Israel/OPT: Older people in Gaza suffering overlooked health crisis amid Israel’s ongoing blockade of aid and medicines – new research

  • HelpAge International survey reveals toll on physical and mental health of older people
  • Severe shortages of nutritious food, medicine and shelter contributing to inhumane conditions
  • “The rights and needs of older people in Gaza must not be ignored” – Erika Guevara-Rosas

Older people in Gaza are suffering an overlooked physical and mental health crisis amid Israel’s ongoing blockade of aid and essential medicines and the recent ban on humanitarian organizations, new research by HelpAge International and Amnesty International has revealed.

In a health survey by HelpAge International, older people said that food scarcity had caused them to skip meals, including to ensure other family members could eat, while others said they had to ration medications for serious health conditions because of lack of access.

Internally displaced older people also described to Amnesty International how their lack of access to nutritious food, adequate shelter and healthcare was causing extreme harm due to the continuing blockade imposed by Israeli authorities. Interviewees had been displaced multiple times since October 2023.

“During armed conflict, older people’s needs are often overlooked. In Gaza, older people are enduring an unprecedented physical and mental health collapse as a direct result of Israel’s deliberate infliction of conditions of life calculated to bring about the physical destruction of Palestinians in Gaza” said Erika Guevara-Rosas, Amnesty International’s Senior Director of Research, Advocacy, Policy and Campaigns.

“HelpAge International’s survey reveals how Israel’s ongoing unlawful, cruel and inhumane restrictions on the entry of life-saving aid have impacted older people’s ability to access critical healthcare and medications and has limited their access to nutritious food and to adequate shelter.  

“The rights and needs of older people in Gaza must not be ignored. Many continue to endure degrading living conditions and desperate humanitarian situation following the destruction of their homes and repeated displacements. Israeli authorities must immediately and unconditionally lift their blockade, and allow the unhindered entry of essential supplies, including medicine and shelter materials.”

During the winter months, Palestinians in Gaza – most of whom live in dilapidated tents or makeshift shelters – have also had to endure overflowing sewage and floodwaters, and have been exposed to heavy winds. Israel has also suspended the registration of 37 NGOs operating in Gaza and the West Bank as of 1 January. and they have been ordered to cease their operations within 60 days.

HelpAge International’s survey findings

HelpAge International surveyed 416 older people in Gaza, and published its findings in a new report Pushed Beyond Their Limits: The survival of older people in Gaza, today. Amid severe food deprivation and the collapse of essential services, older people face distinct and often overlooked risks. Their needs remain largely invisible. Key findings from the HelpAge International survey include:

  • Older people are living in extreme shelter deprivation: 76% of those surveyed live in tents, which are often severely overcrowded; 84% said their current living conditions harm their health and privacy.
  • Displacement has been constant and destabilizing: 79% have been displaced more than three times since October 2023, disrupting family support and increasing isolation.
  • Health conditions are widespread and largely unmanaged: Despite high prevalence of chronic pain and disease, access to medication is extremely limited, with 42% able to obtain it only “sometimes” and 18% “rarely”. 68% of respondents reduced or stopped treatment due to lack of stock. Overall access to healthcare remains low, with just 17% reporting full healthcare availability, and treatment for chronic conditions identified as the most frequently missed service at 31%.
  • Food insecurity is acute and can be life-threatening: While half of respondents said accessing assistance was easier since the ceasefire, 11% still had eaten no meals in the previous 24 hours; 48% had reduced their own intake to ensure others could eat.
  • Mental health strain is severe and directly affects nutrition: 77% said that sadness, anxiety, loneliness, or insomnia had reduced their appetite and impacted their wellbeing.

“Life has become even more miserable”

These findings were corroborated by Amnesty International’s research, which included interviews with 12 older people from all regions of the occupied Gaza Strip who remain in tents in internally displaced persons (IDP) camps in the Zawayda area, where living conditions are extremely challenging. In most cases, a relative facilitated communication with the older person, many of whom had a disability or needed assistance using a smartphone.

Interviewees said they were forced to stop or ration medications for existing chronic illnesses, which were either unavailable or had increased by three or four times in price. According to the World Health Organization, as of October 2025 fewer than 14 of Gaza’s 36 hospitals were partially functioning, while less than one-third of rehabilitation services were operational, severely limiting older people’s access to care.

Some older people had lost significant amounts of weight, and most relied on community kitchens that did not always provide adequately nutritious food. The terrain in the IDP camps, often uneven and sandy, prevented those who used wheelchairs or walkers from moving freely, rendering them fully dependent on relatives.

Mohammed Bili, 61, has been displaced seven times since October 2023. He requires dialysis three times a week. However, the facility he previously visited has been destroyed, and he now gets dialysis only twice a week for shorter sessions. He struggles to use his wheelchair in the camp’s terrain, and has lost nearly 20kg.

Mohammed Bili, 61, struggles to use his wheelchair in the camp’s terrain.

He told Amnesty International’s researchers: “I struggle with extreme stiffness in my arms and weakness in my muscles due to the fact that I can’t access dialysis as frequently as I need.”

Samira Al-Shawa, 88, had used a walker to move about independently. Now she is living in an IDP camp, where the sandy terrain means she is unable to walk at all. She spends most of her time lying on a makeshift bed in her tent. Charity kitchens provide her family with food, but it is insufficient and lacks adequate nutrition. She has lost about 20kg since October 2023.

Sadiqa Al-Barrawi, aged approximately 90, has been displaced three times since October 2023. She is currently living in a tent in Salam IDP camp with her son, his wife and their four children. While going to use the toilet one night in January 2025, she fell and injured herself, and now cannot stand or walk. She told Amnesty International: “Since then life has become even more miserable.”

Sadiqa has diabetes and high blood pressure. She has lost about 25kg and relies on food from charity kitchens. She added: “We are farmers. At home in the village, we have land and the best fresh food – and now we have nothing.”

Sadiqa Al-Barrawi, aged approximately 90, has been displaced three times since October 2023.

Background

People over 60 make up about 5% of Gaza’s population. According to the Palestinian Ministry of Health, as of early December 2025, 4,813 older people had been killed in Gaza since October 2023, although this figure did not include indirect deaths due to destroyed health infrastructure, for example. According to a report by UNWRA, many older people lose connection to caregivers due to the hostilities or the upheaval of displacement. Amnesty International has documented how older people are at heightened risk in situations of armed conflict, and their humanitarian needs systemically ignored.

In December 2024, Amnesty International concluded that Israel is committing genocide in Gaza, arguing that it had carried out acts prohibited under the Genocide Convention with the specific intent to destroy Palestinians in Gaza, including killings, causing serious bodily or mental harm, and deliberately inflicting on Palestinians in Gaza conditions of life calculated to bring about their physical destruction.

Despite a reduction in scale of attacks since the October 2025 ceasefire agreement, there has been no meaningful change in the conditions Israel is inflicting on Palestinians in Gaza and no evidence to indicate that Israel’s intent to commit genocide has changed.

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Tunisia: Authorities intensify crackdown on Ennahda party leadership in Conspiracy 2 appeal  

The heavy prison sentences imposed on Rached Ghannouchi and four other Ennahda party leaders mark is the latest blow in the Tunisian authorities’ campaign to crush the opposition party ousted from power by President Kais Said in 2021 as part of their broader crackdown on dissent, Amnesty International said today.   

On 2 February, a Tunis appeals court convicted at least 20 individuals including opposition figures handing down prison sentences ranging from three to 35 years in the case known as “Conspiracy against State Security 2”.  

The prison term for Rached Ghanouchi, the 84-year-old former Ennahda leader detained on various charges since April 2023, was increased from 14 to 20 years bringing the total prison terms issued against him in multiple cases to 56 years. The court also upheld 35-year sentences in absentia against former intelligence chief Kamel Guizani, former foreign minister Rafik Abdessalem, Lotfi Zitoun and Mouadh Ghannouchi, Rached Ghannouchi’s son.  

Tunisian authorities should immediately quash the unjust convictions and sentences of all defendants. Authorities must respect and ensure the human rights of everyone and uphold the rule of law in the country.

Sara Hashash, Deputy Regional Director for the Middle East and North Africa at Amnesty International.

“Tunisian authorities should immediately quash the unjust convictions and sentences of all defendants. Authorities must respect and ensure the human rights of everyone and uphold the rule of law in the country.” 

“The multiple persecutions of the members of Ennnahda show how Tunisa’s justice system is being instrumentalized by the authorities to crush all forms of political opposition and silence peaceful dissent.  In Tunisia today, the majority of opposition leaders from different political backgrounds/groups/affiliation are already behind bars. The latest Conspiracy 2 case verdict sends a chilling message: peaceful opposition of the authorities is now punished with decade-long prison sentences,” said Sara Hashash, Deputy Regional Director for the Middle East and North Africa at Amnesty International. 

“In recent years the human rights situation in Tunisia has sharply deteriorated, with authorities escalating their repression against the political opposition, carrying out a systematic purge targeting the Ennahdha party. This travesty of justice and attack on the rule of law must end.”  

Since the dissolution of the Tunisian parliament in March 2022, in which the Ennahda party held a strong majority, leaders, former members of parliament, staff and members of the Ennahdha party have been systematically targeted. Its leaders, volunteers, and grassroots members have faced judicial harassment, arrest, detention and prosecutions in relation to terrorism-related accusations or alleged conspiracies against state security, often without credible evidence. At least 26 Ennahdha party leaders, employees and members are currently detained and being investigated or prosecuted. Many others have left the country.  

The First Instance trial in the Conspiracy 2 case had concluded on 8 July 2025 with mass conviction of 21 out of 24 individuals including senior political leaders from Ennahdha Party like Habib Ellouz, Lotfi Zitoun, former members of parliament, former government and security officials. Sentences ranged from 12 to 35 years. The trial was marred by fair trial violations with defendants held in pre-trial detention compelled to participate in hearings remotely via video link from prison, a measure that according to their lawyers hampered their ability to communicate with legal counsel and engage effectively with the court.  

The Ennahda leaders stand accused of running a covert network led by Ghannouchi aimed at “changing the structure of the state” with the help of former Ministry of Interior official Kamel Ben El Bedoui. The charges were based on allegations of “conspiracy against state security”, largely relying on anonymous witness testimony, intercepted communications, and documents seized during police raids.  

Much of the material consisted of political criticism and private communications critical of President Saied dating back to between 2011 and 2022, but with no concrete evidence of a recognizable offense under international law. The authorities’ central claim that certain opposition politicians operated a clandestine “security apparatus” remains unsubstantiated by any independently verifiable evidence.  

Systematic targeting of Ennahda  

In recent years Tunisian authorities have increasingly turned to counterterrorism laws and state security charges to arbitrarily prosecute and detain opposition figures including leading figures amongst the Ennahdha Party leadership. Courts have conducted mass trials based on insufficient evidence or unfounded accusations, resulting in repeated violations of fair trial guarantees.  

In addition to his most recent sentence in the Conspiracy 2 case, Rached Ghannouchi had already been sentenced in multiple other cases. Since his arrest in April 2023, he has been investigated or prosecuted in at least 11 different cases. In May 2023, Tunisia’s anti-terrorism court sentenced him to a year in prison and a fine in connection with public remarks at a funeral in which he praised the deceased as a “courageous man” who did not fear “a ruler or tyrant”. 

In April 2023, shortly after Rached Ghannouchi’s arrest, security forces shut down all offices of the Ennahda party across the country. 

Mondher Ouinissi who replaced Rached Ghannouchi as head of the party was also arrested and detained a few months later on 7 September 2023 and is being prosecuted in a separate case for conspiracy charges. Ajmi Ouirimi who followed as Secretary General of the party, was also arrested and detained since July 2024. 

Even members and supporters of Ennahda have been targeted. In September 2024, security forces arrested at least 97 people for their activism within Ennahda party groups in different regions, as part of a pre-electoral crackdown ahead of the presidential elections. Most of them were released over the following weeks.  

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Russia: Authorities seeking to use “extremism” laws as pretext to ban leading LGBTI organizations

Reacting to the Russian Ministry of Justice’s move to seek to ban as “extremist” the leading LGBTI organizations in Russia – Russian LGBT Network and the Saint Petersburg-based group Vykhod (Coming Out) – Marie Struthers, Amnesty International’s Eastern Europe and Central Asia Director, said:

“The Russian authorities are once again abusing vague ‘extremism’ laws to criminalize human rights work, erase independent civil society and intimidate people whose identity does not fit a state-approved narrative.”

“This move reflects a deliberate strategy by the Kremlin to legitimize and weaponize homophobia in its assault on dissent and equality, non-discrimination, and human dignity. This cynical policy, conducted under the pretext of ‘protecting traditional values,’ creates enduring rifts in society, stigmatizes entire communities and does real harm to many people.

This move reflects a deliberate strategy by the Kremlin to legitimize and weaponize homophobia in its assault on dissent and equality, non-discrimination, and human dignity

Marie Struthers, Amnesty International’s Eastern Europe and Central Asia Director

“Russia’s authorities must immediately halt their vicious campaign against LGBTI people, end all attempts to undermine, stigmatize and persecute LGBTI organizations and rights activists, and ensure that everyone – regardless of sexual orientation or gender identity – can exercise their rights to freedom of association and expression without fear of discrimination.”

Background

On 2 February, the Joint Press Service of the Courts of Saint Petersburg announced that the Ministry of Justice had filed lawsuits seeking to have the two prominent LGBTI initiatives designated as “extremist organizations” and banned. Saint Petersburg City Court will hear both cases on 24 February. The hearings will be closed to the public as the lawsuit purportedly contains “secret documents.”

In November 2023, Russia’s Supreme Court declared the non-existent “international LGBT movement” as “extremist,” which led to a wave of arrests, detentions and fines of individuals for displaying rainbow flags and other symbols associated with LGBTI rights. In November 2025, the Ministry of Justice’s Samara regional branch filed a lawsuit to declare the local queer initiative Irida “extremist,” following 2024 targeting by authorities of its head Artyom Fokin under “extremist” and “foreign agents” legislation.

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North Korea: People ‘executed for watching South Korean TV’, bribery to escape punishment widespread

  • Escapees tell of brutal system of arbitrary punishments for watching South Korean TV
  • Wealthy can escape harshest penalties by bribing corrupt officials
  • Children ‘forced to watch’ public executions as warning not to consume foreign media

North Koreans caught watching South Korean television shows face public humiliation, years in labour camps or even execution – with the harshest punishments for those too poor to pay bribes, according to testimonies given to Amnesty International.

North Koreans who fled the country have told Amnesty of an arbitrary and corrupt system where secret consumption of South Korean TV is widespread but the penalties for violating vaguely worded “culture” laws banning foreign media are determined largely by wealth and connections.

Many of those interviewed recounted living in constant fear of home raids and arbitrary detention, while some said they were forced to watch public executions as schoolchildren as part of their “ideological education”.

“These testimonies show how North Korea is enforcing dystopian laws that mean watching a South Korean TV show can cost you your life – unless you can afford to pay,” said Sarah Brooks, Amnesty International’s Deputy Regional Director.

“The authorities criminalize access to information in violation of international law, then allow officials to profit off those fearing punishment. This is repression layered with corruption, and it most devastates those without wealth or connections.”

Laws criminalizing freedom of expression

Amnesty International conducted 25 in-depth individual interviews with North Korean escapees in 2025. The group included 11 individuals who fled North Korea between 2019 and 2020, with the most recent departure in June 2020. Most were aged between 15 and 25 at the time of their escape. Covid-19 border closures have made escapes extremely rare since 2020.

North Korea has long maintained one of the world’s most restrictive information environments. Testimonies gathered by Amnesty International describe how accessing foreign culture or information was being actively punished, including by execution, at least before 2020.

The introduction of the 2020 Anti-Reactionary Thought and Culture Act, which defines South Korean content as “rotten ideology that paralyzes the people’s revolutionary sense”, enables these severe punishments to persist. The new law mandates between five and 15 years of forced labour for watching or possessing South Korean dramas, films or music and prescribes heavy sentences including the death penalty for the distribution of “large amounts” of content or for organizing group viewings.

Despite the severe risks, interviewees described a society in which consumption of South Korean and other foreign media are widespread. Dramas and films are commonly smuggled in on USB drives from China, which young North Koreans watch on “notetels” – notebook computers with built-in televisions.

‘People sell their houses to get out of camps’

North Koreans who fled the country between 2012 and 2020 told Amnesty International that people commonly watched South Korean TV knowing that they risked extreme punishment, but also that it was possible to escape the worst penalties if you were able to pay.

“People are caught for the same act, but punishment depends entirely on money,” said Choi Suvin, 39, who left North Korea in 2019. “People without money sell their houses to gather 5,000 or 10,000 USD to pay to get out of the re-education camps.”

Kim Joonsik, 28, was caught watching South Korean dramas three times before leaving the country in 2019, but avoided punishment because his family had connections to officials.

“Usually when high school students are caught, if their family has money, they just get warnings,” he said. “I didn’t receive legal punishment because we had connections.”

But he said three of his sisters’ high school friends received years-long sentences in labour camps in the late 2010s for watching South Korean dramas. Their families could not afford bribes. When Kim’s own sister was arrested, the family paid USD 9,000 to secure her release before the case progressed to formal charges.

The bribes described by Choi and Kim – from between USD 5,000 to 10,000 – represent several years’ worth of income for most North Korean families, making them unreachable for all but the wealthiest.

‘Everyone knows everyone watches’

For decades, North Korea’s government has reportedly deployed a specialized law enforcement unit to crack down on foreign media consumption. Referred to as the “109 Group”, the unit conducts warrantless home and street searches of bags and mobile phones. Fifteen interviewees from different regions mentioned the 109 Group to Amnesty, indicating a nationwide, systematic approach to enforcement of these restrictive laws.

Workers watch it openly, party officials watch it proudly, security agents watch it secretly, and police watch it safely. Everyone knows everyone watches, including those who do the crackdowns.

Kim Gayoung, 32, who left North Korea in 2020

Interviewees said security officials actively solicit bribes from people arrested for consuming foreign media, and from their families. One escapee who had been caught watching foreign media quoted members of the 109 Group telling them: “We don’t want to punish you harshly, but we need to bribe our bosses to save our own lives.”

The arbitrary and discriminatory enforcement of laws is systematic. Officials who most likely consume South Korean media themselves arrest and prosecute others for identical conduct. One interviewee described the open secret: “Workers watch it openly, party officials watch it proudly, security agents watch it secretly, and police watch it safely. Everyone knows everyone watches, including those who do the crackdowns.”

Nonetheless, it appears that periodic crackdowns have temporarily disrupted the usual operation of this system of bribery.Kim Gayoung, 32, who left North Korea in June 2020, described how North Korean leader Kim Jong Un began ordering ‘intensive crackdown’ campaigns in the late 2010s. During these periods, officials faced pressure to demonstrate enforcement results, making bribes less effective even for wealthy or well-connected families.

“My cousin worked at the People’s Committee [the local government administrative body]. He said when someone was caught, no one would help them out. Even with bribes or connections, there was no guarantee of help because the crackdowns had become so severe,” she said.

‘Tens of thousands gathered to watch executions’

Interviewees described how North Korea uses public executions to terrorize entire communities into compliance. Choi Suvin witnessed a public execution in Sinuiju, North Pyongan Province “in 2017 or 2018” of someone accused of distributing foreign media.

“Authorities told everyone to go, and tens of thousands of people from Sinuiju city gathered to watch,” she said. “They execute people to brainwash and educate us.”

People were executed for watching or distributing South Korean media. It’s ideological education: if you watch, this happens to you too.

Kim Eunju, 40, who left North Korea in 2019

Some interviewees described schools systematically forcing students to attend public executions as part of “ideological education”. Executions were carried out by firing squad – in one case witnessed, a squad of 10 people fired approximately 30 rounds at the condemned person. Authorities in some cases placed a substance in victims’ mouths to prevent them from speaking before execution. 

“When we were 16, 17, in middle school, they took us to executions and showed us everything,” said Kim Eunju, 40, who fled in 2019. “People were executed for watching or distributing South Korean media. It’s ideological education: if you watch, this happens to you too.”

An interviewee who left in 2017 described how “all” middle and high schools in Chongjin, North Hamgyong Province, were ordered to watch executions. “The message is: this is what happens [when you watch South Korean shows]. I saw two executions, both times in middle school.”

Schools also serve as sites for public humiliation. Kim Yerim, 26, who escaped in 2019, witnessed 10 high school seniors subjected to hours-long “public criticism” sessions for having watched foreign TV.

“Authorities gathered elementary, middle and high school students to show what happens when you do wrong,” she said. “For several hours, officials from the Youth League and other Party organizations criticized the accused, saying ‘your spirit is corrupted,’ ‘you lack ideological preparedness.’”

Schools conduct regular ideological education sessions on the dangers of foreign media. Kim Gayoung described weekly “ideological education” sessions where “teachers explain the laws and new rules”, while other sessions involve witnessing trials.

A system built on corruption and fear

Amnesty International is calling on the North Korean government to respect and protect freedom of expression, including the right to access information, and urgently repeal all laws that unjustly criminalize access to information, including the 2020 Anti-Reactionary Thought and Culture Act. It must abolish the death penalty for all offences, and as a first step urgently establish an official moratorium on all executions, including public executions. Children, in particular, must be protected from the cruel exposure to public executions.

The government must also end the use of arbitrary detention and cease discriminatory treatment based on wealth or social status. Authorities must ensure equal application of the law and guarantee fair trial rights for all persons accused of crimes in line with international standards.

“This government’s fear of information has effectively placed the entire population in an ideological cage, suffocating their access to the views and thoughts of other human beings. People who strive to learn more about the world outside North Korea, or seek simple entertainment from overseas, face the harshest of punishments,” Sarah Brooks said.

“This completely arbitrary system, built on fear and corruption, violates fundamental principles of justice and internationally recognized human rights. It must be dismantled so that North Koreans can dare to enjoy the freedoms to which they are entitled.”

Background

Covid-19 border closures from 2020 to 2023 largely halted North Koreans leaving the country, with arrivals in South Korea plummeting from 1,047 in 2019 to 224 in 2025. The escape process itself typically takes months to years, during which individuals are at risk of human rights violations and abuses. This traumatic journey means escapees often need time before they can provide testimony. Upon arrival in South Korea, they must complete debriefing by South Korean authorities and resettlement programmes.

While Amnesty International publicly and regularly reports on the resort to public executions in North Korea, along with other alarming practices, due to severe restrictions on access to information the organization has been unable to independently verify the extensive use of the death penalty in North Korea. The adoption of the Reactionary Thought and Culture Law in 2020 signified a codification of some of these harsh penalties.

The experiences shared by escapees who left North Korea before 2020 appear consistent with practices allowed for in North Korean laws and policies of more recent years. They also show internal consistency across different time periods and regions and align with findings from UN agencies, notably the UN Office of the High Commissioner for Human Rights.

Testimonies gathered by Amnesty International in 2025 indicate that the consumption of foreign media was criminalized, prosecuted and punished including by death before the 2020 law came into effect. Testimonies collected in separate research, and in media reports, have also indicated that extrajudicial executions have been carried out without any investigation, trial or sentencing.

However, Amnesty International was unable to determine if other laws were used to convict people in these cases, and which ones, or whether the executions witnessed by interviewees were carried out extrajudicially. Amnesty International opposes the death penalty unconditionally, in any cases and under any circumstances.

North Korea’s laws and practices violate international human rights law, including the International Covenant on Civil and Political Rights, which it ratified in 1981. Systematically forcing children to witness public executions constitutes multiple grave violations and also violates children’s rights under the Convention on the Rights of the Child, which North Korea ratified in 1990. 

Since the 1953 armistice that paused but did not formally end the Korean War, North and South Korea have remained technically at war, with the two countries remaining deeply divided.

Amnesty International wrote to the government of the Democratic People’s Republic of Korea, sharing these research findings and inviting a response to the allegations documented. No response has yet been received.

*All names are pseudonyms to protect interviewees.

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