By Riad Othman and Chris Whitman
Current images from Gaza, which the public is becoming more accustomed to seeing with every passing day, unfold a horrific, dystopian reality: in a lunar landscape of destroyed concrete buildings, amidst rubble and alongside churned-up roads or between sand dunes with no infrastructure, tent cities and shattered buildings are home to hundreds of thousands of people. More than 30,000 people have probably died, if one takes into account the thousands of people not yet officially recognised as victims, some of whom are buried under the rubble. In addition, more than 67,000 people have been injured and around two million people have seen the foundations for their lives deliberately destroyed. According to the Hebrew online magazine Sicha Mekomit, the Israeli army declined to estimate possible "collateral damage" in many of its attacks. There have been numerous cases of gross negligence, if not deliberate attacks on civilian targets – in which there were no armed Palestinian groups present at these locations. The picture of suffering in Gaza is echoed by figures being released every few days by the World Health Organisation or the United Nations Office for Humanitarian Affairs (OCHA).
At the beginning of the war, the Israeli army ordered the Palestinian population into supposedly "safe zones". Hundreds of thousands of residents from northern Gaza were forced to flee to towns such as Khan Younis, Rafah and Deir al Balah further south within a very short space of time; or to a place like Al-Mawasi, a patch of sand dunes with no electricity or water supply, which has become a makeshift camp for tens of thousands. But these places were not safe and living conditions have been catastrophic from the outset. They all lack the infrastructure needed to care for so many displaced people. The consequences are hunger, disease and death.
Vegetables are a luxury
In this humanitarian disaster, which many international aid organisations have described as unprecedented, medicos partner organisations are doing the unimaginable. Staff at the Palestinian Medical Relief Society (PMRS) are offering first aid to people in the overcrowded refugee centres. They organise medical care and look after patients with acute infections or chronic illnesses such as high blood pressure and diabetes. A colleague from PMRS regularly embarks on the short but very risky journey from Khan Younis to Rafah, passing wrecked civilian vehicles and ambulances shot up by the Israeli army along the way, beacons of warning to people to remain vigilant. A license plate indicating that a vehicle belongs to a medical aid organisation offers little protection.
Another colleague, who is currently living as a displaced person in Deir al Balah, north of Khan Younis, reports that he has not seen a single aid transport vehicle for weeks. "At the beginning of November, they came by every few days, mostly with medical supplies and food. Muesli bars shortly before their expiration date, small amounts of water, occasionally some stale bread. Most of us had to spend what little money we had left and a lot of time trying to find something else to eat or drink. Fresh vegetables are now a luxury." According to another PMRS colleague, prices for basic foodstuffs have reached inconceivable levels: "A kilo of onions costs 140 shekels [35 euros], whereas it used to be five. The other day I paid 12 shekels for a single piece of bread, that's crazy. Twenty pieces used to cost three shekels."
Hundreds of thousands of people have been facing famine since December. Large parts of Gaza are categorised in the highest and second-highest levels in the international food insecurity warning system. Before the war, around 550 lorries of goods were arriving in Gaza every day. In the first two weeks of the war, Israel imposed a complete blockade, including on humanitarian aid. Since the beginning of December, the number has fluctuated between 75 and 230 lorries a day. The queues of lorries stretch many kilometres deep into Egypt, slowed down by a dearth of personnel and unmotivated Israeli soldiers.
In the eyes of many, the reason for this artificial shortage is obvious: Israel's government seems to be intent on collectively punishing the civilian population in order to sway them to put pressure on Hamas. This is not a new policy, but rather part of the same logic that brought about the 17-year blockade of Gaza. The population receives just enough aid so that they do not starve or become completely dehydrated, but not enough to feel safe and secure. People start queuing up at three or four in the morning to grab a bottle of water, ibuprofen or a piece of bread from the aid deliveries. In view of the pervasive shortages and ever-present hunger that has been a constant companion for months, many are resorting to extreme measures: In the north, people are chopping up animal feed, converting it into a kind of bread. In the south, they pay exorbitant prices if they do not receive aid from the lorries and only eat every two to three days. The soup kitchens are teeming with starving people hoping for a scoop of boiled rice, as we hear from Gaza.
Not a safe place
Our partners from the feminist Culture & Free Thought Association (CFTA) in Khan Younis face a similar situation. Hundreds of people have been seeking refuge in their centres and residential homes. With the intensification of Israeli attacks on the city and the expansion of the ground offensive, their situation had already become completely untenable weeks ago. "Our main centre is located next to the large Red Crescent hospital in Khan Younis. Both have been hit by air strikes and tank shelling for days, including my house," reports Majeda Al-Saqqa. "We were all very scared and had heard terrible stories about Al-Mawasi. So I travelled to Rafah to find a place for all of us. There wasn't a single centimetre of free space there. People were sleeping on the street, under trees. Starving children were running around looking for food. Hundreds of thousands of people in plastic tents that they had to pay for themselves or build with the crudest of material and means. I decided that we should all go to Al-Mawasi. It hurts to even pretend that it was a decision. We had no choice."
A seeing eye in Gaza
Mohammed Zaanoun documents all of this. He is a photographer and has for years been a member of the Active Stills photo collective, which is mainly made up of Palestinians and Jewish Israelis. They photograph everyday life under the occupation and in the face of land theft in the West Bank as well as the blockade of Gaza. And they document protest movements, for example against the judicial coup in Israel. Mohammed has been the eye of the collective in Gaza for many years. medico uses his images over and over again, including on these pages. In the meantime, Mohammed has been expelled for the second time. With his wife and four children, he is hunkered down near the Egyptian border, wedged between Israeli troops to the east and the Mediterranean Sea to the west, as one of well over a million Palestinians. "I am struggling to provide my children with food and water. My two-year-old son Kenan is constantly asking for milk, which I can't give him. They are traumatised and react very strongly to the sound of bombs and explosions. It's often difficult to work, as I cannot leave the house because of the children," he says. He has already had to rescue his children twice from the rubble in the wake of Israeli attacks. His entire existence, like Gaza as a whole, is in shambles. But at least Mohammed, his wife and their children are still alive.
Abduction and torture
Walid Al-Khalili, who works as a driver for a mobile clinic at PMRS, also had a stroke of luck in all his misfortune. This father of three disappeared in northern Gaza in November. For a long time, his colleagues did not know whether he was still alive or not. Walid only reappeared weeks later. According to his report to the Palestinian Centre for Human Rights in Gaza, he was arrested by the Israeli army while working as a medical aid worker and abducted to Israel. Walid reports severe abuse, humiliation and torture. He describes how a pharmacist was killed by an Israeli sniper and how he witnessed the deaths of several prisoners in Israel. After 41 days, Walid, along with around 30 other Palestinians, was taken to the Kerem Shalom, where goods are transported across the border into Gaza. He was reunited with his family and colleagues in Rafah on 23 December.
Two floors of the PMRS centre for non-communicable diseases in Gaza City have been largely destroyed, including the laboratory that PMRS built over a period of several years with support from medico and funding from the German Federal Ministry for Economic Cooperation and Development, offering diagnostic capacities unique in Gaza. This equipment was extremely important because the medical sector in the entire Gaza Strip had been severely weakened by the blockade, while diagnostic and treatment facilities outside the walls of Gaza have not been freely accessible for almost two decades.
Whether PMRS and medico will be able to create establish a centre again is uncertain at present. The much more pressing question for hundreds of thousands of people in Gaza is whether Israel will ever allow them to return to the north of the Gaza Strip. Only if this right to return is made a reality will it be possible for Gaza to have any future at all. This would have to include not only reconstruction, but also the right to self-determination. At this juncture there are no indications of anything like this coming about. What our partners and we do have left right now is the supply of medical aid from Egypt, support for a soup kitchen in Rafah and deliveries of modest quantities of relief supplies in the largely depopulated north of Gaza.
Chris Whitman, head of the medico office in the region, is doing his utmost to support partners in Gaza. Riad Othman is communicating their stories to the German public.