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GENEVA —Warning of a bloodbath should Israeli forces attack Rafah, U.N. agencies are making contingency plans to provide health care and other essential aid to the besieged population in the southern Gaza city.
"Despite measures, the ailing health system will not be able to withstand the potential scale of devastation that the incursion will cause," said Dr. Rik Peeperkorn, the WHO representative for occupied Palestinian territories.
"With more than 1.2 million people crammed in Rafah, an operation will result in worsening the humanitarian catastrophe," he said.
Speaking from Jerusalem Friday, Peeperkorn told journalists in Geneva that an assault on Rafah will trigger a new wave of displacement, which "will lead to more overcrowding, reduced access to essential food, water and sanitation services, and increased infectious disease outbreaks."
WHO reports most health care facilities in Gaza have been damaged or destroyed amid repeated attacks and airstrikes by Israeli forces. It says the health system is barely surviving, with 12 out of 36 hospitals and 22 out of 88 primary health care facilities only partially functional.
The U.N. health agency says three small hospitals in Rafah that currently are partially operational "will become unsafe to be reached by patients, staff, ambulance and humanitarians when hostilities intensify."
Peeperkorn said, "Every time we have seen when there is a military incursion in places in the north, in Gaza city, or Khan Younis, these hospitals very quickly become not reachable. So, they go from being partly functional very quickly to nonfunctional."
As part of contingency efforts in southern Gaza, WHO and partners are setting up a new field hospital in Al Mawasi in Rafah and a large warehouse in the central Gaza city of Deir Al Balah, from where medical supplies can be quickly sent to facilities in the Middle Area and North Gaza.
Plans are underway to set up other warehouses where medical supplies can be prepositioned.
Nasser Medical Complex, the most important hospital in south Gaza, was severely damaged and put out of commission amid heavy fighting and bombing in Khan Younis.
Peeperkorn said the complex is being refurbished and that hospital staff have completed the first phase of restoration, "including cleaning and ensuring essential equipment is functioning."
He noted that the emergency ward, the maternity ward, nine operating theaters, intensive care unit and several other departments now are partially operational.
"I want to really say that this contingency plan is a Band-Aid. It will absolutely not prevent the expected substantial additional mortality and morbidity caused by a military operation," he said.
"We do not want to make those plans. I want to make it very clear: We do not want to make these plans. We all, of course, hope and expect that this military incursion will not happen and that we will move to a sustained cease-fire."
Israeli Prime Minister Benjamin Netanyahu said this week that Israeli forces would invade Rafah regardless of the outcome of ongoing hostage release negotiations with Hamas.
Netanyahu vowed to eliminate Hamas following the militant group's attack on Israel on October 7, which resulted in the killing of some 1,200 people and 250 being taken hostage.
In a statement Wednesday, Martin Griffiths, the U.N. under-secretary-general for humanitarian affairs warned that "a ground operation in Rafah will be nothing short of a tragedy beyond words."
"For the hundreds of thousands of people who have fled to Gaza's southernmost point to escape disease, famine, mass graves and direct fighting, a ground invasion would spell even more trauma and death," he said.
Aid agencies agree there have been recent improvements in bringing more aid into Gaza but say that it still is not enough and "the risk of famine is not over."
"Rafah is at the heart of the humanitarian operations in Gaza," said Jens Laerke, spokesperson for the Office for the Coordination of Humanitarian Affairs (OCHA).
"It is where dozens of aid organizations store their lifesaving supplies that they deliver to civilians across the Gaza Strip. Rafah is central to the U.N. and partners' ongoing efforts to provide food, water, health, sanitation, hygiene, and other critical support to people," he said.
For example, he notes that the U.N. Population Fund operates clinics for sexual and reproductive health at field hospitals in Rafah; UNICEF and partners treat acutely malnourished children at more than 50 sites in Rafah; the World Food Program distributes nutrition supplements to children under 5, pregnant and breastfeeding women in Rafah.
"Most importantly, there are hundreds of thousands of civilians who have fled to Rafah to escape bombardment, an imminent famine and disease," he said.
Laerke told journalists that he had no idea whether it was possible to move 1.2 million people out of Rafah to a so-called safe place in advance of a military incursion by Israel.
However, he scotched any suggestion of U.N. involvement in such a scheme.
"The United Nations is not part of any planning and will not participate in any ordered non-voluntary evacuation of people," adding that "I have not in my experience, limited as it is, ever seen this amount of people voluntarily move overnight."