Medical evacuations in north Gaza have been halted for over a month, leaving severely injured individuals trapped in damaged hospitals without adequate treatment. The absence of operational intensive care units has led to fatalities among Palestinians injured in Israeli airstrikes and ground attacks.

Patrick Münz, the head of mission in Gaza for the German medical charity Cadus, has pointed out the urgent need for ambulances to gain access to transport the most vulnerable patients for specialised care. “The lack of medical evacuations is costing lives. We urgently need ambulances to reach those who require immediate attention,” Münz stressed.

Hope persists for dozens of patients stabilised in the two functional hospitals in Gaza City. They will be able to survive if they receive treatment in Rafah or beyond Gaza. A collaboration between Cadus and the World Health Organization (WHO) aims to facilitate ambulance access for evacuations in the north, accompanying UN aid convoys delivering food or medical supplies.

Münz stated: “These are critical care patients, but they are stable. Their survival hinges on timely evacuations.”

The Palestinian Red Crescent Society (PRCS) ceased evacuations due to Israeli forces repeatedly attacking, harassing, and detaining staff on medical convoys. Two were killed in an Israeli attack in January while attempting to reach six-year-old Hind Rajab, who was trapped in her family car in Gaza City amid deceased relatives. Hind Rajab’s body was found 12 days later inside the car, whom, according to a Euro-Med investigation, was deliberately killed by Israeli forces.

PRCS accused Israel of intentionally targeting the ambulance despite military approval for the rescue mission. However, Israel refuted the allegation but failed to substantiate its claim.

The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) suspended food convoys in February after one convoy was fired upon by Israeli forces.

Patrick Münz from Cadus acknowledged the fear among team members but emphasised the importance of their mission despite the risks. Cadus has faced obstacles in bringing its own ambulances into Gaza, although lobbying efforts by the UN and the German foreign office are ongoing. Despite the risk, they utilise PRCS vehicles, as these ambulances have been targeted before. Additionally, Cadus is attempting to purchase VW Crafters for conversion. However, the roads, damaged by months of Israeli bombardment, pose additional challenges, necessitating preparedness for breakdowns and carrying extra spare tyres.

Much of the route for evacuations passes through a red zone with active combat. There’s a real possibility of encountering injured individuals along the way. They may not always have the resources or time to stop when their primary mission is to collect patients from hospitals.

Münz highlights the mental toll on the team, as they may encounter mass casualties or seriously injured individuals on the streets due to sniper fire or other factors. Despite these challenges, Patrick Münz hopes the first evacuations will occur this week. The process involves the World Health Organization submitting the names of patients for transfer to the Israeli army, which typically takes two to four days for approval. The evacuation will only be carried out if and when the Israeli military provides a time and route for evacuation.

On Monday, a Cadus team conducted a trial mission, successfully reaching al-Shifa Hospital, one of the two hospitals still functioning at a limited capacity, serving approximately 300,000 people trapped in northern Gaza. This mission marked a critical step towards providing much-needed medical assistance to those in the most desperate circumstances.

Cadus initiated its mission in Gaza in early February by establishing a trauma stabilisation point in the Khan Younis district. Patients from this point are transferred to Rafah, where better-equipped field hospitals are available, and some may be further transferred to Egypt for advanced treatment.

Each team of eight must bring all their own supplies, including food, water, and medical resources. Staff volunteers are warned that they cannot easily change their minds once committed to serving in Gaza. Additionally, obtaining permission from Israeli authorities to exit Gaza back to Israel takes a minimum of eight days.

Meanwhile, Israeli forces have launched attacks on Deir al-Balah in central Gaza, killing at least 12 people and the injuring many more, including children, according to videos and eyewitness accounts.

Humanitarian organisations are continuing their efforts to deliver food aid to the starving Palestinians in Gaza despite Israeli blockade and attacks. Thirteen aid trucks arrived in Jabalia and Gaza City, marking the first convoys to travel from the south to the north of the Gaza Strip without incident in four months.

On the diplomatic front, ceasefire talks could soon resume in Qatar, with an Israeli delegation led by Mossad’s spy chief expected in Doha to discuss Hamas’s proposal for a three-stage plan to end the war. At least 31,553 Palestinians have been killed by Israel in its air and ground assault on Gaza since 7 October, over 12,000 of whom are children. In addition, nearly 74,000 others have been injured in Israeli attacks.