Palestinians look for survivors of the Israeli bombardment of Rafah, southern Gaza Strip, October 17, 2023. (Hatem Ali / AP Photo)

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The situation in the Gaza Strip is dire. Amid an intense bombing campaign, Israel has shut off water and power and limited essential supplies such as food, medicine, and fuel, creating a massive public health crisis in a region that was already struggling due to a years-long blockade. According to latest statistics, more than 2,750 people have been killed by Israeli strikes, of whom 1,000 are children. Hospitals in Gaza have already been targeted. After repeated threats and calls to evacuate, the Ahli Arab Hospital was bombed on October 17, with early estimates of casualties reporting 500 dead. The hospital was filled with people seeking shelter from the bombings, as are hospitals across Gaza. At Shifa Hospital alone the number of people seeking shelter is estimated to be around 35,000 people. These are ideal conditions for infectious disease to spread. If there is not immediate intervention, thousands of Gazans will die of infections, malnutrition, and dehydration, in addition to the bombardment.

The shutoff of clean water is of particularly grave concern. When people no longer have access to clean, treated water, they will drink water from whatever source there is, including seawater. These sources may be contaminated with sewage, chemicals, and other contaminants, which can lead to water-borne illnesses like cholera and dysentery; outbreaks of such diseases would strain the medical system in Gaza. These diseases also require rapid rehydration, and without a source of water, they can quickly become deadly. Clean water is also necessary for providing proper medical care to people—for one thing, you can’t wash your hands without it. Water is a key component in many medical procedures, such as dialysis for kidney patients. When clean water is no longer available, medical practitioners have to spend crucial moments looking for water in a time when time can barely be spared. Meanwhile, the blockade prevents medical supplies from entering Gaza, and Médecins Sans Frontières has reported that hospitals have run out of painkillers. As people are gravely injured and arrive at the hospital with open wounds, if hospitals are lacking proper medical equipment to stabilize them and prevent infection, many people will die preventable deaths.

The burden on medical workers cannot be overstated; in addition to caring for a rising number of injured patients with limited capacity and equipment, they have to deal with the psychological burden of being in an active war zone. Many medical providers know people who have been killed, if not family, then close friends. Some end up being victims of air strikes themselves, like Dr. Midhat Saidam. Saidam was a burn specialist at Shifa Hospital, who after working long shifts was killed in an air strike along with his family. Palestinian rescue workers risk being targeted when they arrive on the scene to transport patients to the hospital.

Prior to the bombing of the Ahli Arab Hospital, four hospitals in the Northern Gaza Strip had already been abandoned and 21 hospitals have been told to evacuate, according to the World Health Organization. As the WHO reaffirmed, such an evacuation order is a death sentence for elderly and disabled patients, including Ilyas, a 9-year-old disabled boy being cared for at the Mubarat Al Rehmat centre with 26 other children. The Guardian visited the site a few days ago and found that the kids and their two caregivers were effectively trapped.

Throughout Gaza, people report that there is a stench of death. Bodies remain trapped under the rubble as rescue workers don’t have the tools to get to them. For those bodies that have been recovered, room is running out to store the bodies before burial. This too represents a risk for the spread of disease.

To prevent mass death and urgently address this public health crisis, Israel and Hamas must agree to a cease-fire. It is not merely enough to open up a humanitarian corridor, especially since there is evidence that the IDF bombed civilians evacuating on a promised safe route, calling into question future guarantees of safety. A cease-fire will allow vital supplies to enter Gaza and will allow rescue and medical workers time to tend to the injured and dead without the fear of being bombarded. Aid workers need to distribute badly needed food and water to a population that hasn’t had a proper supply of nutrients or hydration in days. The water and power must also be turned back on. The United States must play a crucial role in ensuring that this happens. Fellow public health professionals and our elected officials must also be vocal. Representatives Cori Bush, Rashida Tlaib, and others have introduced a resolution in Congress calling for cease-fire, and we must support their efforts.

It has been a tragic week in which thousands of people have been killed across Palestine and Israel. Creating a public health crisis, however, is no way to hold people’s grief or pursue peace. We need a cease-fire now.