The US-Israeli genocidal war in Gaza hit a grim milestone on Thursday, with the death toll in the territory estimated to now have reached 20,000 people since 7 October.

Gaza endured “some of the most intense Israeli bombardment of the war” on Thursday, according to Reuters, while Palestinian fighters in the territory continued to fire rockets as far north as Tel Aviv.

Four Israeli soldiers were reported killed in Gaza between Wednesday and Thursday, bringing to at least 138 the total number killed since the beginning of the ground invasion, with another 771 reported injured.

Meanwhile, UN-backed famine monitors said that it is predicted that “between 8 December 2023 and 7 February 2024, Gaza’s population will be the highest share of people facing high levels of acute food insecurity ever classified” by the Integrated Food Security Phase Classification since its establishment nearly 20 years ago.

Around one out of every 115 people among Gaza’s population of 2.3 million – more than half of them children, and the vast majority refugees – have been reported killed in the past several weeks.

Morgue workers in Gaza have struggled to compile casualty figures “amid the collapse of communication services and other infrastructure … due to the Israeli offensive,” according to Reuters.

The actual number of fatalities is much higher. The Palestinian health ministry in Gaza’s death toll only includes those who have been identified or claimed by relatives.

Several thousand others are missing, many of them under the rubble of destroyed buildings.

Recovering and identifying those people’s remains will take years, according to Dr. Gilbert Burnham, “a doctor and professor at Johns Hopkins University who has worked since the 1970s on humanitarian health problems in wars,” Reuters reported.

The official Gaza death toll also doesn’t include people who have succumbed to disease borne of Israel’s siege or because they were unable to access medical care for chronic illnesses or other conditions, with most hospitals in the territory rendered non-functional.

US delays Security Council initiative

A wave of secondary mortality is underway while the US – for a third time – delayed a vote at the UN Security Council calling for an increase in humanitarian aid in Gaza.

The spokesperson for Washington’s mission to the UN claimed that the Security Council proposal would “actually slow down delivery of humanitarian aid by directing the UN to create an unworkable monitoring mechanism.”

The US appears to be blocking any initiative to bring necessities into Gaza that isn’t directly controlled by Israel. Human Rights Watch said this week that Israel is using starvation as a weapon of war by deliberately denying civilians access to food and water.

Washington is also concerned over language that comes close to calling for a ceasefire, which the US and Israel says would benefit Hamas.

“How can it be that there are no demands made of the aggressor and only demands made of the victim,” Blinken said, absolving Israel of all responsibility for what independent UN human rights experts and hundreds of scholars of international law say is a genocide unfolding in Gaza.

“Catastrophic levels of acute food insecurity”

White the US continues to buy Israel time for its military offensive, UN officials and international agencies are warning that the cost to civilians grows worse with each day of the total war and complete siege on Gaza.

International agencies are reporting “catastrophic levels of acute food insecurity across the Gaza Strip,” with around 85 percent of the population displaced, many people relocating multiple times “and currently concentrated into an increasingly smaller geographic area.”

The UN-backed Integrated Food Security Phase Classification said that “there is a risk of famine and it is increasing each day that the current situation of intense hostilities and restricted humanitarian access persists or worsens.”

“Virtually all households are skipping meals every day,” the IPC added. Four out of five households in Gaza’s north, and among displaced families in the south, “go entire days and nights without eating.”

The IPC pointed to the extreme reduction in the delivery of humanitarian food assistance to Gaza, which most people in the territory relied on before 7 October, as a primary reason for widespread and severe food insecurity.

Import restrictions and the suspension of commercial activities in Gaza are also major factors, while fighting has caused “widespread damage to food production, including farmland and infrastructure, such as greenhouses, bakeries and warehouses.”

Arif Husain, a senior official at the UN’s World Food Program, told Reuters that in his 20 years of experience, “I’ve never seen something that bad happening this quickly.”

The reopening of Kerem Shalom allowed the agency to bring in aid to Gaza via Jordan for the first time since 7 October. But the aid that is coming in is a fraction of the goods that entered Gaza on a daily basis before that date, and needs have sharply increased.

“Humanitarian aid alone is not enough,” the UN’s largest provider of humanitarian assistance said. “WFP appeals for commercial supply corridors to be restored.”

An explosion on the Palestinian side of Kerem Shalom crossing was reported on Thursday, killing four people staffing the crossing and forcing the UN to halt pickups.

“Toxic mix of disease and hunger”

Abby Maxman, the head of Oxfam America, said that the “high levels of starvation in Gaza are a direct, damning and predictable consequence” of not only Israel’s actions but also US President Joe Biden’s “unconditional support and diplomatic approach.”

“The US cannot continue to stand by and allow Palestinians to be starved to death,” Maxman added.

Philippe Lazzarini, the head of the UN agency for Palestine refugees (UNRWA), said on Wednesday that Palestinians in Gaza will soon “die because of a combination of weakened immunity, disease outbreak and hunger.”

Responding to Israeli President Isaac Herzog’s claim that the UN was to blame for not getting more aid into Gaza, Lazzarini pointed to the ongoing bombardment and inefficient administrative procedures at the crossings.

“When trucks come in, they are not allowed to go to the final destination,” as they are required to offload at the Gaza boundary and their cargo loaded onto trucks that never leave the territory.

“If we would let trucks go into the final destination, you can let trucks come in in the hundreds, and this would not be a problem,” Lazzarini said.

Tedros Adhanom Ghebreyesus, the head of the World Health Organization, said he was “deeply concerned about the toxic mix of disease, hunger and lack of hygiene and sanitation” in Gaza, which is “already experiencing soaring rates of infectious disease outbreaks.”

Ghebreyesus said that diarrhea cases have soared among children under the age of 5, which can “be lethal for malnourished children, more so in the absence of functioning health services.”

“This carnage must stop,” the UN health chief said.

“Concerns of waterborne diseases such as cholera and chronic diarrhea are particularly heightened given the lack of safe water,” UNICEF added, “especially following this week’s rains and flooding.”

Ambulance center under siege

Dr. Munir al-Bursh, the director of the health ministry in Gaza, was injured in an Israeli strike on his sister’s home in Jabaliya refugee camp, northern Gaza, that killed his 13-year-old daughter Janan on Thursday.

There are no fully functioning hospitals in Gaza after Israel systematically besieged and stormed many of them, forcing them out of service.

The humanitarian group called for “the protection and safe evacuation of women and children” still trapped inside the center.

Meanwhile, the health ministry said that hundreds of people had died as a result of the lack of health services at al-Shifa hospital – the largest medical center in Gaza – and other facilities in the north.

Also on Thursday, the ministry refuted an alleged videotaped confession made by Ahmed al-Kahlout, the director of Kamal Adwan hospital, released by Israel earlier in the week.

Al-Kahlout was arrested at the hospital when it was stormed by troops days earlier. Israel claims that al-Kahlout admitted to being a senior figure in the armed wing of Hamas and that the medical facility was used by the group as a command hub.

The health ministry said that al-Kahlout’s videotaped statement was made under duress and that his rank – brigadier general – refers to his position within the medical apparatus of the interior ministry.

The ministry said that the allegedly coerced statement “is a desperate and ridiculous attempt” by Israel to justify its crimes, especially those against Gaza’s health sector, including its fabricated allegations against al-Shifa hospital.

Palestinian human rights groups reported that at least 24 Palestinians from the Abu Muammar family were killed in an Israeli airstrike in an area near the European hospital east of Khan Younis where they were staying after being displaced.

The groups said that another 13 Palestinians were killed in airstrikes targeting homes near the Kuwaiti hospital and next to an UNRWA school where thousands of displaced people are staying.

Al Jazeera broadcast engineer Moaz Mohsen was injured in the strike:

Field executions

The UN human rights office in the occupied Palestinian territories said on Wednesday that it had “received disturbing information” alleging that Israeli troops “summarily killed at least 11 unarmed Palestinian men in front of their family members.”

The apparent war crime occurred on Tuesday evening in the “Annan” or “al-Awda” building in the al-Rimal neighborhood of Gaza City.

The Euro-Med Human Rights Monitor said on Wednesday that an elderly man was taken by troops to an unknown location from the Annan building. The group said that more than two dozen women and children were trapped inside the building, many of them with severe injuries including amputated limbs due to Israeli shelling.

The Geneva-based group said that it had received similar testimonies about atrocities carried out by Israeli ground troops, “including killings and field executions of civilians.”

“According to the testimonies, when Israeli soldiers raid a house, they blow up the gates and start shooting heavily, ignoring all residents’ appeals for help,” Euro-Med Monitor added.

The group said it had “recorded a rise in field executions following reports of attacks on Israeli military vehicles by Palestinian factions.”

This points to an “unlawful retaliatory policy against Palestinian civilians,” according to Euro-Med Monitor.

The group called on the International Committee of the Red Cross to respond to appeals to evacuate casualties in areas where Israeli ground forces are operating.

Euro-Med accused the Red Cross of coordinating the evacuation of casualties in very limited cases and only after hours of delay. The group pointed to the case of Al Jazeera journalist Samer Abu Daqqa, who bled out for hours after being shot by Israeli troops last week.

Abu Daqqa’s “dead body was recovered along with the corpses of three civil defense workers after they were targeted for five hours in Khan Younis,” Euro-Med said.

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