The Race to Save Premature Babies in Gaza

As Gaza’s biggest hospital complex, Al-Shifa, collapsed from a lack of power, oxygen, and water by Nov. 11, the lives of 39 premature babies hung in the balance after they could no longer receive critical care from incubators.

Soon after, an image began circulating online and grabbed the world’s attention, showing the newborns wrapped in green blankets lying side-by-side on a hospital stretcher. Some weighed less than three pounds, with ribs protruding and diapers too big for their torsos; medical staff tried to keep them warm through skin-to-skin contact, according to news reports.

Within a week, eight babies had died. But help finally arrived on Sunday, Nov. 19, as 31 babies, all critically ill, were evacuated from Al-Shifa to the Emirati hospital near the Rafah border in the south of the Gaza Strip through a joint rescue mission carried out by Palestine Red Crescent and the United Nations.

Read More: What Pregnant Women Face in Gaza

“It was an extremely difficult mission,” Nibal Farsakh, a spokesperson for the Palestine Red Crescent, told TIME in a phone interview. “We needed to urgently evacuate the premature babies as safely as possible because they were on an incubator with no power for a couple of days, and with polluted water in their baby formula that has had side effects on their health.”

The rescued babies, wrapped in aluminum foil to keep their temperatures up, were slowly transported along with six medical staff and 10 family members by six ambulances that made their way through heavy bombardment amid a siege imposed by the Israeli military. The medical vehicles traveled through destroyed neighborhoods and roads before the babies were finally handed over to doctors in Rafah, Farsakh said.

While three babies continue to receive treatment in southern Gaza, the remaining 28 were once again transferred to receive medical treatment at the General Hospital in Arish, Egypt on Monday, Nov. 20. From there, 12 were flown to Cairo for specialist treatment, a World Health Organization (WHO) spokesperson said during a press conference.

The Most Vulnerable of the War

Since November, U.N. agencies have warned that women, children, and newborns in Gaza are disproportionately paying the price of the escalated hostilities during the Israel-Hamas War. Palestinian authorities said on Nov. 19 that the death toll in Gaza has reached 13,000, including over 5,500 children and 3,500 women, since Oct. 7.

Before the rescue operation in al-Shifa, the Palestinian Health Ministry said at least 130 premature babies, and many more newborns, were at risk of dying due to power failures and the lack of any resources. On Monday, WHO told reporters that 21 out of 24 hospitals in Wadi Gaza, or north of the besieged Gaza Strip, are now “entirely dysfunctional” and unable to take any new patients after intensified fighting has seen ambulances under fire, hospitals overwhelmed with a surge of critical patients, and casualties piling on.

“The situation for any premature babies born anywhere on the Gaza Strip is really sort of catastrophic,” says

Toby Fricker, a UNICEF regional representative in Amman, Jordan, who has been working with the team in Gaza.

The number of displaced people in Gaza— some 1.6 million people—includes nearly 800,000 children, according to UNICEF. This means that for children under the age of five, there are “huge risks of potential outbreaks of waterborne diseases and other diseases that would then lead to other catastrophes because these children would not get the child healthcare services they urgently need,” he says. Cases of diarrhea have flared up in recent weeks due to the lack of clean water, and the lack of any vaccination programs means that babies face deadly risks in the event of disease outbreaks.

Read More: Doctors in the U.S. Can’t Be Silent in the Face of What’s Happening in Gaza

The Rush to Identify and Reunite

With the condition of the transported babies finally stable, Fricker says that authorities have been able to pin down their identities. During Monday’s press briefing, WHO confirmed that the three babies remaining in Emirati hospital in Gaza have been reunited with their mothers and are receiving critical care and treatment. But the babies evacuated to Egypt will remain separated from their families, says Farsakh from PRCS, adding that when Israeli forces raided the hospital, “they also forced parents [of some of the babies] inside the hospital to leave.” 

It’s why identifying where any immediate or extended family members has become “urgent and critical,” Farsakh adds. “And it’s happening as we speak.”

In any conflict, UNICEF will usually do so by working with its partners to register any unaccompanied and separated children for identification, and then trace and reunify them with family. “Usually, we work with a cluster of U.N. civil society partners to create, for example, hubs in the hospitals where unaccompanied separated children can be identified and given immediate assistance,” Fricker says. 

But “it's been extremely difficult to do that” inside the Gaza Strip given the current conditions, he says. In some cases, the babies have become orphans during the war. “Many don't even have their parents because they were killed during the bombardment,” says Farsakh.

With Israel and Hamas agreeing to a temporary, four-day ceasefire in the early hours of Wednesday, Nov. 22, Fricker says that humanitarian and medical groups will now focus on caring for babies and children by pushing for more fuel and medical supplies to come into Gaza, improving access to clean water and sanitation, and preparing for what's ahead.

“All these things are urgent—especially since the winter is coming,” he says.