Around 1 in every 25 Palestinians in Gaza are now injured or dead, Islamic Relief says as Israel’s bombardment continues unabated.

The latest figures show around 89,000 casualties with more than 25,000 people killed and over 63,000 people injured – with many suffering life-changing injuries such as loss of limbs. Most of the casualties are civilians, including many young children. The figures may be even higher as many bodies are still unaccounted for under the rubble.

Many of the injured are being denied acceptable healthcare, with fewer than half of Gaza’s hospitals now even partially functioning. There are reports of doctors having to amputate children’s arms and legs without anaesthetic because of the critical shortage of drugs and medical supplies. Other people have reportedly bled to death in the streets as they were unable to get treatment.

The combination of heavy bombing, disease and hunger means that the death toll will keep rising unless world leaders act to demand an immediate ceasefire and an end to Israel’s siege.

Hundreds of thousands more people are facing starvation, as local means of food production have been destroyed and nowhere near enough food is being allowed into Gaza. Aid workers are reporting desperate children forced to eat leaves or scraps they find in the street.

With 1.7 million people displaced from their homes – most of them now crammed into tiny parts of southern Gaza – the shelters are becoming death traps where disease is quickly spreading. The severely overcrowded conditions and lack of safe water means that cases of diseases such as jaundice, Hepatitis A and diarrhoea have rocketed, especially among young children. The UN has recorded almost a quarter of a million cases of acute respiratory infections, now affecting one in 10 people across Gaza.

Despite this humanitarian catastrophe the amount of aid getting into Gaza has actually decreased again in recent days, with Israel continuing to enforce restrictions on what is and isn’t allowed in. Most supplies to people in northern Gaza are prevented from being delivered. Around 500 trucks every day used to enter Gaza even before the latest destruction – now the needs are vastly greater, but in January only around 100 trucks a day have been entering and the latest daily total fell to just 66 trucks.

Islamic Relief is delivering daily ready-to-eat meals to people in the shelters and has so far distributed more than 1 million meals, as well as other aid such as hygiene kits and psychosocial support for children – but the enormity of the crisis means that much more is needed.

Islamic Relief forced to suspend vital programmes and evacuate staff 

Around 300,000 people have fled the city of Wad Madani in central Sudan as fighting rages in and around the city, and desperate civilians are running out of safe places to go.  

Five days of heavy fighting has forced Islamic Relief and many other aid agencies to temporarily halt humanitarian work there and evacuate some staff out of the city.

Wad Madani has been an oasis of relative calm during the past eight months since war broke out across Sudan, and around half a million people have sought shelter in the city after fleeing violence in other parts of the country. Now they have to flee again.

The city is the capital of Sudan’s Al Jazirah province, a major agricultural region known as the country’s breadbasket. The new fighting there risks worsening Sudan’s already extreme hunger crisis, with more than 20.3 million people across the country already facing acute food insecurity as the war has forced people off their land and stopped farmers from planting. With the capital Khartoum extremely dangerous, Wad Madani has become a hub for aid agencies and the latest fighting will further hamper the aid effort across the country.

Islamic Relief staff remaining in Wad Madani report that intensive fighting has continued throughout today. Other staff fled to the town of Sennar only to find it too was under attack.

Elsadig Elnour, Islamic Relief’s Country Director in Sudan, was in Wad Madani when the fighting broke out: “In Wad Madani Islamic Relief has been providing people with emergency aid and supporting local hospitals with food, fuel and medicine. But we’ve had to suspend our programmes and evacuate some of our staff – especially female staff, as we feared for their safety in the city as sexual violence increases.

“Tens of thousands of people previously fled to Wad Madani believing it was safe. They’re now on the move again – many have fled further south to Sennar, where many people are now sleeping on the streets. Others are going to Gedaref in eastern Sudan.

“The area where people feel safe in our country is shrinking smaller by the day. We fear this fighting will now spread east to Gedaref, which is a hub for the humanitarian response across the country.”

Wad Madani has been under the control of the Sudan Armed Forces (SAF), but the Rapid Support Forces (RSF) now claim to have captured the city. Fighting began last Friday and has intensified since then.

All of Islamic Relief’s staff in Al Jazirah are Sudanese – some of them have now been evacuated to other parts of Sudan, while some of the local staff from Wad Madani have remained in the city. The city’s main bridge and markets are all closed.

Sudan’s conflict, which broke out in April, has so far forced at least 5.4 million people from their homes. 24.8 million people in Sudan are in need of humanitarian aid.

As the official death toll in Gaza passes 20,000, Islamic Relief is warning that the actual toll is likely to be even higher – as thousands of people are still missing and buried under the rubble and young children are increasingly suffering severe hunger and disease.  

To see 20,000 people killed in such a short space of time is a stain on the world’s conscience. The thousands of people killed are not just statistics – they are humanitarian workers, doctors, nurses, teachers, journalists, farmers, shopkeepers, artists, labourers and all sectors of Palestinian society. The vast majority of those killed and injured are civilians, with 40% of them children. Relatives of Islamic Relief staff have also been killed in their homes or as they fled on Israeli orders. 

As a humanitarian organisation Islamic Relief responds to horrific wars and crises all over the world, but we have rarely if ever witnessed killing and destruction at this speed and scale. International law is being wilfully ignored on a daily basis. With the death toll still rising every hour, the UN Security Council must demand an immediate ceasefire. Every further day of delay costs many more lives. Only an immediate and lasting ceasefire can protect civilians and begin to address the catastrophic humanitarian situation.  

More than 10 weeks of relentless Israeli assault has flattened much of Gaza and left civilians desperately searching for food, water, medicine and fuel. Most people are now going whole days without food and most civilians are now suffering severe hunger. Hundreds of thousands of people are crammed into makeshift shelters, and heavy rain and falling temperatures are making conditions even worse as tents have been flooded and children are rapidly becoming sick.   

Despite a small number of aid trucks now entering through Kerem Shalom as well as Rafah, the amount of aid being allowed into Gaza is still a drop in the ocean compared to what is needed. With markets now almost empty, Israel continues to ban commercial trucks from entering. Humanitarian aid alone will not be anywhere near enough to address this crisis and it is essential that crossings are reopened to commercial supplies as well.  

As well as the 20,000 or more killed, over 52,000 people have also been wounded – with many suffering life-changing injuries such as loss of limbs.  

Intense Israeli bombardments and ground attacks are continuing despite mounting global pressure for a ceasefire. In the past few days more hospitals have been besieged and homes, refugee camps and school shelters have been bombed. Telecommunications and internet continue to be cut off in much of Gaza for days at a time, restricting information and making aid delivery even more difficult. There are widespread reports of civilians being detained and abused.  

Places of worship have come under unprecedented attack, with at least 112 mosques and three churches now damaged by bombing – including many that are sheltering families who have been forced from their homes.  

The scale of destruction is staggering with at least 60% of homes and 69% of schools now reportedly damaged or destroyed, and almost 80% of hospitals no longer able to function. The need for a permanent humanitarian ceasefire is greater than ever.