Spikes in casualties, attacks on schools and shelters, including the death of a UN worker, and crippling fuel shortages blocking aid deliveries rippled across Gaza over the weekend, as the World Health Organization (WHO) helped to evacuate 31 babies in critical condition at the besieged Al-Shifa Hospital and the UN chief called for a humanitarian ceasefire amid the ongoing Israel-Palestine crisis.
Top UN officials echoed that call to improve conditions for Gaza's 2.3 million people, 1.7 million of which have been displaced since the 7 October Hamas attack in Israel resulted in the killing of 1,200 Israelis and capture of 240 hostages. Since then, more than 11,000 people have been killed in besieged Gaza.
"This war is having a staggering and unacceptable number of civilian casualties, including women and children, every day," UN Secretary-General António Guterres said in a statement on Sunday. "This must stop. I reiterate my call for an immediate humanitarian ceasefire."
Volker Türk, UN High Commissioner for Human Rights (OHCHR), said in a statement on Sunday that: "The horrendous events of the past 48 hours in Gaza beggar belief."
Growing despair
"The killing of so many people at schools turned shelters, hundreds fleeing for their lives from Al-Shifa Hospital amid continuing displacement of hundreds of thousands in southern Gaza are actions which fly in the face of the basic protections civilians must be afforded under international law," Mr. Türk said, stressing that failing to adhere to these rules may constitute war crimes.
According to the UN agency for Palestine refugees (UNRWA), which issued its latest situation report on Sunday, nearly 884,000 internally displaced persons are sheltering in 154 UNRWA installations across all five governorates of the Gaza Strip.
"Just getting into one of the shelters makes you burst into tears," an UNRWA employee said. "Children looking for food and water and standing in queues for over six hours just to get a piece of bread or a bottle of water. People are literally sleeping on streets here in Khan Younis as thousands keep escaping from the north."
Attacks on schools, shelters
In less than 24 hours, two UNRWA schools sheltering displaced families were hit, causing "many deaths" and injuries, mostly of women and children, in addition to other deadly incidents across Gaza and the West Bank against the backdrop of soaring humanitarian needs, UNRWA said.
Mr. Türk said at least three other schools hosting displaced Palestinians have also been attacked.
"This must stop," he said. "Humanity must come first. A ceasefire - on humanitarian and human rights grounds - is desperately needed. Now."
Philippe Lazzarini, who heads UNRWA, said in a statement on Sunday that the attacks are "just cruel".
"I watched with sheer horror reports from an attack on the Al-Fakhoura UNRWA school-turned-shelter in northern Gaza," he said.
Classrooms sheltering displaced families were hit and at least 24 people were reported killed in the strike. Up to 7,000 people were in the school at the time, the UNRWA chief said. On Friday, following strikes on the UNRWA Al-Falah/Zeitoun school in Gaza City, ambulances could not reach the school, where 4,000 people were sheltering.
Beyond 'collateral damage'
Since 7 October, at least 176 people sheltering in the agency's schools were reported killed and 800 wounded during Israeli bombardments, Mr. Lazzarini said.
"The large number of UNRWA facilities hit and the number of civilians killed cannot just be 'collateral damage'," he said, adding that the UN agency routinely shares the buildings' coordinates with parties to the conflict.
"This vicious war is reaching a point of no return when all rules are disrespected, in overt disregard for civilian lives," he said, calling and appealing "once again for humanity to prevail and for a humanitarian ceasefire right now."
![Palestinian civil defence responders search the rubble of a building in the aftermath of an air strike in the Gaza Strip. (file) Palestinian civil defence responders search the rubble of a building in the aftermath of an air strike in the Gaza Strip. (file)](https://global.unitednations.entermediadb.net/assets/mediadb/services/module/asset/downloads/preset/Libraries/Production%20Library/17-11-2023-WHO-Gaza.jpg/image1170x530cropped.jpg)
Al-Shifa Hospital
Israeli military operations have been continuing inside and around Al-Shifa Hospital, with UN colleagues that visited the site on Saturday describing it as a "death zone".
On Sunday, WHO and humanitarian partners helped to evacuate infants in critical condition.
Medical personnel, patients and civilians had fled the hospital over the weekend, ordered to do so by the Israeli military, UNRWA's chief said, adding that hundreds were seen making their way south on foot, at great risk to their lives, health and safety.
WHO reported on Sunday that six Palestine Red Crescent ambulances transported the babies to Al-Helal Al-Emirati Maternity Hospital, where there are receiving urgent care.
"Further missions are being planned to urgently transport remaining patients and health staff out of Al-Shifa Hospital," WHO chief Tedros Adhanom Ghebreyesus said in a social media post on Sunday.
![A joint humanitarian team, led by WHO, accessed Al-Shifa Hospital in northern Gaza to assess the situation on the ground. A joint humanitarian team, led by WHO, accessed Al-Shifa Hospital in northern Gaza to assess the situation on the ground.](https://global.unitednations.entermediadb.net/assets/mediadb/services/module/asset/downloads/preset/Libraries/Production%20Library/18-11-2023_WHO_Shifa_Mission_Gaza.jpg/image1170x530cropped.jpg)
Southern Gaza
In the southern Gaza city of Khan Younis, the Israeli Defense Forces are dropping leaflets demanding residents go to unspecified "recognized shelters", even as strikes take place across Gaza, according to OHCHR.
"Already displaced Palestinians, deprived by extreme restrictions on lifesaving assistance, are struggling to meet their basic needs, forced into ever-diminishing, overcrowded, unsanitary unsafe spaces," Mr. Türk said.
"Irrespective of warnings, Israel is obliged to protect civilians wherever they are," the UN human rights chief said. "The pain, dread and fear etched on the faces of children, women and men is too much to bear. How much more violence, bloodshed and misery will it take before people come to their senses? How many more civilians will be killed?"
![UNRWA schools are sheltering more than 800,000 displaced people in Gaza during the Israel-Palestine crisis. UNRWA schools are sheltering more than 800,000 displaced people in Gaza during the Israel-Palestine crisis.](https://global.unitednations.entermediadb.net/assets/mediadb/services/module/asset/downloads/preset/Libraries/Production%20Library/15-11-2023_WFP_Gaza.jpg/image1170x530cropped.jpg)
Critical needs
Meanwhile, needs are rising, UN agencies said.
The entry of fuel critical for the overall humanitarian operations across the enclave has been largely banned since 7 October when the war began. Limited fuel deliveries began on Wednesday, and UNRWA has been informed that, as of Saturday, 120,000 litres of fuel will be delivered every two days going forward.
UN agencies have said this is not enough for all humanitarian activities, and that at least 200,000 litres per day are required to, among other things, power generators to provide electricity to hospitals and to operate water facilities. Both services have been cut since the start of the conflict.
Fuel is also critical for telecommunications networks, UNRWA said, noting that Gaza's fourth communications blackout on Friday meant the agency was unable to transport trucks of humanitarian assistance arriving via Egypt.
Rising death toll
As of 10 November, over 11,078 people have been killed in the Gaza Strip since 7 October; two thirds of them are reportedly children and women, the UNRWA report said. Due to the collapse in the Gaza's Ministry of Health services and communications in the north, casualty data has not been updated for the last five days.
Media reports indicate the number of Palestinian deaths is nearly 12,000.
Israel reported that around 1,200 Israelis and foreign nationals have been killed in Israel, the vast majority on 7 October, according to the UN humanitarian agency (OCHA).
On Saturday, one UNRWA colleague was killed in the northern area due to strikes. In total, 104 colleagues have been killed since the beginning of the war, the highest number of UN aid workers killed in a conflict in the Organization's history, according to UN Palestine refugee agency.
West Bank
Violent incidents, deaths and injuries struck several areas of the West Bank, including the Fara'a and Jenin refugee camps, according to UNRWA's situation report.
OCHA reported that since 7 October, 198 Palestinians, including 52 children, have been killed by Israeli security forces and eight, including one child, by Israeli settlers.
In the Balata refugee camp in Nablus on Saturday, Israeli security forces launched an operation, entering with an armoured bulldozer and mobilizing a drone that fired missiles towards the Fatah office, killing five, injuring two others and damaging homes and shops, according to UNRWA.