In Khan Younis, the UN agency for Palestinian refugees (UNRWA) reported witnessing “thousands of people fleeing west” as part of the exodus from the enclave’s southern city amid ongoing hostilities, leaving children traumatised and crying uncontrollably.
“Elderly people on the backs of donkey carts…disabled people being pushed through the sand in wheelchairs with the supplies piled on their laps,” said Louise Wateridge, UNRWA Senior Communications Officer. “People are running, hear gunfire (and) run for their lives. Families are really only carrying what they can hold in their hands… People don’t know where to go. That’s the main question people are asking themselves today: ‘Where am I going?’”
Al Mawasi has shrunk
The Israeli evacuation orders have also affected about 8.7 square kilometers of land in the so-called Al Mawasi “humanitarian zone,” which lies on the coast near Khan Younis, reducing the size of the zone by almost 15 percent. according to the UN aid coordination office, OCHA.
“Initial reports indicate that families are currently moving to areas in Deir al Balah and western Khan Younis,” OCHA said. “Both areas are are already severely overcrowded, there are limited reception centres and services available and the additional influx of displaced people can hardly be accommodated.
As of July 22, nearly 83 percent of the Gaza Strip was under evacuation orders or designated as “no-go zones” by the Israeli military.
Condemnation by UN Human Rights Office
The UN human rights office condemned the “repeated” evacuation orders, saying: OHCHRinsisted that the Israeli army had given civilians “no time” to understand where to leave or where to go.
At least 70 Palestinians, including women and children, were killed in the ongoing violence on Monday, the UN rights office said, citing local health authorities. At least 200 others were also wounded, some seriously, amid reports of intensified Israeli airstrikes in Khan Younis since Sunday, with “multiple” strikes on Monday and an “intensification” of shelling in the east of the city.
“Israeli military operations in and around the area continued unabated,” the OHCHR said, noting that the evacuation order affected parts of the Salah al-Deen road – “one of two main routes vital for the transportation and distribution of relief supplies, raising concerns that the delivery and provision of urgently needed humanitarian assistance will be further reduced or impeded.”
Update on polio outbreak warning
Meanwhile, concerns continue to grow about the impact of a potential polio outbreak in Gaza, given dire hygiene conditions and lack of access to health care.
Dr. Ayadil Saparbekov, Health Emergencies Team Leader at the UN World Health Organization (WHO) in the occupied Palestinian territory, said on Tuesday he was “extremely concerned” about the spread of polio and other infectious diseases, which could result in more people dying from preventable diseases than from war-related injuries.
Hepatitis A was already detected in the Gaza Strip last year, he told journalists via video link from Jerusalem.
“With the paralyzed health system, lack of water and sanitation, and lack of access of the population to health services… this will be a very bad situation,” he insisted. “We may have more people dying from various infectious diseases than from injuries.”
On July 16, WHO reported that vaccine-derived poliovirus type 2 (VDPV2) was detected in six locations in sewage samples collected on June 23 in Khan Younis and Deir Al-Balah.
The WHO explained last week that poliovirus can emerge in areas where low vaccination rates cause the weakened form of the orally administered vaccine virus to mutate into a stronger version.
So far, the virus has only been found in sewage samples, and no one in Gaza has been identified with polio-induced paralysis. Further genomic sequencing by the US Centers for Disease Control and Prevention (CDC) in Atlanta indicated that the virus is related to a strain that circulated in Egypt in the second half of 2023, the WHO said.
Dr. Saparbekov explained that no human samples have been collected yet, due to a lack of equipment and laboratory capacity to test them. A WHO team is arriving in Gaza on Thursday with up to 50 sample collection kits; it will send the samples to a laboratory in Jordan for further analysis.
The WHO official said the agency is conducting an epidemiological investigation and risk assessment with partners to identify the source of the virus. There is a high risk of the virus spreading within Gaza and internationally.
“Based on the results of the assessment, WHO and partners (of the Global Polio Initiative Network) will consolidate a set of recommendations, including the need for a mass vaccination campaign,” he said.
Dr. Saparbekov stressed that given the water, sanitation and hygiene situation in Gaza, it will be “very difficult” for the population to follow the advice on handwashing and drinking safe water.
“Unfortunately, the majority of people living in shelters with one toilet for 600 people and perhaps 1.52 liters of water per person will certainly not be able to follow the recommendations,” he said.
The UN health agency representative also urged that if a mass vaccination campaign is decided, It will be the responsibility of COGAT, the Israeli body responsible for the flow of aid into Gaza, to facilitate the arrival of vaccines to the enclave.
He added that the WHO “has so far received assurances that this will happen.”
Health care system closed
Regarding the destruction of the healthcare system in Gaza, Dr. Saparbekov said that less than half of primary healthcare facilities are operational and only 16 of the enclave’s 36 hospitals are “partially functional,” meaning they provide only minimal healthcare, such as triage of the wounded.
On Monday, WHO and partners carried out a mission to Al-Shifa Hospital in Gaza City, where they renovated the outpatient clinic, which was destroyed in March 2024, and converted it into an emergency department.
“The only functional equipment that unfortunately remains in Gaza (in Al Shifa Hospital) is a stationary X-ray machine,” Dr. Saparbekov said. “All other important hospital equipment, such as ventilators, anesthesia machines, operating room equipment, unfortunately, has been destroyed and needs to be replaced.”
WHO and its partners are “working around the clock” to ensure that much-needed equipment is brought into Gaza, despite “restrictions on the dual-use list,” he said, meaning items that are not allowed into the enclave because Israeli authorities believe they could be reused for military purposes.
