In Rafah I saw new graveyards fill with children. Unimaginable that worse could come

By Guardian - James Elder - Wed 1 May 2024 15.00 BST

The European hospital is crammed with severely injured and dying children – a military offensive here will be catastrophic.

The war against Gaza’s children is forcing many to close their eyes. Nine-year-old Mohamed’s eyes were forced shut, first by the bandages that covered a gaping hole in the back of his head, and second by the coma caused by the blast that hit his family home. He is nine. Sorry, he was nine. Mohamed is now dead.

Over three visits to the European hospital’s ICU in Rafah, Gaza, I saw multiple children occupy the same bed. Each one arriving after a bomb had ripped through their home. Each one dying despite doctors’ immense efforts.

Only a few weeks ago the world was decrying the senseless killing of seven aid workers in a convoy for the World Central Kitchen. It was another grim milestone for Gaza. A week later, a Unicef vehicle was hit, again when trying to reach those in the most desperate need. This week further airstrikes in Rafah have killed more civilian adults and children. But this is Gaza, where outrage over attacks fades amid new emerging tragedies.

From looming famine to soaring death tolls, the latest fear is the much-threatened offensive in Rafah in southern Gaza. Can it get any worse? It always seems to. It has been six months and this war is breaking some of humanity’s darkest records: reports state more than 14,000 children have been killed. But there is no slowing in the fighting’s pace or ferocity. If anything, things are getting worse: with clear promises – threats – that this terrifying trajectory will continue.

Rafah will implode if it is targeted militarily because there are more than 1.4 million civilians already there, suffering dire conditions. Most have had their homes damaged or destroyed. All have had their coping capacity smashed. There is simply nowhere left to go in Gaza.

Water is in desperately short supply, not just for drinking but sanitation. In Rafah there is approximately one toilet for every 850 people. The situation is four times worse for showers. That is, around one shower for every 3,500 people. Try to imagine, as a teenage girl, or elderly man, or pregnant woman, queueing for an entire day just to have a shower.

And a military offensive in Rafah will be catastrophic because it is a city of children – some 600,000 of them.

Rafah is home to what is now Gaza’s largest remaining hospital – the “European hospital”– named as such to honour the European Union that paid for its construction. When I visited in April, a paediatric surgeon, Dr Ghaben, was hunched over another little boy, Mahmmoud. He had massive head trauma from a bomb that had hit his family home. “What did this little boy do?” the doctor asked, a tear forming in his eye. Dr Ghaben was 30 hours into his 36-hour shift. He feared Mahmmoud would be dead by the time he returned for his next shift. He was right.

This is one of many stories from the European hospital, where tens of thousands of civilians desperately seek refuge. New ICUs have been built in a vain attempt to manage the wounded. Why is the European hospital today more important than ever before? Because the health system in Gaza has been systematically destroyed. Today 10 out of Gaza’s 36 hospitals are functioning; and each of those is only partially functioning. And so, at a time when Gaza’s children need medical care like never before, there has never been less available.

On 31 October, Unicef called Gaza a graveyard for children. Last month I saw new graveyards in Rafah being constructed. And filled. Every day the war brings more violent death and destruction. In my 20 years with the United Nations, I have never seen devastation like that I saw in the Gaza Strip cities of Khan Younis and Gaza City. And now we are told to expect the same via an incursion in Rafah.

Upon hearing of the UN security council’s decision to pass a resolution demanding an immediate ceasefire (more than a month ago now), hope filled the faces of those in Rafah. One mother told me: “This may be the first night in months that I can promise my daughter she won’t be killed in the night.” But it took only hours for that hope to be obliterated by bombs.

Gaza needs an immediate and long-lasting humanitarian ceasefire. How many times have we said – indeed, pleaded for – that? And we must see the release of all hostages, safe and unrestricted access for humanitarian relief, and more crossings for that relief.

People in Gaza are stunned that the horrors continue. In the north of the territory, close to where a Unicef vehicle came under fire last month, a woman clutched my hand and pleaded, over and over, that the world send food, water and medicine. I will never forget how, as I felt her grasp, I tried to explain we were trying, and she continued to plead. Why? Because she assumed the world did not know what was happening in Gaza. Because if the world knew, how could they possibly let this happen?

How, indeed.

The world has certainly been warned about Rafah. It remains to be seen how many eyes stay, or are forced, shut.

James Elder is Unicef’s global spokesperson