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Twenty trucks carrying humanitarian aid entered Gaza on Sunday – the first delivery of life essentials to the territory since Israel imposed a complete siege 12 days ago.

This came amid growing alarm over the rapidly rising death toll and worsening catastrophe following 15 days of relentless Israeli bombardment of a population totally cut off from supplies of food, water, electricity, medicine and fuel.

On Friday, 100 genocide scholars and Palestinian and international organizations wrote to International Criminal Court prosecutor Karim Khan, calling on him to “urgently issue arrest warrants” for cases related to Palestine already under investigation by his office.

They also call on him to investigate ongoing crimes in Palestine and to issue a preventive statement that warns potential perpetrators of the consequences of their actions – measures Khan has so far failed to take.

Meanwhile, the Israeli military said that it would “deepen” and “increase” airstrikes on Gaza to minimize its losses during “the next stage” of its supposed war on Hamas.

Several UN agencies – the UN Development Program, UN Population Fund, UNICEF, World Food Program and World Health Organization – jointly stated that the 20 trucks of aid that entered Gaza on Saturday “is only a small beginning and far from enough.”

With widespread destruction of civilian infrastructure in Gaza, the agencies said, “time is running out before mortality rates could skyrocket due to disease outbreaks and lack of healthcare capacity.”

The Palestine Red Crescent Society confirmed that its teams received 20 trucks carrying humanitarian aid from UNRWA, the UN agency for Palestine refugees, and its Egyptian counterpart.

Gaza desperately needs fuel

The trucks that entered Gaza on Saturday were not carrying fuel, which is desperately needed to keep hospitals, which are being powered by emergency generators, ambulances and bakeries running.

UN agencies say that both pre-positioned humanitarian supplies and locally secured fuel have run out or are about to run out in Gaza. They are calling for “a humanitarian ceasefire, along with immediate, unrestricted humanitarian access throughout Gaza.”

The lack of fuel leaves “the population without potable water … risking the outbreak of diseases,” the Red Crescent said.

Bushra Khalidi, a representative of the UK-based charity Oxfam in Ramallah, said that nearly half of Gaza is running on generators after Israel cut the supply of electricity, affecting not only hospitals but “water pumping stations, wastewater treatment plants, all of these run on fuel.”

Gaza’s health ministry said that the lack of fuel “means the lives of patients and injured will remain at risk. Gaza hospitals are running out of the basic requirements to pursue medical interventions.”

Medical Aid for Palestinians said on Saturday that doctors in Gaza are urgently warning that “the lives of 130 premature babies are in imminent danger if fuel does not reach hospitals soon.”

Israel could resume the supply of electricity and water to Gaza with the flick of a switch, as Tirana Hassan, the head of Human Rights Watch, said on Saturday.

“Lives are hanging in the balance,” Hassan said.

Enormous mobilization needed

Martin Griffiths, the UN’s humanitarian chief, said that he was “confident that this delivery will be the start of a sustainable effort to provide essential supplies … in a safe, dependable, unconditional and unimpeded manner.”

But it is unclear what the basis of that confidence could be.

Hundreds, perhaps thousands of trucks per day would need to enter Gaza to sufficiently supply its population’s most basic needs, requiring an enormous international mobilization.

Those supplies would then have to be efficiently distributed to a scattered, traumatized population, many of whom are constantly on the move – a perhaps insurmountable challenge in many areas under Israel’s intensifying bombardment and threat of a ground invasion.

US President Joe Biden said that there will be “mechanisms in place” so that aid brought into Gaza via Egypt does not reach Hamas or other “terrorist groups.”

This is an echo of the so-called Gaza Reconstruction Mechanism set up after Israel’s 2014 spasm of killing and destruction in Gaza.

That mechanism effectively turned the United Nations and the Palestinian Authority into enforcers of Israel’s siege on Gaza, imposed since 2007, severely limiting what could be brought in.

Months after it was put in place, Oxfam said that the Gaza Reconstruction Mechanism had had “little or no positive impact on people’s lives so far.”

The group said that the mechanism would “not be enough to meet the huge needs of people in Gaza.” Those words proved to be correct, since the situation in Gaza has remained dire over the last decade with no let up in the Israeli siege.

Oxfam also urged that “donors and the international community must not allow the [Gaza Reconstruction Mechanism] to be a substitute for an end to the blockade.”

That blockade is now tighter than ever.

It is difficult to imagine that any new US-backed “mechanism” would not simply be more of the same: Tighter Israeli control over the lives of people in Gaza, with the complicity and cover of the so-called international community.

Israel says that it will refuse to transfer life essentials via the crossings it directly controls so long as Palestinian armed groups are holding captives in Gaza – a blatant form of collective punishment prohibited under international law.

Israel’s latest measures may well be an attempt by Tel Aviv to permanently shirk its responsibilities, as the occupying power, for the lives and welfare of Palestinians in Gaza, most of whom are refugees from areas that are now in Israel.

“Starvation as a weapon of warfare”

Palestinian organizations have warned that Israel is using “starvation as a weapon of warfare against Gaza’s civilian population,” and that the military’s evacuation order “may amount to the war crime of forcible transfer.”

The 20 trucks that entered Gaza on Saturday represent a small fraction of the average of 450 trucks of aid that entered the territory on a daily basis before 7 October – still under the condition of blockade.

“This is a drop in an ocean of needs,” Tamara Alrifai, an UNRWA representative, told the BBC on Saturday. “What we’re now calling for and what we have been calling for for a few days is to lift the total siege that has been imposed on Gaza for now almost two weeks.”

The International Committee of the Red Cross has affirmed that the Israeli blockade imposed since 2007 constitutes a form of collective punishment illegal under international law.

The blockade, supported by Israel’s allies, was an intensification of Israeli restrictions already in place since the early 1990s. Its goal is to immiserate Gaza’s population so it will disavow armed resistance against Israeli occupation and colonization.

The Palestinian human rights group Al-Haq said on Thursday that Israel’s policy of de-development in Gaza at a minimum constitutes a war crime and “may amount to the crime of genocide.”

On Wednesday, the US vetoed a UN Security Council resolution calling for humanitarian pauses in hostilities so that aid may be safely delivered to and within Gaza. Washington put forward its own bogus “aid” plan that amounts to nothing more than “humanitarian” window dressing for Israel’s genocidal, US-backed bombing campaign.

Arab and some European leaders convened in Cairo on Saturday to push for de-escalation while a ceasefire appears to be nowhere on the horizon.

“The meeting was looking into ways to head off a wider regional war,” Reuters reported. “But three diplomats said it was unlikely there would be a joint statement because of sensitivities around any calls for a ceasefire, and whether to include mention of Hamas’s [7 October] attack and Israel’s right to defend itself.”

On Saturday Israel stepped up warnings to residents in the northern half of Gaza threatening that “no matter where you are,” there will be “significant combat.”

Israeli warplanes dropped leaflets and sent text messages warning residents that remaining in the northern half of Gaza, which includes all of Gaza City, “is putting your lives at risk.”

“Anyone who chooses not to evacuate from the north of the Gaza Strip to the south of the Gaza Strip may be identified as a partner in a terrorist organization,” the warnings add.

Israel appears to be attempting to absolve itself in advance of an even bigger slaughter of civilians.

Anger at UNRWA

Amid rising fears of an imminent Israeli ground invasion, Palestinians in Gaza are accusing UNRWA, the UN agency for Palestine refugees, of abandoning people in the north and acquiescing in Israel’s forced transfer.

Muhammad Shwedih, the director of an UNRWA shelter in the Gaza Strip, told the Arabic news channel Al Mayadeen on Saturday that “UNRWA has abandoned the areas of North Gaza and Gaza City.”

Shwedih said the agency had given an order Friday night to evacuate five UNRWA schools being used as shelters.

“Where will we take the Palestinian refugees and displaced persons who were abandoned by the agency in the northern Gaza Strip and in Gaza City?” Shwedih asked.

He demanded that “UNRWA management take a decision to return to its offices and provide services to refugees and displaced persons.”

Voicing similar sharp criticism on Al Jazeera Arabic on Friday, Shwedih said that evacuation was impossible for thousands seeking shelter, especially young children, pregnant women, elderly and disabled people who already lacked sufficient food, water or means of transport.

He said that he and other UNRWA staff on the ground would remain with the people they were trying to care for and die with them if it came to it.

Hamas said on Saturday that Israel’s continued threats against UNRWA schools and demands to evacuate schools being used as shelters “is a crime added to the series of crimes committed against unarmed and defenseless civilians.”

The group demanded that UNRWA “assume its legal and moral responsibility by rejecting such threats” and “stick to its mandate of supporting and protecting the displaced people.”

UNRWA says that there were nearly 160,000 displaced people sheltering at 57 of its schools in the northern half of Gaza, including Gaza City, before the 12 October evacuation order.

The agency, which reports that 17 of its staff have been killed in Gaza since 7 October, says that it is “no longer able to assist or protect the displaced in those areas and does not have information on their needs and conditions.”

Al Mezan, a Palestinian human rights group based in Gaza, called on the international community, particularly Egypt and UN agencies, to “ensure that the delivery of humanitarian aid and relief will not be conditioned or limited to Gaza’s southern districts.”

Al Mezan also called for “an immediate ceasefire.”

Defense for Children International-Palestine said that Israeli authorities are prohibiting the distribution of humanitarian aid brought into Gaza on Saturday “anywhere in north Gaza.”

The human rights group pointed to statements made by Israeli military leaders declaring their intention to “turn Gaza into a place that is temporarily or permanently impossible to live in” and where “there will only be destruction.”

“Genocide can result from killing or by creating conditions of life that are so unbearable it brings about the group’s destruction,” Defense for Children International-Palestine said.

Ashraf al-Qedra, the spokesperson for Gaza’s health ministry, reiterated on Friday that it was impossible to evacuate the hospitals still operating in the northern half of Gaza, including in Gaza City.

Israel ordered the immediate evacuation of and threatened to bomb al-Quds hospital, run by the Palestine Red Crescent Society, on Friday. Doctors at the hospital, where 12,000 displaced people have sought shelter, have pledged that they would die with their patients rather than abandon them.

“There’s no way to evacuate them safely,” a spokesperson for the Red Crescent said from Ramallah on Friday. “This will put their lives into danger.”

A senior Israeli security official claimed that hospitals in northern Gaza “have turned into military bases” and that Hamas had forced hospital administrations to remain – an apparent effort to preemptively justify another massacre at a Gaza hospital like the killing of hundreds at al-Ahli hospital in Gaza City on Tuesday.

Israel is falsely claiming that Hamas is using all remaining civilians as human shields, again in an apparent attempt to absolve itself of responsibility for wilfully targeting civilian objects and killing civilians.

Palestinian human rights groups have made clear that Israel’s evacuation orders – which many Palestinians have refused and others are unable to follow – do not absolve it of its responsibility to protect civilians and civilian objects.

The World Health Organization said on Wednesday that Israel’s order to evacuate hospitals in the northern half of Gaza has “been impossible to carry out” and called for its reversal.

“International humanitarian law must be abided by, which means health care must be actively protected and never targeted.”

Francesca Albanese, the UN special reporter on the West Bank and Gaza, said on Saturday that the threatened bombing of al-Quds hospital “would be yet another atrocity [that] UN member states have an obligation to prevent.”

Albanese added that Israel’s warning to Gaza City residents that they must leave shelters, including schools, “is not self-defense. This is ethnic cleansing under the fog of war” and she called on the UN secretary-general and others to stop it.

Major developments

Casualties

At least 1,756 Palestinian children have been killed in Gaza since 7 October, with more than 4,000 injured, Defense for Children International-Palestine said on Saturday, citing Gaza’s health ministry.

Overall, according to the health ministry in Gaza, the number of Palestinians killed during the Israeli onslaught is now approaching 4,400, and more than 13,500 people have been injured.

On Friday, the UN office for the coordination of humanitarian affairs reported several Israeli airstrikes resulting in high fatality numbers, including a strike that directly hit the Church of Saint Porphyrius in Gaza City, “killing at least 18 people and trapping dozens under the rubble.”

Ten people were reportedly killed in Israeli airstrikes that hit a home in Deir al-Balah; 21 were reportedly killed in a strike hitting a house east of Khan Younis; and 17 others were reportedly killed in strikes on six houses elsewhere in Khan Younis; and five people were reportedly killed in a strike hitting a tower east of Deir al-Balah.

“The Palestinian Civil Defense estimated that about 1,000 people, including children, are trapped beneath the rubble, some of whom are believed to still be alive,” the UN said on Friday.

“Rescue teams, primarily from the Palestinian Civil Defense, are struggling to carry out their mission, amid continuous airstrikes, severe shortage of fuel to run vehicles and equipment, and with limited or no connection to mobile networks,” the UN added.

As of late Friday, 82 Palestinians, including 25 children, were killed by Israeli forces or settlers in the West Bank since 7 October.

Citing Israeli sources, the UN said that 1,400 people were killed in Israel and more than 4,500 injured, “the vast majority on 7 October.” The UN added that as of 20 October, “the Israeli authorities have released the names of 767 fatalities, whose identity had been confirmed, including 427 civilians, 282 soldiers, and 58 police officers. Among those civilians whose age is provided, 22 are children.”

The Committee to Protect Journalists says that 18 Palestinian journalists have been confirmed killed since 7 October.

Most recently, three journalists who worked for the Hamas-affiliated Al-Aqsa TV were killed between 17 and 20 October, including Issam Bhar, killed in an Israeli airstrike in the northern Gaza Strip; Sameeh al-Nady, killed in an Israeli airstrike on his home in central Gaza; and Khalil Abu Athra, who was killed along with his brother in an Israeli airstrike in Rafah.

Meanwhile, journalist Mohammad Balousha was killed in an Israeli airstrike on the al-Saftawi neighborhood of northern Gaza on 17 October and Mohammed Ali, a journalist from Youth Radio, was killed in an Israeli airstrike in the northern Gaza Strip on 20 October.

The press freedom watchdog has also confirmed the deaths of three Israeli journalists and one Lebanese journalist, the injuries of eight journalists, and the disappearance and detention of three journalists.

The New York-based group says that it has found multiple incidents of “assaults, arrests, threats, cyberattacks, and censorship targeting journalists while carrying out their work in Israel, Gaza, and the West Bank.”

Captives

Abu Obeida, the spokesperson for the Qassam Brigades, the armed wing of Hamas, said that the resistance group had informed its intermediaries in Qatar that it would unconditionally release two of its captives for humanitarian reasons but that “the Israeli occupation government refused to receive them.”

Hamas named the two captives as Nurit Yitzhak and Yocheved Lifshitz and gave their ID numbers.

Israeli Prime Minister Benjamin Netanyahu’s office stated in response that “we will not refer to mendacious propaganda by Hamas. We will continue to do everything necessary to bring all the kidnapped and missing back home.”

However, Israeli military and political leaders have indicated that their priority is the amorphous goal of eliminating Hamas over securing the release of the more than 200 civilians and soldiers taken into Gaza during the 7 October attack.

On Friday, Hamas released two Americans – a mother and her teenage daughter. They are the first of the captives held in Gaza to be released. On Saturday, the group reiterated its intention to release all the civilians it is holding once conditions on the ground allow them to do so.

International human rights groups Human Rights Watch and Amnesty International have called on Hamas and other factions to “immediately and unconditionally release all detained civilians.”

Asked if the US was asking Israel to delay a ground invasion to secure the release of more captives, as media reports suggest, President Joe Biden said on Saturday that “I’m talking to the Israelis” without elaborating.

Foreign passport holders remain unable to leave the Gaza Strip. Antony Blinken, the US secretary of state, said that it was “still holding talks with Egypt and Israel to secure passage out of Gaza into Egypt for an estimated 600 American citizens in the territory,” The New York Times reported.

While national security advisor Jake Sullivan blamed Hamas for stopping US citizens from leaving Gaza via Rafah on 14 October, when Egypt and Israel reportedly agreed to let American exit at a specific time, The New York Times pointed to Egypt.

“Despite Egypt’s public commitments, people familiar with the negotiations say Cairo remains extremely reluctant to allow anyone into its territory from Gaza,” according to the Times. “That in part reflects Egypt’s security concerns about the Sinai Peninsula bordering Gaza, where it has long battled Islamist insurgents.”

Israeli leaders have signaled their intent to push Palestinians from Gaza into Egypt’s Sinai – a move that the US apparently would have backed if it wasn’t opposed by Cairo and Amman.

State of Gaza’s health care system

As of 20 October, 17 hospitals still operational in the northern half of Gaza are under Israeli military evacuation orders.

“These hospitals have not been evacuated yet because doing so would immediately endanger the lives of vulnerable patients,” the UN said. “There is extremely limited capacity and space to transfer them to other hospitals.”

The UN added that hospitals in Gaza are “on the brink of collapse” as the number of patients is at 150 percent of their capacity. “To keep emergency rooms operational, vital procedures such as sterilization and dialysis may soon be halted,” the UN said.

More than 60 percent of Gaza’s primary healthcare facilities have shut down as of 20 October.

“Of particular concern are over 9,000 cancer patients, who depend on chemotherapy treatment for their survival,” the UN said. “The Turkish-Palestinian Friendship Hospital, the only facility in Gaza providing chemotherapy, is struggling to remain operational, relying on a single electricity generator.”

Other patients are missing appointments due to their inability to get to hospitals in Gaza and to their regularly scheduled treatment in hospitals outside of Gaza.

The World Health Organization announced on Saturday that it was moving to transfer medical supplies into Gaza.

“The supplies include trauma medicines and supplies for 1200 people and portable trauma bags for on-the-spot stabilization of up to 235 injured people,” the UN health body said.

“They also include chronic diseases medicines and treatments for 1500 people and basic essential medicines and health supplies for 300,000 people for three months.”

WHO called for “sustained and uninterrupted humanitarian access through the Rafah border crossing.”

Internally displaced persons

UNRWA established the first tent camp for internally displaced persons in Khan Younis, southern Gaza, on 19 October. The camp consists of 60 tents and is hosting hundreds of displaced people, the UN said.

Some people who followed Israel’s evacuation orders have returned to areas in the northern half of Gaza Strip “following the continuous bombardments in the south” and because of “the inability to find reasonable accommodation,” the UN added.

Many of those who have fled or were forced to leave their homes have been repeatedly displaced in the past two weeks.

“In Israel, hundreds of thousands residing in the vicinity of the Gaza Strip, as well as along the border with Lebanon, have fled or been evacuated, with the Israeli authorities providing” for their needs, the UN said.

Ali Abunimah contributed reporting.

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