No Ignoring the Injustice of Gaza: UNRWA Health Department Director Seita Akihiro

People Flood Evacuation Shelters

Seita Akihiro traveled to Gaza from Jordan’s capital Amman, site of the headquarters of UNRWA, the United Nations Relief and Works Agency for Palestine Refugees in the Near East. It was the UNWRA Health Department director’s third time to visit Gaza since the recent hostilities began, and the situation had noticeably deteriorated. To date, Israel has issued no evacuation advisory. A large portion of southern Gaza’s population of 1.8 million people have flocked to the so-called humanitarian zone, which is less than 10% of the total area of Gaza. There is virtually no free space, with tents even erected on sandy beaches along the coast.

According to the Gaza Health Ministry, Gaza has seen more than 40,000 deaths since the start of hostilities in October 2023. UNRWA estimates that 1.9 million people have been displaced, approximately 90% of Gaza’s population.

At UNRWA evacuation shelters, there are an average of 470 people per toilet block and 2,700 people per shower block; they are unable to accept any more people. Evacuation shelters are mainly housed in schools, where women and children are accommodated in classrooms, while men sleep outside in tents.

Even prior to the crisis, there was a lack of functioning infrastructure, but now the flood of evacuees has caused supply shortages, worsening sanitation, exhaustion, and a growing sense of hopelessness about the future.

Medical Supplies Hit Rock-bottom, Sanitation is Deteriorating

“Attacks are impacting the operation of UNRWA facilities,” explains Seita. “As at the end of August, only five of the UNRWA’s twenty-two health centers in Gaza are operational. Since the outbreak of hostilities, UNRWA has established four new clinics, in addition to fifty-four temporary clinics in evacuation shelters. There are many other medical nongovernmental organizations from various countries operating in Gaza, but UNRWA is the primary care body with the largest platform. Although UNRWA has been able to secure primary care doctors to a degree, specialist doctors have evacuated Gaza, creating shortages.”

Humanitarian Situation in Gaza

Note: Figures are current as of the end of September 2024
Source: UNRWA, etc.

UNRWA was established by a United Nations General Assembly Resolution in December 1949, following the First (1948) Arab-Israeli War, to conduct relief works for Palestinian refugees, and began operations in May 1950. It has continued to provide support for this group of refugees for many years, and has features that make it distinctive body even within the UN. It is active is a wide range of areas, including education, health care, and provision of refugee camp infrastructure. Since October 2023, over 200 of its staff have been killed in attacks.

The shortage of medical supplies is particularly critical, says Seita. “When the Israeli army launched its operations in Rafah, southern Gaza, in May, our staff were forced to evacuate, and a large-scale pharmaceutical warehouse belonging to UNRWA was looted. Around half the warehouse’s 4 million dollars’ worth of pharmaceuticals were taken. Since then, only one truckload of medical supplies has reached us, due to factors including import restrictions imposed by Israel and raids by organized gangs. In another month, medical supplies will hit rock-bottom.”

Children being vaccinated against polio on September 2, 2024, in Deir al-Balah, Gaza Strip, State of Palestine. (Courtesy Seita Akihiro)

In August, polio infections were detected among unvaccinated infants in Gaza. It was the first polio outbreak in Gaza in 25 years. On September 1, the United Nations began vaccinating children to prevent the spread of infection. UNRWA posted on X (formerly Twitter) that it must “do everything possible to help all children under 10 years of age receive the vaccination.”

Water and sewage systems are not functional, raising concerns that polio infection will spread from human excrement. Worsening sanitation conditions, due to contamination of underground water by excrement, combined with a lack of soap, shampoo and other hygiene products, is also causing other infectious diseases such as hepatitis A to spread.

Collapse of the Social Fabric a Man-Made Disaster

Gaza is not a land of plenty, but prior to the hostilities, its residents lived in relative peace and safety, Seita explains. “They helped one another in hard times, much like residents in Japanese rural communities: The social fabric provided for mutual support, but this has collapsed with the repeated forced evacuations. Before the conflict, I never saw homeless people in Gaza.”

This current situation is entirely due to the failure of international politics, he goes on. The UN framework is unable to function due to the competing interests of member states. “It is a completely man-made disaster. Neighboring countries have a wealth of resources, but there is no way to obtain them here. The matter could be resolved through diplomacy, but thus far, this has not been possible. Gaza is a microcosm of the injustice of the world.”

According to the UN, 2.1 million people in Gaza require food assistance, but by July, just over 1.1 million had received it.

UN agencies and NGOs are continuing their efforts, but Seita says: “I am ashamed to say we cannot keep up with the rapidly deteriorating situation. The people of Gaza have started to feel abandoned by global society, and the situation is at a crisis point.

UNRWA Health Department director Seita Akihiro (far right) observes the vaccination of children against polio on September 1, 2024, Nuseirat, Gaza. (Courtesy Seita Akihiro)

“I cannot forget the words of a friend of mine who evacuated Rafah: ‘When will the world consider us as human beings?’”

The only response for Seita is that the rest of us must not abandon ongoing support efforts. He expresses his hope that the people of the world will not turn their backs on this injustice.

(Originally published in Japanese. Banner photo: UNRWA Health Department director Seita Akihiro surrounded by children displaying the mark on their fingers that indicates they have been vaccinated against polio on September 3, 2024, Deir al-Balah, Gaza. Courtesy Seita Akihiro.)