The floor of Al-Awda Hospital in northern Gaza is streaked with fresh blood as 146 injured Palestinians lie there waiting to be treated after people were shot while trying to reach an aid distribution site for food.
The scene Tuesday was the latest in nearly daily violent incidents near aid centres one month after distribution was taken over by the Gaza Humanitarian Foundation (GHF).
The U.S.- and Israeli-backed GHF has drawn controversy since replacing UN-run relief operations in Gaza for using private American contractors and forcing people past Israel Defence Forces soldiers on the perimeter to reach these hubs.
As of Wednesday, 549 people have been killed and more than 4,000 have been injured while attempting to reach GHF sites or waiting for other aid trucks to arrive since the new system began operating on May 27, according to Gaza’s Health Ministry.
“We went to go get food for our children,” Mahmoud Abu Armana, 26, told CBC News Tuesday.
“They said the [road] opened so the vehicles went in and they started to fire upon the people walking. We were running … the [Israeli military] were spraying us down with their guns. People started to lay on top of one another.
“They were supposedly opening the distribution centre and told people to come and grab [the aid]. Why are they executing us?”
Hospital officials say 19 deaths Tuesday resulted from gunfire.
Israel’s military said that a gathering overnight was identified adjacent to forces operating in Gaza’s central Netzarim Corridor, and it was reviewing reports of casualties.
The deaths come as humanitarian groups and UN agencies continue to slam the distribution system, saying it forces people to risk their lives by entering combat zones where they are repeatedly fired upon while trying to access food.
Civilans and health officials in Gaza have largely blamed the deaths on the Israeli military. Multiple people have told CBC News on the ground in Gaza that they have been fired upon by the Israeli forces just several kilometres away from the GHF sites.
Israel’s military has said in connection with several incidents that it fired warning shots at people who approached its forces near aid sites.
Rachael Cummings, a humanitarian director with Save the Children in Gaza, says the lack of trust with locals and the unpredictable nature of the aid distribution since the U.S.-backed Gaza Humanitarian Foundation launched in the territory, has contributed to the violence reported near the sites.
Palestinian gangs have also been blamed by witnesses for some of the violence that erupts near the areas where aid is expected to arrive.
The Red Cross said the “vast majority” of patients who arrived at its Gaza field hospital during mass casualty incidents in the past month had reported that they were wounded while trying to access aid at or around distribution points.
Rachael Cummings, humanitarian director for Save the Children, says the further bloodshed as parents try to scavenge for food for their children is a result of a “dangerous” aid mechanism that is “designed to fail” — pointing at a range of causes including a lack of trust among locals, an inability to reach those most vulnerable and difficulty controlling the chaotic crowds.
Lack of trust on the ground
Cummings said the key to distributing aid in Gaza in a calm, safe and dignified way is the engagement and relationship with the community.
“If people know that there’s a predictable nature around the distribution, that they know today is not my day, but tomorrow will be my day, then [they] can react calmly and again we can facilitate safe and dignified distributions,” Cummings told CBC News on Monday.
The distribution system GHF uses “is not aid, it is not humanitarian, it is not based on need and it doesn’t follow humanitarian principles,” said Cummings. “It’s designed to fail. It’s designed to be dangerous — and that’s exactly what we’re seeing.”
At least 20 people were killed and 200 others wounded in Israeli fire near an aid distribution site in Rafah on Monday, according to medics. The deaths are the latest in mass shootings that have killed at least 300 Palestinians in the past several weeks, Gaza’s Health Ministry says, as they try to access food through the U.S.-backed Gaza Humanitarian Foundation’s distribution system.
Cummings said civilians have complained of unpredictable opening times and amounts of food and no list of people who are eligible for food on that day — resulting in a “survival of the fittest” for people to get their hands on the life-saving assistance.
“People are being forced into making decisions. They’re not choices. They’re forced into making decisions for the survival of their family,” she said, adding that she has seen men carrying knives out of fear of being robbed while walking away with the aid.
In an email to CBC News, a GHF spokesperson denied that its three sites — two in southern Gaza and one in the north — were dangerous, saying it delivered aid in a “secure, controlled, accountable manner — eliminating the risk of diversion.” It added that the group “works daily to establish trust with people on the ground.”
In a report Tuesday, GHF said that it formally raised complaints with the Israeli Defence Forces of “possible harassment” by Israeli soldiers directed at its convoys that were en route to its northern distribution site.
Al-Awda has been treating dozens of wounded in similar incidents last week. The hospital treated more than 60 wounded and received 10 bodies of people who were killed after trying to get aid from the GHF distribution centre in the Netzarim area, Dr. Suleiman Shaheen said last week.
“That is not [a] humanitarian [method] in distributing aid.”
While witness reports and human rights groups say many of the shootings appeared unprovoked and occurred without warning, Israel has said its actions were necessary to control crowds that posed a threat to its troops or to prevent breaches of restricted zones.
WARNING: The following section includes an image of a dead body.
GHF working on ‘maintaining secure corridors’
Since late May, GHF said it has distributed nearly 35,000 boxes of aid across its three distribution sites “without incident.”
“This stands in stark contrast to the United Nations, which sees its sites overrun and its trucks looted by bad actors,” the group said in the email to CBC News Tuesday.
“We are working in partnership with international monitors to maintain secure corridors for civilian movement, minimizing any exposure to violence.”
The group said that its sites were managed by civilian humanitarian teams, which include local Palestinian partners.
“Our aid workers are civilian contractors trained in humanitarian operations, not combatants,” it said in the statement.
The GHF aid system was launched after a complete blockade lasting nearly three months on medical, fuel and food supplies imposed by Israel was lifted in the territory.
The war in Gaza was triggered when Hamas-led militants attacked Israel on Oct.7, 2023, killing 1,200 people and taking 251 hostages, according to Israeli tallies.
Israel’s subsequent air and ground war in Gaza has killed around 56,077 Palestinians, according to Gaza’s Health Ministry, while displacing almost the entire population of more than two million and spreading a hunger crisis.
Ten Palestinians were killed by Israeli tank fire in Gaza on Friday, local health authorities said, as a U.S.- and Israeli-backed group handing out aid in the enclave said all its distribution sites were closed until further notice.
Last week, UNICEF said that the aid distribution system run by GHF was “making a desperate situation worse.”
Outside of the aid distributed by the GHF, Cummings said non-governmental organizations in Gaza are getting “very limited” aid on trucks through border crossings, most of which are stopped and looted after entering.
Despite the limited aid entering, Save the Children has been helping provide clean drinking water for around 20,000 people each day in Gaza, even though there is a largely destroyed water infrastructure.
UNICEF also sounded the alarm last week, saying Gaza is facing a human-caused drought as its water systems collapse, with just 40 per cent of drinking water production facilities remaining functional.
“Without immediate and massively scaled-up access to the basic means of survival, we risk a descent into famine, further chaos and the loss of more lives,” Tom Fletcher, emergency relief co-ordinator with the UN’s Office for the Co-ordination of Humanitarian Affairs (OCHA), said in a statement earlier this month.
“Hunger must never be met with bullets. Humanitarians must be allowed to do their work.”