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World Health Organization officials say Gaza's health system remains under siege and is barely functioning, as Israel ramps up its offensive against Hamas militants in the southern part of the Palestinian enclave while maintaining an iron grip in the north.
"WHO and partners remain firmly committed to staying in Gaza and assisting the population," said Richard Peeperkorn, WHO representative on the occupied Palestinian territory.
"But as hostilities increase across Gaza, aid falls short of needs. The humanitarian support system is on the verge of falling apart."
Peeperkorn has been on a medical mission to Gaza for the last two weeks. He told journalists in Geneva that after 66 days of combat, Gaza's health system has been reduced from 36 functioning hospitals to 11 partially functioning hospitals - one in the north and 10 in the south.
"Northern Gaza looks like a wasteland," he said. "The devastation is simply enormous. We were still surprised that we saw so many people who were in the streets, lying on the streets."
Peeperkorn said the mission visited Al-Ahli Hospital in Gaza City, the only partially functioning hospital in the north. He said the hospital corridors and grounds - the courtyard, every room, the library, even the chapel - were full of patients and internally displaced people.
"We saw many trauma patients in donkey carts, dead people, unfortunately, and seriously injured people on foot and in personal vehicles," he said. "I worked for 7 ½ years in Afghanistan and have seen some pretty grim scenes, but I have never seen scenes like this in my life. Al-Ahli Hospital can only be described as in a state of utter chaos and a humanitarian disaster zone."
Peeperkorn said all efforts must be exhausted to keep the remaining hospitals functioning and that the health system requires urgent protection and restoration
"We cannot afford to lose any more health facilities," he said.
WHO officials are also calling for humanitarian assistance in Gaza. This plea follows the obstruction on December 9 of a joint WHO, United Nations and Palestine Red Crescent Society mission to transfer critically ill patients and to deliver supplies to Al-Ahli Hospital.
WHO says the team encountered delays at an Israeli military checkpoint and that health partners were detained, with one person reportedly harassed, beaten, stripped and searched.
In a statement, the U.N.-backed health organization said, "Obstructing ambulances and attacks on humanitarian and health workers is unconscionable. Health care, including ambulances, are protected under international law. They must be respected and protected in all circumstances."
The latest report by Gaza's Hamas-run Health Ministry puts the number of fatalities in the enclave at 18,205 and 49,645 injuries. Over 60% of the victims are women and children.
WHO describes the health situation of many Palestinians as critical. Since the start of the war, it reports there have been around 165,000 respiratory infections and more than 50,000 cases of diarrhea among children under five in Gaza - around 40 times higher than normal.
Other problems include the presence of lice, tens of thousands of skin rashes, chicken pox, meningitis, jaundice, as well as other infectious and noncommunicable and chronic diseases.
As Peeperkorn was briefing journalists, WHO got word that Israeli forces had stormed the Kamal Adwan health facility in the northern Gaza Strip.
"The Ministry of Health is reporting just now that the hospital is being forcefully evacuated," said WHO spokesperson Christian Lindmeier. "There currently are 68 patients inside the hospital, 18 intensive care unit patients, including six neonates."
He added, "What it means is that another of these unnecessary evacuations is taking place. It is again putting another hospital out of use. It is again putting the last patients who need help on the streets."
The U.N. Office for the Coordination of Humanitarian Affairs reported Monday that the maternity department at Kamal Adwan health facility had been hit, reportedly killing two mothers and injuring several people.
It noted, "The hospital remains surrounded by Israeli troops and tanks, and fighting with armed groups has been reported in its vicinity for three consecutive days."
In response to WHO and international criticism that it was denying essential medical and other humanitarian aid to Gaza, Israel announced Tuesday that it will open its Nitzana and Kerem Shalom crossings into Gaza.
"This crucial step is set to expand the volume of aid reaching Gaza. We trust the U.N. did all the adjustments to receive and distribute the aid," Elad Goren, Israel's coordinator of government activities in the territories, said.