Scale of deaths and injuries in Gaza, attacks on medical infrastructure, and breakdown of the health system during the war and ceasefire period

The ongoing conflict in Gaza has led to a staggering and highly contested toll of civilian casualties, exposing the devastating human cost of the war and the profound collapse of the healthcare system amid relentless violence. Recent reports estimate that over 72,000 Palestinians have been killed since the escalation began, with more than 171,700 wounded. These figures, sourced from the Lancet study and UN reports, are widely believed to be underreported, especially among vulnerable populations such as women, children, and the elderly—who constitute approximately 56% of the fatalities.

The casualty figures are accompanied by an alarming deterioration of Gaza’s medical infrastructure. 94% of medical facilities are damaged or non-operational, leaving hospitals overwhelmed and unable to cope with the surge in casualties. The destruction of hospitals, clinics, and ambulances has severely hampered emergency response efforts, with aid organizations warning that the healthcare system risks total collapse if urgent intervention does not occur. Aid restrictions have worsened the crisis; since Israel announced the closure of all crossings into Gaza and the West Bank—including the crucial Rafah crossing into Egypt—the flow of essential supplies such as medicines, fuel, and medical equipment has been nearly halted. Out of tens of thousands in need, only five patients have been evacuated through Rafah, highlighting the critical barriers to medical evacuation and treatment.

The collapse of medical infrastructure is compounded by shortages of fuel, medicines, and medical supplies, which prevent hospitals from operating generators, maintaining sanitation, or providing adequate care. This has led to conditions conducive to waterborne disease outbreaks like cholera and dysentery, especially as sanitation facilities are damaged or overwhelmed. Recent flooding from winter storms has further contaminated water sources and submerged tents in displacement camps such as al-Taawun, creating hazardous living conditions and increasing health risks for displaced families enduring cold nights and unsafe shelter.

The destruction extends beyond healthcare alone. Power outages and damaged water pipelines have left nearly 100,000 residents without access to clean water, significantly worsening sanitation conditions. The destruction of critical communication infrastructure, including the Al-Wehda Street telecommunications tower, hampers coordination among aid agencies and isolates communities, delaying emergency responses and rescue efforts.

Violence continues unabated, with Israeli military operations targeting infrastructure and security sites. Night drone strikes have killed at least six Palestinians overnight, and reports indicate that Israeli forces have shot over 900 bullets at Gaza medical convoys in 2025—many aid workers have been injured or killed in these attacks. The revocation of NGO licenses, such as those of MSF and other humanitarian groups, early this year has further impeded aid delivery, leaving civilians without essential medical and humanitarian support.

Environmental crises, driven by ongoing hostilities and winter storms, threaten to exacerbate the humanitarian emergency. Flooding and heavy rains have destroyed shelters, contaminated water supplies, and increased the risk of disease outbreaks. Displaced families face freezing temperatures and unsafe living conditions, heightening fears of cholera, respiratory illnesses, and malnutrition spreading rapidly.

International calls for urgent action emphasize the necessity of opening secure, sustained humanitarian corridors—particularly through Rafah—to deliver fuel, water, and medical supplies. Protecting civilians and aid workers, restoring critical infrastructure, and enabling safe evacuations are vital steps to prevent further catastrophe. Diplomatic efforts remain hampered by ongoing restrictions and security concerns, but the global community insists that immediate intervention is essential.

In summary, Gaza is experiencing an unprecedented humanitarian crisis characterized by:

• Mass civilian casualties and a collapsing healthcare system
• Severe shortages of medicines, fuel, and medical supplies
• Destruction of hospitals and medical convoys, with persistent barriers to treatment and evacuation
• Total border closures limiting the flow of aid and evacuations
• Environmental crises due to flooding, sanitation breakdowns, and winter storms
• Continued violence targeting infrastructure and aid operations

Unless urgent, coordinated international efforts are undertaken—focused on opening safe humanitarian corridors, ensuring continuous supplies, and protecting civilians—the region risks further deterioration. Millions face preventable suffering, disease, and death. The window for effective intervention is rapidly closing, and the lives of Gaza’s civilians remain precariously hanging in the balance.