North Gaza’s Neonatal Intensive Care Unit Is In Danger

Northern Gaza is facing a catastrophic collapse in neonatal care after Israel’s latest evacuation order, according to doctors and aid groups. The order affects an estimated 20 to 25,000 people in the Al-Remal and Sabra neighborhoods, which includes the ​​Patient’s Friends Benevolent Society Hospital. It has the only neonatal intensive care unit (NICU) in northern Gaza that receives premature babies.

The evacuation order came from IDF Spokesperson Achivay Adraee’s X account Thursday evening. The post, originally in Arabic, reads: “This is a warning before an attack! Terrorist organizations are firing rockets again from this area. This specific area has been warned several times in the past. For your safety, move immediately to shelters in Gaza City Center.”

“It’s not a game when they throw leaflets or when they announce that there are evacuation orders,” Mahmoud Shalabi, Deputy Director of Programmes at Medical Aid for Palestinians (MAP) told TIME from Gaza City. Shalabi and his family have been internally displaced for more than seventy days.

“[The evacuation order]  is like spreading fire in hay. Everything starts spreading immediately over social media,” Shalabi said. MAP, a private British aid group, has provided assistance with essential staffing and resources to PFBS since August 2024. Its NICU started operations in October, with incubators salvaged from other hospitals – including Kamal Adwan Hospital in Beit Lahia to the north. That facility, which the chief of the World Health Organization says still has 96 patients, remains besieged by Israeli forces operating in the area, and CNN reported that a hospital official said four doctors were among dozens killed around the compound on Friday. Shalabi says some of the half-dozen incubators now at PFBS came—babies included—from Kamal Adwan.

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The only other Gaza City hospital with a NICU, Al-Sahaba hospital, operates under limited capacity, and is only able to offer basic  level one care to infants— those without complex or intensive medical needs. PFBS also provides gynecology, delivery and general surgery services. Many of the patients cannot be moved in their condition. This fall, when the facility began providing life-saving treatment for premature infants in a region where the health care system has been steadily dismantled, patient visits surged, climbing from 7,320 in July to 42,999 by October.

All health care professionals in Gaza, including the five doctors and ten nurses working at the NICU, are at personal risk. As of summer 2024, nearly 500 healthcare workers had been killed in Gaza since the conflict began. On Thursday, Dr. Saeed Jouda, the last orthopedic surgeon in northern Gaza, was killed by an Israeli drone near Kamal Adwan.

“Gaza is very tiny. There aren’t many options left for the health authorities to decide where we want to move [services],” Shalabi says. “ Much of the space has been taken out and has been reduced to smithereens. So there is no place left for people to go.”

The buzz of a drone that Shalabi described as “armed to the teeth” was audible as he spoke to TIME.  ”It has been a constant feature in our lives, you know, drone sounds… but not as intense as what’s happening during this war, not as intense as it is right now.”