In central Gaza, the UN World Health Organization (WHO) warned on Sunday that medics at the only functioning hospital in Deir al Balah governorate “had been forced to cease lifesaving and other critical activities…and leave” after an evacuation order issued amid “increasing” Israeli military activity.

Only five doctors reportedly remain at Al-Aqsa Hospital in the Middle Area of Gaza, where a WHO team delivered medical supplies to support 4,500 dialysis patients for three months and 500 patients requiring trauma care.

Patients treated on the floor

From Al-Aqsa, WHO Health Emergency Officer Sean Casey posted a video on X social media platform on Sunday evening showing chaotic scenes as medics treated patients on the blood-streaked floor, some of the “hundreds” being brought in for urgent treatment.

“They are seeing in some cases hundreds of casualties every day in a small emergency department,” Mr. Casey said. “So, they’re treating children on the floor.”

Echoing those concerns, WHO Director-General Tedros Adhanom Ghebreyesus in a post on X reported “immense needs” at the hospital, “especially health workers, medical supplies and beds. But staff said their greatest need was for their hospital, and its staff, patients and families there, to be protected from strikes and hostilities.”

More than 600 patients “and most health workers” had reportedly been forced to leave the facility, Tedros said, adding that it was “inconceivable” that the protection of health care could not be counted on.

According to the UN health agency, no hospitals are “fully functioning” in northern Gaza. Another WHO mission had to be cancelled to the north on Sunday, Tedros said, “due to dangers and lack of necessary permissions”. Elsewhere in Gaza, “a mere handful of health facilities operate”, the WHO chief said.

In recent days casualty numbers have “increased markedly”, Tedros continued, with “over 120 trauma cases and dozens of dead arriving per day due to increased shelling, gunshot wounds, crush injuries from collapsed buildings, and other war-related trauma”.

WHO is also involved in plans to deploy an emergency medical team to support medical teams at Al-Aqsa. “This will only be possible in a secure environment,” the UN health agency’s Director-General noted.

Targets struck in north

In a separate update on the emergency confirming “intense” Israeli strikes “across (central) Deir Al Balah governorate and the southern cities of Khan Younis and Rafah”, OCHA reported on Sunday evening that Israeli forces “struck targets in Gaza city, Jabaliya Camp, Tal Az Za’atar, and Beit Lahiya” causing “a very large number of fatalities” in the Al Fallouja area of Jabaliya Camp.

Rocket fire into Israel by Palestinian armed groups also continued, the UN aid office said, amid “ground operations and fighting…across much of the Gaza Strip, resulting in additional fatalities”.

No end to rising toll

Latest data from the Gazan health ministry cited by the UN aid wing indicated at least 22,835 fatalities since Israeli military strikes began, in response to Hamas-led terror attacks in southern Israel on 7 October that left some 1,200 dead including at least 33 children and around 250 taken hostage. 

OCHA also noted reports of 225 Palestinian fatalities between Friday and Sunday and almost 300 injured, with 174 Israeli soldiers killed in Gaza and more than 1,000 injured since ground operatio

ns began, according to the Israeli Defense Forces. 

Deadly disease threat

Amid ongoing deadly violence, UN Children’s Fund UNICEF estimated that there are now approximately 3,200 new cases of diarrhoea per day among under-fives. Before the escalation in hostilities, the average was 2,000 per month.

There is also dire concern for nine in 10 children under two years old who are now in “severe food poverty” and “only getting grains (including bread) or milk” to eat.

“Time is running out. Many children already face severe acute malnutrition in Gaza,” said UNICEF’s Executive-Director Catherine Russell. “As the threat of famine intensifies, hundreds of thousands more young children could soon be severely malnourished, with some at risk of death. We cannot allow that to happen.”

Updated information from OCHA on the number of aid trucks entering Gaza indicated that on 6 and 7 January, a total of 218 trucks carried food, medicine and other supplies through the Rafah and Kerem Shalom crossings. Before the conflict erupted, more than 500 trucks carried aid into the Strip every day, some 60 per cent passing through Kerem Shalom.

Secretary-General António Guterres (right) meets with Sigrid Kaag, Senior Humanitarian and Reconstruction Coordinator for Gaza.

UN Coordinator for Gaza

The new Senior Humanitarian and Reconstruction Coordinator for Gaza officlally began her role on Monday. Sigrid Kaag will facilitate monitor and verify relief shipments coming in to the stricken enclave, in line with the Security Council resolution 2720 passed last month.

She has held a number of senior humanitarian jobs within the UN but most recently served as finance minister for the previous administration in the Netherlands.

Ms. Kaag will also have the challenging task of establishing a mechanism for accelerating aid into Gaza through States which are not party to the conflict. 

She was in New York meeting the UN Secretary-General on her first day in office but will be heading to Washington DC later in the week before travelling to the Middle East. 

“Even if there is no ceasefire, you would expect humanitarian corridors to operate… in a much more sustained way than what’s happening now,” said Dr Rik Peeperkorn, WHO Representative for the Occupied Palestinian Territory. “It’s too little. It’s too late and specifically in the north.”

Begging for food

Humanitarian assistance – and particularly food – is desperately needed across Gaza, particularly in northern areas, confirmed WHO Emergency Medical Teams Coordinator Sean Casey.

“The food situation in the north is absolutely horrific, there’s almost no food available,” he told journalists in Geneva via video from Rafah in southern Gaza. “Everybody we talk to begs for food and comes up and asks, ‘Where, where’s the food?’ People help us get our medical supplies through. But they are constantly telling us that we need to come back with food.”

Echoing that appeal and expressing concerns about intensifying hostilities in the south, Dr Peeperkorn explained that moving staff and supplies “safely and swiftly” had been compromised, “as deconfliction is required for any moves across Gaza, including the south – often leading to delays”.

In addition to getting more essential supplies into Gaza, what was also needed urgently was easier movement of humanitarian aid and workers within the enclave, “so that we can reach people wherever they are”, Dr Peeperkorn explained.

According to Gaza’s Ministry of Health, 23,084 people have been killed in the enclave, 70 per cent were women and children. Nearly 59,000 people have also been injured, which is approximately 2.7 per cent of Gaza’s population.

UN ‘completely ready’ to deliver

The WHO official insisted that the UN and its partners remained “completely ready” to deliver assistance to Gazans, who have endured a massive bombing campaign by the Israel military, in response to the Hamas-led terror attacks in southern Israel beginning 7 October that killed some 1,200 people.

But hostilities and evacuation orders in Gaza’s central areas and further south in  Khan Younis have affected access to hospitals for patients and ambulances, Dr Peeperkorn explained, adding that it has also become “incredibly complex” for WHO to reach “ailing” facilities with medical supplies and fuel. 

Of concern are three hospitals located near evacuation zones – European Gaza Hospital, Nasser Medical Complex and Al-Aqsa – “a lifeline” in the south for about two million people, the WHO official said, speaking from Jerusalem. 

Healthworkers fleeing for their lives

“(The) constricted flow of supplies and access and evacuation of medical staff from many hospitals due to fears for safety are a recipe for disaster and will make more hospitals non-functional, as witnessed in the north. The international community must not allow this to happen,” Dr Peeperkorn said.

One indication of the “shrinking space” for lifesaving humanitarian work in the enclave is the fact that the UN health agency has not reached northern Gaza for two weeks. 

A total of six planned WHO humanitarian missions have had to be cancelled since 26 December, according to the UN health agency. “Our team is ready to deliver but we have not been able to receive the necessary permissions to proceed safely,” Dr Peeperkorn explained.

Safe passage requests denting aid response: UN Spokesperson

UN Spokesperson Stéphane Dujarric said on Tuesday that so-called “denials of coordinated movement requests” were causing critical hold-ups in aid delivery across Gaza.

Addressing reporters at the regular noon briefing in New York, he said that since 1 January, “humanitarian partners have requested 20 convoys, of which 15 were denied and two were unable to proceed because of delays or routes that were impassable.”

Only three went to the hardest hit north of Gaza and that was with modifications to the plan that wound up impacting operations, he added .

Despite the major challenges to delivering humanitarian assistance, aid partners have provided healthcare and medical services to about half a million people since 7 October.

“But the needs are massive – and just over a third of more than 350 formal and informal shelters for internally displaced people in Gaza have access to any sort of medical points.”

He said “continued denial of fuel delivery to water and sanitation facilities is leaving tens of thousands of people without access to clean water and increasing the risk of sewage overflows, significantly heightening the risk of the spread of communicable diseases.”

Assembly Vice President Cheikh Niang of Senegal, holding the gavel in the General Assembly Hall and deputizing for President Dennis Francis, read out a statement on his behalf.

Mr. Francis said he welcomed the adoption of Security Council resolution 2720 late last month, which called for safe, unhindered and expanded humanitarian access and conditions for a sustainable cessation of hostilities. 

He urged all warring parties in Gaza to “fully implement” the Council resolution as well as the Assembly resolution of 12 December calling for a ceasefire, arising from the Assembly’s reconvened Emergency Special Session.

On protecting civilians, Mr. Francis urged all Member States “to keep this shared goal to the forefront during today’s debate.” 

Debate triggered by Assembly resolution

The General Assembly adopted a resolution designed to foster greater cooperation with the Security Council, in the wake of Russia’s full-scale invasion of Ukraine in early 2022.

That resolution states that anytime the veto is used in the Security Council, it automatically triggers a meeting and debate in the General Assembly, to scrutinize and discuss the move.

The veto is a special voting power held by the permanent member States on the Council, whereby if any one of the five — China, France, Russia, the UK and the US — casts a negative vote, the resolution or decision automatically fails.

The Assembly resolution which introduced this extra scrutiny calls for the Assembly President to convene a formal debate within 10 working days, so that the 193 members of the wider body can have their say.

The intention behind it is to give UN Member States the chance to make recommendations, which could include the use of armed force, to maintain or restore peace and security on the ground.

As with all Assembly resolutions they carry moral and political weight but are non-binding and do not generally carry the force of international law, unlike some measures agreed by the Security Council. 

Tuesday’s meeting came on the heels of the US vetoing a Russian amendment prior to the successful passing of last month’s Council resolution on Gaza.

Watch full coverage of Tuesday morning’s session in New York, below:

US committed to ‘bringing all of the hostages home’

The US Deputy Permanent Representative, Robert Wood, said the US welcomed the adoption of December’s Security Council resolution on 22 December.

Deputy Permanent Representative Robert A. Wood of the United States addresses the UN General Assembly meeting on the situation in the Middle East, including the Palestinian question.

Although the US abstained, he said the US had worked closely with other key States “in good faith” to forge a strong resolution. “This work supports the direct diplomacy the US is engaged in to get more humanitarian aid into Gaza and to help get hostages out of Gaza”, he said.

Without naming Russia – whose amendment provoked the US veto in question – he said one Member State persisted in putting forward ideas which are “disconnected from the situation on the ground”.

He said it was “also deeply troubling” that many States seemed to have stopped talking about the plight of hostages still being held in Gaza by Palestinian militants.

The US is committed to bringing them all home he said and remains “engaged in efforts to secure another pause” in the fighting. Also lacking, he added, are demands that Hamas lay down its arms and surrender.

“It would be good if there was a strong international voice pressing Hamas’s leaders to do what is necessary to end the conflict that they set in motion on 7 October”, he said.

Palestinians enduring a ‘war of atrocities’

Permanent Observer of the State of Palestine, Riyad Mansour, said that he was standing before the Assembly “representing a people being slaughtered, with families killed in their entirety, men and women shot in the streets, thousands abducted, tortured and humiliated, children killed, amputated, orphaned – scarred for life.”

Riyad Mansour, Permanent Observer of the State of Palestine to the United Nations, addresses the UN General Assembly meeting on the situation in the Middle East, including the Palestinian question.

He said “no people” should have to endure such violence and it must stop. 

 No one can understand that the Security Council is still being prevented from calling for an immediate humanitarian ceasefire, he added, while 153 States in the General Assembly have called for just that, along with the UN Secretary-General.

Israel’s assault is without precedent in modern history he said, “a war of atrocities”.

“How can you reconcile opposing the atrocities and vetoing a call to end the war that is leading to their commission?”, he asked.

The State of Palestine has long supported a proposal from France and Mexico “for the suspension of the veto in the case of mass atrocities, when crimes of genocide, crimes against humanity and war crimes on a large scale are committed.”

He said the assault on Palestinians in Gaza, “demonstrates how vital this proposal is.  Supporting an immediate ceasefire is the only moral, legitimate, and responsible position.”   

During these last 90 days, 11 Palestinians have been killed every hour, including seven women and children, he told the Assembly.

“This is not about Israeli security; this is about Palestine’s destruction. The interests and objectives of this extremist Israeli government are clear and incompatible with the interests and objectives of any country that supports international law and peace”, Mr. Mansour said.

Security will never come through the death, destruction and dehumanization of Palestinians, he added.

Palestine is here to stay, he declared: “Don’t call for peace and spread fire. If you want peace, start with a ceasefire. Now.”

No morals, ‘only bias and hypocrisy’: Israel

Israel’s Ambassador to the UN, Gilad Erdan, wondered how, with 136 people still held hostage, including a baby about to mark his first birthday, any delegations could be calling for a ceasefire.

“How morally bankrupt has this body become?”, he said. Why are there no deafening calls inside the hall to bring him home, and “why are you not holding Hamas accountable for the most heinous war crimes?”

Ambassador Gilad Erdan of Israel addresses the UN General Assembly meeting on the situation in the Middle East, including the Palestinian question.

He said that “despite the UN’s moral rot”, the citizens of Israel are resilient, with faith, hope and unbreakable resolve to defend themselves.

He said the UN had become “an accomplice to terrorists” and now lacked the justification to exist.

Rather than focusing on bringing hostages home and their suffering, the UN “has been obsessed only with the well-being of people in Gaza”, those who put Hamas in power and supported the group’s atrocities, he added.

“You ignore all Israeli victims”, he said. 

He asked how the Convention on the Prevention of Genocide be weaponized against the Jewish State, when the only thing Hamas wants, is to repeat the Holocaust.

“There are no morals here, only bias and hypocrisy”, he said. By calling for a ceasefire is giving the green light to Hamas to continue its reign of terror. 

He said that by calling for a ceasefire, the Assembly is sending a clear message to terrorists across the world. “The UN is signalling to terrorists that rape as a weapon of war, is fine”, he added.

US responsible for ‘toothless’ resolutions: Russia

Deputy Permanent Representative for Russia, Anna Evstigneeva, said that Washington had been guilty of playing an “unscrupulous game” to protect Israel’s actions in Gaza, when it used the veto in the Security Council on 22 December.

Anna Evstigneeva, Deputy Permanent Representative of the Russian Federation, addresses the UN General Assembly meeting on the situation in the Middle East, including the Palestinian question.

She said that using blackmail and arm-twisting, the US had given Israel a license to carry on killing Palestinians “blessing the ongoing extermination of the Gazans”, which is why they put forward their amendment.

She said the real aim of the US veto was to push through its aim of giving Israel free rein, and “deliberately undermine multilateral efforts under the auspices of the UN to serve its own geopolitical interests in the Middle East.”

Ms. Evstigneeva said that “the sad result” of this is that over the past three months of escalation in Gaza, the Council has only been able to adopt “toothless” resolutions.

Russia abstained on both documents, rather than voting against them, solely based on requests from the Palestinian and Arab representatives.

A clear demand from the Security Council for a full ceasefire remains an imperative, she said.

Without it, implementing the Council’s decisions in Gaza “is just not possible”. 

She said the spiral of continuing violence is “clearly catastrophic” and will continue until the root causes of the conflict are properly addressed, through a two-State solution. 

Under current conditions, our shared goal is to assist the parties in establishing the negotiation process. A “collective diplomatic mechanism” is required and one of the most pressing tasks is the restoration of Palestinian unity, she added.