A ‘humanitarian pause’ in deadly Israel-Gaza conflict is not enough, say aid agencies

Health personnel prepare premature babies to be transferred to Egypt after they were evacuated from Gaza's Al-Shifa hospital, at the Emirates Crescent Hospital in Rafah, southern Gaza, on 20 November 2023. According to the Palestinian Red Crescent, 28 premature infants were transferred on 20 November from the Emirati Hospital to the Rafah Crossing, in coordination with the World Health Organization and the United Nations Office for the Coordination of Humanitarian Affairs. (Photo: EPA-EFE / Haitham Imad)

By Tamsin Metelerkamp

23 Nov 2023

International aid organisations have warned that a four-day humanitarian pause in the Israel-Gaza conflict is not enough to address the ‘catastrophic’ situation in the Gaza Strip. They have reiterated calls for a sustainable ceasefire allowing unrestricted humanitarian access and the investigation of possible war crimes in the region.

International aid organisations have reiterated the call for an immediate and sustainable ceasefire in Gaza, warning that a “humanitarian pause” of a few days will in no way be enough to meet the urgent needs of people on the ground.

Israel and Hamas recently agreed to a four-day pause in fighting as part of a Qatar-mediated deal, according to an Al Jazeera report. Under the agreement, 50 people held captive by Hamas in Gaza will be released in exchange for the release of 150 Palestinian prisoners held in Israeli jails.

The temporary halt in military action is expected to allow hundreds of trucks carrying humanitarian supplies, medical aid and fuel into the Gaza Strip.

Read more in Daily Maverick: Israel and Hamas agree to hostage deal and four-day ceasefire; heavy fighting continues in northern Gaza

“It is so important that yesterday, a commitment was made to release some of the Israeli hostages and release Palestinian detainees… and that there may be a several-day pause in the fighting… But... on a humanitarian basis, it’s not enough, and it’s certainly not enough in human rights terms,” said Paul O’Brien, executive director at Amnesty International USA.

“Gaza was once an open-air prison; today, it is worse than that. After a 16-year blockade, living in occupied territories, which violates the international law of apartheid, meeting urgent needs in Gaza is not going to happen in a pause of a few days and is not going to happen with a few hundred aid trucks, as essential… as they are.”

Read more in Daily Maverick: Israel-Palestine War

Israel-Gaza An injured man is assisted following Israeli air strikes in Rafah town in the southern Gaza Strip, on 20 November 2023. (Photo: EPA-EFE / Mohammed Saber)

O’Brien was speaking at a press briefing on the need for a ceasefire in the Gaza Strip and Israel on Wednesday. He was joined by representatives of various international aid agencies, including Doctors Without Borders (Médecins Sans Frontières/MSF), Doctors of the World (Médecins Du Monde), Save the Children and Handicap International.

Joel Weiler, executive director of Doctors of the World, described the situation in Gaza as “catastrophic”, adding that several of the organisation’s members remained trapped in the northern region due to ongoing bombing attacks.

“We need a real ceasefire… A pause is not realistic… You can’t come from Egypt to Gaza and be able to do a good distribution in four hours, in 10 hours or even in five days. For medical organisations, we can’t do follow-up treatment for injured people,” he argued. “We need time and unrestricted humanitarian access… We are tired of technical discussions… Now we need to be operational in the field.

“We call on the US government, the UK Government, the EU, France [and] the international community to put pressure on Israel and Hamas to respect international humanitarian law and agree on an immediate, sustainable ceasefire.”

Since the onset of the conflict, over 14,000 civilians are estimated to have been killed in Gaza, of which at least 5,800 are children, according to Jason Lee, Save the Children's country director for Palestine.

Israel-Gaza Relatives of Palestinians from the Siam family killed following Israeli air strikes, mourn next to wrapped bodies outside Nasser Hospital in Khan Yunis, southern Gaza Strip, on 22 November 2023. (Photo: EPA-EFE / Haitham Imad)

Hamas is believed to be holding about 240 Israeli hostages in Gaza, taken during a coordinated attack that breached Israeli defences on 7 October. It has been widely reported that more than 1,200 Israelis were killed in that attack.

Read more in Daily Maverick: Pretoria ponders implementing ANC vote to cut ties with Israel

Read more in Daily Maverick: People are dying here – the faces and stories behind the escalating death toll of the Israel-Gaza war

Health system targeted

Since the onset of the Israel-Gaza conflict, there have been repeated instances in which hospitals, clinics, health workers and patients have been targeted, according to Avril Benoît, executive director of MSF in the US. She pointed out that the World Health Organization (WHO) had documented 178 attacks on healthcare infrastructure in Gaza, resulting in hundreds of fatalities.

“We have more than 300 staff who are Palestinians who are trapped there under the siege and we have an international team that is also now trying to [reinstate] surgeries in a hospital. The conditions are impossible to be able to do proper, coordinated humanitarian aid, which is something that people have a right to receive in a conflict,” she said.

“We’re extremely worried about our own colleagues and all the civilians in Gaza. There's no safe space.”

Two MSF doctors, Dr Mahmoud Abu Nujaila and Dr Ahmad Al Sahar, were killed in an air strike on Al Awda Hospital in northern Gaza on Wednesday. MSF stated that it had regularly communicated the fact that Al Awda was a functioning facility with MSF personnel on-site to warring parties, including sending the GPS coordinates of the hospital to Israeli authorities the day before the attack.

Benoît emphasised that hospitals should “never, under any circumstances, be a target”, as they are places where people go for treatment and protection during conflict.

“It’s like this dystopian reality now, where all the normal scaffolding [for] the conduct of responsible parties in a conflict has been completely perverted and the supporters of some of these belligerents are standing by watching it happen,” she said.

“We’re not lawyers — we’re doctors, we’re nurses, we’re midwives just trying to alleviate the suffering and treat people. And what we see is these arguments, these fake justifications for why it’s okay to target civilians in a hospital. It’s not and no one should stand aside and watch this perversion of the norms of international law.”

Read more in Daily Maverick: ‘Nowhere to go’ – Children and healthcare workers trapped in Gaza as food and water run out

Investigation of war crimes

The widespread bombing campaign and “collective punishment” of people in Gaza should be halted immediately, said Benoît, and an investigation should be launched into possible war crimes.

“There should be international observers on the ground. There should be much more probing of misinformation, disinformation that is out there flying around while we humanitarians are just trying to save lives,” she said.

O’Brien echoed Benoît’s call for an investigation into possible war crimes. He referenced hostage-taking by Hamas, which violated international law, but also Israel’s forcible displacement of over a million people in Gaza and the blockade preventing food, water and fuel from entering the region.

“The IDF [Israel Defense Forces] and the United States argue that because Hamas is targeted and they live in Gaza, the IDF is adhering to humanitarian law when they bomb churches, schools, hospitals. They are wrong and these acts must be investigated as war crimes,” he said.

“Because the IDF suspects that there might be Hamas infrastructure under a hospital or a refugee camp, they believe they can shut down those spaces and kill or forcibly displace thousands of civilians in order to find out… That needs to be investigated as a violation of humanitarian war. Until we have those investigations, we have every reason to fear that what happened in Al Shifa [Hospital] will happen in every other hospital.”

The IDF raided Al Shifa Hospital last week, claiming that Hamas was using the facility as a command centre. A WHO-led team who visited the facility on 18 November described it as a “death zone”, with a mass grave at the entrance. At the time of the team’s visit, there were still 25 health workers and 291 patients on site. The WHO reported that the IDF had issued evacuation orders to the 2,500 internally displaced people who had been sheltering on the hospital grounds earlier that day.

“WHO is deeply concerned about the safety and health needs of patients, health workers and internally displaced people sheltering at the few remaining partially functional hospitals in the north, which are facing the risk of closure due to a lack of fuel, water, medical supplies and food, and the intense hostilities,” stated the organisation.

“Immediate efforts must be made to restore the functionality of Al-Shifa and all other hospitals to provide urgently needed health services in Gaza.” DM

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