Attack on hospitals and healthcare system in Gaza – Letter from the State of Palestine (A/ES-10/1018-S/2024/1000)

30 December 2024

Identical letters dated 30 December 2024 from the Permanent Observer of the State of Palestine to the United Nations addressed to the Secretary-General, the President of the General Assembly and the President of the Security Council

For 450 days, Israel, the occupying Power, has waged a genocidal war against the Palestinian people, ravaging the Gaza Strip and its civilian population with utter depravity and inhumanity.

This savage Israeli onslaught has been deliberate and methodical in its decimation of all that sustains life, including the destruction of hospitals and the healthcare system in Gaza and the targeting of doctors, nurses, medics and other humanitarians struggling to preserve life under the most inhumane and appalling conditions. This is genocide.

No one can deny that depriving a people of healthcare in the midst of a war – by which the aggressor is knowingly and systematically inflicting on them mass casualties, mass displacement and mass starvation – is aimed at destroying this people in whole or in part, aimed at obstructing their healing and recovery and aimed at preventing their subsistence and very existence in their homeland. This is genocide.

As stressed by the non-governmental organization Doctors Against Genocide, “destroying healthcare systems is a genocidal tactic to accelerate death. Without functioning hospitals, lives cannot be saved …”.

The latest large-scale Israeli attack has been on Kamal Adwan Hospital, which had been the last major functioning hospital in besieged north Gaza, receiving sick and wounded patients and operating a maternity ward and nursery for newborn babies. The hospital had also been providing oxygen and other medical gases to ambulances and other partially functional health facilities in the area that were left with none as Israel continued its sinister obstruction of the entry of food, water, medical supplies and other humanitarian necessities, while at the same time deceiving the world with claims that it was not doing so.

After more than three months of siege of the area and attacks near and around the Hospital, the Israeli occupying forces invaded Kamal Adwan Hospital on 27 December, attacking the Hospital with snipers, tanks and quadrocopter drones; terrorizing, torturing and executing patients and medical personnel; and destroying equipment and setting fire to and burning entire wards in the Hospital. It is estimated that at least 50 people were killed in Israel’s raid on the hospital.

Terrified patients, including mothers that had just delivered babies and severely wounded patients, were ordered by Israeli soldiers to leave the Hospital, with no means of transportation and nowhere to go for safety in the winter cold. Israeli soldiers then carried out a violent arrest raid, forcing the detained persons to strip outside in the cold winter weather, and abducted at least 240 people from the Hospital premises, including patients and medical staff.

Among those abducted and whose fate is unknown, as with thousands of other Palestinians, mostly men, abducted by Israel, was Dr. Hussam Abu Safiyah, the director of Kamal Adwan Hospital. Dr. Abu Safiyah had vowed to remain in the Hospital to care for his patients, even after Israel had killed his young son Ibrahim in an assault in October, and had been making appeals to the international community for weeks to intervene to protect the Hospital and save the patients and hundreds of civilians within it from Israeli attack.

We demand that the occupying Power release Dr. Abu Safiyah and release the thousands of other Palestinians, mostly men, young and old, that it has abducted, to cease their imprisonment and torture and to return them safely to their families.

There must be a halt to this absolute depravity and inhumanity with an immediate, permanent and unconditional ceasefire and a hostage-for-prisoner exchange. It is clear, however, that Israel’s political and military leaders are not interested in either.

Instead, Israel is continuing its war crimes and crimes against humanity unabated, ignoring the international community’s repeated calls for a ceasefire and carrying on with its genocidal onslaught on the Palestinian people with no end in sight, soon to reach the 15-month mark. In fact, Israel has not only carried on, but has also escalated its military assaults, with no relief whatsoever for the civilian population, including for Gaza’s Christian community, who observed another sombre Christmas under Israeli bombs and missiles and ever-worsening humanitarian conditions, especially in the north of the territory.

As of today, more than 153,600 Palestinians have been massacred or injured by Israel in Gaza. Another 800 Palestinians have been murdered in the West Bank, including East Jerusalem, by the occupying forces and extremist settlers.

International doctors working with medical missions on the ground in Gaza attest to the fact that the overwhelming majority of the killed and wounded are civilians, and over 70 per cent are women and children. Among the recent casualties of Israel’s war on our people were six newborn infants who froze to death from hypothermia in the tents where their forcibly displaced families have sheltered for months on end with no access to heating or medicines, nor to water or food, denied by the occupying Power the minimum requirements to sustain life. Dozens of other children have died of malnutrition as Israel continues to forcibly starve the population, openly imposing a famine.

According to Oxfam International, Israel has killed more women and children in Gaza over the past year than in the equivalent period of any other conflict over the past two decades. Moreover, according to data estimates, Israel has killed, wounded or rendered missing at least 10 per cent of Gaza’s population.

As we have repeatedly stressed, this shocking casualty toll is a conservative figure, as estimates are that thousands more have likely died, including as a result of disease outbreaks and of malnutrition that has gravely compromised immunity and weakened the population and its ability to survive yet another winter in displacement and under assault.

Thousands more will die, if this genocide is not stopped, due to Israel’s military assaults as well as the spread of malnutrition, communicable diseases and the many long-term health risks caused by Israel’s devastation of civilian infrastructure and the massive environmental impact of the war, especially due to the toxic pollutants of the explosive munitions used by Israel against the population and the massive destruction of water and sanitation networks.

All of this is happening while Israel is destroying the healthcare system in Gaza, deliberately denying medical care and emergency assistance to the population in a time of war, deepening their suffering and hastening both their ethnic cleansing and demise in an unprecedented, grotesque act of mass collective punishment.

In this regard, the World Health Organization has stressed that “the systematic dismantling of the health system in Gaza is a death sentence for tens of thousands of Palestinians in need of health care. This horror must end and health care must be protected. Ceasefire!”

We echo these calls, which have reverberated across the international community, with governments, parliaments and countless human rights and humanitarian organizations – international, Palestinian and Israeli – calling for a ceasefire and an end to the atrocities being perpetrated by Israel against the Palestinian people under its illegal colonial occupation and apartheid regime.

It is past time to end these horrors, to end this depravity, to end this inhumanity. There must be an immediate, permanent and unconditional ceasefire. There must be immediate, unimpeded and continual humanitarian access to all parts of Gaza, including by the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), the pillar of the international community’s humanitarian efforts in Gaza and throughout the rest of the Occupied Palestinian Territory, including East Jerusalem.

Israel must be demanded and pressured to abide by international legal obligations, including under international humanitarian law, the provisional measures orders of the International Court of Justice and the relevant United Nations resolutions, and this must include respect for the mandate of UNRWA and its privileges and immunities. The international community cannot allow the Agency’s lifesaving humanitarian operations to be obstructed or prevented by the occupying Power. Allowing that to be done in the midst of this genocide is tantamount to a death sentence for the millions whose survival depends on its indispensable aid.

There must be international protection for the Palestinian people. This must include the urgent delivery of all necessary humanitarian supplies, including shelters, food, water, medicine and fuel to all areas of Gaza, including the north, to ensure the shelter, healing and recovery of the civilian population and to sustain life, which remains under mortal threat by Israel.

There must be independent, transparent international investigations and a full accounting of all the crimes perpetrated by the occupying Power against the Palestinian people. There must be full accountability and an end to this impunity once and for all.

We therefore once again implore the international community to act with utmost urgency to end this torment of our people. The Security Council must uphold its duties under the Charter of the United Nations, respond to the General Assembly’s demand for an immediate, unconditional and permanent ceasefire and ensure respect for the provisional measures order of the International Court of Justice, and all relevant resolutions must be implemented forthwith. There can be no more delays and no more equivocation; there can be no justification for genocide whatsoever.

We once again appeal to all parts of the United Nations system and all States and all peoples to act swiftly and concretely to uphold their legal, political, humanitarian and moral obligations, to act now to implement international law, including humanitarian law and human rights law, in all circumstances without exception, and to act now to save our people.

Do not let this catastrophe and these abhorrent atrocities continue for one more day. Do not let another year begin with such cruelty against the Palestinian people and such shame for our collective humanity. Stop this genocide and end this historic injustice.

The present letter is in follow-up to our 853 letters on the ongoing crisis in the Occupied Palestinian Territory, including East Jerusalem, which constitutes the territory of the State of Palestine. These letters, dated from 29 September 2000 (A/55/432-S/2000/921) to 16 December 2024 (A/ES-10/1017-S/2024/919), constitute a basic record of the crimes being committed by Israel, the occupying Power, against the Palestinian people since September 2000. For all of these war crimes, acts of State terrorism and systematic human rights violations against our people, Israel, the occupying Power, must be held accountable and the perpetrators must be brought to justice. This illegal colonial occupation and apartheid regime must end now.

I should be grateful if you would arrange to have the present letter distributed as a document of the tenth emergency special session of the General Assembly, under agenda item 5, and of the Security Council.

(Signed) Riyad Mansour

Minister

Permanent Observer