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Gaza death toll nears 66,000 as siege starves the north

Crumbling hospitals, blocked convoys, and a UN walkout frame Gaza’s rising death ledger as famine spreads and diplomacy stalls.

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Gaza City — The arithmetic of Gaza’s war is now a ledger of mass death, hunger, and flight. This weekend, the Health Ministry in the enclave said the toll of Palestinians killed since October 2023 had climbed to just under 66,000, a number that would be unthinkable anywhere else and yet, here, arrives with numbing regularity. The count rose after previously unregistered victims were identified and added to the registry, and after another set of bodies was pulled from crushed stairwells and narrow alleys where rescuers say they are too often forced to leave the living to attend to the newly dead.

The figure is not a single moment’s snapshot but a composite of days and weeks in which the Israeli military has kept up aerial, artillery, and ground operations across the Strip, insisting that combatants remain embedded in Gaza City and across the north and center, and that commanders cannot allow fighters to reconstitute. The result, residents say, is a war whose front lines coil through apartment kitchens and school courtyards and makeshift markets, where the soundscape is small drones, low-flying jets, and the metallic scrape of a bulldozer cutting a trench that will soon reroute traffic and aid in equal measure. As Reuters noted, the death toll passed 65,000 this month, a marker that frames the daily increments reported by local authorities.

Hospitals, already beleaguered by siege conditions and recurring evacuations, are again triaging on bare minimums: oxygen rationed, diesel thin, surgical teams operating by phone light when generators stutter. Humanitarian doctors describe a stepwise collapse that stops short of total darkness only because staff refuse to leave. WHO said Gaza’s hospitals are on the brink of collapse, a warning echoed daily by surgeons who count ampoules by touch when the lights fail.

In the north, where repeated evacuation orders and returns have become a rhythm of its own, families speak of “displacement within displacement”—a phrase as common now as the word “ration.” Lines for bread and water scatter with each burst; the line reforms, and someone counts the children again. Aid agencies say the formal deconfliction process has frayed. Convoys stall at checkpoints. Roads can be cut overnight, and when they reopen the route is different, doubling the distance to a clinic already out of sutures. When hospitals empty under threat, the sick move in zigzags, hoping to outrun a war that moves in circles.

Long queue for bread outside a damaged Gaza bakery amid shortages
Residents queue for bread outside a damaged bakery as shortages deepen and lines scatter under intermittent fire [PHOTO: Al-Jazeera].

The new death toll lands against another grim threshold: Famine (IPC Phase 5) confirmed in Gaza Governorate and the steady widening of catastrophic hunger into central districts. Health agencies project over 640,000 facing catastrophic food insecurity by end-September. Humanitarian analysts say the data set is constrained by access; the humanitarian picture, they caution, often lags the reality on the ground by weeks. Aid officials warn that, even if access improves, malnourished children and pregnant women will bear the consequences well after the shelling slows. The geometry of hunger—warehouses empty, bakeries destroyed, water unfit—interlocks with siege and bombardment to produce what relief workers describe as a “system failure,” where every fix depends on another that is missing.

None of these numbers exists in a vacuum. In New York, the war moved back to the rostrum of the United Nations General Assembly, where Israel’s prime minister declared that his country “must finish the job” in Gaza. Dozens of diplomats stood and left as he began, an image that traveled the globe in seconds and set off a familiar argument about optics and substance. Our earlier reporting on delegates walked out of the UN hall captured the moment’s choreography; the speech, framed as defiance in the face of global criticism, repeated the Israeli case that fighters are embedded in civilian areas, that hospitals serve as shields, and that any end short of the complete dismantling of the armed groups would plant the seeds of the next war.

Palestinians watching on crackling television feeds heard a different message: that the airstrikes would continue, that ground units would keep pushing through the same blocks where families have already fled twice, that the siege—flexed or tightened—was the baseline condition rather than the exception. Many pointed to the map the prime minister held up in the hall, a prop for a larger narrative about the region’s alignment, and asked what map could capture a life lived between two evacuation orders and a hospital where the oxygen fails at midnight. According to Reuters, Netanyahu told the UN Israel “must finish the job,” prompting walkouts, and broadcast outlets carried the video of the UN address in full.

In the ruins of Gaza City, residents are learning to read shadows again. They sleep with shoes tied, keep small bags packed with documents and a handful of dates. Parents practice routes with their children: the stairwell that might hold, the corridor that bends away from the window. Phone batteries, more precious than cash in many neighborhoods, are hoarded and shared; a single call to a cousin in Khan Younis can drain a power bank that took a day of waiting to charge. The economy has thinned to micro-markets—boxes of biscuits behind sandbags, sachets of water sold through a hole in a shutter.

For months, Gaza’s health authorities have kept a grim archive: names, ages, districts, the manner and place of death. The ministry’s critics challenge the data for coming from a government under the control of combatants. Yet, over two decades and several wars, the ministry’s methodology has proven broadly consistent and has frequently aligned with later, independent assessments. When officials recently added hundreds of identified victims to the registry, they also noted the tally of those killed while trying to reach humanitarian aid. That number—already in the thousands—tells its own story about scarcity, panic, and the deliberately narrow apertures through which relief is allowed to pass.

Inside Israel, the debate is split between those insisting that overwhelming force is the only language left and those warning that the war’s maximalist aims are unattainable and morally ruinous. For the families of hostages, time is the enemy; each week without a deal is an eternity. For the government, the bargain is the same as it has been since January’s frail ceasefire: a phased exchange, a drawn-down of forces, a mechanism to verify compliance inside an enclave shattered beyond ordinary governance. Hardliners reject that trade as capitulation. Others argue that the strategic price of fighting past diminishing returns is already visible: Israel’s diplomatic stock is down, its economy strained, its moral authority battered by images of children dying in corridors lit by candles.

In Western capitals, patience has thinned. Allies who once spoke of “quiet diplomacy” now couch their statements in blunt terms about civilian protection and proportionality. Recognition of a Palestinian state by several governments has shifted the conversation from whether to when, and accelerated a debate about how to build a transitional authority capable of restoring some semblance of basic services in Gaza without installing a proxy that lacks legitimacy. Across Europe, talk of penalties for settlement expansion and settler violence has moved from the op-ed page to the policymaking committees; in Washington, officials define a red line on annexation even as weapons and spare parts still flow. Corporate signals are part of the backdrop: corporate limits on military AI have entered the debate about accountability and restraint.

On the ground, these global discourses compute to very little. What matters at 6 a.m. on a Saturday is whether a corridor opens for medical evacuations; whether a bakery in Deir al-Balah can run three hours on a donated generator; whether a convoy makes it through the choke points to the battered districts just north of the city. Relief organizations say they are trapped in a cycle of request and denial, submit and wait, with access contingent on local battlefield calculations and the day’s intelligence picture. Even the best-run distributions falter when a single strike collapses a road that took a week to clear.

UN OCHA map showing aid access routes, closures, and denial rates in Gaza
UN OCHA map outlines access corridors, checkpoint bottlenecks, and denial rates to northern Gaza [PHOTO: UN OCHA].
“Deconfliction,” a word that once suggested precision, has drained of meaning. Aid groups transmit coordinates and schedules through established channels, but there are still incidents—some days, many—in which convoys are turned around or come under fire. OCHA’s access updates show high denial and impediment rates, a pattern that has persisted through September; OCHA’s latest sitrep records rising denial rates to northern Gaza as routes open and shut without warning.

Beyond the acute emergency lies the slow violence of dismantled systems. Education has been in suspended animation for months; an entire cohort has learned to run before it learned to read. Municipal workers, unpaid and exhausted, do what they can to clear rubble and restore water lines. Markets reappear in damaged blocks, stocked with whatever surplus a family can part with: a single gas canister, a cracked pot, a pair of shoes one size too small. Cash matters less than fuel and medicine; medicine matters less than a short message confirming a relative is alive.

In interviews across central Gaza, residents describe a war that breaks routines in the morning and restores them by evening, as if people have no choice but to act like life goes on. One widow keeps a log: airstrikes at 4:12 and 5:03; quiet until 7:20; a rumor of a corridor opening at 10; the sound of a bulldozer at 11:30; a child’s fever spiking at noon; the water vendor arriving at 2, late, but arriving. Her handwriting is neat, the day segmented into manageable blocks, a way of bending chaos toward order. Asked where she would go if told to evacuate again, she shrugged. “South,” she said, and then, after a pause, “Then maybe north.”

What remains of Gaza’s civic life survives in pockets: volunteer networks that run food lines, neighborhood committees that keep track of the frail and the elderly, a few journalists who file dispatches through narrow bandwidth and patched routers, a set of doctors who have developed a kind of second sight for when the generator will fail. Faith leaders officiate funerals without graves, promises of formal reburial later; teachers hold five-minute lessons under stairwells, reciting multiplication tables over the thud of artillery.

Israel’s leaders continue to argue that the campaign is precise, that leaflets and messages warn civilians to move, that roof knocks precede strikes when possible, that fighters use schools and hospitals to lay traps. But in neighborhoods smashed into sand and exposed rebar, there is no clean way to separate the living from those who fight among them, at least not without a patience the war has not shown. International lawyers warn that intent is not the only measure; effect matters, too, and effect is visible in the morgue overflow and the hurried burials and the infants who do not survive the night.

The law, like the ledger, is catching up. Cases at international courts grind forward in a world where precedent and politics wrestle in the open. Arrest warrants and genocide allegations can feel abstract to those hunting for bread and water, but they shape the choices of capitals that supply weapons and cover. In the hallways of the UN, diplomats speak of “guardrails,” a word that implies a road and a destination; in Gaza, the road is often a crater, and the destination is wherever the next order tells you to stand. For a fuller picture of the week’s civilian toll amid pressure for a ceasefire-and-hostage deal.

Late on Saturday, as the smoke lifted over parts of Gaza City, a grocer in a battered quarter took stock: three sacks of flour left, two crates of tomatoes starting to spoil, one crate of onions, a few small cans of tuna, and a ledger open to the names of neighbors who will pay later if they can. A woman walked in and asked for three candles and two batteries. He had one candle and no batteries. She bought the candle and a bottle of warm water. On the wall behind the counter, a taped scrap of paper listed phone numbers of a clinic that had moved addresses twice in a week. “They will move again,” the grocer said. He did not sound angry, only certain.

In another quarter, an ambulance driver sat outside a shuttered clinic and watched the sky turn from gray to the hard blue of early autumn. He had slept an hour in the past day, he said, and even that hour was fretful. His partner had lost a cousin in the last strike; they had driven the cousin to the hospital knowing there was nothing to be done. “I have to drive,” he said, tapping the steering wheel. “If I don’t drive, someone will wait and die.” Asked how long he would stay in the job, he looked at the empty street and then at the sky again. “Until there is a road,” he said, “and it is safe to use it.”

For now, Gaza’s numbers define the story: Thousands of killed, many more maimed; neighborhoods turned to geometry problems for engineers who will one day be tasked with rebuilding; a humanitarian system squeezed at every seam; a political horizon that narrows with each strike and each speech. What the numbers cannot capture is the particular: the way a child reads by the light of a phone, or a nurse counts ampoules by touch in the half-dark, or a man writes his name on the wall of a bombed stairwell so his family will know where he fell. Those details, kept on scraps and in memory, will outlast communiqués and podiums. They will inform the next reckoning, and the one after that. According to local media, the Gaza death ledger continued to expand through the weekend as rescue teams retrieved bodies from collapsed homes.

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Arab Desk
Arab Desk
The Eastern Herald’s Arab Desk validates the stories published under this byline. That includes editorials, news stories, letters to the editor, and multimedia features on easternherald.com.

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