Gaza crisis

Since the start of the war MSF teams have witnessed the worsening of the humanitarian and medical situation for people in Gaza. Communicable diseases, including skin conditions, are spreading. Bombings are leaving more and more people with traumatic injuries and burns, with over 101,000 wounded according to the Ministry of Health. People don´t have proper access to water, food and other basics including medical and sanitation services.

On top of the casualty toll caused by the bombardments and fighting, there are many ‘silent killings’ – people who have succumbed to entirely preventable conditions or had their healthcare disrupted due to the conflict: dialysis patients who can’t receive treatment, noncommunicable diseases patients left untreated, pregnant women with complications who can’t find treatment.

Combined with a destroyed health system and civilian infrastructure, including housing and water, and people struggling to even access the most basic needs, including food or soap, health needs are becoming a vicious cycle. MSF teams are treating numerous newborns and children under one year old in Nasser hospital. Children are getting sick with respiratory tract infections due to dire living conditions, some even suffering from malnutrition as they don’t have proper access to clean water and nutrition. Newborns are getting sick with fever, putting them at high risk. 

As a last-resort response to the systematic destruction of the health system by Israeli forces, MSF had to open two field hospitals in August in Deir Al Balah, central Gaza. Services include outpatient consultations, pediatrics and trauma care. In Gaza clinic located in Gaza City, north central Gaza, the number of cases has more than doubled between Sept. 30 and Oct. 6 and then Oct. 14 and 20, as people fled northern governorates and particularly Jabalia. 

The violent incidents include airstrikes damaging hospitals, tanks being fired at agreed deconflicted shelters, ground offensives into medical centres, and convoys fired upon. These incidents show the blatant disregard of medical humanitarian action and failure of deconfliction measures. 

As Nov. 5, 2024, over 1,000 health workers in Gaza have been killed since October 2023, according to the UN. At least 318 aid workers, the vast majority Palestinian, have been killed in Gaza since the start of the war. Eight MSF colleagues have been killed since the start of the war, two during the month of October 2024. 

The blockades and search of ambulances, destruction of the infrastructure and electricity and water supplies which in turn impact hospitals functioning, and the impossibility for medical organizations to operate in insecure environments, are examples of medical impact from Israeli attacks.

Throughout the war, MSF has witnessed patients dying on hospital floors, as facilities have been unable to cope with the overwhelming number of patients or haven´t had the supplies needed to provide care. Israeli authorities have on numerous occasions denied and delayed entry for items like oxygen concentrators which are essential for anesthesia. The same for surgical equipment and generators, without which it is almost impossible to provide surgical care – resulting in more lives lost.

Supply processes remain extremely complex and long, with MSF teams having to declare each item and even then some medical items having been rejected at the border. MSF activities have been compromised due to restrictions from Israeli authorities on supply, the length of administrative processes and arbitrary decisions on which material can enter Gaza. The increasingly frequent lootings in Gaza have also an impact on supply – more than half of the trucks carrying non-medical items are looted. As a result of these combined challenges, MSF had to lower our medical standards for wound dressings, resulting in less-than-ideal healing. Our teams have been forced to perform surgeries under substandard conditions without specialized items and have facilities running under capacity.

One of the central pillars of our identity is to bear witness and call attention to the problems driving emergency needs in the places where we provide humanitarian assistance. 

We have a long history of speaking out and advocacy when governments or other actors implement policies that threaten the health and safety of our patients or our staff, for example in conflicts in Syria, Yemen, and Afghanistan. 

International humanitarian law and the rules of war require militaries to distinguish between civilians and combatants and prohibit attacks that cause disproportionate harm to civilians and civilian objects. The way Israel is prosecuting this war is causing massive death and suffering among Palestinian civilians and is inconsistent with these norms and laws. 

Medical facilities and their surrounding areas have repeatedly been attacked or subjected to evacuation orders by Israeli forces, making access to healthcare extremely dangerous for patients and putting the lives of medical staff at risk. This compels us to speak out and demand an immediate ceasefire. 

As humanitarians, we grieve for all civilian lives lost, and the vast majority of the victims of this conflict are civilians, including many elderly people, women and children. Violence against civilians is never justified, and all civilians deserve protection. 

MSF’s reporting is based on what our patients and staff tell us they are seeing on the ground in Gaza, where the Israeli military campaign and siege have had devastating consequences. The healthcare system has collapsed, and hospitals have run out of drugs, medical supplies, and fuel for generators. People have limited access to food, water, shelter, and electricity. And the death toll continues to rise. 

We are calling for a sustained ceasefire because widespread and indiscriminate attacks on civilians—including attacks on healthcare—have made it impossible to deliver the humanitarian assistance needed in Gaza. 

MSF offers medical humanitarian assistance to people based solely on need, irrespective of race, religion, gender, or political affiliation. As an organization, we focus on filling the greatest gaps in healthcare. 

We have no agenda except to go where we are needed and treat patients and we are struggling to do so right now in Gaza due to the lack of drugs, medical supplies and fuel for generators.

MSF takes any allegation of anti-Semitism extremely seriously. At any given time, MSF has approximately 68,000 people working in our projects and headquarters. Any form of bigotry or discrimination by MSF staff is unacceptable. 

We do not believe that criticism of Israeli government policies is equivalent to anti-Semitism. 

MSF speaks out when governments or actors implement policies that are harmful to the health and safety of our patients or our staff. The way Israel is prosecuting this war is causing massive death and suffering among Palestinian civilians and putting our staff at risk. This is inconsistent with the norms and laws of war. 

No state is above criticism. 

As humanitarians, we grieve for all civilian lives lost, and the vast majority of the victims of this conflict are civilians, including many elderly people, women, and children. Violence against civilians is never justified, and all civilians deserve protection.

MSF works with the Ministry of Health in Gaza. We coordinate our work through them. When it comes to ensuring the safety of our teams in Gaza, we maintain contact with the Ministry of Interior in Gaza, just as we maintain contact with the Israeli authorities. MSF works in more than 70 countries around the world. Wherever armed conflict is present, we maintain contact with all actors to safeguard our teams and activities.