Gaza “Most Dangerous Place on Earth for a Child”

James Elder for United Nations Children's Fund (UNICEF) said the Gaza Strip remained the most dangerous place in the world to be a child. Day after day, that brutal reality was reinforced.

Over the past 48 hours, the largest remaining fully functional hospital in Gaza, Al-Nasr in Khan Younis, had been shelled twice. It not only sheltered a large number of children who had brutal wounds of war, but also hundreds of women and children from across the Gaza Strip who were simply seeking safety.

Mr. Elder told of a 13-year-old girl called Dounia who had survived when her house in Khan Younis was completely destroyed, killing her mother, father and two brothers. She was badly injured and had her leg amputated. Somehow, Dounia had not lost hope. She told UNICEF, “I feel injustice. When I grew up, I'll become a lawyer so I can enjoy my rights and the rights of all children.” Dounia was one of those killed in the hospital shelling on Sunday, the day after she shared her story of hope.

“Where could children and families go?” Mr. Elder asked. They were not safe in hospitals or shelters, and certainly not safe in so-called “safe zones”. These zones could not be humanitarian when they were unilaterally declared. In addition, under international law, during evacuations, sufficient resources needed to be provided for survival, including medical facilities, food and water. Authorities had not even mentioned providing such resources.

Under the current besieged conditions, adequate supplies for such zones were impossible. They were tiny patches of barren land, street corners in neighbourhoods or half-built buildings with no water, no facilities, no shelter from the cold and now the rain and certainly no sanitation.

Currently in Gaza, there was a toilet for around every 700 people. If authorities were to relocate people from shelters to the so-called safe zones, tens of thousands of people would need to resort to buckets or open defecation. Without water, sanitation or shelter, the so-called safe zones had become zones of disease. There were over 100,000 diarrhoea cases in children, and 150,000 civilians had acute respiratory illnesses. Both these numbers were gross undercounts of the woeful reality. Malnutrition was also soaring in Gaza's children, so diarrheal and other diseases were now deadly. More than 130,000 of Gaza's most vulnerable children, new-borns up to two years of age, were not receiving the critical life-saving breastfeeding or age-appropriate complementary feeding that they absolutely required.

Without sufficient safe water, food and sanitation that only a humanitarian ceasefire could bring, child deaths due to disease could well surpass those already killed in bombardments. Parents were painfully aware that hospitals were not an option for their sick children, as they were being hit and were utterly overwhelmed with children and citizens with ghastly wounds of war. One parent of a critically sick little child told Mr. Elder, “Our situation is pure misery. I'm overwhelmed. My son is very sick. All we have is hope. I don't know if we will make it through this. Please tell the world.”

The delivery of aid was a matter of life and death for children in Gaza and the conditions to provide that aid were simply not being met. An immediate and long-lasting humanitarian ceasefire was the only way to end the killing and injuring of children and ensure the urgent delivery of desperately needed life-saving aid, so that we would not see thousands of children die from disease.

In response to questions, Mr. Elder said some trucks had delivered a tiny fraction of what was required in the north. The chaos that had been brought from the skies led to chaos on the ground, with competition over scarce resources. In the south, there were so many people on the move that it was very difficult to navigate trucks through the streets. Around four-fifths of children were eating insufficient amounts of food, which put them in the category of malnutrition.

There had been a large amount of work done by various humanitarian organizations to send in aid trucks. Before the conflict, 500 trucks a day had entered Gaza. If 100 trucks a day were currently entering Gaza, one-fifth of the population would be on its knees.

The authorities had said that the south would not endure the ferocious attacks seen in the north, but such attacks had occurred, with the only difference being that there was one million more civilians being told to flee. It had also been said with all sincerity that precision in attacks was a priority, but last week proof had emerged of the massive use of dumb bombs. Without sufficient food, water, medicines and shelter, many more Palestinian children would be killed because of wilful neglect and deathly disregard. Senior officials had said that their focus was on creating damage, not accuracy, and on eliminating everything. Those statements were the only ones that had proven to be sincere.

Ambulances had been hit in aerial bombardments. There had been delays that had led to the deaths of people. One bus with severely injured children had taken three days to move through various checkpoints.

Mr. Elder said he felt guilt about having to leave Gaza. He was furious that those with power shrugged at the humanitarian nightmares unleashed on a million children; that children who were recovering from amputations were killed in hospitals; that more children would face further injuries in the coming days; that of all the senseless attacks, the only admittance of “dumb” was the use of dumb bombs; that devastating disease did not get enough attention; that Christmas would likely bring an increase in savage attacks as the world would be busy with other issues; that the little boy of a friend he had made was now worryingly sick and they have only hope and dirty water; that around 7,000 children had been killed and they were becoming statistics, not stories; that hypocrisy was crushing empathy; and that he was unable to do more.

Around 1,000 children had lost one or more of their lower limbs as of two weeks ago. The sheer number of children with amputations was shocking. Children with amputations were often outside waiting rooms in hospitals in the north, as their conditions, while horrific, were deemed to be stable. Families had moved several times with no respite to mourn lost loved ones, impacting their psychological resolve. There was no way to get out of the conflict zone. Every single child in Gaza had endured 10 weeks of hell, and not one of them could escape.

Answering other questions, Alessandra Vellucci, Director of the United Nations Information Service in Geneva, said that the Security Council was scheduled to discuss the situation in the Middle East today at around 4 p.m. Geneva time, but there were multiple items on its agenda. She recalled the Secretary-General’s call for an immediate humanitarian ceasefire. The Secretary-General’s exceptional use of article 99 of the United Nations Charter demonstrated his concern about the situation. After the use of article 99, the Secretary-General and his staff had been in continuous dialogue with all parties able to help implement a ceasefire and improve humanitarian access.

The United Nations was doing what it could in terms of humanitarian support, and it needed more access. Colleagues were doing impossible things, and they were doing them now. United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) colleagues were working under incredible strain on the ground. Political discussions were ongoing between member States at the Security Council.

Margaret Harris for the World Health Organization (WHO) said that obstruction of ambulances and health care workers’ activities were defined as attacks on healthcare. The neutrality of healthcare needed to be respected. Sick persons, regardless of their affiliation, needed access to healthcare.

There were only eight of 36 hospitals in Gaza that were currently functioning, and they were barely functioning. WHO colleagues who had visited hospitals in Gaza had told of being afraid of stepping on people on the floor in emergency wards, and that when they were not stepping on people, they were stepping on blood. People on the floor in severe agony were not asking for pain relief, they were asking for water. It was unconscionable that the world was allowing this to continue.

WHO had a team doing limb reconstruction in Gaza, but one of its members had been killed in an airstrike.

Doctors, nurses and paramedic staff were desperately working to help people in need. Supplies needed to be delivered safely and at an appropriate volume. Roads that large trucks could travel on were limited. Women in labour were arriving at maternity hospitals on foot or being carried by donkeys. Vast numbers of people needed healthcare supplies, but very little was coming across the border and even less was making it to hospitals due to infrastructure damage.

WHO was very concerned about the welfare of medical doctors who were reportedly arrested. Only about 30 per cent of health care workers in Gaza were now available to work. At least 200 doctors had been killed and even more nurses. Many health care workers simply could not get to places where they could work.

Currently, there were only 11 doctors and nurses and 70 volunteers working at Al-Shifa Hospital, but there were tens of thousands of people sheltering there, including over 1,000 patients. There were many more patients than staff could provide care for. Staff had, however, managed to provide life-saving kidney dialyses for people in need, in spite of the dire circumstances.

Displacement Crisis Deepens in Sudan as Fighting Spreads

Jens Laerke for the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), said OCHA was alarmed by the ongoing fighting in Wad Medani in Al Jazirah state of Sudan, which started on Friday, 15 December and had continued, with airstrikes and shootings still being reported late yesterday.

Eight months into the war, this development dramatically affected the humanitarian situation in this south-eastern town of 700,000 people, and OCHA’s ability to respond there and in the wider region.

Preliminary information from the International Organization for Migration (IOM) field teams in Al Jazirah indicated that at least 250,000 people had fled Al Jazirah state, many in panic and with no other option than fleeing on foot.

Wad Medani was considered a place of refuge for nearly half a million people who fled violence and bloodshed elsewhere in the country earlier in the war.

Since April, Wad Medani had operated as a key humanitarian hub, but aid organizations had been forced to temporarily suspend operations because of the fighting and relocate to neighbouring states.

Local authorities had announced a state of emergency and introduced a nightly curfew in Wad Medani. A similar curfew was introduced in neighbouring Gedaref, Sennar and White Nile states.

All humanitarian field missions within and from Al Jazirah state had been suspended until further notice. If the fighting continued, aid distribution to two million people - about a third of the population of the state - would be compromised. The fighting needed to stop so OCHA could restart its programmes for people in acute need.

National health authorities had also relocated outside Al Jazirah state and were working remotely to coordinate emergency health response.

This put further strain on the health system in the middle of a cholera outbreak in Al Jazirah and neighbouring states.

Health care was already stretched to the limit. 70 per cent of hospitals were out of function in conflict-affected states, while facilities in non-conflict-affected states were overwhelmed by the influx of displaced people.

For context, almost 25 million people required humanitarian assistance in Sudan. The UN and partners had reached five million people with some form of assistance this year, including food, health support, shelter supplies and protection services.

Major response challenges in Sudan were a lack of access due to insecurity and bureaucratic impediments. The humanitarian community was engaging continuously with the conflict parties to address this. Funding for the response was also a challenge: the humanitarian plan for this year was only 39 per cent funded of the 2.6 billion United States dollars (USD) required.

William Spindler for the United Nations High Commissioner for Refugees (UNHCR) said UNHCR, the UN Refugee Agency, was concerned at the deepening forced displacement crisis in Sudan and neighbouring countries, as hundreds of thousands more people fled from the latest fighting in Sudan’s central Al Jazirah state, southeast of the capital, Khartoum.

UNHCR was also very concerned about reports of an escalation in the conflict in the Darfur region. On 16 December, renewed fighting in El Fasher in north Darfur resulted in civilian casualties, injuries and further displacement, followed by looting of homes and shops and arrests of youth. In Nyala in south Darfur, an aerial attack was reported, causing death, injuries and destruction of civilian homes.

Heavy fighting, including airstrikes and shootings, was reported on the outskirts of Wad Madani, the capital of the Al Jazirah state, on Friday, 15 December. The fighting had now reached the town. After conflict first broke out in Sudan’s capital in April this year, over half a million people, including some 7,000 refugees, fled to Wad Madani from Khartoum.

With this latest bout of fighting, panic had reportedly spread among the civilian population in Wad Madani and people were seen leaving the town in vehicles and on foot, some for the second time in only a few months. According to IOM, between 250,000 and300,000 people had fled Wad Madani and surrounding areas since the clashes began.

UNHCR was working to deliver and distribute urgently needed core relief items to the people newly displaced from Al Jazirah to Sennar and Gedaref states. Despite efforts by national and international humanitarian organizations and local actors to provide assistance, the overall humanitarian situation remained dire.

Since the war broke out in April, more than seven million people had fled their homes in Sudan, many of them moving repeatedly to find temporary safety. This repeated displacement showed how devastating this conflict had been for the civilian population.

UNHCR was very worried that if the fighting further escalated and spread to White Nile state, it could significantly impact the work of UNHCR and other humanitarian organizations, which provided critical assistance to over 437,000 South Sudanese refugees and some 433,000 internally displaced Sudanese there. Since the onset of the conflict in April, UNHCR had provided emergency shelter to approximately 42,000 families and core relief items to nearly 12,000 vulnerable families in White Nile state and, in collaboration with United Nations and non-governmental organization partners, had taken measures to mitigate the high risk of a cholera outbreak in displacement sites. However, a spread of the fighting or any new influx could disrupt health and water, sanitation and hygiene (WASH) services, resulting in severe consequences.

There were also reports of people on the move towards South Sudan, where the border town of Renk was severely overcrowded and lacking enough aid to meet the needs of the people who had already arrived. Heavy rains had made the roads impassable, hampering the relocation of refugees. UNHCR and partners were doing what they could to prepare, but resources were already severely overstretched.

It continued to strongly appeal to all parties to end the conflict, to respect the safety of civilians in accordance with international law, and to allow humanitarian access so that critical lifesaving aid and services could reach those in need.

UNHCR appreciated the funding received already from many donors, but it was just not enough to meet the needs of the families that were facing unimaginable hardship.

The 2023 Sudan Regional Refugee Response Plan, which called for one billion USD to meet the needs of 1.8 million people in Chad, Central African Republic, Egypt, Ethiopia and South Sudan this year, was only 38 per cent funded.

In response to questions, Mr. Laerke said the situation in Sudan was getting worse. There was little hope for an end to the protracted conflict, which had started as a rivalry between two generals. OCHA was continuing to speak to the conflicting parties, requesting access to those in need.

Much of Darfur was closed off, and OCHA was concerned by what it did not know. There was bureaucratic red tape being put in front of OCHA, which slowed down its operations and made aid stop-start. It was also experiencing issues with getting visas for aid workers. In addition to visas, there were requirements in certain states that caused delays in moving humanitarian personnel. Bureaucratic decisions ended in the death of people, as aid was not getting in in the scale that was needed.

Responding to questions, Mr. Spindler said UNHCR had been doing its best to continue aid operations and reach populations in need throughout the conflict in very difficult circumstances. There were areas of Sudan where operations were ongoing, but with the spreading of the fighting, those areas were decreasing and difficulties were increasing.

James Elder for United Nations Children's Fund (UNICEF) said Sudan had the largest amount of child displacement in the world, with three million children on the move, fleeing the unrelenting, ferocious attacks. Sudan had high malnutrition rates, and the ready-to-use therapeutic food factory was burnt down. 600,000 children were unable to access food, health and other care that they needed. Many children had died because they could not access the care they needed and were severely malnourished. 14 million children needed humanitarian assistance and not a single child was able to access formal education.

Margaret Harris for the World Health Organization (WHO) said WHO was very concerned that there was an active cholera outbreak in Sudan among displaced people, which was made worse by the ongoing fighting causing disruptions to the health response. This was a very bad combination of risk factors. The health system, which had been struggling before the conflict, was hanging in the balance and was dependent on aid. Fighting was only contributing to greater misery.

Announcements

Clare Nullis for World Meteorological Organization (WMO) said Professor Petteri Taalas had completed his mandate and would be stepping down as Secretary-General at the end of the year. From 1 January, Professor Celeste Saulo would take office as WMO’s first female Secretary-General and first Secretary-General from South America. WMO would send out a press release in the first week of January on her appointment and likely hold a press conference with her in the second week of January.

Alessandra Vellucci, Director of the United Nations Information Service (UNIS) in Geneva, said the Palais des Nations would be closed as of tomorrow until Sunday, 7 January. The closure was part of a series of energy-saving measures being implemented since October. Accredited journalists could continue to access the Palais, though the Chemin de fer gate would be closed. Such journalists could work in the heated S2 building but most Palais services, including cafeterias, would not be available. Press briefings held during the period would be in hybrid format.

ANNOUNCEMENT

WMO - Clare Nullis: New SG Celeste Saulo starting on 1 January.

TOPICS

• UNICEF - James Elder: From attacks to malnutrition and no water, why Gaza is the most dangerous place on earth for a child
• OCHA - Jens Laerke: Update on the humanitarian situation in Sudan following increase in fighting in Aj Jazirah State
• UNHCR - William Spindler: Displacement crisis deepens in Sudan as fighting spreads