnutrition and, and anything you might say about those figures, those other figures.
[Other language spoken]
[Other language spoken]
[Other language spoken]
And at the moment, so I think you also say the the even the one UN and the one UN, the various clusters etcetera.
We talk about relatively small numbers with their partners trying to focus on the priorities.
So for WSO, the priorities, how do we make sure that the hospital, the health system which is on its knees, how do we make sure it's at least keeps on providing basic health services.
That's our key priority.
That's what we focus on when we try to, to get a sustained supply supplies, medical supplies, essential medicine to those facilities, which is already incredibly difficult to do now with this, with this, with this, the, these figures coming out and what we have observed about the situation around hunger and malnutrition, food insecurity, extreme food insecurity.
Yes, the both the health cluster and nutrition cluster, they they want to work first with the the Primary Health care facilities just what always should be done and and under 5 clinics that you do middle or upper arms circumferences, etcetera that you separate the system that you also do that in try to get them do that in some Sentinel sites in, in, in, in some of the shelters and some of the makeshifts, makeshifts shelters, plants are made currently to do that.
So to other.
But the first, the first priority should be that there should be a sustained flow of food and water and reaching everywhere within the South, within the North.
That should be the, the, the key priority.
And yes, we need to, to get, to get to, to get better data on, on, on this work is being done by the nutrition cluster and the health cluster.
Sean, you might want to add something on this.
[Other language spoken]
I'll say, I mean, we're struggling with numbers on a number of fronts because communications was down for much of the last week.
I mean, we have very often no cell signal people in the North actually when when I go to the North, people ask me what's happening because they don't have Internet access, they don't have cellular service.
They don't have any visibility on what's happening outside of the small area where they're staying where it's safe to, to, to exist.
And as a consequence of that, you know, we have limited reporting.
We have people who are unable to access services to even get streamed for malnutrition.
We we have challenges in transporting therapeutic foods to the north because supplies are sometimes compromised.
Trucks are looted as I I hate using the word looted because looted implies criminal intent.
But there are desperate people who are looking for food who will, as Rick said, jump on the trucks and and they're desperate to eat something.
So we have challenges just in the security and transporting therapeutic foods for for young children and infants and challenges in getting information and challenges for patients themselves, for mothers to take their babies, parents to take their small children to a clinic because there's fighting in the area and they don't feel safe moving from whatever location they happen to be in.
That's all.
[Other language spoken]
[Other language spoken]
Next question, Catherine Biancambe Conga from France.
[Other language spoken]
Catherine, thank you, Tariq and good morning.
Thank you to both doctors for meeting us this morning.
[Other language spoken]
The 1st is to Doctor Sean Kezi.
He spoke about amputations that could have been avoided in normal circumstances.
So, doctor, could you give us a percentage of the amputations that could have been avoided if we were in a place where people could get access to normal hospital services or a doctor?
Richard, the paper call on one of both of you.
And I'd like also to know if you have some more children that have been evacuated, could you please give us more details on on that one?
Thank you to both of you.
[Other language spoken]
I, I can comment on the, the amputations and the simple answer is no, I don't have the numbers of limbs that could have been saved.
I think the hospitals that are functioning particularly in the north, but even here in the southern part of the Gaza Strip in, in pan unis, they're absolutely overwhelmed.
And I mean, hundreds of patients coming in every day with serious injury and staff who were not able to access the hospital.
So not long ago I was at European Gaza Hospital where they said the staff who live across the road, you know, 500 metres away, are unable to get to the hospital and consequently they are unable to perform some of these very simple procedures, actually not just amputations, simple procedures that would save lives.
So people are dying.
The doctors told us that European Gaza Hospital and a doctor medical complex in communist and then as well as in health facilities in the north, that people are dying because there are not the providers in place to provide care for basic illnesses and injuries that would otherwise be very treatable.
So we don't have a hard number, but I can tell you in every, in every hospital that I've been to in the last 2 1/2 weeks, I've seen patients who have had amputations, who have lacked access to care simply because the providers are no longer available, because they've been displaced.
They've had to flee because they are scared to, to go to work or they're scared to leave their families to go to the hospital and that they may never return.
They may not be able to get back across the room.
So no firm numbers on it, but it's, it's a common, a common occurrence, unfortunately that we're seeing that people are really struggling to access basic care and and they're dying of things that they shouldn't die from and they're losing them that they shouldn't have to lose because of these access constraints and because of ongoing conflict.
I'll hand over to Rick, maybe on the evacuation club.
[Other language spoken]
And maybe to add or one thing on the amputation, I think it's for me, it was more than telling that to incredibly well trained medical specialists a week ago when I was in this Alaki hospital straightaway told me that like, hey, I'm an orthopaedic surgeon, my colleague and we know them as a general surgeon.
We do not have the skills.
[Other language spoken]
So we have done and will be doing amputations when that should not happen.
That's, I think it's for me more than more than telling on the on the efficuation of patients.
So as WHO political, we think that many more patients should be evacuated out of Gaza and we know that that Egypt is ready for that and they've they've raised Egypt and government and EOC as such and and we're very grateful for that.
It has to speed up and increase and including the there are other countries in the region which which which are willing to also assist with with accepting patients and their companions.
You know, when there are needs for a referral.
And I'm really literally thinking about hundreds, maybe even thousands of patients over the next month which should be referred.
The way shall we wear together with with the Egyptian government the ESC and that was already a couple of weeks ago where we facilitated with Saint Jude's Hospital the transferred of a number of I think 30 children with cancer and and to Egypt and from Egypt to other places.
But much more is needed.
I also want to remind everyone that before the crisis that on average, 50 to 100 patients a day, five days a week would go.
Would go for referral care to East Jerusalem hospital or East or East to East Jerusalem to the hospitals there or to the West Bank.
40% of that was oncology related, paediatric oncology, adult oncology, etcetera.
Those patients we don't we don't even talk about anymore.
We only focus on trauma and say that for because it's so overwhelmed, but that's another group of patients.
The, the, the patients with non conical diseases which cannot be treated in, in, in, in, in Gaza, oncology patients, etcetera, which so we need to, what is needed is a much better medical adequation outside Gaza into Egypt and, and, and when needed from Egypt to, to other countries in a more organised way.
And, and there's literally a need for hundreds, probably thousands of patients.
It would also help to decompress the completely overwhelmed healthcare system.
Every hospital we talk about 3, three times as many patients as their normal vets and, and all the ICU and and a last point which I've never seen in any conflict, but the many patients which could be discharged, patients are afraid to be discharged.
They don't want to be discharged because they are afraid to go back to where they come from.
So they're later around in this hospitals and it's like some of the hospitals that is very difficult to to get rid of these patients.
Over to you.
[Other language spoken]
[Other language spoken]
We have two follow up questions from Nick and Katrine.
So let's do those and try to be short.
[Other language spoken]
Yeah, this is a very short one and perhaps the answer is rather obvious, but maybe you could just explain what are the constraints on evacuation of patients at this point?
How much of this is down to the fundamental insecurity and continuing conflict and how much of it is due to, if you would like, bureaucratic procedure or political will?
[Other language spoken]
[Other language spoken]
I would expect the political will is there and people talk about it all the time.
So I think it has to be implemented.
[Other language spoken]
The political will is there to to organise a better medical evacuation.
I think it's a lot of the procedures it has to do partly with, with security and screening etcetera.
But for me that's not, I don't want to go there.
I mean, we see what is needed and many more patients need to be evacuated on a regular and a more organised way.
What we hear and see is like 20 to 40 patients, sometimes a day.
That is way too 20.
That's way too little.
We've seen lists of patients which are much longer than that.
And and it should be facilitated.
I understand everywhere where when I listen that the political will is there that that the resources are there, that the the hospital facilities are are there on the other side.
[Other language spoken]
That will be my plea.
[Other language spoken]
And let's go to to last follow up question from Katrine.
[Other language spoken]
In fact, the follow up is, is regarding the French floating hospital that was initially supposed to to dock off the coast of Gaza.
So I'd like to know if you work with this hospital, and I know that the hospital is in Egypt for the moment, is it possible for any boat to dock off the coast or did the Israeli bombing damage in fact the Gaza port?
Yeah, OK, I'm going to, I'm not a docking specialist or specialist on ships and boats as but first of all, the issue is not about boats in front of the Gaza coast.
That's not going to help the efficuation.
The medical efficuation to Egypt can be organised and should be organised from there.
That's the second step.
And Egypt, Egypt and I think they we're very grateful that they are ready to receive many more patients.
Hospitals are ready.
And if there's need to refer from Egypt to other countries and there's many countries in the region which, which have offered a reheard from, from Qatar and from Iraq and from the UAE and Turkey, for example, they are already, we heard from some European countries that they are ready to, to, to if needed to accept.
So then maybe, I don't know, maybe they can go from, from, from Egypt to that boat.
[Other language spoken]
But I think there is, there is, there is the, the best way possible is to get out of Gaza into Egypt and from Egypt.
I will remain into Egypt.
There's a lot of good services available in Egypt or when he does go to other countries, certain places.
That should be the focus.
Thank you to your people.
Sean, would you like to add something to that?
[Other language spoken]
Yes, I'll just just add, I mean as Rick said, it's about getting, it's about getting out and there's plenty of destinations.
But I think the fundamental point at the moment within Gaza is that we have 20 or so percent of hospital beds functioning.
We have a huge reduction of staff available and they're even, they're basically no beds available.
There's there's no room for patients to move within the, the, the biggest referral facilities in the South, in the South which are still functioning are 203 hundred 400% capacity.
So internal referrals are occasionally possible, very complex, but international referrals are absolutely needed.
We're we're scaling up bed capacity.
My role here as emergency medical team coordinator is to help bring in field hospitals and expand that capacity within the hospitals.
We have the ICRC at European Gaza Hospital, adding beds within the hospital and adding a field hospital next door.
We have a number of emergency medical teams setting up additional beds, but it's not even coming close to the number of beds that we've lost.
And we're, so we've lost beds and at the same time multiplied the number of injured and I'll who need hospital bed.
So they can't wait.
The people that I saw yesterday and on Saturday and Shifa yesterday at Alafi, they can't wait for two weeks or three weeks for additional beds to open or new hospitals to, to be built.
They need to be evacuated now.
They need, they need care immediately.
So we're working on some, you know, extreme cases.
If we can move them to a hospital here in Rothwell, for example, that can accept one or two patients, that's great for those one or two patients, but there's hundreds or thousands more behind them.
And there will not be enough beds in the short term to meet that need, especially with, as we've alluded to, some of the very complex surgical cases that need care that require vascular surgery, orthoplastic surgery, reconstructive surgery.
[Other language spoken]
Those are very complex cases that just can't be cared for within Gaza at the moment.
There's no hospital that has that capability.
[Other language spoken]
Maybe Tarik, if I may add to what Shandu's race, I think this is what we have tried to, to to push for for weeks.
It says, of course, that the, what we, what we call SOBH, so the protection of healthcare.
And I think what, what has happened in the North, there can absolutely not be a blueprint of the South.
So in the north, we're talking now about four, well, minimal, barely functioning hospitals.
[Other language spoken]
So we, we need to help to make those hospital functional again, because there's between 2 and 600,000 people in the north.
And the first focus is of course, to make cheaper research the state Sheeta hospital again.
So that's, that should be, that should be happening, should be allowed.
And then you talk about fuel, we talk about medical supplies, but you also talk about emerging medical teams and emerging medical teams are willing to go to Shifa and to assist the current staff.
So that's that is for the north.
That should happen immediately as soon as possible.
Make sure that there is a minimal level basic level of health care available in the north to serve the many, the thousands of remaining people now in the South.
We currently talk about 7 hospitals extremely overwhelmed, but they are the backbone of this 1.92 million people.
They've now the backbone of the health systems and, and we have to make sure that not only to keep them functional and to restore, we also have to make sure that what Sean is trying to do and help to that emerging medical team come in and are linking up to those hospitals.
[Other language spoken]
ICOC is in the European Gaza hospital and, and, and, and they are pledged to expand that hospital with another 150 beds.
Now that's need to happen in Nasser close to NASA medical complex.
The Jordanian 7 field hospital, even as a matter of complex will need an emergency medical team to assist to expand the number of beds, ETC.
NASAR Medical Complex and European guys hospitals are like what what Shiba was for the whole of Gaza Strip.
They're the third level hospitals and they need to be functioning constantly.
Now we are very concerned that, but we also see much more military activities in Han units very close to national Complex.
And we already saw one of the stench shell landing on on national complex killing actually an amputee girl in that hospital.
And there's many Ieps as well in this in that area.
Now they're getting concerned.
They say, oh, it's the cheaper scenario repeating here.
And, and, and you know, do we have to even move further?
The same in if you talk about middle area, the middle area and, and, and around Al Aqsa hospital there and, and D'arabella, thousands, hundreds of thousands of ID PS Now, if so, there's two things.
This hospitals infrastructure, this vulnerable hospital infrastructure on his knees needs to be supported and strengthened with additional hospital beds with EMTs.
But also and I want to say to to help improve beyond trauma care, to help improve the access to reproductive maternal, newborn and child health treatment of comical and the non comical diseases.
And we don't even talk about mental health and cycle psychological support services.
We have to do this in a in a much broader way.
And and very concerning that military activities are continuing in this area.
Can illness they will come to the mill area.
We will probably see more influx of Idps coming from those areas to the South.
And then and then, well, we can all describe situation in a Rafa, a town of 230,000 people normally and they have over 1,000,000 people.
They're probably more than a million ID PS already sheltering in, in the town, all these makeshift shelters, there's no space.
So I can't understand why people don't want to go because there's no space.
Where do you want to go?
[Other language spoken]
So what there is nothing safer.
So you don't want to go in the place where where you don't have any shelter and and you have the same problem.
So this should be prevented.
And the the almost a plea from us.
The health care services need to be protected in the South and we need to get it going again in the north, starting with research with making cheaper again at least work as a first level hospital and maybe then after that again to a second and served that hospital over from me.
[Other language spoken]
Rick, I understand that Sean has to leave.
[Other language spoken]
We are well beyond the hour and and 15 minutes now and we don't really want to ***** also the hospitality of our colleagues at you in information that I have one hand from John Zaracostas.
So Sean, if you have to leave, please just go.
And Sean, John, please ask your question if it's possible just to be very yes, yes, good morning.
Doctor Peppercorn, I was wondering if you could give us a bit of an outline.
What is your relationship with the Israeli authorities and what responses are you getting when you're asking for the access to the various facilities?
What are their responses?
[Other language spoken]
[Other language spoken]
Well, it's not just my relationship, it's the, it's the one UN.
And I think the one UN is, is, is coordination is coordinating with with all parties to the context as as good as possible, as good as possible.
And that is on a very, I would say direct and in an intense way.
So that's, that's happening at at levels above me, but it's and, and we are also all operational UN agencies are, are constantly reaching out.
We do this in a coordinated fashion with, with the one UN and, and Gaza and RA and and OCHA leading, leading in this process as both in, in, in, in Gaza as well in, in Jerusalem.
So there's a whole system in place.
The issue is what I, what I, I think I said that from the, from the start that specifically going up north when there's a lot of military activities, when there is roads are destroyed, when, when there's a lot of insecurity for any convoy.
And specifically when we talk about larger convoy convoys which we would like to send up north convoys which would include fuel, foods, water, medical supplies, it becomes incredibly difficult to to plan for that.
There's constant planning on going, there's constant interaction.
But the reality on the ground is that we, we, we plan for convoys.
They often get delays or they take a lot of time and they are very **** risk.
So these convoys need to be properly deconflicted.
It should happen in corridors that they can move quickly.
So there's a lot of work on that.
Some progress has been made, but it has to be much, much better.
And, and we struggled, for example, with larger corn wards.
We had once we tried to plan a corn ward, both the medical supplies and, and with, with food and water and it is difficult to move around.
So the final decision was we have to keep this convoy small and, and, and, and, and agile.
It's another issue, for example, that when the UN is struggling something very, very simple, the number of AV vehicles, we need to increase our, our, our armoured people to do all things we struggle to get them in, get permission for that and to get a constant flow.
PPS It's absurd that in in such a large and there's such a large needs and this has got to be such a large humanitarian operation that we struggle to get a VS in and PPS etcetera and and get more starving.
And that of course has everything to do everything.
All of that is related to the to the volatile security environment.
Over to you.
Thank you very much, Doctor Peppercorn, and thanks to all the reporters who were with us this morning.
[Other language spoken]
Sorry, Tarek, I need to leave as well.
[Other language spoken]
Thank you very much.
We are, we are, we are really concluding.
Thank you, Doctor Peppercorn.
Thanks also to to Sean Casey who had to leave as well.
Reporters, thanks to reporters who were with us and thanks to our colleagues from UN Information Service for facilitating this this press briefing.
I wish you all a nice rest of the day.