Sky News analysis shows that aid distributions by the Gaza Humanitarian Foundation (GHF) are associated with a significant increase in deaths.

Warning: This article contains descriptions of people being killed and images of blood on a hospital floor.

The US and Israeli-backed group has been primarily responsible for aid distribution since Israel lifted its 11-week blockade of the Gaza Strip last month.

The GHF distributes aid from four militarised Secure Distribution Sites (SDSs) – three of which are in the far south of the Gaza Strip. Under the previous system, the UN had distributed aid through hundreds of sites across the territory.

According to Gaza’s health ministry, 600 Palestinians have been killed while seeking aid from GHF sites, which charities and the UN have branded “death traps”.

The UN put the figure at 410, but has not updated this number since 24 June. Both the UN and health ministry source their figures from hospitals near the aid sites.

Speaking to Sky News, GHF chief Johnnie Moore disputed that these deaths were connected with his organisation’s operations.

“Almost anything that happens in the Gaza Strip is going to take place in proximity to something,” he said.

“Our effort is actually working despite a disinformation campaign, that is very deliberate and meant to shut down our efforts.

“We just want to feed Gazans. That’s the only thing that we want to do.”

However, new analysis by Sky’s Data & Forensics Unit shows that deaths in Gaza have spiked during days with more GHF distributions.

On days when GHF conducts just two distributions or fewer, health officials report an average of 48 deaths and 189 injuries across the Gaza Strip.

On days with five or six GHF distributions, authorities have reported almost three times as many casualties.

Out of 77 distributions at GHF sites between 5 June and 1 July, Sky News found that 23 ended in reports of bloodshed (30%).

At one site, SDS4 in the central Gaza Strip, as many as half of all distributions were followed by reports of fatal shootings.

Sky News spoke to one woman who had been attending SDS4 for 10 days straight.

“I witnessed death first-hand – bodies lay bleeding on the ground all around me,” says Huda.

“This is not right. Food should be delivered to UN warehouses, and this entire operation must be shut down.”

Huda says that the crowds are forced to dodge bombs and bullets “just to get a bag of rice or pasta”.

“You may come back, you may not,” she says. “I was injured by shrapnel in my leg. Despite that, I go back, because we really have nothing in our tent.”

One of the deadliest incidents at SDS4 took place in the early hours of 24 June.

According to eyewitnesses, Israeli forces opened fire as people advanced towards aid trucks carrying food to the site, which was due to open.

“It was a massacre,” said Ahmed Halawa. He said that tanks and drones fired at people “even as we were fleeing”. At least 31 people were killed, according to medics at two nearby hospitals.

Footage from that morning shows the floor of one of the hospitals, al Awda, covered in blood.

The IDF says it is reviewing the incident.

Issues of crowd control

Unnamed soldiers who served near the aid sites told Israeli newspaper Haaretz that they were instructed to use gunfire as a method of crowd control.

An IDF spokesperson told Sky News that it “strongly rejected” the accusations that its forces were instructed to deliberately shoot at civilians.

“To be clear, IDF directives prohibit deliberate attacks on civilians,” the spokesperson said, adding that the incidents are “being examined by the relevant IDF authorities”.

Eyewitness testimony and footage posted to social media suggest that crowd control is a frequent problem at the sites.

The video below, uploaded on 12 June, shows a crowd rushing into SDS1, in Gaza’s far southwest. What sounds like explosions are audible in the background.

Footage from the same site, uploaded on 15 June, shows Palestinians searching for food among hundreds of aid parcels scattered across the ground.

Sam Rose, the director of UNRWA operations in Gaza, describes the distribution process as a “free-for-all”.

“What they’re doing is they’re loading up the boxes on the ground and then people just rush in,” he says.

Sky News has found that the sites typically run out of food within just nine minutes. In a quarter of cases (23%), the food is finished by the time the site was due to officially open.

Confusing communications

Sky News analysis suggests that the issue may be being compounded by poor communications from GHF.

Between 19 June and 1 July, 86% of distributions were announced with less than 30 minutes’ notice. One in five distributions was not announced at all prior to the site opening.

The GHF instructs Palestinians to take particular routes to the aid centres, and to wait at specified locations until the official opening times.

The map for SDS1 instructs Palestinians to take a narrow agricultural lane that no longer exists, while the maps for SDS2 and SDS3 give waiting points that are deep inside IDF-designated combat zones.

The maps do not make the boundaries of combat zones clear or specify when it is safe for Palestinians to enter them.

The same is true for SDS4, the only distribution site outside Gaza’s far south. Its waiting point is located 1.2 miles (2km) inside an IDF combat zone.

The official map also provides no access route from the northern half of Gaza, including Gaza City, across the heavily militarised Netzarim corridor.

“They don’t know what they’re doing,” says UNRWA’s Sam Rose.

“They don’t have anyone working on these operations who has any experience of operating, of administering food distributions because anyone who did have that experience wouldn’t want to be part of it because this isn’t how you treat people.”

Once the sites are officially open, Palestinians are allowed to travel the rest of the way.

The distance from waiting point to aid site is typically over a kilometre, making it difficult for Palestinians to reach the aid site before the food runs out.

The shortest distance is at SDS4 – 689m. At a pace of 4km per hour, this would take around 10 minutes to cover.

But of the 18 distributions at this site which were announced in advance, just two lasted longer than 10 minutes before the food ran out.

“We don’t have time to pick anything up,” says Huda, who has been visiting SDS4 for the past 10 days.

In all that time, she says, all she had managed to take was a small bag of rice.

“I got it from the floor,” she says. “We didn’t get anything else.”

More than 200 charities and non-governmental organisations have called for the closure of GHF and the reinstatement of previous, UN-led mechanisms of aid distribution.

In a joint statement issued on 1 July, some of the world’s largest humanitarian groups accused the GHF of violating international humanitarian principles. They said the scheme was forcing two million people into overcrowded, militarised zones where they face daily gunfire.

Additional reporting by OSINT producers Sam Doak and Lina-Serene.

The Data and Forensics team is a multi-skilled unit dedicated to providing transparent journalism from Sky News. We gather, analyse and visualise data to tell data-driven stories. We combine traditional reporting skills with advanced analysis of satellite images, social media and other open source information. Through multimedia storytelling we aim to better explain the world while also showing how our journalism is done.

A red shipping container sits on the tarmac of Sierra Leone’s Queen Elizabeth II Quay, under swinging cranes and towering stacks of similar steel boxes.

This one will likely be parked at the port permanently. The contents are suspected to be the ingredients of kush, the deadly synthetic drug ravaging Sierra Leone.

Sky News was given access to the container two weeks after it was seized.

“Preliminary testing has shown that these items are kush ingredients,” says the secretary of the Ports Authority, Martin George, as he points to the marked contraband in massive multicoloured Amazon UK bags and a large blue vat of strongly smelling acetone.

He adds: “Shipped from the United Kingdom.”

The container was selected for screening based on its origin. The UK is with the EU and South America on the list of places considered high risk for the import of illicit substances fuelling the drug trade in Sierra Leone and the region.

Kush has shaken this part of West Africa to its core – not just Sierra Leone but Liberia, Guinea, Guinea-Bissau and the Gambia. It is highly addictive, ever-evolving and affordable.

The sprayed grey-green marshmallow leaves are rolled in a joint like marijuana and are extremely dangerous. Samples of the drug tested by researchers contained nitazens, one of the deadliest synthetic drugs in the world.

“It was a shock to find them in around half of the kush samples we tested, as at that point there was no public evidence they had reached Africa,” says Lucia Bird Ruiz-Benitez de Lugo from Global Initiative Against Transnational Organised Crime (GI-TOC) who independently tested kush from Sierra Leone.

“Nitazenes are among the deadliest drugs available on retail drug markets across the world – with one nitazene in kush in Freetown being 25 times stronger than fentanyl,” she added.

The shocking effects of its potency can be seen on the bodies of young men and women around Freetown. Teenagers with sores eating away at their legs, unable to walk. Mothers who smoked during pregnancy carrying sickly rash-covered infants. Young men drooling from the intense high and slumped over while still standing.

They are not the fringes of Sierra Leonean society but a growing demographic of kush users searching for an escape. People riddled by poverty and unemployment, living in the dark corners of a capital city which has endured a brutal civil war and Ebola epidemic in the last three decades alone.

An entire community of men and women of all ages is held together by kush addiction under a main road that cuts through the heart of Freetown.

They call themselves the “Under de Bridge family” and live in the shadows of the overpass, surrounded by the sewage and rubbish discarded by their neighbours.

One of them tells us the harsh conditions drive him to keep smoking kush even after losing more than 10 friends to the drug – killed by large infected sores and malnutrition.

Nearby, 17-year-old Ibrahim is pained by growing sores and says the drug is destroying his life.

“This drug is evil. This drug is bad. I don’t know why they gave me this drug in this country. Our brothers are suffering. Some are dying, some have sores on their feet. This drug brings destruction,” he says.

“Look at me – just because of this drug. I have sores on my feet.”

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Across a stream of sewage, a young mother expecting her second child cries from fear and anguish when I ask her about the risk of smoking while pregnant.

“Yes, I know the risk,” Elizabeth says, nodding.

“I’ll keep smoking while I live here but I have nowhere else to go. It helps me forget my worries and challenges.”

Life under the bridge is disrupted from its sleepiness by a yell. A plain-clothed police officer is chasing a child accused of selling kush.

The lucrative industry is absorbing all age groups and spreading rapidly to nearby countries – even passing through three different borders to reach the smallest nation in mainland Africa, The Gambia.

Gambian law enforcement has cracked down on spreading kush use with regular zero tolerance drug raids. The small population is extremely vulnerable and the country is yet to open its first rehabilitation centre. Rising xenophobia seems to be mostly directed at Sierra Leonean immigrants who they blame for smuggling kush into the country.

We spoke to one man from Sierra Leone who was arrested for dealing kush in The Gambia and spent a year in prison. He says that though he feels saddened other Sierra Leoneans are being alienated as a result of the trade he was involved in, he has no remorse for “following orders”.

“Do I feel guilty for selling it? No, I don’t feel guilty. I’m not using my money to buy the kush, people always give me money to get kush for them,” he tells Sky News anonymously.

“I needed a job. I needed to take care of my son.”

Gambia’s hardline approach has been credited with driving its local kush industry underground rather than eradicating it but is still hailed as the most impactful strategy in the region. Sierra Leone’s government told Sky News it needs help from surrounding countries and the UK to tackle the sprawling crisis.

Transnational crime experts like Lucia Bird Ruiz-Benitez de Lugo see the rise of kush as part of a global synthetic drugs network that requires a multi-national response.

“Coordinated action is urgently needed across the supply chain, particularly focused on nitazenes – the deadliest kush component,” says Ms Bird.

“Our research indicated that kush components are being imported to West Africa from countries in Asia and Europe, likely including the UK. All countries in the supply chain bear responsibility to act to mitigate the devastating and expanding impacts of kush across West Africa, a region with scarce resources to respond.”

The Women’s Euros begin in Switzerland today – with extreme heat warnings in place.

Security measures have had to be relaxed by UEFA for the opening matches so fans can bring in water bottles.

Temperatures could be about 30C (86F) when the Swiss hosts open their campaign against Norway in Basel this evening.

Players have already seen the impact of heatwaves this summer at the men’s Club World Cup in the US.

Read more: A complete guide to the Women’s Euros

It is raising new concerns in the global players’ union about whether the stars of the sport are being protected in hot and humid conditions.

FIFPRO has asked FIFA to allow cooling breaks every 15 minutes rather than just in the 30th minute of each half.

There’s also a request for half-time to be extended from 15 to 20 minutes to help lower the core temperature of players.

FIFPRO’s medical director, Dr Vincent Gouttebarge, said: “There are some very challenging weather conditions that we anticipated a couple of weeks ago already, that was already communicated to FIFA.

“And I think the past few weeks were confirmation of all worries that the heat conditions will play a negative role for the performance and the health of the players.”

Football has seemed focused on players and fans baking in the Middle East – but scorching summers in Europe and the US are becoming increasingly problematic for sport.

While climate change is a factor, the issue is not new and at the 1994 World Cup, players were steaming as temperatures rose in the US.

There is now more awareness of the need for mitigation measures among players and their international union.

FIFPRO feels football officials weren’t responsive when it asked for kick-off times to be moved from the fierce afternoon heat in the US for the first 32-team Club World Cup.

FIFA has to balance the needs of fans and broadcasters with welfare, with no desire to load all the matches in the same evening time slots.

Electric storms have also seen six games stopped, including a two-hour pause during a Chelsea game at the weekend.

This is the dress rehearsal for the World Cup next summer, which is mostly in the US.

The use of more indoor, air conditioned stadiums should help.

There is no prospect of moving the World Cup to winter, as Qatar had to do in 2022.

And looking further ahead to this time in 2030, there will be World Cup matches in Spain, Portugal and Morocco. The temperatures this week have been hitting 40C (104F) in some host cities.

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FIFA said in a statement to Sky News: “Heat conditions are a serious topic that affect football globally.

“At the FCWC some significant and progressive measures are being taken to protect the players from the heat. For instance, cooling breaks were implemented in 31 out of 54 matches so far.

“Discussions on how to deal with heat conditions need to take place collectively and FIFA stands ready to facilitate this dialogue, including through the Task Force on Player Welfare, and to receive constructive input from all stakeholders on how to further enhance heat management.

“In all of this, the protection of players must be at the centre.”