MSF strongly condemns Israeli attack on Al-Mawasi shelter, killing two family members of an MSF colleague and injuring six

MSF strongly condemns Israeli attack on Al-Mawasi shelter, killing two family members of an MSF colleague and injuring six

21 February 2024 —Médecins Sans Frontières/Doctors Without Borders (MSF) condemns in the strongest possible terms the killing of two MSF staff family members during an Israeli offensive on Al-Mawasi, Khan Younis, Gaza. Six other people were injured in the attack.

Late on the evening of 20 February, Israeli forces conducted a military operation in Al-Mawasi, located on Gaza’s coastline, during which an Israeli tank fired on a house sheltering MSF colleagues and their families. The attack killed the daughter-in-law and wife of one of our colleagues, and injured six people, five of whom were women or children. Bullets were also fired at the clearly marked MSF building, hitting the front gate, the building’s exterior, and the interior of the ground floor.

Ambulance teams were delayed for more than two hours by the shelling in the area but were later able to reach the site and bring the wounded, some sustaining burn injuries, to the International Medical Corps Field hospital in Rafah.

“We are outraged and deeply saddened by these killings,” says Meinie Nicolai, MSF General Director, who is currently coordinating MSF medical activities in Gaza. “On the same day the United States chose to veto an immediate ceasefire, two daughters saw their mother and sister-in-law killed by an Israeli tank shell.”

“These killings underscore the grim reality that nowhere in Gaza is safe, that promises of safe areas are empty and deconfliction mechanisms unreliable,” says Nicolai. “The amount of force being used in densely populated urban environments is staggering, and targeting a building knowing it is full of humanitarian workers and their families is unconscionable.”

At the time of the attack, 64 people were sheltering in the house. All parties to the war, including Israeli forces, are regularly informed of the whereabouts, and have acknowledged the presence, of MSF teams in specific locations. Israeli forces have been clearly informed of the precise location of this MSF shelter in Al-Mawasi. In addition to this, a two by three metre MSF flag was draped on the outside of the building. No evacuation orders were issued by the Israeli forces before the strike. MSF has since contacted Israeli authorities and is seeking further explanation.

Some of our colleagues and their family members who were living in the MSF shelter before the attack in Al-Mawasi had already survived the 8 January strike on another MSF shelter in Rafah, which killed the five-year-old daughter of an MSF staff member. This demonstrates, once again, that Israeli forces are not ensuring the safety of civilians in their military operations and shows a complete disregard for human life and lack of respect for the medical mission. This makes it almost impossible to sustain medical humanitarian activities in Gaza. 
 
MSF teams are supporting our colleagues and their family members who survived yesterday’s attack, as well as the loved ones of those who were killed. Five MSF staff have been killed since the beginning of the war, in addition to numerous family members.
 
We reiterate our call for an immediate and sustained ceasefire in Gaza. The violence against civilians must end now.

Gaza: MSF calls for the protection and safe evacuation of patients from Nasser hospital

Gaza: MSF calls for the protection and safe evacuation of patients from Nasser hospital

Médecins Sans Frontières / Doctors Without Borders (MSF) is outraged that medical staff and patients are still trapped after Israeli forces attacked and raided Nasser hospital in Khan Younis, Gaza, on 15 February.

Some 130 patients and at least 15 healthcare workers are still in the hospital with no electricity or running water and limited food, according to the United Nations, who say they have managed to transfer 32 patients in critical condition and are trying to evacuate the rest in the coming days. MSF is deeply concerned for the well-being of these patients and calls for their safe evacuation. Our teams at al-Aqsa hospital and Rafah Indonesian Field hospital are prepared to treat them if need be.

In the early hours of 15 February, a shell struck the orthopedic department of the facility causing chaos and killing and wounding an undetermined number of people. Fearing for their lives, MSF staff members had to flee the compound leaving behind several patients in severe condition. We have very little information about the remaining medical staff and patients and their condition.

This comes following weeks of heavy fighting near the hospital, where medical staff, patients and displaced people found themselves trapped inside the compound with very little access to essential supplies. Many people who were wounded by the intense bombing in Khan Younis were also unable to reach the hospital for emergency care.

Four days after the attack, MSF has still not heard from two of our staff members who were in the hospital at the time of the attack. One who has been unaccounted for since the attack and another who was detained at a checkpoint by Israeli forces while trying to leave Nasser hospital. We ask Israeli authorities to share information about their whereabouts and we call for their safety and protection of his dignity.

“The situation in Nasser hospital is yet another example of the way healthcare facilities are being dismantled one by one in this war. Even though they were initially told they could stay inside the facility, medical staff and patients were put in danger in a place where they should have been protected. We are outraged that once again they have had to pay a heavy price,” says Guillemette Thomas, MSF medical coordinator for Palestine.

On 13 February, Israeli forces ordered the evacuation of the thousands of displaced people sheltering in Nasser hospital and told medical staff and patients they could remain in the building with one caretaker per patient. Many civilians were afraid to leave the hospital because shots had been directly fired at the building and at people trying to leave the hospital’s compound.

Once the largest healthcare facility in southern Gaza, Nasser hospital no longer has the capacity to treat patients. What is left of Gaza’s health system is barely functioning due to its main hospitals being constantly affected by military operations and heavy fighting in their immediate vicinity. Tens of thousands of people have not only been injured but maimed for life and there is currently no possibility for proper treatment or continuation of care.

Attacks on medical facilities, their staff and patients must stop. MSF reiterates its urgent call for an immediate and sustained ceasefire to allow spare civilians’ lives and for substantial aid to enter the enclave.

Lebanon: MSF helps to bridge gaps in struggling healthcare system in Tripoli

Lebanon: MSF helps to bridge gaps in struggling healthcare system in Tripoli

Ataa is a 23-year-old patient at the Médecins Sans Frontières (MSF) supported primary healthcare centre in Tripoli Governmental Hospital, in Lebanon’s second largest city. She visits the health centre with her husband Adnan for her routine antenatal check-up. Lebanon’s deep economic crisis makes it very difficult for them to afford daily necessities. “The crisis is affecting everyone,” said Adnan, 26 who takes whatever work he can find each day—but his earnings aren’t always sufficient to cover his family’s needs. “Our income is in Lebanese pounds, but everything is priced in US dollars. Nowadays, we have to travel long distances—sometimes outside of the city—just to buy something for a lower price.”

Twenty-five year old Rima is also a patient at the health centre. She described the barriers she faces to access quality healthcare. “If you don’t have enough money or can’t pay immediately, you won’t have access to health services. Plus, the national social security fund now covers very little, with the currency decline. One has to pay a lot of money for hospitalization.”

Ataa and Rima are like many others who struggle to access healthcare in Tripoli, Lebanon. Living conditions have deteriorated over recent years due to limited housing, depleted infrastructure, lack of clean water and sanitation, and inadequate access to social services. The unemployment rate exceeds 35 percent and half of the city’s residents live below the poverty line[1]. The escalating financial challenges have made it increasingly difficult for individuals to access essentials such as food, water, and medical supplies.

These factors take a severe toll on people’s mental well-being and cause significant stress, trauma, and depression. Many of Tripoli’s healthcare centres are struggling to provide residents with the medical care and medications they need due to a lack of staff and supplies. The high cost of care also puts healthcare centres out of reach for many. On top of that, the economic crisis has increased the cost of services in private clinics and a shortage of many essential medicines.

Recognizing the urgent need for accessible and equitable healthcare in Tripoli, in June 2022, MSF launched a project to support the city’s primary healthcare system. The project supports four primary healthcare centres in different areas in Tripoli, focusing on non-communicable diseases, such as diabetes and heart disease, and mental health services. This support includes providing technical guidance to local health workers, subsidizing the cost of non-communicable diseases consultations for patients at the supported facilities, capacity-building, social work, and donating medicines.

Lebanon: MSF helps to bridge gaps in struggling healthcare system

Through the activities, MSF helping to provide holistic and patient-centred healthcare. “We put the patient at the core of healthcare,” said MSF project coordinator Ivan Sinaga. “This means that our teams prioritize the needs, preferences, and well-being of each patient, tailoring medical care to address their specific circumstances, as a treatment should be comprehensive and not just medical.”

In a patient-centred approach, the focus is on fostering a collaborative and respectful relationship between healthcare providers and patients, ensuring that medical decisions consider the patient’s values and input. 

“We prioritise empathy, inclusivity and responsiveness to people’s individual needs,” said Sinaga. 

From June 2022 to December 2023, MSF staff in Tripoli supported 1,554 non-communicable disease consultations, 1,843 mental health consultations, 3,175 health promotion sessions for 28,717 participants, donated three tons of medications, conducted 116 training sessions for health workers, and paid stipend of 28 local health staff.

“We are collaborating with partners, including the Ministry of Public Health and the primary healthcare facilities in Tripoli, to implement a patient-centred approach and increase access to primary healthcare,” said Sinaga. “Given the current situation and challenges, an increasing number of people will seek care at primary healthcare centres. This necessitates collective efforts from everyone to make it more accessible.”

About MSF

MSF is an independent international medical humanitarian organisation providing free healthcare to people in need, without discrimination. MSF first began work in Lebanon in 1976 and its teams have worked in the country without interruption since 2008.

MSF teams currently work in seven locations across Lebanon, providing free medical care for vulnerable communities, including Lebanese citizens, refugees, and migrant workers. MSF’s services include mental healthcare and psychosocial support, sexual and reproductive healthcare, paediatric care, vaccinations, and treatment for chronic diseases. With more than 700 staff in Lebanon, MSF teams provide around 150,000 medical consultations every year.

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Syria: One year after earthquake, mental scars are still raw

Syria: One year after earthquake, mental scars are still raw

“We live in a tent – the children are afraid of houses and buildings,” says Hind, a 36-year-old mother of five in Afrin, in northwest Syria’s Idlib province. “We are very tired.”

Where can you find refuge when your home is no longer safe? How can you comfort your children when they live in fear of the ground rocking beneath their feet? These are some of the questions in the minds of people in northwest Syria, a region grappling with the impact of economic crisis and more than a decade of war, compounded by the aftermath of the devastating earthquakes that struck northwest Syria and south Türkiye on 6 February 2023.

People gather amongst the rubble of destroyed buildings in Idlib province. Northwest Syria, 7 February 2023. OMAR HAJ KADOUR/MSF

“The earthquakes created more poverty, homelessness and displacement, and caused a decline in people’s living conditions, worsening the economic situation and the functioning of the education system and causing damage to infrastructure,” says MSF head of mission Thomas Balivet. “In addition, thousands of children lost caregivers or suffered physical injuries and amputations. All of these factors have exacerbated the mental health situation for thousands of people across the region.”

Before last February, many people in northwest Syria had already been displaced from their homes by the war. In the aftermath of the quakes, they found themselves destitute – without shelter, food, clean water or other basic essentials.

“We left our hometown in Saraqib, east of Idlib, because of the war and constant shelling, and after years of being displaced and looking for safety, we settled in Afrin, further north,” says Hind. “The house we stayed in had no walls – we hung up blankets for shade and privacy. My husband used to work but we barely had enough to eat. Then the earthquake happened and we lost everything again.”  

The first quake, of magnitude 7.8, left a swathe of destruction reminiscent of the war damage that already scarred northwest Syria.

Omar Al-Omar, MSF mental health supervisor in Idlib, remembers the first hours after the earthquake. “At the break of dawn, I went down to Salqin, a town in Idlib province. I saw entire buildings collapsed and turned into rubble. What hurt me the most was hearing the voices of people under the rubble asking for help, while I was unable to provide assistance. Then I went to Salqin hospital, which is co-managed by MSF. When I entered, I was shocked by the sight of the wounded and corpses in the rooms and corridors of the hospital. I was no longer able to stand – I sat on the ground and burst into tears. In the hospital, we could feel the aftershocks, and every moment large numbers of wounded and injured people entered the hospital. It was a night that will remain engraved in my memory until the last day of my life.”

Even before last February, the healthcare system in northwest Syria was struggling, with underfunded medical facilities and limited services. The earthquakes damaged 55 health facilities, leaving them unable to function fully. As well as medical assistance, people across the region needed toilets, showers, heating systems, winter clothing, generators, blankets, hygiene kits and cleaning products. 

In the hours following the first quake, MSF teams provided emergency medical care and immediately started distributing MSF’s existing stocks of essential relief items. In the following days, MSF sent 40 trucks loaded with medical and non-medical items to the area, including food and shelter materials. Meanwhile MSF water and sanitation experts constructed toilets and showers for earthquake survivors and provided them with clean drinking water.

“Following the acute phase of the emergency response, our focus shifted towards providing shelter, food and relief items, ensuring access to healthcare as well as water and sanitation services,” says Balivet. “The lack of these basic necessities has had a profound impact on people’s mental health.”

One year on, the physical destruction caused by the quakes is less visible than before, but the impact on people’s mental health is stark.

“Since the earthquake, cases of post-traumatic stress disorder and behavioural problems have surged, especially among children,” says Omar, “in addition to panic attacks, various types of phobias and psychosomatic symptoms.”

Addressing people’s mental health needs

MSF has provided mental health services to people in northwest Syria since 2013. After the earthquakes, MSF launched a comprehensive mental health initiative as part of its emergency response. Mobile teams of mental health counsellors were deployed to provide psychological first aid, as well as specialist counselling for moderate and high-risk patients, in 80 locations across the region. They also ran sessions to help people deal with both their immediate psychological reactions and the emotions that come later. MSF teams provided a total of 8,026 individual mental health consultations in the aftermath of the earthquakes.

‘Safe spaces’ for women and children

MSF also set up a ‘safe spaces’ programme in four locations in northern Aleppo and Idlib provinces, in collaboration with partner organisations, to provide places where women and children could take a moment of respite from the harsh reality outside. These activities are still running, with three additional sites added in Idlib province. Within these dedicated tents, women and children engage in games and activities, such as drawing, take part in group sessions, or simply sit and rest. Whether engaged in quiet contemplation or lively conversation, the women and children in these spaces find a refuge where they can momentarily disconnect from the weight of their troubles and simply breathe.

Some 25,000 women and children have used the safe spaces; MSF teams also referred 1,900 of the women and children to other organisations to receive follow-up treatment for physical or mental health issues.

Hind, who frequently visits one of MSF’s safe spaces, says: “When I come inside the safe space, I forget everything, I forget the agony and fear. My children come with me and play. We all forget the fear, we all forget what happened after the earthquake.”

Living amidst the rubble of the conflict and the earthquakes, people in northwest Syria still need clean water, food, shelter and access to essential healthcare. “Investment in improving the living conditions of the people of northwest Syria is essential,” says Balivet. “Only by addressing the root causes of suffering can we hope to pave the way towards recovery.”

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Gaza: Staff at Al-Shifa are struggling to care for patients because the needs are huge

Gaza: Staff at Al-Shifa are struggling to care for patients because the needs are huge

Last November, Al-Shifa hospital, located in Gaza City, Palestine was brought to a standstill after the Israeli army massively bombed the area around the facility. The hospital was hit several times, then surrounded before being evacuated.  The largest hospital in the Gaza Strip was gradually transformed into a camp for displaced people, and now houses some 50,000 people. On site, the medical team is striving to maintain access to healthcare for people and has partially resumed their activities. Aurélie Godard, head of Médecins Sans Frontières’ (MSF) medical activities in Gaza, was able to visit the hospital as part of a supply convoy organised by the United Nations on 22 January. Here she provides an overview of she saw during her visit.

“The main objective of this convoy was to deliver 19,000 litres of fuel to Al-Shifa. This fuel is essential, because it is used to run the generators that supply the hospital with electricity. We managed to pass the checkpoint which separates north and south Gaza at the beginning of the afternoon, and immediately afterwards, our two cars and the fuel truck were surrounded by a crowd of quite young people who demanded water and food. They were really disappointed that we were only transporting fuel. We had a lot of difficulty getting through this very dense crowd of hungry people.”

Three operating rooms, but few resources

“Al-Shifa hospital is still standing, but it is badly damaged and barely functional. In the corridors, the false ceilings have been ripped open, and we have seen IV bags [to provide patients with drugs intravenously] hanging directly on the walls of the hospital, for lack of anything better. The medical teams on site managed to get the emergency room up and running, but it is largely occupied by patients who have been admitted. The rest of the hospital is filled with displaced people seeking safety.

“The health personnel manage to receive and triage the injured and stabilise them, but they are then a little stuck, because there is a severe shortage of hospital beds. Doctors have a resuscitation space, where people in life-threatening, critical condition can be treated; patients here either have a chronic illness, or, most often, because they have been injured by a bullet or in an explosion. During our visit, we regularly heard explosions not far from the hospital.

“The team at the hospital, made up of many volunteers, including two from MSF, managed to set up three operating rooms for urgent surgeries. We understood medical staff want to reopen the intensive care unit. Right now, they have no way to properly monitor the patients they manage to operate on.

“In the emergency room, we saw a seriously injured patient, who had arrived the day before. He had had a tracheotomy, a chest tube had been inserted and he also had had abdominal surgery. He was surrounded by dozens of other patients in a room without electricity, since there was a power outage at the time, and therefore his vital functions weren’t being monitored, because the monitoring devices were not working. The team told us that they had recently lost a patient because they were unable to give him a blood transfusion. Their blood bank was empty. They work in terrible conditions.”

Large cohort of patients

“Staff at Al-Shifa are struggling to care for patients because the needs are huge. There are a lot of people in the hospital and all around, made up mainly of those who are displaced. There are still many people living in northern Gaza, and many of them have suffered trauma related to war injuries, but also because of poor living conditions and winter illnesses.

“The number of patients is very high and medical staff have reported difficulties in many areas, whether with the supply of oxygen, electricity, medical equipment or simply food. All of this makes providing medical care extremely difficult, and they have enormous operating difficulties to overcome. The convoy’s 19,000 litres of fuel will supply the hospital for barely a week. Around 3,000 litres per day are required for it to be functional.

“This visit was very short, as the journey from the south of the Gaza Strip took us a very long time, and we were not allowed to stay there for long. The convoy was supposed to go to the hospital five days earlier, but until then it was impossible for various reasons. It was moving to see the surprise of patients, displaced families and staff at the sight of new people. They had probably been holed up in the hospital for weeks.”

Last November, Al-Shifa hospital in Gaza City was brought to a standstill after the Israeli army massively bombed the area around the facility. The hospital was hit several times, then surrounded before being evacuated.

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Gaza: MSF condemns strike on shelter that killed staff member’s five-year-old daughter

Gaza: MSF condemns strike on shelter that killed staff member’s five-year-old daughter

Jerusalem, January 9, 2024 – Médecins Sans Frontières/Doctors Without Borders (MSF) condemns in the strongest possible terms the January 8 strike on an MSF shelter, which led to the death of the five-year-old daughter of an MSF staff member.

Yesterday morning, a shell, resembling that from a tank, broke through the wall of the building where over 100 MSF staff and their family members were seeking shelter in Khan Younis in the south of the Gaza Strip. The five-year-old girl was critically injured by the strike and underwent surgery at the Gaza European Hospital. However, she later died of her injuries on January 9. Three other people were slightly injured in the strike.

“We are outraged and deeply saddened by the death of yet another family member of our MSF staff. This strike on civilians is unacceptable and, once again, goes to show that it doesn’t matter where you are in Gaza, nowhere is safe,” said Thomas Lauvin, MSF project coordinator in Gaza. “The shell did not detonate on impact, otherwise many more of our staff and their families would have most likely been killed.”

Prior to the incident, MSF notified Israeli forces that the shelter near Gaza European Hospital was housing MSF staff and their families. Furthermore, no evacuation orders were issued before the strike. While MSF is not able to confirm the origin of the shell, it appears to be similar to those used by Israeli tanks. MSF has contacted Israeli authorities and is seeking further explanation.

Four of MSF’s staff have been killed since the beginning of the war in addition to numerous family members.

We reiterate our call for an immediate and sustained ceasefire in Gaza. Indiscriminate violence against civilians must end now.

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Lebanon: MSF provides healthcare to people displaced by military escalation along southern border

Lebanon: MSF provides healthcare to people displaced by military escalation along southern border

08 January 2024 – Escalating military activity along Lebanon’s southern border has forced thousands of people to flee border towns and seek refuge further north or in major cities. Israeli forces and Hezbollah have exchanged fire across the Israel-Lebanon border since the start of the Israel-Gaza war on 7 October of 2023, but in recent weeks the violence has escalated, with Israeli forces launching heavy bombardments of Lebanon’s southern border region. Many of the displaced people are in need of essential relief items, while others have run out of their regular medications. In response, international medical organisation Médecins Sans Frontières/Doctors Without Borders (MSF) has deployed a mobile team to help provide the displaced people with healthcare.

“People need mattresses, clothes and medications” says Abbas Chite, from Kfarkila in south Lebanon. “We left everything behind when the bombardment became heavy. We can’t even go back to get our medical prescriptions or clothes.”

The armed escalation is compounding an ongoing humanitarian crisis in Lebanon and intensifying people’s existing needs. The country is in the fourth year of a severe economic crisis that has pushed two out of three citizens into poverty, heavily impacting their ability to afford basic goods and services, including food and healthcare.

Abbas used to work in the construction industry, but now there is no work available, leaving him unable to earn a living and support his family. “I work in construction, but everything has stopped since the beginning of the ,” he says.

MSF activities in South Lebanon in additon to patients testimonies

MSF’s mobile medical team is supporting two health centres in Nabatieh district, south Lebanon, by caring for patients with chronic diseases and providing psychological first aid. Lebanon’s healthcare system, like other sectors in the country, was already overburdened by the economic crisis. Local health centers, that are already at capacity, could face increasing pressure if they contend with the growing medical needs of displaced people.

“When people are displaced, they are forced to leave their homes abruptly, interrupting their treatment, especially for those with chronic diseases,” says MSF mobile team member Dr Aida Hassouni. “With uncertainty about when they can return, we’re here to bridge that gap by offering chronic disease care. This ensures that individuals can continue their treatment until they can resume their regular lives.”

Since October, MSF teams have pre-positioned ten tonnes of medical supplies in various hospitals and medical facilities in Lebanon. The teams have also provided training to hospital staff across Lebanon in emergency trauma care and the management of mass casualty events, in accordance with the Ministry of Public Health’s emergency preparedness and response plan and in collaboration with other health partners. More than one hundred medical personnel were trained in nine hospitals over the course of three weeks.

ENDS

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MSF concludes activities at Rafik Hariri University Hospital Birth Center

MSF concludes activities at Rafik Hariri University Hospital Birth Center

Beirut, Lebanon – January 2nd , 2024 – After years of working in the birth center at Rafik Hariri University Hospital (RHUH) in support to the Lebanese Ministry of Public Health (MoPH), Médecins Sans Frontières (MSF) has made the decision to conclude its activities in the birth center by the end of December 2023 and handing over its management to Rafik Hariri University Hospital (RHUH).

Since July 2018, MSF has been running the Birth Center at Rafik Hariri University Hospital (RHUH), establishing a midwife-led model of care. This model   provides comprehensive care for low-risk pregnant women and newborns through the expertise of trained and qualified midwives and throughout pregnancy, birth, and the postnatal period. While midwives lead the normal deliveries, a dedicated team of obstetricians is readily available for support in case of complications. For pregnancies requiring advanced specialized care, our teams established a referral system to ensure transfer to appropriate facilities.  The Midwives led model of care is an evidence-based, sustainable, and cost-efficient approach that can be implemented in Lebanon. Its cost-effectiveness, especially for low-risk pregnancies, lies in judicious resource allocation and preventive measures. Midwives, as primary caregivers, offer personalized care tailored to each case, reducing reliance on costly medical interventions.

From July 2018 to December 2023, MSF has provided free quality sexual and reproductive health care to 21,851 patients and assisted with 17,812 deliveries within the birth center. To ensure continuity of care, MSF will support Rafik Hariri University Hospital (RHUH) by providing the needed equipment.

The decision to conclude activities aligns with MSF’s goal in expanding the reach of its midwife-led model care. By providing technical support and expertise, MSF aims to replicate the birth center’s success within local facilities, reinforcing access to quality care for pregnant women in Lebanon.

MSF remains dedicated to supporting the people in Lebanon. Through its ongoing projects in the country, MSF will continue adapting its approach to meet evolving needs and prioritize accessibility and quality healthcare for all.

About MSF in Lebanon:

Médecins Sans Frontières (MSF) is an international, independent, medical humanitarian organization that delivers emergency aid to people affected by armed conflict, epidemics, natural disasters and exclusion from healthcare in almost 70 countries around the world. MSF offers assistance to people based on need and irrespective of race, religion, gender or political affiliation. Médecins Sans Frontières (MSF) began working in Lebanon in 1976 in response to the civil war, sending medical teams to the south of the country and Beirut. This was MSF’s first mission in a war zone. Today, MSF is providing free medical care in various locations with over 600 staff members in Lebanon.

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Let me die with my family: the story of a Gazan refugee in the West Bank

Let me die with my family: the story of a Gazan refugee in the West Bank

Abbas* is one of over 6,000 Palestinians from Gaza who used to work in Israel and became refugees in the West Bank as a result of the Israel-Gaza war. Now a patient of MSF teams offering psychological support in Nablus, he describes the ordeal of being displaced and separated from his family, who remains trapped under the bombs in Gaza.

 

At dawn, Abbas lights a cigarette and looks into the distance, at the rugged West Bank landscape. He hasn’t slept all night: he spent it thinking of his family under the bombs in Gaza, over one hundred kilometres away. His only objective for the day is the same as any other day: to be able to talk to them.

“All my family is in Gaza, scattered between the north, and Khan Yunis and Rafah in the south. My wife and kids are living in a tent: they have already been displaced four times since the start of the war. At times they slept in the street, in mosques or in abandoned buildings. My four children are between five and 14 years old, can you imagine?” says Abbas clearing his throat. “Every morning at dawn, I try to reach them by phone to know if they survived the night. Some days, communications are cut off and I have to wait for days to hear from them.”

Abbas is a so-called ‘Gazan worker’: a Palestinian from Gaza who used to commute to Israel for work. Every month, he would cross the border from the north of the Strip, where his home was, to go to work in an iron factory for a few weeks and return home for a three-day break. Since his dad passed away, as the oldest surviving family member, he has also been responsible for the rest of his family, including his brothers and sisters.

On 7th October, when Hamas launched its attack in Israel, Abbas was at work. The next day, Israeli soldiers turned up at the factory and began to harass the Palestinian workers, threatening to shoot them if they did not flee to the West Bank. Abbas sought refuge in the mountains for two days, before finally reaching the West Bank – one of over 6,000 Gaza residents to do so, according to the Palestinian Authority’s Ministry of Labour. When he passed the Israeli checkpoint, the soldiers took his money and belongings, except his phone. “I consider myself lucky because I managed to keep my phone. Others were not that lucky: they were arrested, beaten or even made to disappear” explains Abbas. “I don’t have any family here in the West Bank, so I found refuge in a community with other workers. We live in terrible conditions, sleeping on the ground with no mattresses, blankets or heating, but it is nothing compared to the horrific conditions of Gaza.”

While Gaza is being crushed by the Israeli army’s relentless bombing, the West Bank is experiencing a bloody ordeal of its own. Violence and harassment against Palestinians by settlers and the Israeli forces alike was already rife before 7 October and 2023 saw a new record in the number of Palestinians killed in this area according to the United Nations, continuing the shocking trend of the past few years. After that watershed date, the number of attacks on Palestinians soared even further. To be attacked by settlers or arrested and beaten by the Israeli forces has become a daily occurrence for Palestinians in the West Bank, while Israeli military operations in the Jenin and Tulkarem refugee camps have resulted in many being killed.

In the Nablus area, Abbas met a team of MSF social workers who referred him to their colleagues offering psychological consultations as part of a mental health programme that has been running for over two decades, branching out over time to the nearby towns of Qalqiliya and Tubas. By the end of November, psychologists and psychiatrists working in the programme had offered over 2,600 consultations in 2023.

This is Abbas’s first experience with therapy and he says it’s helping. He knew MSF from back in Gaza: his father had been a patient a few years ago.

“I am desperately trying to go to Gaza and join my family, but it is impossible” he says. “At some point the Israeli authorities said they would allow Gazan workers to return to Gaza, but the ones who tried were arrested, robbed, interrogated and beaten. If I get arrested, I will lose contact with my family.”

Still, Abbas is determined to find a way to return. “My wife wants me to go so we can die together” he adds. “It is hard for her to take care of the children. The more weeks go by, the more surviving is a miracle. There is no drinking water and they can barely find food. Some days they drink the salty water from the sea. If they get sick they can’t go to the hospital, as it is overcrowded with trauma patients and not safe.”

He continues in a sobbing voice: “My five-year-old asked me the other day ‘Dad, why do you let me starve? Dad, other kids, their father died with them, so don’t let us die alone’. I don’t know what to reply so I strive to find comforting words but he replies ‘Don’t lie to me dad’. Come now, so we die together.”

“Because of the constant bombing, it has become customary in Gaza to make people identifiable, in case they are killed, by writing their names on their bodies: a hand, an arm, a leg or the neck. My wife and three of my kids wrote their names on themselves but she could not do it on the youngest. It was too painful.”

“What will our lives be like after they have finished bombing? Streets, hospitals, universities and schools are all destroyed. This is not right, I am a good citizen, I work, I pay my taxes and so on. I should have basic human rights. Stop the suffering” concludes Abbas.

* Not the real name

Note: MSF teams in Nablus first started offering mental health consultations in 1988. MSF teams in the West Bank are also running mental health activities and emergency preparedness in Hebron and supporting the emergency medical response in Jenin, particularly at Khalil Suleiman hospital, and in Tulkarem refugee camp.

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Inside Gaza: “Staying alive is only a matter of luck”

Inside Gaza: “Staying alive is only a matter of luck”

Ricardo Martinez is a logistics coordinator with Médecins Sans Frontières/Doctors Without Borders (MSF) who is just back from four weeks in Gaza.

We know that the humanitarian situation in Gaza is horrific. What did you witness personally?

“First of all, an immediate and sustained ceasefire is needed in Gaza. But I also insist on raising the alarm about the lack of water and sanitation in Gaza. At this point, I´m fairly certain that it could in the long run, be as dangerous as the bombings, and kill as many people.

The water system isn´t working anymore – it has completely collapsed. People are being pushed to the limit, having to fight for their survival. At most, people have one litre of water per day – that’s for drinking, washing and cooking. There is only one shower for 500 people. The ones able to have showers are considered lucky. In the south of Gaza, our teams are distributing 50 to 60 cubic meters of water a day, but this is only a drop in the ocean.

In the south of Gaza, places are so overcrowded that it feels like you are in a packed football stadium. With so many people using the same few toilets, and with no fuel for pumping the water, I´ve seen sewage flowing into the streets where vendors are working, where children are playing and splashing in the filthy black water. You can only imagine the impact on people’s health.

Whatever people want to do, they have to plan it ahead of time: you must think, plan and organise, and then you will find out if you are lucky or not. You want to go to the toilet? When and where do you go when there are hundreds of people queueing for one toilet? I don´t think I need to go into further details of how people are getting by.”

Do people in Gaza have fuel or electricity?

“In some places, there is no fuel or electricity. It´s impacting everything. Without fuel, the grinding mills are not working, so nobody has wheat – no wheat, no food. Trucks coming from Egypt are offloading aid to trucks in Gaza, but without fuel these trucks are unable to move and distribute the aid.

We have seen the devastating loss of life caused by the lack of fuel in hospitals, with generators not working and doctors unable to save people´s lives. Hospitals have become villages, with people living in corridors.”

Israel forces have repeatedly ordered people to evacuate locations within Gaza. On 3 December, MSF had to close its clinic in the southern city of Khan Younis after an order to evacuate the area. Can you describe what happened?

“The Israeli forces announce evacuation orders through a military website that they launched on 1 December. One day an area on the map will be declared a ‘red zone’ – meaning that it will be targeted. Let´s keep in mind that there is barely any electricity in Gaza, meaning no internet. How can you find out if you have to leave?

We knew it was just a matter of time before the area we were working in would receive an evacuation order. We had discussed it just two or three days earlier. Then, on 3 December, we were forced to close our clinic and leave Khan Younis. That morning, I was in charge of the logistics to get us a few kilometers towards the west. For me, this was the most painful day I experienced during my time in Gaza.

I started packing the cars, taking care of the logistics and making sure that everything was ready.  It was heartbreaking: running away and having to look at Palestinian colleagues and neighbours who had been with us all the time, helping us with everything, and knowing that most probably I would never see them again. There was no time to thank them all for the good things they had done for us. To tell the truth, I was ashamed.

But in reality, no place is safe in Gaza. I remember revisiting a place with my colleague Omar, a Palestinian logistics supervisor, that had been destroyed since our visit the previous day. He said to me: “Look at this, Ricardo, we were just here yesterday and look at the rubble now.” Who could have told us not to go there because it would be bombed? No one. Staying alive is only a matter of luck. This was one of six different places that were destroyed just after we had visited them – six places demolished into rubble. Schools: gone. Offices: gone. Private houses: gone. Water plants: gone.”

What was the reaction of people in Gaza to the temporary truce that took place from 24 to 30 November?

“I remember very well when the pause from bombing started. That morning, the minute the clock turned seven, I started to hear chanting and singing and cheers of joy. That day I finally cried; I cried because I saw them so happy. But that only lasted for a few short days. The truce ended at 7 pm, and already by 7.03 all hell was unleashed again.

For a short period, people were able to visit their families. This was the most important thing for everyone. Some went to the north of Gaza and took the time to spend several days with their loved ones.

At the same time, it wasn’t completely over: others took the time as an opportunity to bury the dead. Many went to collect the corpses of people whose bodies were rotting in the streets – some for almost two months. Can you imagine the smell and the pain?”

MSF teams are providing emergency medical care and donating medical supplies to hospitals and clinics in Gaza. Can you describe how MSF is managing to provide aid in these circumstances?

“When I arrived in Gaza, it became very clear that whatever impact we are having is solely thanks to our dedicated Palestinian staff. Since day one they have been doing everything to keep saving lives. They’re truly bringing hope in the middle of a nightmare.

Most of our staff have been displaced from their homes and have lost loved ones. Tragically, the brutality happening now isn’t new to them – they’ve experienced it before. They know they could die at any given moment but they still greet you each morning with a smile. And when you ask how they are, they reply: ‘I’m okay, I´m still alive.’

I will never forget when we were still working in our clinic in Khan Younis. I would wake at 6 am and go to the clinic. Each morning, our staff member Ishaq would open the door and greet me with a huge smile on his face. I would apologise for waking him up but he would reassure me: ‘No, no, Ricardo, I woke up half an hour ago. Welcome! I have been waiting for you.’

Like Ishaq, many of our staff members are making sure that those of us who come from outside Gaza have everything we need, from helping us charge our torches to having food and feeling welcomed. They care not only for their patients, but for everyone around them. They will tell you: ‘I want to help you – I must help you – because I want to help my people.’

At the same time, they keep asking: ‘Why? What did we do to deserve this punishment? Why has the world forgotten us?’”

ENDS

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