07:06 - Source: CNN
Gaza's health system in its 'death throes,' says doctor
CNN  — 

The main United Nations agency in Gaza says it will have to halt aid operations within a day if fuel is not delivered, in what the organization says would mark the end of a “lifeline” for civilians.

While some aid has reached Gaza through Egypt, those deliveries included food, water and medicine – but not fuel. Israel has refused to allow fuel to enter Gaza since Hamas’ brutal October 7 attack, saying it would only be used by the militant group to fuel its fight against Israel.

Asked how long the UN Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) could last without fuel, spokesperson Tamara Alrifai told CNN: “We’re probably talking a day. We have already warned that if fuel runs out by tonight or tomorrow, we as UNWRA, the largest UN agency in Gaza, will no longer be able to work.” The organization initially said it would have to halt operations Wednesday evening.

UN officials warned the current supplies were “a drop in the ocean” for the needs of 2 million Palestinians living in Gaza and will be of little use without the fuel needed to collect and distribute the aid.

“Without fuel, aid cannot be delivered, hospitals will not have power, and drinking water cannot be purified or even pumped,” UN Secretary-General Antonio Guterres told the UN Security Council Tuesday.

Doctors in overwhelmed hospitals on the brink of shutting down have repeatedly warned that waves of new patients injured in the daily bombings and babies relying on oxygen supplies will die if fuel is not brought in.

The warnings from senior UN officials came after Israeli airstrikes on Gaza killed more than 700 people in 24 hours, the highest daily number published since Israeli strikes against what it called Hamas targets in Gaza began two and a half weeks ago, according to the Palestinian Ministry of Health in Ramallah on Tuesday.

UNRWA director of communications Juliette Touma told CNN that the agency was sheltering some 600,000 people across Gaza. “UNRWA is their only lifeline,” Touma said.

The UNRWA director for Gaza Tom White told CNN that aid workers would have to decide what aspects of life-saving aid they could and could not provide to civilians.

“Do we provide fuel for desalination plants for drinking water? Can we provide fuel to hospitals? Can we provide the essential fuel that is currently producing the bread that is feeding people in Gaza?” he said.

UNRWA was founded in the wake of the 1948 Arab-Israeli War to provide essential services for Palestinians who had been made refugees by the conflict. It began its operations in 1950 and its mandate has since been repeatedly renewed.

As well as humanitarian aid, UNRWA also provides schooling to almost 300,000 students in Gaza, according to figures from the 2021/22 school year. Recent fighting has meant that schools have become places of refuge for thousands of Gazans who have fled their homes.

But White warned that fuel shortages could lead to the agency “winding down” its operations, even as some humanitarian supplies begin to arrive through the Rafah crossing. White did not specify exactly when that process would begin, but stressed that the agency cannot operate without fuel. “Even if convoys come into Gaza, we won’t have the fuel in our trucks to collect that aid or distribute that aid,” he said.

“We need to find a solution to the fuel – otherwise our aid operation will come to a stop,” White told CNN.

A deepening crisis

The deteriorating health environment, lack of sanitation, and consumption of dirty, salty water in Gaza is raising fears of a health crisis in which people could start dying from dehydration as the water system collapses while bombs continue to rain down.

Just eight out of 20 aid trucks scheduled to cross into Gaza on Tuesday made the journey, UNRWA said. No specific reason was provided as to why the other 12 trucks didn’t make it through the Rafah crossing.

Since the start of the Israeli siege two weeks ago, six hospitals in Gaza have been forced to close due to a lack of fuel, the World Health Organization said on Tuesday.

Among those at risk of dying or suffering medical complications are “1,000 patients dependent on dialysis” and “130 premature babies” and other vulnerable patients “who depend on a stable and uninterrupted supply of electricity to stay alive,” WHO said in a statement.

Mustafa Hassona/Anadolu/Getty Images
Patients receive treatment at Nasser Hospital in Khan Yunis, Gaza on October 24, 2023.

The Israel Defense Forces (IDF) on Tuesday ruled out any fuel being allowed to enter Gaza, saying Hamas would co-opt fuel for its operational infrastructure and to continue its rocket attacks.

Israel has also disputed that there are fuel shortages in Gaza. Responding to the UNRWA’s post on X about low supplies, the IDF posted an aerial photo of what it said were fuel tanks in Gaza, and claimed they held more than 500,000 liters of fuel. CNN is unable to verify the IDF claim.

Israel’s leadership has vowed to wipe out Hamas in response to its October 7 deadly terror attacks and kidnap rampage in which 1,400 people, mostly civilians, were killed and more than 200 taken hostage.

In the wake of the assault, Israel launched a sustained aerial bombardment of Gaza that has killed more than 6,400 people and injured a further 17,000, according to information from Hamas-controlled health authorities in Gaza and published by the Palestinian Ministry of Health in Ramallah

Mohammed Salem/Reuters
An aid truck arrives at a UN storage facility as the conflict between Israel and Hamas continues, in central Gaza on October 21, 2023.

More than 700 of those were killed in Gaza in the previous 24-hour period, according to Palestinian officials. Those killed included 305 children, 173 women and 78 elderly individuals, the ministry said.

Some two million people are crammed into the 140 square mile coastal strip that makes up Gaza, half of whom are children.

Al Jazeera said its bureau chief in Gaza, Wael Al-Dahdouh, lost his wife, son, and daughter in what it said was an Israeli airstrike. The blast hit a house in the Nuseirat refugee camp in the central Gaza Strip where the family was taking shelter after being displaced, according to Al Jazeera.

CNN cannot independently confirm the source of the blast at the house and Al Jazeera did not provide evidence linking it directly to an Israeli strike. The IDF has not yet responded to CNN requests for comment.

No international consensus

On Wednesday, United States President Joe Biden described killing innocents as “a price of waging war,” and urged Israel to try to avoid civilian deaths.

“I’m sure innocents have been killed, and it’s a price of waging war,” Biden said Wednesday during a press conference in the Rose Garden.

Israel should be “incredibly careful to be sure that they’re focusing on going after the folks that are propagating this war against Israel,” rather than civilians. “It’s against their interests when that doesn’t happen.”

Biden also said that he had “no confidence” in civilian death figures provided by the Hamas-controlled health ministry in Gaza. “I have no notion that the Palestinians are telling the truth about how many people are killed,” he said.

Meanwhile, a spat has broken out between Israel and the UN, after Secretary General Antonio Guterres appealed for a ceasefire and said he was “concerned about the clear violations of international humanitarian law we are witnessing in Gaza.”

Guterres condemned Hamas’ “horrifying and unprecedented” terror attack on October 7, but said it “cannot justify the collective punishment of the Palestinian people.”

“It is important to recognize the attacks by Hamas did not happen in a vacuum,” Guterres said in remarks to the UN Security Council on Tuesday.

His comments sparked a furious response from Israeli officials. Israel’s ambassador to the UN GIlad Erdan said Guterres was “not fit to lead the UN” and called for him to “resign immediately.”

Nearly three weeks since the outbreak of fighting, the UN’s Security Council remains divided on how to proceed with the crisis. Two differing resolutions on the matter, introduced by the US and Russia, both failed to pass on Wednesday.

The draft resolution from the US called for “humanitarian pauses,” not a ceasefire, to allow for aid to reach Gazan civilians. The US previously vetoed a Brazilian draft calling for a humanitarian pause.

The US has rebutted calls for a ceasefire between Israel and Hamas, with National Security Council spokesperson John Kirby telling CNN on Monday that Hamas must first release hostages held in Gaza.

Talks to secure the release of a large number of hostages being held by Hamas in Gaza are ongoing, CNN reported Tuesday, citing two sources familiar with the matter and one Western diplomat familiar with the deliberations, but the talks are being complicated by a number of factors.

The US, Israel, Qatar, Egypt and Hamas are engaged in the ongoing deliberations. Four hostages – two American and two Israeli – have been freed so far. But the hope now is to reach a deal for a bigger group of hostages to be released at once.

Israel has so far held off on making a ground incursion into Gaza, and the US has pressed Israel to further delay to allow for the release of more hostages held by Hamas.

Israeli Foreign Minister Eli Cohen said outside the UN Tuesday it was Israel’s mission to bring the hostages home.

“While we are still here, there are babies that are in captivity, twins, holocaust survivors, and we have one mission: To bring them home,” Cohen said.

US military advisers have also urged Israelis to avoid an all-out ground assault in Gaza, and steer Israel away from the type of brutal, urban combat the US engaged in against insurgents during the Iraq War, in an effort to keep the Israelis from getting bogged down in bloody, house-by-house fighting, multiple sources familiar with the matter told CNN.

Israeli Prime Minister Benjamin Netanyahu appeared to tell soldiers on Tuesday a ground offensive was still on track, saying, “we stand before the next stage, it is coming.”

In a television address Wednesday, Netanyahu spoke for the first time since the October 7 attack about his own role in the security breakdown.

“Everyone will have to give answers, me too. This will happen after the war,” he said. “As the prime minister, I’m responsible to secure the future of the country, and now it’s my role to lead the country and the people for crushing victory on our enemies.”

This story has been updated with additional developments.

CNN’s Abeer Salman, Hamdi Alkhshali, Kareem El Damanhoury, Eyad Kourdi, AnneClaire Stapleton, Mariya Knight, Richard Roth, Chris Liakos, Maya Szaniecki, Tamar Michaelis, Eve Brennan, Vasco Cotovio, Julia Puckette, Clarissa Ward, Jomana Karadsheh, Amy Cassidy, Akanksha Sharma, MJ Lee, Kaitlan Collins, Kevin Liptak, Michael Johnson and Alex Marquardt contributed reporting.