Gaza’s Hospitals Face ‘Impossible’ Choices With Israel Evacuation Order

Hundreds of people injured in Israeli airstrikes are streaming into hospitals in Gaza, transported by overfilled ambulances and sharing bloodied gurneys at the entrances. Workers and bystanders rush to carry the victims inside, where only the most critically wounded are allowed to stay, and the rest are sent home.

On Friday, Israel ordered hospitals in northern Gaza — along with more than one million Palestinians — to evacuate and flee southward before an anticipated Israeli ground invasion of the territory. The order has created for patients and their caretakers an impossible dilemma: stay or go.

“It’s absolutely impossible to evacuate the hospital,” said Dr. Muhammad Abu Salima, the director of Gaza City’s Al Shifa Hospital, the territory’s largest medical complex. “There is nowhere in Gaza that can accept the number of patients in our intensive care unit or neonatal intensive care unit or even the operating rooms.”

“If someone doesn’t die from the bombardment, then he’ll die from the lack of medical service,” he said.

At Al Shifa Hospital, patients included 70 people on ventilators, 200 receiving dialysis and many babies in incubators. Moving them elsewhere is logistically impossible, said. Dr. Abu Salima.

Friday’s evacuation order came as Israel has been pummeling the territory with airstrikes in response to the attack last week by Hamas, the group that controls Gaza, which killed more than 1,300 people. The attack was the single deadliest day in Israel’s modern history and the deadliest day for Jews since the Holocaust, according to Israeli officials.

The evacuation of northern Gaza is meant to take civilians out of harm’s way, Israel says. But it has left people in Gaza with an impossible choice. Services in southern Gaza, already strained after years of an international blockade, are at their breaking point, and the south is also subject to airstrikes. Hundreds of thousands of Palestinians have already fled south, and by Sunday, displaced families had crammed into every inch of schools, hospitals and mosques. Others crowded into the houses of friends and family. Many more slept out in the open in the streets even as the airstrikes, including on southern Gaza, continued.

Many Gazans also say they would rather die in their homes than flee.

At least 2,760 Palestinians in Gaza have been killed since last Saturday, the Palestinian Health Ministry said. Another 9,600 Palestinians have been wounded.

On Monday, Israel’s defense minister imposed what he called a “complete siege” of Gaza, vowing to cut off electricity, food, water and fuel from entering the territory, which has for 16 years been under blockade by Israel and Egypt. Egypt, which also borders the enclave, has held up aid convoys to Gaza over disagreements with Israel about how and where the convoys should be screened for weapons, according to a senior diplomat familiar with the discussions.

There has been little to no aid distribution in Gaza since the airstrikes began and most shops are closed. On Saturday the United Nations warned that all of Gaza was about to run out of drinking water. Many Gazans do not have access to clean drinking water, according to the U.N., and are resorting to drinking polluted water.

“It has become a matter of life and death,” said Philippe Lazzarini, the commissioner general for UNRWA, the U.N. agency that aids Palestinians. “It is a must: Fuel needs to be delivered now into Gaza to make water available.”

Nearly half of Gaza’s population of more than two million has been displaced over the past week, according to UNRWA.

Transporting critically wounded patients, has also been a challenge. There are also not enough ambulances, according to the Gazan authorities. Since last Saturday, at least 15 ambulances have been bombed and destroyed in airstrikes, the Gazan health ministry said.

On Saturday, the World Health Organization said Israel’s call for the evacuation of 21 hospitals in northern Gaza could be a “death sentence” for the sick and wounded.

There are about 2,000 desperately ill patients inside the hospital wards under evacuation orders, the group said, including those in intensive care or on life support, including newborn babies in incubators. As a result of the Israeli assault, Gaza’s hospitals are operating beyond maximum capacity, it added, with some patients being treated in corridors and outdoors in the surrounding streets.

“Forcing more than 2,000 patients to relocate to southern Gaza, where health facilities are already running at maximum capacity and unable to absorb a dramatic rise in the number patients, could be tantamount to a death sentence,” the W.H.O. said.

The Palestine Red Crescent said Friday that it didn’t have the means to evacuate the sick and wounded from hospitals — or older people and the disabled from their homes.

“There are no safe areas in the whole of the Gaza Strip,” the group said in a statement.

Despite Israel’s repeated orders to evacuate the north — through SMS messages and leaflets — many in Gaza City have refused to leave.

On Friday, an Israeli airstrike struck a convoy of vehicles trying to flee the north along a main highway, according to the Palestinian Health Ministry in Gaza, killing 70 people and injuring 200. Video of the aftermath showed bloodied bodies strewn on the road along with suitcases and belongings.

By Sunday, some of those who had refused to leave earlier reconsidered. But once in the south, they found an equally dire situation.

A 33-year-old aid worker who was not authorized to speak to the news media, said she and her family decided to leave their home in Gaza City only after Israel dropped leaflets over the city warning resident to leave for the third time. She said that as they drove south, they passed people walking barefoot and resting along the Gazan coasts Mediterranean beaches.

The family, she said, arrived at a friend’s house just south of the evacuation zone. At a school nearby, each person was given a loaf of bread to eat, she said.

“In every war there were at least organizations that used to distribute meals and water, but not this time,” she said.

While hundreds of thousands have fled to the southern Gaza Strip, an Israeli airstrike Sunday morning struck a home in the town of Rafah — near the border crossing with Egypt where people are amassing in hopes of being able to flee — killing 17 members of a family.

The family was among 55 families killed during nine days of airstrikes, according to the health ministry.

Iyad Abuheweila contributed reporting.