The human toll of Israel's 'evacuation orders' in Gaza

Gazans repeatedly displaced to
ever-changing 'humanitarian area'

The Israeli army has issued about 60 eviction orders since the start of the war, which has killed more than 41,200 Gazans, health authorities in the enclave have said. The conflict began when a Hamas-led attack on Israel killed 1,200 people.

Israel initially cut off water to Gaza and closed borders that would allow vital aid to enter the enclave. Northern Gaza and Gaza city were bombed as the military prepared for a ground invasion. The first eviction order was issued on October 13, directing residents of Gaza city and northern Gaza to relocate south of the Wadi Gaza River within 24 hours. This order affected more than 1.1 million people and covered about 135 square kilometres, more than a third of the enclave. UN Secretary General Antonio Guterres criticised the move, saying it would lead to “devastating humanitarian consequences”.

By October 16, the army expanded the order to include central Gaza. Throughout October, five such orders were issued, causing mass displacement. By mid-November, eviction orders extended to areas of Khan Younis in the south. On December 1, the army introduced a block system it claimed would “enable the residents of Gaza to orient themselves and to evacuate from specific places for their safety if required".

Fifteen eviction orders were issued in December, the highest monthly total to date. About 31 per cent of the overall orders have affected Gaza city residents, with Khan Younis the second area most affected by Israel's forced displacement.

Gazans were first ordered to travel to Al Mawasi on October 21, with Israel referring to the small strip of land as a "humanitarian area".

The zone now stretches from Deir Al Balah to areas south of Al Mawasi, but its boundaries change frequently, forcing displaced people into increasingly crowded areas.

The Israeli army’s map for these orders, shared on social media, is divided into 615 sections, beginning from area one in Rafah and ending with area 2356 in Deir Al Balah. The areas are inconsistently numbered and the designation of "humanitarian areas" is often unclear or changes unpredictably, making it difficult for Gazans to know what places are supposed to be safe.

The map includes sections 231 to 256, but not 257 to 259. Al Fukhari, an area along the border in south-eastern Khan Younis, is referred to as 260, but numbers 261 to 269 are missing from the map. Area 270, referring to Al Bayuk, is directly beneath Al Fukhari, in south-eastern Rafah.

Gazans have limited access to communications and are unfamiliar with the labelling convention, making the map difficult to read. They also do not believe anywhere to be safe.

“We moved to Al Mawasi, Khan Younis, on the basis that this area is safe but, until now, there has been bombing in Al Mawasi," said Suhaila Hussain, 42, who has been displaced three times since October. "The areas all around us are targeted. Suddenly we’ll feel the tent shake as we’re sitting. Our children and everyone will scream because the sound is so close to us.

“Safety is non-existent in Gaza. There is nowhere safe, nor is there any kind of [truth to the messages] that say certain areas are safe and that we should evacuate to safe areas. These are all lies and rumours – this doesn’t exist in reality.”

From October to December, more than 3.4 million displacements took place in Gaza, the Internal Displacement Monitoring Centre (IDMC) said. But that is likely to be a “big underestimate", regional co-ordinator Clementine Andre added.

“We were reporting on two different figures: the total number of [internally displaced people] and how many times that individual has been forced to move. And by looking at data from shelters, managed by UNRWA, we were able to tell there were at least 3.4 million movements,” she said, adding that data from shelters has since been disrupted by the war.

The IDMC categorises the Israeli orders as “forced displacement”, due to the lack of alternatives for civilians.

“If people are being forced to leave an area due to an imminent threat of bombardment, it’s a forced displacement," Ms Andre said. "Even if it’s coined by the army as an evacuation or relocation, the way we see it is, people didn’t have a choice."

More than 1.9 million people in Gaza have been displaced since October 7, UNRWA reports. The constant upheaval has taken a severe toll on Gazans, especially children, the International Committee of the Red Cross said. "Civilians in Gaza have lived through countless rounds of evacuation orders and the impact this has physically, mentally and emotionally, particularly on children and people who are vulnerable or have been made more vulnerable by this conflict, is catastrophic," said ICRC spokeswoman Sarah Davies.

"People are exhausted," she said. "Some people have been displaced more than 20 times, not just from evacuation orders but because they feel unsafe in certain areas - and there's only so much space in Gaza that people can move around to."

Article 49 of the Geneva Conventions, ratified by Israel in 1951, prohibits forcible displacement unless those affected can return home, as well as having access to essentials while displaced. But most displaced Gazans are unable to return because their homes were destroyed, while they lack consistent access to food, water and shelter.

The Israeli army maintains that it is meeting its legal obligations and accuses Hamas of using civilians as “human shields". An army representative told The National that efforts are made to minimise the risk to civilians and that "evacuations" are communicated through various channels in Arabic.

On September 9, Israel bombed the “safe zone" in Al Mawasi, killing at least 40 people. There have been repeated attacks on the area despite its designation.

Couple whose children were killed in Israeli strike vow never to leave Gaza

On May 5, leaflets fell from the sky ordering hundreds of thousands of residents of eastern Rafah to leave for Al Mawasi.

The order, also distributed on social media and through phone messages, claimed the displacement would be temporary and that Palestinians in the "humanitarian zone" would have access to "field hospitals, tents and increased amounts of food, water, medication and additional supplies", the army added.

But the order never reached Ahmed and Eida Abu Amra.

Two nights later, Israel bombed eastern Rafah, hitting dozens of places, including the Abu Amra home.

The family had eaten dinner and prayed together before going to bed. The couple’s eldest son, Ibrahim, 23, told his mother he would stay up a little longer with his colleague - a barber – in the living room, before going to bed himself.

“I woke up to find fire everywhere,” Ms Abu Amra said. “The fire was higher than the three-storey apartment building next door.

“I didn’t hear or feel anything. I woke up from the heat of the fire, it had reached our bed. My husband and I weren’t in our room. We had been flung out of our house to the area outside [their neighbours'] home and my children were caught in the fire."

Five members of their family were killed: Ibrahim, his wife Israa, 23, and her three-year-old niece, who was staying with them. Two more of Ms Abu Amra’s children, Nancy, 22, and Eid, 17, were also killed.

It would be a few more days before the family could gather the 200 shekels ($53) they needed to travel to Khan Younis.

By May 12, 300,000 people had fled the area, UNRWA officials in Gaza said, adding that the mass displacement was “forced and inhumane”. The Abu Amras were among those who fled, travelling first to Tel Al Sultan in western Rafah, before being displaced again to Qizan Abu Rashwan, in southern Khan Younis. There, the family contended with snakes and scorpions.

“I would have to kill them myself then throw them away while I was on the way to the mosque,” Mr Abu Amra said.

“After that, they told us to evacuate again because the area became a war zone. We didn’t know where to go. We didn’t have money and we had to leave. We sorted ourselves out and we left Abu Rashwan [on July 27] for ‘Fish Fresh’, [an area on the coast of Al Mawasi], which is a dump.”

Initially, the family were told to move on but, after hearing their story, the landowner took pity on them and they were allowed to stay - provided they cleaned the area up.

"It was a dump. It was filled with bugs. We cleaned it for two days, me and my husband and children. while I was sick," Ms Abu Amra said. "We removed all the rubble and dirt and my back was killing me, but we did it so we could stay here."

Their living conditions remain stark - much like hundreds of thousands of Palestinians displaced across Gaza. The family resides in a tent constructed from scraps of corrugated iron and other material. In an effort to makeit more homely, and to protect them from bugs, the family laid pieces of material across the sandy ground.

“There is nowhere safe in Gaza,” Mr Abu Amra said. “We are staying by the sea now, but there is no safety with the ongoing war.”

As the family struggle to adapt to their living conditions, he is determined to avoid further displacement.

"I'm so tired, I can't move anywhere else after this," he said. "We can't get help, and I want to go back to my home, even if it's just to live among the rubble. We don't have money to buy anything and we're struggling to access basic necessities like bathrooms and water. We're also sick and can't get the medicine we need."

Ms Abu Amra also wishes to remain in Gaza, despite their hardships.

“My children were born and raised in Palestine. It’s our country … I want to be buried in Palestinian soil," she stressed. "There’s no way I would leave. Despite all that happened and even if they do worse, we won't go. I will be buried in my country with my children.”

The family’s situation is dire. They have to buy water at two shekels a gallon and they use seawater for washing. Their makeshift kitchen, created from scraps, includes a gas stove, which is used to cook lentils and rice on the day The National visits. Ms Abu Amra suffers from jaundice and has been advised against eating canned goods by a doctor, but they rely on aid agencies for food.

“My son, who was a barber and provided us with money, was killed,” Ms Abu Amra said. “Where do I get money from now?

“Our lives have changed completely. After my children were killed, the world became much darker. We have lost everything. Our lives have been destroyed by this war.”

Teacher regrets leaving her home in Gaza city after year of displacement

Ms Hussain and her family were displaced for the first time on October 13, when they fled their home in Sheikh Radwan after a night of heavy bombing in Gaza city.

“It was a terrifying evening. The glass in our homes shattered and my children and I would move from room to room, trying to protect them,” she said.

Ms Hussain, her husband and their five children, aged 11 to 20, escaped to her parents’ house at dawn, leaving with only a small bag containing essential documents and a few clothes. Ms Hussain hoped to wait out the attack and return home.

“That was my first displacement," she explained. "It was with the understanding that I would return home after things calmed down in an hour or two, or even after a day or two at most.”

The same day, Israel issued its first eviction order, telling all residents in northern Gaza and Gaza city to move to an area near Nuseirat camp, about 12km from Sheikh Radwan. Gazans were told they had 24 hours to leave and Israeli forces conducted raids.

“I started laughing at first because I thought, ‘There’s no way. How can we leave our homes when we are planning to back to our houses?’ They told me that is what we have been told to do,” Ms Hussain said.

She and her extended family of about 50 packed into her brother’s truck and joined hundreds of thousands of Palestinians travelling on the road south, in search of safety.

“The route was congested,” she said. “Everyone [was leaving]. Some were walking, others were passengers, some were carrying their children’s things or couldn’t find a ride to the south. The situation was really bad.”

The family travelled towards Rafah and settled in Baraksat Al Wakala, an area north-west of the enclave's southernmost city. What they expected to be a temporary stay turned into a seven-month struggle.

In early May, Israeli forces began an invasion of Rafah, where hundreds of thousands of civilians were sheltering.

 “There started to be strikes near us and we were told to evacuate to Al Mawasi,” Ms Hussain said.

The family once again grabbed what they could and moved farther north. They travelled to the newly expanded humanitarian area to stay with Ms Hussain’s brother in Al Mawasi.

“We didn’t know where else to go or where to find space," she said. "We’re a large family so we couldn’t all squash together and live in one tent. We had to search for somewhere [to stay] until we found this empty area.”

Ms Hussain now faces daily challenges to survive, with even the simplest tasks – such as providing food for her family - requiring immense effort.

“[Before the war,] we would accomplish a million things in one day, unlike today in our lives in tents," she said. "We spend the whole day to achieve one thing, like maybe to source a loaf of bread for our children, or to wait our turn for water, or queue at the tikieh [charity food kitchen] to collect a plate of food, or get the most basic of essentials needed for life.”

She laments the loss of their lives before the war, when she worked as an Arabic school teacher, and her children had a future. Two of her daughters were at university, one studying nursing and the other engineering, while the rest of her children were in school.

“My son was in his final year of school and now would have been the time that we would celebrate their results, but unfortunately, he has been denied this too," she said. "My children in years eight and six, Malak and Adam, have also been denied their education and finishing the year – just like all other children in Gaza.”

Father of six displaced seven times sees no future for his children in Gaza

Shadi Abu Ataya and his family have been displaced seven times since the war began. Within the first week of the Israeli offensive, his home in Sheikh Radwan was destroyed in a bombing, forcing him to flee to a relative’s house in the same neighbourhood. When that area was threatened, he sought refuge at his parents’ house.

The violence followed him again, when a neighbouring home was bombed, injuring his father, siblings and uncles. "About 15 injuries," said Mr Abu Ataya, 39. "Thank God no one was killed [from my family], but the martyrs were in the [bombed] house and in the streets just outside."

That night, they fled to Al Shifa Hospital, the largest medical complex in the enclave. They enduring extreme shortages of basic supplies for six weeks. “The water was salty- it was seawater,” he said. “Food was scarce and there were serious illnesses because we were at the hospital.”

By mid-November, Israeli forces had completely encircled Al Shifa, placing it under siege. A few days before the army was expected to launch a raid, and with the area around the complex under bombardment, Mr Abu Ataya and his family fled.

Their escape was fraught with danger. “The tanks reached near to us and the bombing would be around Al Shifa," he explained. "The martyrs were around Al Shifa, so we found the situation very difficult.”

They headed south on foot, passing through a newly established Israeli checkpoint between the Netzarim corridor and Kuwait Roundabout on Salah Al Din Road. The family faced tanks as soldiers checked their IDs.

"My brother has a disability, so my other brother had to carry him," Mr Abu Ataya said. "My father has a slipped disc. We left with only the clothes on our backs. Everything else was left behind."

They walked about 14km south to reach Nuseirat camp, where the family spent two months. However, the threat of another raid forced them to move again, this time to Deir Al Balah. Their stay there was also brief as they were soon displaced to Rafah, where they lived for about four months.

The conditions were a little better, but they continued to struggle to find water. "We would carry water by hand," Mr Abu Ataya said. "My young children and my father would help carry it, too. Sometimes we had to drink salty water because there was no other option."

During their time in Rafah, Mr Abu Ataya was confined to his bed for two months because of severe back and leg pain. But when Israeli forces prepared to enter Rafah, the family moved on again, this time to Al Mawasi.

"The journey from Rafah to Khan Younis was under bombardment," he said. "Whatever we managed to gather, we took, and whatever we couldn’t was left behind and is gone.”

His family was lucky to have a truck to help carry their belongings to Al Mawasi, he added.

Mr Abu Ataya and his family found refuge in a camp they set up, receiving donations from residents and charities. But despite the assistance, the conditions were harsh and the family lives in a torn tent with no proper mattress, kitchen or bathroom.

"Life here is hard," Mr Abu Ataya said. "We can’t get anything except through the charities. When we get food from the tikieh, it’s with difficulty. Water is collected with suffering, it’s a journey to go and get the water and come back.”

The family, including Mr Abu Ataya's pregnant wife and six children, struggled to cope with the extreme heat and inadequate shelter. "My children have had allergic reactions, fevers and rashes," he said.

The children, aged from one to 14, have been deeply affected by the war. Their education has been interrupted and Mr Abu Ataya is worried about their future. "I want to take the children abroad so they can finish their education," he said. "Our lives have been completely destroyed and our children have lost their futures entirely."

Displaced woman who lost contact with her husband says nowhere is safe

Eizdehar Hassaballah and her family were forced to flee their home in mid-November after it was bombed.

The 59-year-old, a grandmother to nine, lived in Al Zeitoun area of Gaza city before the war broke out, but has spent months moving from place to place in search of safety.

“The first time [we were displaced], when they struck my house with a drone, I went to our neighbour’s home,” Ms Hassaballah said. “I couldn’t return to my house, so I stayed there for the night. At 4am, they bombed my house. I hadn’t taken anything with me, nothing at all. My children and I spent that night at the neighbour’s and left.”

Ms Hassaballah and her children initially sought refuge at Hesham Attah Al Shawa School, in Al Zeitoun. But as bombings intensified and the death toll mounted, they were forced to leave.

“We stayed there about a month,” she said. “When the bombing increased and the numbers of martyrs increased, and the bodies were at our doors, we were forced to leave.”

They went to Khan Younis, where they sought shelter at Al Amal elementary school for girls, run by UNRWA. “We stayed there about a month. [Israeli forces] started to threaten Khan Younis and told us to evacuate and dropped leaflets, so we were forced to go to Rafah.”

The family stayed in Baraksat Al Wakala for about seven months, but were displaced once more when Rafah and Tel Al Sultan came under threat from attack.

“We then moved to my brother’s house and stayed there while searching for a more permanent place," she said.

Eventually, Ms Hassaballah and her children found a place where they could build a makeshift shelter. “We spent a week pulling together bits and pieces until we turned it into what it is today,” she said. Despite their efforts, the conditions remain dire and the family faces severe hardships. 

“The situation is very bad,” she added. “We suffer from everything. My granddaughters have itching and contagious spots. We suffer from a lack of basic cleaning supplies, so we are forced to keep scrubbing and I don’t sleep at night from how much my hands hurt. Everything is exhausting and filled with hardship.”

The family of 16 share a single tent and one bathroom. “We have to wait our turn to use the bathroom or shower,” she explained. “We only have five cups for tea, so we wait for someone to finish before we can use a cup.

"We suffer from the lack of things. Our tent has no light, no cupboards, and our awning has holes. The sun burns us through the gaps.”

As they left Al Zeitoun, Ms Hassaballah’s husband stayed behind to watch over their home until the family returned.

“The first month, he would call us every so often, but after that we lost communication with him and I don’t know anything about him now, she said. "My daughter’s husband calls every so often – he is in the north too – but we have no breadwinner, so we rely on ourselves for basic things to carry on.”

The family’s difficulties are compounded by the death of Ms Hassaballah’s brothers-in-law in Israeli attacks. One was killed in the bombing of Al Ahli Arab Hospital on October 17. 

“Everywhere we go, there is no safety,” Ms Hassaballah said. “Whenever they tell us to move, there is bombing and more casualties. There is nowhere safe at all.”

She is forced to rely on aid to survive. “We wake up, light the fire and make breakfast,” Ms Hassaballah said. “If we have laundry, we wash it. If we have dishes, we clean them. We teach the girls the Quran to keep up their education. We make do with whatever food we can find, often from the tikieh, and collect bits of plastic and paper to light fires.”

Prolonged conflict and constant displacement fuel mental health crisis

The war has also deeply traumatised generations of Gazans. Dr Samah Jabr, head of the mental health unit at the Palestinian Health Ministry, has worked extensively in Gaza. She told The National that mental health issues were severe before the outbreak of the war.

“They faced significant mental health challenges due to a combination of factors, such as the ongoing blockade, multiple military aggressions, economic hardship, high levels of unemployment, food insecurity and recurrent episodes of violence,” Dr Jabr said.

Long-term exposure to violence has led to widespread anxiety, depression and complex post-traumatic stress disorder. “Children, in particular, have shown symptoms of developmental delays, behavioural issues and emotional difficulties, due to their exposure to violence and instability from a young age,” she added.

A 2022 survey on Palestinian psychological conditions, conducted with the World Bank, found about 70 per cent of Gazans experienced depression. The war has exacerbated this with frequent displacement occurring “under the threat of extermination", Dr Jabr said.

“The immediate effects of displacement include acute stress reactions, severe anxiety, and heightened fear and uncertainty,” she explained. “Individuals may experience grief, fear, flashbacks, nightmares and constant hypervigilance.

"The loss of home, disruption of social networks and uncertainty about the future contribute to a deep sense of insecurity and helplessness. For many, the trauma of displacement is compounded by the grief of losing loved ones, witnessing violence and physical injuries.”

During her work with displaced Gazans, Dr Jabr observed increased stress, depression, detachment and numbness, including occasional “interpersonal violence”.

“Sometimes, the stress and frustration of living in overcrowded, unsafe conditions can lead to aggression and violent behaviour, often directed at the most vulnerable, such as women and children,” she said.

Suicidal thoughts are also more prevalent during such times, with displacement often accompanied by instability and a lack of access to basic supplies.

In September, ACAPS, a non-profit NGO, released a report on the effect of the war on mental health in Gaza. Adults and children expressed a desire to die rather than endure further displacement, violence and deprivation, it found. “This is particularly concerning for children, who are at a critical stage of psychological development and are highly susceptible to the long-term impacts of trauma, as they need stability and daily routine,” Dr Jabr said.

The lack of mental health infrastructure and psychological first aid has prevented people from processing their trauma. “The absence of such services means many Gazans are left to cope with their trauma on their own, worsening symptoms and leading to chronic mental health issues,” Dr Jabr said.

“In the long term, this could result in a generation struggling with untreated trauma, impacting Gaza’s social fabric and future.”

A robust mental health system is vital to address the secondary effects of displacement, such as the breakdown of families, economic hardships, and loss of education opportunities, she added. “This creates a cycle of trauma and poverty that is difficult to break, further entrenching the mental health crisis in Gaza.”

Dr Zaher Sahloul, president of US-based NGO MedGlobal, which operates in Gaza, said displacement also prevented people from having medical treatment. “When you move from place to place, the presence of tents everywhere catches your attention," he said. "Continuous displacement means you are disconnected from healthcare access. If you have a condition or need dialysis, you need to find new healthcare points."

Ms Andre, from the IDMC, warned that, even if the war ended soon, it would take decades for Gazans to recover.

“We can’t compare the situation in Gaza to anywhere else in the world,” she said. “When people return to their communities, they face the trauma of what happened and the loss of family members. Even if you rebuild the walls, the structure is there but it’s not a home any more. It’s going to take decades for people to feel safe or at home again, if they can even secure the funds to rebuild.”