Israel’s demands for the rapid mass evacuation of over a million people from the northern part of the Gaza Strip is an “insurmountable” challenge that will result in a lack of adequate healthcare and inevitably lead to deaths, experts have warned.
On 7 October, Hamas militants from Gaza invaded Israel, capturing and killing citizens and soldiers. In retaliation, Israel has bombed the territory, and on 13 October issued a warning that 1.1 million people north of the Wadi Gaza river – almost half of the region’s population – must evacuate to the south within 24 hours for “safety and protection”.
This rapid evacuation of such a large number of people, and subsequent overcrowding in the south in what is already considered one of the world’s most densely populated regions, is likely to cause a humanitarian disaster, say experts.
Israel claims that the evacuation is necessary to separate civilians from the Hamas militants who have staged sustained attacks against Israelis. Gaza’s health ministry has said that retaliatory strikes by Israel have killed more than 1500 people.
The UN has urged that the evacuation order be rescinded, with spokesperson Stéphane Dujarric saying in a statement: “The United Nations considers it impossible for such a movement to take place without devastating humanitarian consequences.”
Whether Israel expects a full evacuation within 24 hours is unclear. “This is a war zone, we are trying to provide them the time and we are doing a lot of effort, and we understand it won’t take 24 hours,” Israel Defense Forces spokesperson Daniel Hagari told the BBC.
David Alexander at University College London says that while similar numbers of people have been moved quickly at short notice in the past, it has only been accomplished in the US and India ahead of hurricanes where conditions and infrastructure were conducive to mass coordination. The situation in Gaza is far more difficult because of poor infrastructure and already appalling conditions.
“It presents insurmountable problems under current circumstances,” says Alexander. “It’s almost impossible to supply aid, [there are] severe dangers in doing anything. I can’t imagine what conditions are like.”
Alexander says that the refugees will face a lack of shelter, clean water, food and adequate healthcare, and that it was inevitable that the mass migration would lead to deaths.
“The situation there appears to be so precarious, so difficult, that unless there is some kind of armistice, some kind of truce, some kind of relaxation to allow probably massive humanitarian aid then there are going to be, inevitably, people who are killed.”
He says that while most people believe that disease outbreaks are a major problem during mass migrations, this is rarely true because healthcare provision tends to be ramped-up by aid agencies. However, in this case, he warns that may not be possible.
While the European Union and UN have disaster relief equipment on hand, including temporary shelters, organisations would struggle to identify the right location and get supplies there quickly, says Alexander.
“The numbers needed might easily overwhelm that sort of capacity,” he says. “I can’t quite see how they’re going to get the resources into Gaza. It’s one thing to do that if you’ve just had a hurricane or a major flood, [but] I think it’s another thing to do that when rockets are being fired all over the place and also when you have a complete blockade.”
Because of fighting on the ground there are also complications in using foreign armed forces to supply aid, because there are strict rules and treaties on ensuring that they only supply humanitarian support and not military, says Alexander.
“It’s one of the most densely populated places in the world; it really isn’t conducive to separating the humanitarian from the military, which is one thing that needs to be done. It can easily get mixed up with the types of total warfare that you seem to be getting these days,” he says.
The World Health Organization (WHO) warned on 12 October – just hours before Israel issued the evacuation order – that Gaza’s healthcare system was already “at a breaking point”. Hospitals only have a few hours of electricity a day and are relying on diesel generators to power vital equipment, but fuel reserves are dwindling.
Casualties from fighting and bombing are growing, and stocks of medical supplies are inadequate, warned the WHO. The organisation said that it has documented “34 attacks on health care” in Gaza since last Saturday, saying these have resulted in the deaths of 11 health workers on duty, 16 injuries and damage to 19 health facilities and 20 ambulances. The WHO is calling for an end to hostilities and the opening of an aid corridor into Gaza.