Six months of war have left Al-Shifa hospital in ruins, the WHO mission reports

A WHO-led multi-agency mission accessed Al-Shifa Hospital in northern Gaza on 5 April to conduct a preliminary assessment of the extent of the destruction and identify needs to guide future efforts to rebuild the facility. The very complex mission was carried out in close partnership with the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), the United Nations Mine Action Service (UNMAS), the United Nations Department for Security and Protection (UNDSS), and in cooperation with the acting director of the hospital.

Prior to the mission, WHO efforts to reach the hospital to medically evacuate patients and staff and conduct an assessment were rebuffed, delayed or hindered 6 times between 25 March and 1 April.

Like most of the north, Al-Shifa Hospital – once Gaza's largest and most important referral hospital – is now an empty shell after the latest siege. There are no patients in the institution. Most of the buildings were badly damaged or destroyed, and most of the equipment was unusable or reduced to ashes. The WHO team said the scale of the destruction had left the facility completely non-functional, further reducing access to life-saving health care in Gaza. Restoring even minimal functionality in the short term seems improbable and will require considerable effort to assess and clear the terrain for unexploded ordnance to ensure safety and accessibility for partners to bring in equipment and supplies.

The buildings of the hospital's emergency department, surgery and maternity ward were significantly damaged by explosives and fire. The west wall of the emergency department and the north wall of the neonatal intensive care unit (NICU) were demolished. At least 115 beds in the former emergency department were burned, and 14 intensive care incubators were destroyed, among other things. A detailed assessment by a team of engineers is required to determine whether these buildings are safe for future use.

The hospital's oxygen plant was destroyed, leaving Kamal Adwan Hospital as the only source of medical oxygen production in the north. Further comprehensive assessment is necessary to assess the functionality of vital equipment such as CT scanners, ventilators, sterilization devices and surgical equipment, including surgical instruments and anesthesia devices. The current situation has left northern Gaza without CT scanning capabilities and significantly reduced laboratory capacity, seriously jeopardizing effective diagnosis, which will increase the number of avoidable deaths.

Numerous shallow graves were dug directly in front of the emergency department, and the administrative and surgical buildings. In the same area, many dead bodies were partially buried with their limbs visible. During the visit, WHO staff witnessed at least 5 bodies lying partially covered on the ground, exposed to the heat. The team reported the pungent smell of decomposing bodies pervading the hospital complex. Preserving dignity, even in death, is an indispensable act of humanity.

According to the acting director of the hospital, patients were kept in disastrous conditions during the siege. They suffered severe shortages of food, water, health care, hygiene and sanitation, and were forced to move between buildings at gunpoint. At least 20 patients have reportedly died due to a lack of access to care and the limited movement allowed for medical staff.

Despite the deconfliction, yesterday's mission faced significant delays at a military checkpoint en route to Al-Shifa Hospital. On the same day, another WHO-led mission en route to Al-Awda and Kamal Adwan hospitals in northern Gaza – to deliver medical supplies, fuel, deploy emergency medical teams and support the referral of critical patients – encountered unnecessary delays, including the detention of a supply truck driver who was part of a convoy. He was detained for over an hour in a separate location, out of sight of the mission team. In the end, this mission was aborted due to safety concerns as the delays did not leave enough time to safely complete and return before dark.

Between mid-October and the end of March, more than half of all WHO missions were rejected, delayed, prevented or postponed. As health needs grow, the lack of a functioning deconfliction system is a major obstacle to delivering humanitarian aid – including medical supplies, fuel, food and water to hospitals – anywhere near the scale needed.

Six months – half a year – after the end of the war, the destruction of Al-Shifa Hospital and the Nasser Medical Complex broke the backbone of an already ailing health care system. Before the latest siege, WHO and partners supported the revival of essential services at Al-Shifa Hospital, and the Nasser Medical Complex was regularly supplied to continue serving as the main hospital in southern Gaza. Those efforts are now lost.

As the World Health Organization celebrates World Health Day tomorrow under the slogan “My Health, My Right”, this basic right is completely unattainable for civilians in Gaza. Access to health care in Gaza has become completely inadequate, and the ability of WHO and partners to help has been constantly hampered and hampered.

Of the 36 main hospitals that served Gaza's more than 2 million residents, only 10 remain somewhat functional, with severe limitations in the type of services they can provide. The proposed military incursion into Rafah can only result in further reductions in access to health care and would have incalculable health consequences. The systematic dismantling of healthcare must stop.

WHO reiterates its calls for the protection of patients, health and humanitarian workers, health infrastructure and civilians. Hospitals must not be militarized, abused or attacked. WHO requires an effective, transparent and functional mechanism for deconfliction and security guarantees, which ensure that the movement of aid within Gaza, including through checkpoints, is safe, predictable and expeditious. WHO calls for additional land crossings to allow safer and more direct access to and through Gaza.

As famine threatens, disease epidemics spread and traumatic injuries mount, the WHO calls for unimpeded access of humanitarian aid to and from the Gaza Strip and a permanent ceasefire.