Seven more health facilities forced out of service in Gaza City

Over recent weeks, Gaza City has seen seven more health facilities forced to suspend or shut down operations — a troubling development amidst a broader deterioration of medical infrastructure that has been underway since the war’s escalation in October 2023. The closure of these facilities compounds an already dire humanitarian crisis, raising urgent questions about access to care, international law, and what the world must do to prevent a further unraveling of health services in Gaza.

What We Know: The Latest Closures & Immediate Causes

The most recent reports indicate that several hospitals, clinics, and medical points in Gaza City have been forced out of service due to a combination of:

• Damage from bombardment — direct attacks or shelling nearby have damaged infrastructure, made access too dangerous, disabled critical power supplies.

• Evacuation orders and displacement — medical facilities located in areas that the Israeli military has ordered cleared or that have come under threat have had to evacuate patients and staff, halting operations.

• Fuel shortages and lack of essential supplies — without fuel, generators and oxygen plants shut down, meaning that even if buildings remain standing, services become impossible.

While the specific names of all seven facilities in the most recent wave are still being confirmed, similar closures have included major facilities like Al‑Rantissi Children’s Hospital (crucial paediatric services), the Eye Hospital, and the destruction of a six‑story health facility in the Samer area operated by the Palestinian Medical Relief Society. 

These are not isolated incidents. The closures follow a pattern documented in multiple reports: health centres and clinics are suspended when their areas are declared evacuation zones or when they come under fire.

The Broader Landscape: How Gaza’s Health System Got Here

To understand the gravity of these six or seven additional closures, one must see them in the context of longer‑term systemic breakdown:

1. Widespread damage and destruction
   According to assessments (including from the UN, WHO, the World Bank, and other agencies), hundreds of health facilities have been partially or totally destroyed in Gaza. In one report, over 720 health facilities were damaged, and more than 70% of Gaza’s health facilities have ceased operations for extended periods. 

2. Severe shortages of fuel, power, water, medicines, and staff
   Even when infrastructure is intact, the ability to deliver medical care depends on electricity (for lighting, cooling, life‑support equipment), clean water, and supplies. Many hospitals are operating on limited or no fuel. Oxygen plants have shut down; medicine stocks are depleted. 

3. Evacuation orders, forced displacement, insecurity
   New evacuation zones, orders to leave certain neighbourhoods, and the intensification of hostilities have rendered many health facilities non‑functional or unsafe. This forces patients and medical staff to flee, abandoning critical care and creating gaps in the network of services available. 

4. Overwhelmed remaining facilities
   As more clinics and hospitals close, the remaining ones are overwhelmed by caseloads, lacking capacity. The few that are still operational struggle with the influx of trauma patients, displaced people, and exacerbated chronic conditions. Continuity of care is severely compromised. 

Human Cost: What This Means for Civilians

The closure of each health facility carries a heavy toll:

• Delayed or denied access to care
  Emergencies — births, trauma, surgeries — cannot wait. When hospitals or clinics shut down, people often must travel farther, through dangerous territory, or may be unable to reach care at all.

• Increased mortality and morbidity
  Lack of oxygen, inability to handle infectious disease outbreaks, or delays in treating injuries lead to preventable deaths. Already, some reports estimate thousands of life‑altering injuries due to delayed operations, amputations, infections. 

• Suffering from chronic diseases worsened
  Cancer, dialysis, chronic NCDs (non‑communicable diseases) require regular treatment. Disruptions mean disease progression, complications, decline in quality of life.

• Psychological and social impacts
  Loss of health facilities compounds trauma, erodes trust, increases anxiety—especially among the most vulnerable: children, elderly, pregnant women. Displacement means family members separated from care.

• Public health risks
  Closure of facilities also disrupts vaccination, maternal and child health programmes, infection control, waste disposal, water sanitation – leading to outbreaks of diarrhoeal disease, respiratory infections, etc. Some reports already note a rise in infectious disease and malnutrition, especially among displaced and food insecure populations. 

Legal, Ethical & Policy Dimensions

The forced closure of medical facilities in conflict zones isn’t just a humanitarian issue — it implicates international humanitarian law, human rights, and ethical norms.

• Protection under the Geneva Conventions
  Hospitals, medical workers, and patients are supposed to be protected under international law, including prohibitions against targeting medical facilities except in exceptional circumstances and with precautions. The systematic disabling of health infrastructure raises serious potential violations.

• Principle of proportionality and distinction
  Where there are claims of military necessity or that medical sites are being used for non‑medical purposes, independent investigation is essential. Even then, international law requires minimization of harm to civilians.

• Obligations of occupation
  Given the de facto occupation/responsibility structures, there is an obligation to ensure access to health services, protect medical staff, allow humanitarian aid, fuel, supplies.

• Moral responsibility of international actors
  Aid donors, international organizations, states must ensure safe passage for medical supplies, fuel, enable medical evacuations, and press for protection of medical facilities and personnel.

Why Seven More Closures Matter: Ripple Effects & Thresholds

Each closure eats away at what little remains. Some ways these recent closures contribute to cascading failure:

• Compounding of shortages: When one hospital closes, pressure increases on neighboring facilities already stretched. More patients, more cases, especially emergencies.

• Geographic isolation: Some areas of Gaza are increasingly cut off. Closure of a clinic in one neighbourhood may leave an entire population without reasonable access.

• Breakdown in referral chains: Health systems have levels — primary care, clinics, hospitals, specialist centres. If primary care points shut down, conditions worsen earlier; if specialist hospitals close, no place to send complicated cases.

• Psychological message of collapse: Repeated closures undermine morale among staff and civilians, may provoke further displacement, erode social fabric.

• Aid delivery challenges increase: With fewer facilities, fewer stable locations for NGOs and international actors to partner with — also makes logistics, security, and coordination more complex.

Underlying Constraints That Hamper Response

Even well-intentioned relief efforts face steep obstacles:

1. Access and Safety
   Many roads are blocked, bombing or shelling continues, evacuation zones declared. Facilities or rescue routes are exposed to fire. Medical staff often risk their lives.

2. Fuel & Power
   Hospitals are energy‑intensive: ICU equipment, ventilators, oxygen plants, cold chain for medicines/vaccines, water pumping. Without fuel, generator failure means near‑catastrophic loss of function.

3. Supply Chains & Border Closures
   Restrictions on crossings (for goods, fuel, medicines), damaged infrastructure, and disrupted coordination mean that supplies arrive late or not at all.

4. Human Resources
   Deaths, injuries, flight, stress among health workers reduce available manpower. Supporting survivors, ensuring safe working conditions is difficult when facilities are being bombed or evacuated.

5. Coordination among NGOs, UN agencies, local authorities
   In chaotic conflict settings, there are gaps in communication, duplication, or missed needs.

6. Funding
   Reconstruction and restoration require massive resources — both physical repairs and restocking supplies. Reports estimate billions of dollars needed to rehabilitate Gaza’s health sector. 

What Must Be Done: Pathways to Recovery & Mitigation

While the situation is severe, there are several urgent steps and longer‑term strategies that must be pursued in tandem to avert further collapse, save lives, and preserve dignity.

1. Immediate Protections & Cease Operations of Hostilities around Hospitals

   • A firm guarantee, enforced, of safe zones around medical facilities — no shelling, no damage, unimpeded access for patients, staff, supplies.

   • Transparent investigations of any credible reports that medical facilities are being used for military purposes, with independent observers.

2. Humanitarian Corridors & Unhindered Aid Delivery

   • Secure routes for fuel, medicines, oxygen, and essential medical equipment.

   • Cross‑border or multiparty agreements to ensure that border crossings and checkpoints do not unduly hinder medical relief.

3. Mobilization of Emergency Medical Field Capacity

   • Expansion of field hospitals, mobile clinics, emergency medical points in safer or accessible zones.

   • Support for remote or community‑based care where travel is impossible.

4. Support for Health Workers

   • Ensuring safety, psychological support, rest, medical supplies for staff.

   • Training and back‑up support for cases needing specialty care.

5. Rehabilitation & Reconstruction

   • Assessment of damage; prioritization of facilities that serve large populations or are strategically located.

   • Financing for rebuilding, retrofitting for protection (e.g. blast‑resilient infrastructure, safe water and power supply).

6. Long‑term Health System Resilience

   • Strengthening supply chains, diversifying energy sources (solar, etc.) to reduce reliance on insecure fuel delivery.

   • Building redundancy: multiple smaller clinics rather than few centralized ones, to reduce risk from single facility loss.

   • Public health infrastructure: water, sanitation, disease surveillance, vaccination programmes.

7. International Legal and Diplomatic Pressure

   • Use of international bodies (UN, WHO, ICRC) to document violations, put pressure for accountability.

   • Diplomatic engagement to ensure that health care is protected under international law, and that all parties comply.

Conclusion: At the Edge of Collapse — But Not Yet Without Hope

The forced closure of seven more health facilities in Gaza City is neither just a statistic nor an isolated event — it is symptomatic of a health system pushed to the brink. When multiple hospitals, clinics, and medical points go offline, the effects ripple outward, compounding suffering, and eroding what little remains of essential care infrastructure.

Yet, even in adversity, there are glimmers of resilience. Medical workers still going in; NGOs and agencies setting up field hospitals; facilities that manage to partially reopen. The human cost is very high, but so is the capacity for response — if international support, protection, access, and funding can catch up to the scale of the crisis.

If Gaza’s devastated health infrastructure is to be preserved or rebuilt, momentum must shift: from reactive emergency care to sustained protection of health infrastructure, from occasional aid drops to robust supply chains, and from calls for help to enforceable, rights‑based action by the global community.