Sudan: MSF halts activities as violence engulfed Zamzam camp

Sudan: MSF halts activities as violence engulfed Zamzam camp

Port Sudan, 24 February 2025 – The current escalation of attacks and fighting in and around Zamzam camp for displaced people near El Fasher in North Darfur is making it impossible for Médecins Sans Frontières (MSF) to continue providing medical assistance in such dangerous conditions. Despite widespread starvation and immense humanitarian needs, we have no choice but to take the decision to suspend all our activities in the camp, including the MSF field hospital.

In the first three weeks of February, our teams in Zamzam received 139 wounded patients in the MSF field hospital, mostly suffering with gunshots and shrapnel injuries. Designed to help tackle the massive malnutrition crisis unfolding in the camp, which was declared as undergoing famine conditions by the Integrated Food Security Phase Classification last year, the MSF facility cannot provide trauma surgery for people in critical conditions.

11 patients died while in the MSF hospital, 5 of them children, because we could neither treat them properly nor refer them to Saudi hospital, the only facility with surgical capacity in nearby El Fasher. In January and December, two of our ambulances carrying patients from the camp to El Fasher were shot at. Now it's even more dangerous and as a result, many people, including patients requiring trauma surgery or emergency caesarian section, are trapped in Zamzam.
Yahya Kalilah, MSF Head of Mission in Sudan

The area has seen heavy fighting between the Rapid Support Forces and the Joint Forces, a coalition of armed groups allied with Sudanese armed forces, with dreadful consequences on civilians. Besieging and shelling the town of El Fasher for the last 10 months, the Rapid Support Forces have stepped up their offensive in recent weeks and launched attacks against Zamzam camp, in particular on February 11 and 12. People who were already struggling to survive now find their access to water and food even more compromised, as the central market has been looted and burnt down.

Halting our project in the midst of a worsening disaster in Zamzam is a heartbreaking decision. During more than two years, our teams did their utmost to provide care against all odds, despite the siege, supply shortages, and multiple other challenges, calling and waiting for a scaled up humanitarian response which never materialised.
Yahya Kalilah, MSF Head of Mission in Sudan

“However, as the battle for El Fasher rages on and now directly reaches Zamzam camp, the most minimal security conditions are currently not met for us to stay. The sheer proximity of the violence, great difficulties in sending supplies, the impossibility to send experienced staff for adequate support, and uncertainty regarding routes out of the camp for our colleagues and civilians leave us with little choice” adds Yahya Kalilah.

Hosting about 500,000 people, Zamzam camp saw new arrivals fleeing from Abu Zerega, Shagra and Saluma who are now staying in schools, community buildings, or under the trees in the open. They have told our teams of dwellings set on fire, looting, sexual violence, killings, beatings and other abuses in villages and roads of El Fasher locality. Some hundred families also reached Tawila, sometimes barefoot after leaving everything behind and escaping horrific violence on their way.

MSF is deeply concerned about the safety of its staff and the hundreds of thousands of people in Zamzam camp and urges the Rapid Support Forces, the Joint Forces and all armed actors in the area to protect civilians and let those willing to flee able to do so unharmed.

In North Darfur, we continue to run emergency activities in Tawila while looking for every possible way to help people in Zamzam and El Fasher without exposing our staff to unacceptable risk levels. In West, Central and South Darfur and in other parts of the country, our teams keep responding to the catastrophic malnutrition and health crisis driven by a relentless conflict, continued obstructions of the warring parties, and exacerbated by a failing humanitarian response. MSF reiterates its call to drastically scale up the provision of assistance in the many places where it remains possible. Warring parties must grant unhindered access for aid delivery, and their allies and influential States must use their leverage to ease the obstacles that are causing deaths and starvation.

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Libya: Migrants face violence and exclusion from healthcare

Libya: Migrants face violence and exclusion from healthcare

In 2024, some 787,000 people who are migrants and refugees were present in Libya, according to the International Organization for Migration. While some of them come in search of work, others try from here to reach Europe by crossing the Mediterranean Sea. In Libya, they live in precarious conditions and are subjected to a range of violence and abuse, both inside and outside the country’s detention centers. Abducted, subjected to extortion and trafficking practices, assaulted or sexually abused, their access to healthcare is severely hampered at a time when they desperately need it.   

I fainted under the blows, and when I woke up, they were still beating me. I was disfigured, I had no teeth, and my friend Saud told me they had hit my head with a brick.
Ahmed*, a young Sudanese boy arrested while trying to travel to Tunisia

Taken care of by Médecins Sans Frontières (MSF) teams in Zuwara, a coastal town around 100 kilometers from the capital, Tripoli, Ahmed* spent a month in hospital.

“People living undocumented in Libya have no protection, either in law or from the country’s fragile institutions, which prevents them from accessing healthcare,” says Steve Purbrick, MSF’s Head of Programs in Libya. “They are exposed to violence on a daily basis. We see people who have been trafficked, others who have been tortured, raped.”

No protection and no access to healthcare

Libya is the first country of departure for people attempting to cross the Mediterranean Sea to Italy. Like Ahmed*, undocumented migrants and refugees arriving there are exposed to violence throughout their journey. On the spot, they live in places often overcrowded, dangerous and unhealthy –  shared rooms, but also sometimes abandoned sheds or building sites where they are also at risk of contracting diseases.

Their state of health reflects both their living conditions and the extreme violence they face, without protection and access to care, their injuries and traumas are rapidly worsening.
Issam Abdullah, Deputy Medical Manager for MSF in Libya

MSF teams provide medical support in the cities of Misrata, Tripoli and Zuwara for primary health care, sexual and reproductive health, mental health, diagnosis and treatment of tuberculosis and sexual violence. The most serious medical cases requiring hospitalization are referred to the capital. Ahmed*’s jaw operation was financed by MSF and carried out in a Tripoli hospital as there was no alternative solution.

In 2024, MSF teams carried out over 15,000 consultations. The majority of those receiving mental health care were suffering from post-traumatic stress disorders linked to the violence they had endured.

“Your destiny can change at any moment in Libya, all it takes is one little thing and your life is turned upside down, you can die, you can end up in prison”, says Nelson, a man from Cameroon who has been under the care of an MSF psychologist since the sinking of the boat he had boarded with his wife and two children to reach Europe. His wife and children did not survive the shipwreck. “To go and see a doctor, for example, or to buy bread, you can take the wrong road and run into police. If it’s your lucky day, they don’t see you; if it’s not your lucky day, they arrest you,” says Nelson.

Delayed care

Faced with the risk of abduction and arrest by the police or militia, people are forced underground in isolated places where they are even more vulnerable. They seek medical care only as a last resort when their state of health has already seriously deteriorated.

In 2024, MSF teams diagnosed and treated more than 250 people with tuberculosis. Sixteen died because they were not treated in time.

“We receive people suffering from tuberculosis who seek treatment very late, which leads to high mortality and further spread of the disease,” say Dr. Abdullah. Our teams are also seeing the negative impact of interrupted treatment.”

Salma* is 37 and has diabetes. She fled the war that broke out in Sudan in April 2023. “Diabetes requires regular meals and medication, and in Libya that’s not possible,” says the university professor. “When I had to leave, my health deteriorated rapidly as the days went by – I became incapable of doing anything, not cooking, not even getting dressed… I became completely dependent on my daughters.”

More evacuations from Libya

“People on the move are an integral part of an economic model set up by militias, with the complicity of the European Union and its member states, with the aim of extorting money from them. They have to pay in exchange for their crossing, in exchange for their release and the continuation of their journey, but always with the risk of falling victim to criminal networks once again,” says Purbrick, MSF Head of Programs. “This is why, in addition to providing access to healthcare in the country, we are also focusing our efforts on opening up safe and legal pathways to evacuate people from Libya, in particular via the humanitarian corridor that exists between Libya and Italy. MSF participates in this corridor by identifying vulnerable people to be evacuated and taking charge of some of them in Italy. But these options need to be drastically increased.”

Since 2021, this corridor has already enabled the evacuation of more than 700 people, around 60 of whom were patients of MSF in Libya. Fourteen people were subsequently cared for by MSF in Palermo, Sicily.

In April 2023, the United Nations published a report concluding there were grounds to believe a wide array of crimes against humanity have been committed against migrants in Libya.

*Names have been changed

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MSF mobile clinics brings care to Syria’s neglected region of east Ghouta

MSF mobile clinics brings care to Syria’s neglected region of east Ghouta

“Going to east Ghouta and seeing it with my own eyes was heartbreaking,” says Patrick Wieland, MSF’s head of mission in Syria. “The scale of destruction is huge, people are trapped in extreme poverty, barely holding on, and in urgent need of medical care.”

After years of neglect, east Ghouta, a region located only 10 kilometres from Damascus, shows little signs of normalcy, the streets lined with the ruins of buildings are empty of the signs of life. The people here are struggling under the strain of overwhelming economic hardship. Years of health facility closures have left huge needs for medical care, and the available services are incredibly limited. East Ghouta’s suffering is far from over and urgent support is needed now.

Following the fall of Bashar al Assad’s 24-year rule, Medecins Sans Frontieres (MSF) has gained access to Damascus for the first time in over a decade. We began operating mobile clinics on 21 January, offering basic healthcare like consultations for gastrointestinal infections. In this short time, we have seen 576 patients, including 77 children under the age of five.

Families living in the shells of buildings

East Ghouta was once a lush and green 110 square kilometres, filled with fruit trees and farms. After years of relentless airstrikes by the former Syrian government forces it now stands in ruins. What’s left behind of this major food producing region is destroyed land dotted with grey buildings that have been stripped of rooftops, windows, and life. Still, families are here and struggling to make do.

People are living in difficult conditions. They lack clean water, proper food, sanitation infrastructure, and heating for their homes, exposing them to many health hazards.

Entire families are living in the rubble of destroyed buildings that look as if they have come from the Middle Ages. The level of negligence is unimaginable; the medical needs are huge and for people to find healthcare is a desperate race against time.
Bilal Alsarakibi, MSF’s medical referent in Syria

A new chapter of hope

Since January 2025, MSF has sent several teams to cities in east Ghouta, including Douma, Harasta, Zamlka, Hamoria, Ain Tarma, and Kafr Batna. Our teams are providing basic healthcare, like medical consultations and mental health support, through mobile clinics. 

We attempted to reach east Ghouta many times during the rule of Bashar al Assad. Our teams were repeatedly denied entry, which ensured that people had less access to healthcare than they desperately needed.

“When people get sick or injured, getting healthcare is really hard, there are no ambulances and medicine is too expensive,” says Mohammed Riad, who attended a mobile clinic. “Mobile clinics are a great idea. If they were covering all the areas, it can save people a lot of trouble.”   

Our teams are helping people suffering from different conditions, with the most common being respiratory infections, asthma, and gastroenteritis due to food contamination. We are also seeing people for non-communicable diseases such as diabetes, hypertension, and other cardiovascular diseases.

Our teams are also assessing the overall medical and humanitarian situation in these cities. The work is currently underway to understand the depth of people’s needs after our years of absence.

Besieged and bombarded

When the opposition forces gained control of the east Ghouta in 2012, the Syrian armed forces then imposed a severe siege on the area. Relentless ground and aerial bombardments targeted homes, markets and hospitals, while food, water and medicines were deliberately denied as a method of warfare.  

A UN report shows the devastating toll on people. Between 18 February and 11 March 2018, attacks by the former government forces killed 1,100 people and injured 4,000. During the same period, shelling on Damascus city by different armed groups killed and injured hundreds more people.

Saving lives was everyone’s struggle

“Due to the siege in 2013, a lot of people were injured and lost their limbs in daily airstrikes,” says Othman Al-Rifai, a resident of east Ghouta. “The doctors travelled abroad because salaries were low and until today you can see the impact.” 

Between 2013 to 2018, MSF provided remote support to Syrian medics in east Ghouta. Our teams sent medical supplies, offered financial support and provided technical guidance. Since MSF could not work in east Ghouta directly, this was the only way to help the medical teams there.  

We supported 20 clinics and hospitals in 2013. Over the years of escalating violence, the number went down to just one clinic by 2018. The other 19 facilities were either closed or abandoned after former government forces took over the area. At a certain point, there was nothing left that we could support.

“Today, the mobile clinics give a small sense of relief to the people who endured a lot in east Ghouta over the past years,” adds Bilal Alsarakibi. “Despite what they have seen, people are still able to smile. They have been through a lot of suffering, and they urgently need support to regain their lives.”

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“Inflicting harm and denying care” in the West Bank

“Inflicting harm and denying care” in the West Bank

Jerusalem, 6 February 2025 – Israeli forces and settlers have increased the use of extreme physical violence against Palestinians in the occupied West Bank since the all-out war on Gaza began in October 2023, according to a new report by Medecins Sans Frontieres (MSF). In total, at least 870 Palestinians have been killed and over 7,100 injured between October 2023 and January 2025[1]. According to the MSF report, “Inflicting harm and denying care”, the escalation of violence in the West Bank has severely hindered access to healthcare and is part of a pattern of systemic oppression by Israel which has been described by the International Court of Justice (ICJ) as amounting to racial segregation and apartheid.

The report which covers a one-year period from October 2023 and 2024, provides in-depth interviews from 38 MSF patients and personnel, hospital staff paramedics and volunteers supported by MSF who report prolonged and violent Israeli military incursions and stricter movement restrictions, all of which have severely hindered access to essential services, particularly healthcare.  The situation has further deteriorated since the ceasefire in Gaza and has exacerbated dire living conditions for many Palestinians who are paying an immense physical and psychological toll.

“Palestinian patients are dying because they simply cannot reach hospitals,” says Brice de le Vingne, MSF emergency coordinator. “We’re seeing ambulances blocked by Israeli forces at checkpoints while carrying critical patients, medical facilities surrounded and raided during active operations, and healthcare workers subjected to physical violence while trying to save lives.”

An increased number of attacks on medical personnel and facilities have been reported to MSF teams, including attacks on hospitals, destruction of makeshift medical sites in refugee camps, as well as the harassment, detention, injury, and killing of first responders and medical workers by Israeli forces. Between October 2023 and December 2024, WHO has recorded 694 attacks on healthcare in the West Bank, with hospitals and healthcare structures often besieged by military force. Healthcare workers express a feeling of insecurity as they are frequently harassed, detained, injured and even killed.

“Israeli forces surrounded the stabilisation point [in Tubas], closing both its entrances, even though it was very clear that this was a medical building. They ordered all the paramedics to exit the stabilisation point. There were around 22 of us paramedics there. Israeli soldiers shot inside and outside the building, damaging our supplies and the stabilisation point,” says a medic from the Palestinian Red Crescent Society, supported by MSF.

In case of medical emergency, restrictions of movement can have deadly consequences. Access to healthcare in this context has been severely impeded by the obstruction and targeting of ambulance movements and the escalation of violent military raids resulting in injuries, fatalities and the destruction of vital civilian infrastructure, including roads, healthcare, water pipelines and electrical systems, particularly in Tulkarem and Jenin refugee camps. In remote areas and outskirts of cities like Jenin or Nablus, the situation is especially dire, as patients with chronic conditions, such as those who need regular dialysis treatment, are forced to stay home due to the untenable obstacles to reaching healthcare.

On top of the frequent Israeli military incursions, settler violence and the ever-increasing expansion of settlements has left many Palestinians vulnerable to violence and afraid to move across the West Bank. In total, 1,500 attacks by Israeli settlers against Palestinians have been reported by OCHA between October 2023 and 2024.

As the occupying power, Israel has legal obligations under international law to ensure access to healthcare and protect medical personnel. The healthcare system in the West Bank is under immense strain and forced into a state of perpetual emergency.

MSF calls Israel to stop the violence against healthcare workers, patients and health facilities and to stop obstructing medical personnel from performing lifesaving duties.

[1] OCHA, 31 December 2024

Download the Full Report in PDF
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MSF Boosts Emergency Operations in Southern Lebanon amid Recovery Phase and Ongoing Attacks

MSF Boosts Emergency Operations in Southern Lebanon amid Recovery Phase and Ongoing Attacks

Since the ceasefire between Lebanon and Israel first came into effect on 27 November, Israeli forces have continued to engage in military operations in southern Lebanon. Hundreds of thousands of people have returned to their homes and villages in southern Lebanon. Many of them saw their homes destroyed by the Israeli bombardment and remain displaced. Others are still unable to return home due to the continued Israeli military presence in their towns and villages. Both returning and displaced communities are facing significant challenges accessing medical care, due to damaged infrastructure, understaffed health facilities and the costs of medical treatment, which is unaffordable to many after they lost their livelihoods during the past months of war.
 
In response, international medical organisation Médecins Sans Frontières (MSF) has expanded its activities in southern Lebanon over the past 60 days, deploying three mobile medical teams to 11 towns in the Nabatieh governorate. This is in addition to two mobile medical teams which already visit towns in the South governorate. These teams are providing essential medical services to address critical healthcare gaps in some of the worst affected areas. 
Throughout the ceasefire since November, and still today, Israeli forces continue to open fire, carry out strikes, and demolish civilian infrastructure, causing daily devastation and civilian casualties in southern Lebanon. The hardships of these communities are greatly aggravated; people are already struggling to cope with their losses and the impact of the war.
Francois Zamparini, Emergency Coordinator for MSF in Lebanon.

According to the Ministry of Public Health, 83 people have been killed and at least 228 others have been injured by Israeli forces in Lebanon since the announced ceasefire on the 27th of November 2024.

“The scale of the destruction is massive. Towns have been reduced to rubble, with homes, schools, and farmlands wiped out,” says Zamparini. Over 90,000 structures—including homes, businesses, agricultural facilities, schools, and water infrastructure—have been damaged or destroyed by the bombardment across the country, according to UNDP. “MSF is committed to supporting the people during this recovery period and ensuring that they are not left without essential medical care as they start to rebuild their lives.”

Our mobile medical teams—now 15 across the country- provide primary healthcare services, medications for chronic illnesses, health education, mental health support, and post-operative nursing care.

From the announcement of the ceasefire in November 2024 till January 15, 2025, our teams in southern Lebanon have provided over 19,000 general medical consultations, conducted 3,427 health awareness and education sessions, and supported over 3,000 individuals with mental health services—and this vital work continues. Patients with complicated medical conditions are referred to the Public Emergency Turkish Hospital in Saida city, where MSF is working in partnership with Ministry of Public Health to deliver free, high-quality trauma, emergency, and surgical care to all the communities in Lebanon.

Beyond healthcare, MSF is also addressing immediate humanitarian needs across the country. In the heavily bombarded Bint Jbeil district, the organization is donating essential relief items. We have already delivered 7,000 blankets, 4,000 mattresses, 5,820 hygiene kits, as well as 2,015 floor mats and other necessities to support the war-affected communities as they rebuild their lives. Our teams are also actively coordinating with several affected hospitals in the area to offer support, such as donation of fuel and 19,270 medical items, and training medical staff to deal with emergencies.

“Serious efforts must be made to ensure safety for the civilian population, healthcare facilities and staff,” says Zamparini. “Any escalation of violence or breaches of the ceasefire would further jeopardise the health and wellbeing of thousands of families in southern Lebanon who have already lost so much.” 

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North Gaza’s destruction is a “sight that cannot be described”

North Gaza’s destruction is a “sight that cannot be described”

While the ceasefire in Gaza has finally been announced, in the past months people across the Strip have continued to suffer from Israeli forces’ relentless bombardments. The northern governorate of Gaza in particular has been under siege and subject to horrific bombing and attacks. Meanwhile, almost no humanitarian aid has managed to enter the north and people have been cut off from healthcare as hospitals have also been under siege and subject to incursions. In our clinic in Gaza City, patients who managed to escape the horror recount their experience during the siege.

Mustafa Hassan Abu Hamada and his family were living in Jabalia camp in northern Gaza, Palestine, during the recent brutal Israeli military siege, which has left the city completely destroyed and killed and injured countless civilians, including Médecins Sans Frontières (MSF) staff.

“People in front of us tried to escape at the Al-Awda junction, but they were shot at,” says Mustafa. “We were forced to return. We said, ‘Let us die in our homes.’ I would rather die in my house than be displaced.”

In north Gaza, the Israeli military has been carrying out a ground offensive since 6 October 2024. This ongoing military offensive is a clear illustration of the brutal war the Israeli forces are waging on Gaza, and we are witnessing Palestinian life being wiped from the area.

“When the Israeli forces arrived, we stayed for an hour or two before shells started raining down on us from all directions,” says Sabah Al-Sharawi, who was sheltering in her home in Beit Hanoun, northern Gaza, when it was targeted by an airstrike.

“The first shell came through the living room. It hit my legs – both of my legs,” she says. “They took us to Kamal Adwan hospital.”

“On the way, we saw bodies lying everywhere. Dogs were gnawing at them. Drones were hovering above us, and a helicopter circled overhead,” says Sabah.

Sabah was evacuated from Kamal Adwan to Gaza City where she is now displaced and receiving treatment for her wounds at the MSF Gaza Clinic.

“I buried my daughter and left. I didn’t even see her one last time. I didn’t see my daughter. I didn’t see my loved ones. I left without seeing anyone,” says Sabah.

In addition to the relentless destruction, the offensive has left thousands of people without access to food, water, or healthcare in northern Gaza. The effects of these conditions are devastating, especially on elderly people, children and people with special needs, including those with disabilities.

Hospitals have been subject to sieges and violent incursions one by one over weeks and many medical staff have been detained, including one MSF staff member. Gradually the number of hospitals for people has reduced and since 9 January there has not been a single functional hospital in north Gaza left for people in need of medical care.

In addition, since 21 November 2024, no MSF supply trucks have been allowed by Israeli authorities to enter the north. This has meant that people with medical conditions, including war wounds, have had almost no access to medical care.

As the situation in northern Gaza has become untenable, many people have risked their lives fleeing to Gaza City. In our clinic, we have seen an upshot of patients in need of medical care. Before October 2024, our teams had been providing around 600 consultations per week, however since the violent incursions began, we have been providing more than 1,400 consultations per week up until December 2024, with an increased proportion of burn injuries.

“Honestly, this situation is unprecedented. I am 40 years old and throughout my life I have never seen such a level of aggression or conflict,” says Mohammed Wadi, MSF deputy medical coordinator in Gaza. “It is a war that has annihilated many aspects of life. Drinking water is not available. Food, unfortunately, is not sufficiently available. This is extremely heartbreaking.”

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Relief after temporary ceasefire: Immense scale-up of life-saving aid must flow into Gaza now

Relief after temporary ceasefire: Immense scale-up of life-saving aid must flow into Gaza now

The temporary ceasefire agreement in Gaza is a relief, but it arrives more than 465 days and 46,000 lives too late.  While this temporary cessation of fighting and bombing must be both respected and long-term, this is only the beginning in addressing the immense humanitarian, psychological, and medical needs in Gaza.  Israel must immediately end its blockade of Gaza and ensure a massive scale up of humanitarian aid into and across Gaza so that the hundreds of thousands of people in desperate conditions can begin their long road to recovery.

The toll of this hideous war includes the obliteration of homes, hospitals, and infrastructure; the displacement of millions of people that are now in desperate need of water, food, and shelter in the cold winter. The massive destruction has caused pain and suffering to millions of people in the Gaza Strip, while many families in Israel continue to desperately wait for the return of their loved ones taken hostage on 7 October 2023.

For more than 15 months, hospital rooms have been filled with patients with severed limbs and other life-altering trauma, caused by strikes, and distressed people searching for the bodies of their family members. Health facilities and medical staff have been attacked, and eight MSF colleagues have been killed during this war. Meanwhile, the number of people arbitrarily detained from Gaza and the West Bank is appalling.

MSF remains committed to working around the clock to provide care to people in Gaza. Humanitarian needs have mounted to catastrophic levels; meeting even a fraction of these needs will only be possible through a rapid and massive scale up of global humanitarian aid into and within the Strip. We call on Israeli authorities to urgently ensure humanitarian aid into Gaza, medical evacuations and particularly access to the north which has been under siege since October 2024. We call as well on Israel, Hamas, and other groups and organisations in control of Gaza, to respect the agreement, as well the safe and secure delivery of humanitarian assistance to people.

The Israeli government, Hamas, and world leaders have tragically failed the people of Gaza, by not agreeing and imposing a sustained ceasefire sooner. The relief that this ceasefire brings is far from enough for people to rebuild their lives, reclaim their dignity and to mourn for those killed and all that’s been lost.

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Humanitarian needs in Lebanon: the post ceasefire landscape

Humanitarian needs in Lebanon: the post ceasefire landscape

Two months following the ceasefire agreement reached on 27th of November between Lebanon and Israel, the humanitarian needs in Lebanon persist. As of 9th January (OCHA), an estimated 868, 947 internally displaced persons (IDPs) have begun returning to heavily war-affected areas, notably in the South, Nabatieh, Baalbek-Hermel governorates, as well as Beirut’s southern suburbs. These returnees face massive destruction of their homes, civilian infrastructure, water distribution systems, and health facilities. Lebanon is currently facing the dire consequences of war, and the road to recovery on both the infrastructure and human levels is a long way ahead.

For returnees, access to basic services such as electricity, water, heating, food, relief items and healthcare poses a great challenge in the midst of destruction and the harsh winter weather. Medecins Sans Frontieres (MSF) teams have been donating relief items such as mattresses, blankets, hygiene kits, potable water, and providing primary healthcare through mobile teams in Beirut, South, Nabatieh, Bekaa and Baalbek-Hermel.

Those who found their homes destroyed or heavily damaged remain displaced, estimated at 115,439 people (OCHA). Many have had to seek shelter elsewhere within their communities, either renting houses when they have the means, or living in apartments belonging to family and friends.

Additionally, ongoing Israeli military activity in southern Lebanon has prevented many people from returning to their areas of origin in some villages. Despite the ceasefire agreement, there have been incidents of Israeli bombardments and land incursions, which resulted in the killing of at least 27 civilians according to Lebanese authorities.

Access to healthcare remains a challenge post war. Several medical facilities, including hospitals and clinics, have been destroyed or damaged, severely limiting access to healthcare for those in need. We are seeing many patients whose routine treatment for chronic diseases has been interrupted. And there is a huge demand for mental health care services as people return home.
Sadie St. Denis, MSF deputy emergency coordinator in Lebanon

Many hospitals and clinics in war-affected areas are either heavily damaged or completely destroyed, exacerbating an already dire situation.

The damage to these critical services creates a gap in medical care for those who need it. The needs in Lebanon shifted from providing healthcare in shelters and gathering points for displaced people during the war, to providing healthcare in areas heavily affected by bombardments.

In response, MSF continues to deploy 15 mobile medical teams all over Lebanon, four of them in Baalbek-Hermel governorate and six of them in the south of the country in South and Nabatieh governorates, while the other six respond to needs across Bekaa, Mount Lebanon, and other areas.

The mobile medical teams are focusing on areas and towns where newly arrived Syrians and Lebanese returnees are gathering in shelters or found refuge in host communities.

Our teams have also reopened our long-standing clinic in Burj El-Barajneh, located in the hard-hit southern suburb of Beirut, after having to close its doors for two months amid Israeli bombardment. We have also reopened our clinic in Hermel at full capacity after limiting services to distribution of medication for non-communicable diseases to ensure continuity of care during the war.

MSF has provided more than 4967 medical consultations in south Lebanon one of the region most affected by the war, 4460 in Baalbek-Hermel and 1326 in Beirut since the ceasefire came into effect.

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MSF Suspends Activities at Key Khartoum Hospital

MSF Suspends Activities at Key Khartoum Hospital

KHARTOUM/BRUSSELS. Médecins Sans Frontières/Doctors Without Borders (MSF) strongly condemns ongoing violent attacks on patients and staff at Bashair Teaching Hospital, located in a Rapid Support Forces-controlled area of Khartoum. Despite extensive engagements with all stakeholders, these attacks have continued in recent months. MSF has now taken the very difficult decision to suspend all medical activities in the hospital.

In the 20 months MSF teams have worked alongside hospital staff and volunteers, Bashair Hospital has experienced repeated incidents of armed fighters entering the hospital with weapons and threatening medical staff, often demanding fighters be treated before other patients. On 11 November 2024, a patient was shot and killed inside the hospital. On 18 December, attackers fired weapons inside the emergency ward, directly threatening medical staff. In an earlier incident, weapons were fired at the hospital, bullets entered the hospital compound, and one person was wounded.

The suffering we witness in Khartoum is enormous. Intense and extreme violence continues daily. Shortages and blockages of food, supplies and humanitarian aid leave people scrambling to survive. The medical needs are overwhelming. Injuries are often horrific. Mass casualty incidents have become almost routine. Our team, hospital staff and volunteers have worked tirelessly in very difficult conditions to provide the medical care. But without the security to operate safely it has become untenable to continue when the lives of our staff and patients are threatened
Claire San Filippo, MSF Emergency Coordinator

Bashair Hospital is one of the last functioning hospitals in south Khartoum offering free medical care. Since the end of September, the hospital has seen a surge in cases of people arriving with violent trauma injuries as fighting has escalated. Sometimes dozens of people arrived at the hospital at the same time after shelling or airstrikes on residential areas and markets. On Sunday 5 January 2025, 50 people were brought to the emergency room – 12 of them already dead – after an airstrike one kilometre from the hospital.

At the same time, our teams have seen an increase in paediatric and maternity cases as other health facilities have closed down or reduced services. We have also been responding to cholera, malaria and dengue outbreaks and seeing very worrying levels of malnutrition.

The hospital has already faced serious difficulties. In October 2023, all surgeries were temporarily suspended after surgical supplies were blocked by the Sudanese Armed Forces. The transport of medical supplies and staff movements from Port Sudan have now been blocked for more than a year. MSF has previously had to suspend medical activities at nearby Turkish Hospital in July last year as a result of threats to and violence against staff.

It is devastating to have to stop supporting lifesaving medical care at this hospital, particularly in the face of such great and growing medical needs. Every time an organisation is forced to suspend activities, patients have less access to medical care they desperately need. Hospitals must be places where people can seek healthcare without risking their lives and where medical professionals can safely deliver care.
Claire San Filippo, MSF Emergency Coordinator

An MSF team first joined volunteers and medical staff who had reopened the hospital in May 2023, shortly after the start of the war. Between May 2023 and December 2024, the hospital treated 25,585 patients in the emergency room, more than 9,000 due to violence, such as blast and gunshot wounds. During the same period, the team performed 3,700 surgical procedures – the vast majority violence-related injuries – and assisted in almost 3,800 deliveries, including 850 caesarean sections. MSF continues to work in 11 states in Sudan, including the city of Omdurman in Khartoum state. We hope that conditions will allow us to return to Bashair Hospital in the future and restart medical activities.

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Healthcare under occupation: Hebron’s H2 residents are suffocating

Healthcare under occupation: Hebron’s H2 residents are suffocating

The H2 area of Hebron, one of the most restricted areas in the West Bank, comprises about 20 percent of the city and is emblematic of the challenges faced by Palestinians living under Israeli control. Home to approximately 7,000 Palestinians and several hundred Israeli settlers, this neighbourhood is ruled by strict movement regulations, systemic closures, and continuous violence. Médecins Sans Frontières (MSF) teams have been providing primary healthcare and mental health support in two clinics to Palestinians whose access to healthcare has been directly obstructed.

H2 has around 28 permanently staffed Israeli checkpoints, many of which are fortified with metal detectors, surveillance cameras, and facial recognition technology, along with facilities for detention and interrogation, severely limiting the movement of Palestinian residents and healthcare workers.

Since Israel´s war on the people of Gaza, restrictions by Israeli forces have drastically increased in the West Bank, including in Hebron. In December 2023, citing security concerns, Israeli authorities forced MSF teams to suspend activities for over five months in the Jaber neighbourhood, inside H2. As an alternative, MSF teams opened a mobile clinic close to the Jaber neighbourhood outside the checkpoint and in Tel Rumeida, accessible to people who can exit H2 but only a few people could access it.

Although we are now able to provide care in the MSF clinic in Jaber neighbourhood, access remains challenging as our staff can be searched and delayed at the checkpoints to enter the H2 area. Access to medical care should never be arbitrarily denied, impeded or blocked.
Chloe Janssen, MSF Project Coordinator

Restricted access to health care

Since the beginning of the war, most of the Ministry of Health´s medical staff were unable to obtain the necessary permissions to cross Israeli checkpoints, leaving only one MSF clinic operational during this period.

“I am 77 years old, and my feet hurt. Israeli forces prevent us from using vehicles, so I hold my children’s hands and walk paths between houses to reach the clinic or any medical service.” – shares MSF patient and resident of the H2 area.

MSF frequently faces interruptions to their mobile clinic services, being barred from entering the area or encountering movement restrictions during Israeli public holidays. These disruptions to care have profound impacts on the health of patients, particularly those who require continuous care, such as those with diabetes or hypertension.

MSF clinics provide not only essential medical care but also a rare space for social connection in an environment marked by isolation and restricted mobility. Twice a week, mobile clinics treat 60 to 70 patients, offering physical care alongside mental health support to help residents cope with the ongoing trauma of their circumstances.

The Impact on Children and Families

Between October 2023 and May 2024, three Palestinian schools serving at least 350 students remained shut, while over 13,000 students in the area missed in-person learning. Many have since dropped out entirely due to the logistical and psychological toll of attending school in such conditions. (OCHA)

“We’ve seen a dramatic decline in children’s mental health,” explains Ola Jabari, MSF’s mental health counsellor. “Many of the children suffer from bed-wetting, nightmares, and academic struggles. We also see symptoms of trauma like hyperactivity and difficulty concentrating, all linked to the violence and restrictions they witness daily.”

Jabari adds, “Parents here are under immense pressure. They can’t provide for their children’s needs—economically, emotionally, or psychologically. We’ve even seen a rise in domestic violence as stress builds up within households.”

MSF is also offering recreational activities to Palestinian women and children coming from across Hebron governorate. “Participants appreciate having a safe place to meet and talk to other women,” continues the mental health counsellor. “For those coming from H2, these appointments are an excuse to escape a confined environment akin to a prison.”

The Mental Toll of Continuous Trauma

“Palestine isn’t a case of post-traumatic stress disorder (PTSD) because the trauma never ends. Here, we’re talking about continuous and complex trauma. The entire population is affected.” says Lucia Uscategui, MSF’s Mental Health Activity Manager,

She recounts the story of an 11-year-old boy who was forced to undergo a humiliating body search at a checkpoint. “He refused to leave his home for weeks afterward,” she says. “He had nightmares, bed-wetting, and severe anxiety. His father brought him to us, but the trauma had deeply affected both of them. This is the reality for many families in H2.”

Despite the immense challenges, some in the community continue to show remarkable resilience. However, Lucia notes a troubling rise in unhealthy ways. “We see more people turning to smoking, scrolling endlessly on their phones, or other quick fixes that offer short-term relief. Long-term solutions, like therapy, feel out of reach because people have lost hope for change.”

Even if the conflict and occupation ended tomorrow, the consequences would linger for years. But our work is about showing people they are not alone—that there is still some hope, even in the darkest times.
Lucia Uscategui, MSF’s Mental Health Activity Manager

MSF calls on the Israeli forces to stop implementing restrictive measures that impede the ability of Palestinians to access basic services, including medical care. Israel must take all feasible measures to ensure that medical care remains unobstructed and accessible. Access to medical care must never be arbitrarily denied, impeded or blocked. 

Healthcare under occupation: Hebron’s H2
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