Hospitals in Rafah risk being overwhelmed by a wave of sick and injured people if the fighting there intensifies and routes into Gaza remain impassible, doctors and medical officials in the city say.
Medics and patients hastily evacuated the Abu Yousef al-Najjar hospital, one of the few remaining functioning hospitals in Rafah, Gaza’s southernmost city, on Tuesday after the Israeli army seized the nearby border crossing with Egypt in a dawn raid.
“It was a bitter experience, and the situation now is catastrophic,” said Marwan al-Hams, the general director of the Najjar hospital.
The Rafah crossing, a vital supply route into Gaza in recent months, remained closed on Wednesday, cutting off much-needed supplies, including fuel.
The Kerem Shalom crossing from Israel, Gaza’s main cargo terminal a mile east of Rafah, reopened after a 48-hour closure on Wednesday, but all traffic was stopped by continuing shelling by Israeli forces in the vicinity and further rocket barrages launched by Hamas.
The Israel Defense Forces (IDF) said they were investigating “an incident of fire towards a vehicle with Palestinian workers who were on their way to work at the Gazan side of the Kerem Shalom crossing” in which several people were injured.
Continuing airstrikes have already strained medical facilities in Rafah, sending a new wave of casualties to be treated. There were sporadic explosions and gunfire in the area of the Rafah crossing overnight, including two large blasts early on Wednesday. At Kuwait hospital, the wounded arrived on hand-pulled carts. The Israeli military said it had hit dozens of “terrorist targets” overnight.
With the seizure of Rafah, Israel now controls all of Gaza’s crossings for the first time since it withdrew troops and settlers from the territory nearly two decades ago, though for most of that time it has maintained a blockade with Egypt’s cooperation. The Rafah crossing is the only place where people can enter and exit.
Gaza’s health ministry said dozens of patients and wounded people who had been scheduled to leave on Tuesday for medical treatment had been left stranded.
Dr Subhi Sukeyk, the director general of cancer medicine in Gaza who is based in Rafah, said these included cancer patients.
“The situation is very bad. We are now trying to work from a very small field hospital with very limited resources … We are getting no supplies of cancer drugs and so we have lost lots of patients. A lot of them must travel outside Gaza as soon as possible but they cannot because Rafah is closed. It is beyond words,” Sukeyk said.
There are also fears for increasing numbers suffering from widespread outbreaks of hepatitis and gastroenteritis, a consequence of overcrowding, insanitary conditions and rising temperatures as summer approaches, while the main maternity hospital in Rafah has now been forced to stop admitting patients.
Only a third of Gaza’s 36 hospitals and primary health care centres are working and all face acute shortages of medicine, basic medical supplies, fuel and manpower. There was only enough fuel to run health services in the south of Gaza for three more days, the World Health Organization said on Wednesday.
Hams said the death rate among patients had more than doubled in recent months because of shortages of medicine, equipment and staff.
He described chaotic scenes as the Najjar hospital was evacuated, with medical staff frantically seeking alternatives for seriously ill or injured patients. With no ambulances, some were moved to facilities elsewhere in Rafah or in the town of Khan Younis by donkey cart.
Rafah’s prewar population of 300,000 has grown to 1.2 million with an influx of those displaced from elsewhere in Gaza during the seven-month conflict.
Muhammad Moein al-Hour Hakim, a doctor at Najjar hospital, said anaesthetics and oxygen were running very low.
“The situation was very difficult so we had to go, but that meant we left behind all medical supplies, equipment and medicines,” he said.
Many medical workers have been repeatedly displaced themselves, and struggle to feed and protect their families.
Hams said many of his colleagues’ homes had been destroyed or were now full of relatives forced to flee from elsewhere in Gaza.
“Many of my relatives and friends have been killed … I lost four of my cousins yesterday, and a while ago I also lost 10 of my cousins and dozens of injured from my family in Gaza. Our lives are difficult,” he said.
It is unclear whether the Israeli seizure of Rafah is the start of the full-scale assault on the city that Israel has often threatened. Senior officials said on Tuesday that the military offensive would not stop before the total elimination of Hamas in Gaza or the release of hostages held by the militant Islamist organisation.
Israel has said Rafah is a stronghold for Hamas, and that its war aim of ensuring Hamas in Gaza no longer poses a threat can only be achieved by killing, capturing or dispersing the remaining Hamas fighters and leaders based there.
So far 34,700, mainly women and children, have been killed during the Israeli offensive, which was launched after Hamas killed about 1,200, mostly civilians, and took 250 hostages in a raid on southern Israel in October.
Aid officials say that the prolonged closure of the crossings due to continued fighting could cause the collapse of aid operations and a humanitarian catastrophe.
Dr Ali Barhoum, the deputy head of the emergency department at Najjar hospital, said he no longer knew how to keep his family safe.
“A month ago, I moved my wife and children to our relatives’ home and now that house is among the areas threatened by the [Israeli] army. Now I have no idea where I can go with them.”