Negotiators arrive in Cairo as Israel captures the Rafah crossing

What the Israeli military calls a “limited operation” in Rafah in the southern Gaza Strip has already had devastating consequences for medical workers and patients across the enclave over the past two days, doctors and humanitarian aid groups say.

The Israeli army’s orders to evacuate some 110,000 people from east Rafah on Monday spread fear throughout the Abu Yusuf al-Najjar hospital, which is inside an area Israel said would operate with “greater force,” the hospital’s Dr. Marwan al-Hams. director, said in a telephone interview on Tuesday.

Medical staff in al-Najjar rushed to evacuate more than 200 patients, fearing an attack by Israeli forces, as has been done in hospitals across Gaza. Some patients were left in cars protected by their family members, while the seriously injured were transferred by ambulance to other hospitals in southern Gaza, including the European Hospital in Khan Younis and the International Medical Corps Field Hospital in Rafah.

But even during the struggle to evacuate the hospital, Israeli airstrikes on Rafah continued. Dr. Al-Hams said the bodies of 58 people killed in the Israeli strikes had arrived at the hospital since Sunday, adding that hospital staff should ask the victims’ families to bury the bodies.

“The situation is not critical; The situation is catastrophic, catastrophic, catastrophic,” he said.

The Israeli military’s actions immediately limited access to basic health services throughout Rafah. Project HOPE, a U.S.-based aid group that operates several clinics across Gaza, was forced to close a mobile medical unit inside the area that Israel has told people to leave. It provided primary care in the eastern part of Rafah, treating widespread upper respiratory tract infections and gastrointestinal illnesses among displaced Palestinians confined to shelters with limited access to clean water and sanitation.

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The aid group had to close another medical clinic in Rafah, outside the evacuation zone, early Monday morning because six of its medical staff – including a general practitioner, a gynecologist and nurses – lived inside or immediately adjacent to where the Israeli army was stationed. It said it would begin its operations, said Chessa Latifi, deputy director of emergency preparedness for Project Hope.

Many medical workers have already been displaced from their homes in Khan Younis and Gaza City and were once again forced to leave with their families, including dozens of children – this time, with patients they were treating in East Rafah.

The injured Palestinian woman was taken to a hospital in Rafah on Tuesday.debt…Hatem Khaled/Reuters

At least two delegations of doctors who tried to enter Gaza on Monday were forced to turn back as the security situation worsened, before the Israeli army took control of the Rafah crossing on Tuesday.

A team of Jordanian doctors organized by Project HOPE reached the Kamal Adwan Hospital in northern Gaza, aiming to relieve overstaffed medical staff and deliver badly needed supplies such as anaesthetic, surgical sutures and gauze. The delegation must also pay the salaries of the aid group’s medical staff in Rafah — money they desperately need to secure housing and transportation during the chaotic evacuation.

“We had contingency plans for a very long time, especially as it became more and more clear that the offensive was going to start in Rafah,” Ms Latifi said. But “the consequences of what’s going on continue to grow,” he said.

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Another delegation of medical workers, organized by aid group MedGlobal, was halfway from Cairo to Rafah on Monday when it began receiving warnings. Rafah Crossing may be closed soon, World Health Organization Coordination Committee

The doctors tried to get their way. But when they were told the border crossing was imminent, “most of us realized what was going to happen was going to be significant,” said Dr. John Kahler, co-founder of MedGlobal.

The delegation includes an anesthesiologist and a midwife who is going to support Al-Awda Hospital, which is one of the few hospitals still able to provide maternity care to pregnant women. Dr. Kahler wanted to visit Kamal Adwan, where his organization opened a nutrition stabilization center for malnourished children over the weekend.

Speaking from Cairo on Tuesday, Dr. Kahler described the difficult decision to disband the delegation. If this was the start of a long-threatened ground offensive, he said, even if doctors were able to get through the Rafah crossing on Monday, it would have been too dangerous to travel from Rafah to northern Gaza.

Anxiety levels are “sky-high” among team members inside Gaza and their Palestinian partners as they wait to see what happens next, Dr. Kahler said.

“Babies keep on being born; Injuries persist; People are going to keep dying,” he added.

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