The critical situation of the health system in the Gaza Strip has reached the highest levels of the international community. On Friday, December 8, before the United States vetoed a Security Council resolution calling for an "immediate humanitarian ceasefire," United Nations (UN) Secretary-General Antonio Guterres warned against the "constant bombardment by the Israel Defense Forces."

"Amid constant bombardment by the Israel Defense Forces, and without shelter or the essentials to survive, I expect public order to completely break down soon due to the desperate conditions, rendering even limited humanitarian assistance impossible," he wrote in a letter to the Security Council. Philippe Lazzarini, the director of the UNRWA, the UN agency for Palestinian refugees, warned that "UNRWA's ability to continue delivering its mandate in Gaza has now become very limited."

"More than 130 UNRWA colleagues have been killed, most with their families. At least 70% of UNRWA staff have been displaced. Many multiple times. Those who are still working strive to still provide food assistance and health care. They take their children to work so they know they are safe or that if they die, they will die together," he wrote. "In my 35 years of work in complex emergencies, I would never have expected to write such a letter, predicting the killing of my staff and the collapse of the mandate I am expected to fulfill."

A few hours earlier, Mohamed Salha, a doctor, sent a series of messages from one of the rooms at Al-Awda hospital, in the north of the Palestinian territory. He then went to place his iPhone on the rooftop, to find some network via the virtual Spanish SIM card that friends had given him – local telecommunications in the enclave are frequently out of order. "It's very dangerous," he said on Friday morning. "We've been under siege for four days, no one can get in or out of the hospital. Yesterday, a sniper killed one of our colleagues, a nurse, while he was standing at the window. A few days ago, another sniper killed a woman who was accompanying a relative who had come to give birth at the hospital. Her body is still in the street and we can't bring it back."

According to the doctor, more than 250 people – nursing staff, around 40 patients and their families – are gathered in one of the four buildings of the Al-Awda hospital, with barely enough water to last two or three days. "I can't describe how we feel. We have no control over anything," he added. "Al-Awda hospital has been attacked six times, as well as other attacks near our buildings, since the war in Gaza began on October 7." In the afternoon, loud explosions interrupted another voice message from the doctor.

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