None of Gaza’s 36 hospitals are functional enough to treat critical trauma cases or perform surgery, the World Health Organization said on Monday, even as the number of people needing urgent medical treatment was rising daily among the enclave’s population of 2.2 million.

Michael Ryan, the W.H.O. executive director, said in a video briefing that most of the hospitals were closed entirely, particularly in Gaza’s northern end, where Israel has focused its ground offensive. Of the 11 medical facilities in the southern part of the Gaza Strip, he said, four were not functional and the rest could provide only basic services, making them more akin to community clinics than major hospitals.

“The scale of injuries, the need for supplies, the inability to move around within the Strip and the inability to do that safely is a huge strain on all of the U.N. community and NGO community to serve the people on the ground,” he said.

Mr. Ryan also spoke of the Indonesian Hospital, which is in the northern part of Gaza and was struck by a deadly explosion on Monday. He said it was unable to receive new patients and its medical staff might soon request evacuation.

The dire conditions for civilians and the high death toll in Gaza has drawn international criticism of Israel’s military response to the terrorist attacks Hamas launched from Gaza on Oct. 7. On Monday, the U.N. chief, António Guterres, who has repeatedly called for a cease-fire, said, “We are witnessing a killing of civilians that is unparalleled and unprecedented in any conflict since I have been secretary-general.” He assumed that post in 2017.

Mr. Ryan, in the W.H.O. briefing, said that the loss of Al-Shifa Hospital, which Israeli forces took over last week, was a major blow, because it has provided cancer, dialysis, trauma and reconstructive surgery, “all of the complicated stuff you would expect of a very high-powered reference center.” Al-Shifa, Gaza’s largest hospital, has been a key part of the enclave’s health care system for 75 years.

Thirty-one premature babies were evacuated Sunday from the hospital, where they had to be removed from incubators because of a lack of fuel. Five others had already died, the U.N. said on Sunday. Twenty-eight were transferred to Egypt on Monday for treatment.

Several hundred thousand civilians remain in northern Gaza, and the conditions there present a major challenge to providing them with urgent medical care, said Rob Holden, W.H.O. senior emergency officer in Gaza, who also spoke by video at the briefing on Monday from the border in Rafah, Egypt.

The areas outside some of the hospitals — including Al-Shifa and Indonesian — were active battlegrounds, Mr. Holden said, and were a major focus of attention. But the struggles of smaller hospitals are also important, he said, because those facilities often serve as the first line of treatment for the sick and injured.

A medical worker tending to injured children at Al-Aqsa Martyrs Hospital in Deir al Balah, Gaza, this month.Credit…Samar Abu Elouf for The New York Times

With the majority of Gaza’s population displaced, Mr. Ryan said, overcrowded shelters are struggling with poor hygiene, malnutrition and the approach of cold weather. The likely spread of disease in those conditions will add to the burden on a health care system already unable to treat new waves of patients.

Even though Israel ordered civilians to evacuate to the south, Mr. Ryan said, southern Gaza was not safe. More than a third of all deaths and injuries from Israeli airstrikes have been recorded in Gaza’s south, he said.

The logistics of evacuating patients from hospitals in the north are nearly impossible, and such operations could place some patients in “huge danger,” Mr. Ryan said, because medical facilities in the south are not equipped to treat them.

“The care of oncology patients, the trauma care, the reconstruction surgery — many of those services are either only available or mainly available in those major hospitals in the north,” Mr. Ryan said.

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