With the largest hospital in Gaza largely destroyed and out of action, access to healthcare has now become "totally inadequate" following six months of brutal fighting between Israeli forces and Palestinian militants, said the World Health Organization (WHO) on Saturday.
That's the assessment following a WHO-led multi-agency mission to Al-Shifa Hospital in northern Gaza on 5 April which examined the extent of destruction following a weeks-long Israeli offensive aimed at rooting out militant forces who were allegedly operating inside.
The highly complex mission was conducted in collaboration with the acting Hospital Director.
Prior to the mission, WHO's efforts to reach the hospital to evacuate patients and staff and conduct an assessment, were denied, delayed or impeded six times between 25 March and 1 April.
'An empty shell'
Like the majority of the north, Al-Shifa Hospital "is now an empty shell after the latest siege", said WHO, with no patients remaining at the facility.
"Most of the buildings are extensively damaged or destroyed and the majority of equipment is unusable or reduced to ashes."
The WHO team said that the scale of devastation has left the facility completely non-functional, further reducing access to life-saving healthcare in Gaza.
"Restoring even minimal functionality in the short term seems implausible and will require substantial efforts to assess and clear the grounds for unexploded ordnance to ensure safety and accessibility", said WHO.
The hospital's emergency department, surgical, and maternity ward buildings are extensively damaged due to explosives and fire.
At least 115 beds in what once was the emergency department have been burnt and 14 incubators in the NICU destroyed, among other assets. An in-depth assessment by a team of engineers is needed to determine if these buildings can be made safe for future use.
The hospital's oxygen plant has been destroyed, leaving Kamal Adwan Hospital as the only source of medical oxygen production in the north. Further comprehensive assessment is essential to evaluate the functionality of vital equipment such as CT scanners, ventilators, sterilization devices, and surgical equip
ment, including surgical tools and anaesthesia devices, the agency reported.
Shallow graves
Numerous shallow graves have been dug just outside the emergency department, and the administrative and surgical buildings, WHO said.
"In the same area, many dead bodies were partially buried with their limbs visible. During the visit, WHO staff witnessed at least five bodies lying partially covered on the ground, exposed to the heat" with "a pungent smell of decomposing bodies engulfing the hospital compound.
"Safeguarding dignity, even in death, is an indispensable act of humanity", the agency added.
According to the acting Hospital Director, patients were held in abysmal conditions during the siege. They endured severe lack of food, water, healthcare, hygiene and sanitation, and were forced to relocate between buildings at gunpoint. At least 20 patients have reportedly died due to the lack of access to care and limited movement authorized for health personnel.
Unnecessary delays
Despite deconfliction, Friday's mission faced significant delays at the military checkpoint en route to Al-Shifa Hospital. On the same day, another WHO-led mission bound for Al-Awda and Kamal Adwan hospitals in northern Gaza - to deliver medical supplies, fuel, deploy emergency medical teams, and support referral of critical patients - encountered unnecessary delays, including the detention of a supply truck driver who was part of the convoy.
Between mid-October and the end of March, over half of all WHO missions have been denied, delayed, impeded or postponed. "As health needs soar, the lack of a functional deconfliction system is a major obstacle in delivering humanitarian aid at the scale that is needed", the UN health agency said.
The destruction of Al-Shifa Hospital and Nasser Medical Complex in the southern city of Khan Younis last month, "has broken the backbone of the already ailing health system."
As WHO marks World Health Day on Sunday, under the theme My health, my right, this basic right is utterly out of reach for the civilians of Gaza, said the agency.
"Access to health care in Gaza has become totally inadequate, and the ability of WHO and partners to help is constantly disrupted and impeded."
Of the 36 main hospitals that used to serve over two million Gazans, only 10 remain somewhat functional, with severe limitations on the types of services they can deliver.
Rafah invasion: 'unimaginable health consequences'
Any military incursion into Rafah where nearly 1.5 million are sheltering can only result in further loss of healthcare and would have unimaginable health consequences.
"The systematic dismantling of healthcare must end", said WHO.
It also demanded the opening up of additional land crossings, as Israel has indicated that it was prepared to do following a call with the White House earlier in the week, to allow access into and across Gaza more safely and directly.
