Where do I go now, ask Gazans uprooted by new Israeli evacuation orders

In Khan Younis, the UN agency for Palestine refugees (UNRWA) reported witnessing “thousands of people fleeing” westwards as part of the exodus from the enclave’s southern city amid ongoing hostilities, leaving children traumatized and crying uncontrollably.

“Elderly people on the back of donkey carts…disabled people being pushed in wheelchairs through the sand with the belongings piled up on top of their lap,” said Louise Wateridge, UNRWA Senior Communications Officer. “People running, hearing gunfire [and] running for their lives. Families are really only carrying what they can hold in their hands…People do not know where to go. That is the main question people are asking today, ‘Where do I go?’”

Al Mawasi shrunk

Israel’s evacuation orders have also impacted about 8.7 square kilometres of land in the so-called “humanitarian zone” of Al Mawasi, which lies on the coast near Khan Younis, reducing the size of the zone by nearly 15 per cent, according to the UN aid coordination office, OCHA.

“Initial reports indicate that families are currently moving towards areas in Deir al Balah and western Khan Younis,” OCHA said. “Both areas are already heavily overcrowded, have limited shelters and services available and can barely accommodate the additional influx of displaced people.

As of 22 July, nearly 83 per cent of the Gaza Strip has been placed under evacuation orders or designated as “no-go zones” by the Israeli military.”

UN rights office condemnation

Condemning the “repeated” evacuation orders, the UN human rights office, OHCHR, insisted that the Israeli military had given “no time” for civilians to understand where they were expected to leave or where they should go.

At least 70 Palestinians, including women and children were killed amid ongoing violence on Monday, the UN rights office said, citing the local health authorities. At least 200 others were also injured, some critically, amid reports of intensifying 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 continued in and around the area unabated,” OHCHR said, noting that the evacuation order covered parts of Salah al-Deen Road – “one of two main routes vital for the transport and distribution of aid, raising concerns that delivery and provision of desperately needed humanitarian assistance will be further reduced or prevented”.

Polio outbreak alert update

Meanwhile, concerns continue to grow over the impact of a possible polio outbreak in Gaza, amid disastrous sanitary conditions and a lack of access to health care.

Dr. Ayadil Saparbekov, Team Lead for Health Emergencies at the UN World Health Organization (WHO) in the Occupied Palestinian Territory, said on Tuesday that he was “extremely worried” about the spread of polio and other communicable diseases, which could lead to more people dying of preventable illness than from war-related injuries.

Hepatitis A was already confirmed last year in the Strip, he told journalists, via video link from Jerusalem.

“With the crippled health system, lack of water and sanitation, as well as lack of access of the population to health services… this is going to be a very bad situation,” he maintained. “We may have more people dying of different communicable diseases than from injury-related conditions.”

On 16 July, the WHO said that vaccine-derived poliovirus type 2 (VDPV2) had been identified at six locations in sewage samples collected on 23 June from Khan Younis and Deir Al-Balah.

WHO explained last week that polio virus can emerge in areas where poor vaccination coverage allows the weakened form of the orally administered vaccine virus strain to mutate into a stronger version.

So far, the virus has been found in sewage samples only 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 linked to a strain that was circulating in Egypt during the second half of 2023, WHO said.

Dr. Saparbekov explained that human samples have not yet been collected, as there is a lack of equipment and of lab capacity to test them. A WHO team will be coming into Gaza on Thursday with up to 50 sample collection kits; it will send the specimens to a lab in Jordan for further analysis.

The WHO official said that together with partners, the agency is conducting an epidemiological investigation and risk assessment to identify the source of the virus, which is at high risk of spreading within Gaza and internationally.

“Based on the results of the assessment, WHO and the [Global Polio Initiative Network] partners 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 advice on handwashing and drinking safe water.

“Unfortunately, the majority who live in shelters with one toilet for 600 people and maybe 1.52 litres of water per person will definitely not be able to follow the recommendations,” he said.

The UN health agency representative also insisted that if a mass vaccination campaign is decided, it will be the responsibility of COGAT, the Israeli body responsible for the flow of aid in Gaza, to facilitate the arrival of vaccines into the enclave.

He added that WHO has “so far received reassurances that this will be done.”

Health care system shut down

Turning to the devastation of Gaza’s health system, Dr. Saparbekov said that less than half of primary health care facilities are operational and only 16 out of the enclave’s 36 hospitals are “partially functional”, meaning that they provide only minimal health care services such as triage of the injured.

On Monday, WHO and partners conducted a mission to Al-Shifa hospital in Gaza City, where they have been rehabilitating the outpatient department, destroyed in March 2024, and converting it into an emergency department.

"The only functional equipment that unfortunately remains in Gaza [at Al Shifa hospital] is a stationary X-ray machine,” Dr. Saparbekov said. “All other major hospital equipment, such as ventilation machines, anaesthesia machines, operating theatre equipment have unfortunately been destroyed and it needs to be replaced.”

WHO and partners are “working around the clock” to make sure that that desperately-needed equipment is being brought into Gaza despite of the “restrictions on dual use list”, he said, meaning items which are banned from entering the enclave because the Israeli authorities consider that they could be repurposed for military purposes.