In just a matter of weeks, some 5,500 women are due to give birth in Gaza, where doctors in overstretched hospitals are delivering babies with little or no anaesthesia - sometimes by the light of mobile phones.
As the conflict between Israel and Hamas militants enters a second month, the UN Population Fund (UNFPA) and sister agencies continue to appeal for a humanitarian ceasefire and an increase in convoys bringing food, fuel, water and other desperately needed aid into the enclave.
Laila Baker, Regional Director for the Arab States at the sexual and reproductive health agency, said she fears for the fate of new mothers and their children amid the "loss of complete humanity" in Gaza.
Supporting mums-to-be
Staff from UNFPA have been providing emergency health and safe delivery kits to mothers-to-be "when we can reach them", she said.
She told UN News that pregnant Palestinian women fleeing bombardment are riddled with anxiety, but also hope and happiness, as they struggle to find qualified health professionals who can support them with a safe delivery.
"Put yourself in the shoes of that woman when the surgeon says to her 'I have no anesthesia, I don't even have water or soap to wash my hands, but I'm going to try and save your life,'" she said.
Speaking from Cairo, Ms. Baker outlined why a humanitarian ceasefire and stronger international response are needed now in Gaza.
The interview has been edited for clarity and length.
Laila Baker: If I'm truthful, I'm at a loss for words about the catastrophic situation on the ground and the loss of complete humanity in what we see in Gaza. It is an unprecedented and unparalleled brutality in the history of humanity in recent times: 2.2 million people, amongst them 50,000 pregnant women, besieged for one month. 5,500 women are going to give birth within the next few weeks. And for the 160 women who I should have said are lucky today to try and bring joy and life into this world, I fear for their lives and the lives of their children.
Over 135 health facilities have been targeted. The remaining health facilities that stay standing have very little medication, no fuel to run electricity. We've had caesarean sections for emergency deliveries that have been done with little or no anaesthesia and on occasion only with the light from a mobile phone.
So, when you ask me about what the situation is on the ground, where we have already lost 89 UN staff members - never in the history of the United Nations in such a short duration and one single event have we lost that many staff members.
And yet, the world leaders seem paralyzed to be able to intervene on what is one of the most flagrant breaches of human rights and international humanitarian law - by besieging and constantly bombarding the Gaza Strip.
UN News: Several UN agencies have reiterated in a joint statement urgent appeals for an immediate humanitarian ceasefire to allow more lifesaving aid into Gaza. UNFPA is among the signatories. Can you tell us more about that joint call and its significance now?
Laila Baker: It is a significant appeal. Right now, we are we are putting a humanitarian bandage on what is primarily a crisis of humanity. The ceasefire is necessary and a necessary condition for two things.
One, for us to be able to enter into Gaza with the goods unhindered and unconditionally, to be able to provide for those who have been forcibly displaced to the south, for those who are injured and overwhelming the hospital facilities, and to bring in the goods and people where we can start to at least address some of those critical humanitarian needs.
Secondly, it's critically important that the protection of all humanitarian staff - the sanctity of life in general is protected.
There's no such thing as a humanitarian pause. A pause implies that you can come in, bring your things, but then we're going to bombard and then we're going to commit and continue to put that pressure on the people of Gaza. That cannot continue. It must stop immediately.
UN News: You mentioned that important point about targeting health facilities and also targeting health workers. How can that complicate the situation which is already complicated on the ground in Gaza?
Laila Baker: It's fairly apparent, I would assume, even from a human perspective. But let me give you the situation of a pregnant woman. You're anticipating bringing a child into this world. If it's your first child, there's a mixed anxiety about what might happen during that delivery, but there's also hope and happiness.
When you have no one who can help that woman while she's fleeing from continuous bombardment, when she doesn't have enough water to drink that will allow her to carry to term and healthily, when she cannot protect herself or her family as she moves to try and find a qualified health professional…
Put yourself in the shoes of that woman when the surgeon says to her, 'I have no anaesthesia, I don't even have water or soap to wash my hands, but I'm going to try and save your life.'
What kind of torturous pain goes through her mind, or through the doctor's mind, or through her husband's mind, on what might be the outcome for her and that baby? Even if she survives, there will be no one to help her.
There was a woman who we spoke to who said, 'Every step when I was trying to find some place to deliver my baby felt like a race against death.' I can't imagine the choices for her and for her family. As a woman myself - as a person, a human being who's also enjoyed having new members of the family and seeing the joy of a birth - I can't imagine what torture it is to be put through those conditions and those choices. All of it is reversible if the international community can come together and say 'stop'.
UN News: UN agencies are working around the clock to provide lifesaving supplies. Can you tell us more about what UNFPA has provided since aid convoys started to enter Gaza through the Rafah crossing?
Laila Baker: We are continually trying to do the best that we can. We have provided clean drinking water to our staff. We've provided emergency reproductive health kits and safe delivery. It's anything from a bag that has a clean plastic sheet, a clamp to help clamp off the umbilical cord and a pair of scissors to cut them, a bar of soap and some wipes to ensure that at least some level of hygiene and sterile environment is protected. Those we distribute to the pregnant women when we can reach them.
We also are moving in goods that are to help the hospital facilities that are currently overwhelmed with simple equipment for delivery and a lot of the disposable supplies, like gauze, saline, some of the other kinds of products and goods like oxytocin that can help with the delivery, which right now are completely depleted.
We are very concerned, however, that those are a drop in the bucket. They are insufficient.
We try our best also to protect young girls who are in overcrowded centres and where hygiene is at best very minimal. In one centre where we work, there is one bathroom facility for a thousand people. Can you imagine the situation for a young girl - your sister, your daughter, a person who you care about, a good friend - where she needs the privacy, to feel the respect and dignity as a young woman and grow into a healthy adult?
UN News: Can UNFPA staff reach northern Gaza? We know there are many challenges facing humanitarian workers there. Also, how challenging is it to provide aid to 5,500 women who are expected to give birth in the coming weeks?
Laila Baker: It is an impossible equation at the moment. I wish that I had better news. I wish that we could provide for them. That would take an enormous amount. And I think that there's one thing that I would like to stress is that no amount of humanitarian aid responsibly would be delivered at the scale that we need, nor is it our responsibility, nor is it responsible to replace the public and private sector that provide for that civilian population.
It's important to insist - and this is why we were saying - that it is the protection of the civilian infrastructure that provides for any community: the hospitals, the schools, the houses, With half of the residential buildings in the north of Gaza demolished, what will there be to go back to?
That lack of respect for civilian infrastructure, including the targeting of hospitals, is such a blatant breach of human rights. The real emphasis needs to be on the protection of civilian infrastructure and protection of the dignity and the principle of allowing the Palestinian people in Gaza to live in their home safely.
