5 things you need to know about people trapped in the North of Gaza

The living conditions of people in North Gaza is no short than 'hell on earth', according to the Director of CARE’s partner organization Juzoor, Dr. Umaiyeh Kammash. Up to 25 people share one single room in shelters. 45% of children under two years of age are malnourished. Almost every person struggles with a form of illness. 

Dr. Kammash and his team run 54 shelters in Gaza, 44 of those in the north and Khan Younis, providing from medical services to food, water and hygiene to over 200,000 people. He shared with us what life is like now in North Gaza as well as the endless challenges his staff faces to give life-saving support. 

What is the situation of people in northern Gaza at the moment? How do people survive? 

The best way to describe people’s situation is to say they are living through hell on earth. Hundreds of thousands of people are trapped in the north, without access to food and relief items, and unable to leave for specialized treatment. 27 children have already died from hunger in the north, and our doctors are describing that the boys and girls they are seeing are getting thinner by the hour. They know of at least a dozen children who might soon also starve to death. Our latest assessment showed that 45% of all children under two years of age are malnourished. Almost every person in the north struggles with some sort of illness; diarrhoea, respiratory tract infections, scabies, Hepatitis A, or meningitis.  

The poor hygiene and sanitation conditions are what drives the spread of diseases such as respiratory infections, scabies, and watery diarrhoea. In our shelters, up to 25 people share one room. The sheer density of people living together means that they must take turns sleeping, as not everyone will find a spot to lie on the floor at night. 

The situation is particularly bad for women and girls. Hundreds of people share one toilet, and sanitary napkins, diapers, and other personal hygiene items are not available. We are hearing that young girls have started taking hormone medication to avoid menstruation. People’s health is also particularly impacted by the lack of food. When we can’t distribute food to people, they search for anything that is left in destroyed houses, putting their lives at risk from falling debris and unexploded devices. People are resorting to eating plants they find outside, and food usually consumed by animals.  

How is your team able to help people in the North? 

Our team in northern Gaza includes doctors, nurses, and midwives. Our team in Gaza is operating a total of 54 shelters, 44 of those in the north and Khan Younis, hosting more than 200,000 people. With support from international organizations like CARE we have been able to supply people with food, water, hygiene and clean delivery kits for expectant mothers. However, the stocks in the north are rapidly diminishing and aid continues to be impeded from entering. In our shelters, we are providing families with health and psychosocial services. A lot of our team members are doctors and nurses who themselves live as refugees in the shelters. Despite their own suffering and ongoing risks to their safety, they decided to stay to help their neighbours and friends.   

We also support about 1,000 pregnant women in the shelters we run. Midwives and doctors try to do whatever they can to help them deliver healthy children. Unfortunately, we are lately seeing increasing numbers of miscarriages and stillbirths. The stress expecting mothers are under, and the hunger they are facing, are lethal to those who are yet to take their first breath. With CARE, we are hoping to establish maternity wards soon, to make up for the lack of specialized hospitals for mothers and infants. 

What are the main challenges your colleagues are facing? 

UNRWA and other international organizations are not operating in the north anymore. UNRWA was the main provider for health care, meaning that all of this is now on hold. Clinics and health facilities have been attacked and destroyed since the start of the war, making treatment of any severe cases and surgeries basically impossible. 

For now, we were able to procure some medication within northern Gaza, and we are also using supplies left behind in the destroyed hospitals. However, in the next weeks we will run out of medication. Our doctors must already operate without anaesthesia while babies are taking turns in incubators. Once the last pill has been used up, we won’t even be able to give people who have lost their limbs or have other severe injuries the most basic painkillers. The teams already have to leave children and adults living with cancer to their fate, as there is no treatment available. 

In northern Gaza, a lot of people who weren’t able to leave are elderly or people with disabilities, who face particular medical challenges and protection needs. Another big challenge is the lack of plumpy nut and other high caloric food used to treat severe malnutrition. There is simply nothing available we can give children to prevent them from starving. Parents and doctors forced to watch see a toddler perish before their eyes is probably the most inhumane thing imaginable.   

How about the safety and wellbeing of your staff? 

There is no such thing as safety in Gaza right now. Just a few days ago, our friends and colleagues at WCK were killed. The convoy was clearly marked as humanitarian and was coordinating closely with the authorities. These people were our friends, our humanitarian allies. 

Since October, we have also lost two of our own staff, and many of them have lost close family members. There are incidents where our aid operations have been attacked in the past, and we are unfortunately fearing for this to happen again, at any day, any minute. The fear and trauma my colleagues are living through is probably what makes our work the most difficult. 

One of the doctors lost his young son during an airstrike. He took leave for two days and then continued to work. The resilience and commitment to help people is beyond anything I have ever seen, but it is also taking a huge toll. Our colleagues feel trapped as movement between the North and South is currently completely blocked and anyone approaching the checkpoints risks being shot. 

Feeling this siege every day, knowing that supplies are drying up and no one can leave the north, feels like a deathtrap to many of them. Our colleagues are also themselves suffering from malnutrition. One doctor recently told me he hasn’t been eating anything but one egg per day for the past weeks. Another colleague said his only meals are dried and mouldy breadcrumbs found on the floors of destroyed, deserted homes.  

What is the most important thing now?  

More than 2.2 million people are facing starvation. The most important thing right now is an immediate, long-lasting ceasefire, and immediate humanitarian access to the northern Gaza to provide comprehensive medical and nutrition services. The plight of every single person in need must stand at the centre of everything that happens next to mitigate the humanitarian catastrophe.

We need to stop children starving to death; we need to stop mothers dying during childbirth; we need to stop fathers dying because there is no insulin available. So far, we are able to support tens of thousands of people in northern Gaza every month, however much more is needed. Hospitals need to be rehabilitated to function again, with specialized staff available. Medical supplies, fuel for electricity, clean water and food are all urgently needed.