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Analysis | The ‘impossible choices’ facing Palestinians in Gaza

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Amid close to three punishing weeks of Israeli airstrikes, a bleak practice has emerged in Gaza. Some parents in the embattled, besieged territory are scrawling the names of their children on the limbs of the little ones. Others are tying makeshift identification bracelets or little colorful pieces of string around their wrists.

There’s a simple, brutal logic: As the Palestinian death toll soars past 7,000 killed, including close to 3,000 children, according to aid agencies, morgues and hospitals are overwhelmed. Muslim clerics have approved mass burials for the unidentified dead, but families hope that clearer markers of identification may prevent that fate for their slain loved ones. “If something happens,” a 40-year-old father told Reuters, “this way I will recognise them.”

It’s unclear when Israel will commence a much-anticipated ground operation into the Gaza Strip as part of its campaign to “eliminate” the Islamist group Hamas, whose grisly Oct. 7 attack on southern Israel marked the single bloodiest day in Israeli history and in the history of the Jewish people since the Holocaust. Israeli officials have made it clear that their current campaign of retribution will irrevocably change the status quo in Gaza, where Hamas has held sway since a 2007 putsch. Invoking the demands of a “mighty vengeance,” Prime Minister Benjamin Netanyahu vowed to lay waste to any part of the territory where Hamas remained entrenched.

The war has plunged the lives of ordinary Palestinians in Gaza into crisis. They have endured 16 years under Israeli blockade, but now find themselves largely without fuel, water, electricity and other basics for survival. Israel unilaterally ordered the evacuation of civilians from northern areas of Gaza for their own safety, but many have died in airstrikes farther to the south.

“When the evacuation routes are bombed, when people north as well as south are caught up in hostilities, when the essentials for survival are lacking, and when there are no assurances for return, people are left with nothing but impossible choices,” Lynn Hastings, the top U.N. humanitarian official for the occupied Palestinian territories, said in a statement, adding that “nowhere is safe in Gaza.”

Some 1.4 million people out of Gaza’s 2.3 million population are now internally displaced. More than 613,000 displaced Gazans are sheltering in 150 facilities operated by the United Nations’ agency for Palestinian refugees, or UNRWA, some of which hold 10 to 12 times more people than their designed capacity. Over the past week, the agency has recorded about 7,000 cases of acute respiratory infections, about 3,000 cases of diarrhea, and hundreds of cases of scabies and lice.

Those conditions are set to grow more dire as fuel stores effectively run out in the territory. With electricity out and backup generators unable to operate without fuel, water pumping and desalination facilities are failing. Many in the territory are drinking dirty or salty water. For many Palestinians in Gaza, when they’re not sheltering from airstrikes, their daily life revolves around lining up for hours in a desperate search for food and safe drinking water.

The humanitarian aid that Israeli authorities have permitted to enter the territory from Egypt is far short of what’s needed. According to analysis by the charity Oxfam, only 2 percent of food supplies normally delivered to Gaza have been allowed in since Oct. 7. “There have been a few trucks that have gotten over the border. That doesn’t mean anything,” Cindy McCain, head of the U.N. World Food Program, told NPR. “We need hundreds of trucks to get across the border to help mitigate what this catastrophe could mean.” She also warned that “there’s going to be disease like nobody’s business unless we get in there.”

On Wednesday, the Palestinian Red Crescent said it will run out of fuel to operate its ambulances before the end of the week. Already, more than a third of Gaza’s hospitals and nearly two-thirds of its primary health-care clinics have shut down, either because of the bombardments or a lack of power. The facilities still operating are doing so under considerable duress, with patients strewn across hallways and critical medical supplies dwindling.

“Theatres are full of wounded people. They have to make very difficult decisions about who they treat because they cannot cope with the sheer number of [wounded] people coming,” Abdelkader Hammad, a British surgeon now sheltering in a U.N. facility, told the BBC. “They are running out of medical equipment.”

See how Israel’s siege has plunged Gaza into darkness and isolation

The options for Gaza’s residents are grim. There’s the daily toil of survival in a rubble-strewn landscape of war, which also includes searches for WiFi signals and phone-charging stations. Families are separating and moving children and relatives to different parts of the territory out of hope that the odds of avoiding airstrikes are better when dispersed. The roads linking Gaza’s north to its south have themselves become death traps, vulnerable to bombings. Many Gaza residents lack the resources to make the journey south or find safe accommodations once they reach it.

The idea of leaving Gaza entirely is all the more fraught: For different reasons, neither Israel nor Egypt is willing to accept hundreds of thousands of refugees. And Palestinians, as well as Arab governments, fear that an exodus from Gaza will mark another loss of land to the Israeli state — another “nakba,” the Arabic term often invoked to describe the “cataclysm” that represented Israel’s founding in 1948 and the expulsion of hundreds of thousands of Palestinians from their native villages.

“An overwhelming majority of those enduring the hellish bombardment in Gaza would accept temporary refuge only if guarantees were provided for their return to their homes in Gaza after the war ends,” wrote Palestinian author and human rights activist Raja Shehadeh. “This determination of Palestinians not to allow Israel to displace them once again also acts as a restraint against a second nakba.”

U.N. officials denounced Hamas’s act of terrorism and called on the group to immediately release the many hostages it abducted and now holds in Gaza. But the atrocities carried out by Hamas do “not justify the ongoing crimes against the civilian population of Gaza, including its 1 million children,” wrote Philippe Lazzarini, UNRWA chief, in a Guardian op-ed.

“Gaza has been described over the last 15 years as a large open-air prison, with an air, sea and land blockade choking 2.2 million people within 365 sq km,” Lazzarini wrote. “Most young people have never left Gaza. Today, this prison is becoming the graveyard of a population trapped between war, siege and deprivation.”

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