Category: News & Stories

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.

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.

Beirut, Lebanon – January 2^nd , 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.

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 7^th 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.

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

“We are alone in this huge community, to take care of people suffering from burns”

In 2012, a year after war broke out in Syria, Doctors Without Borders/Médecins Sans Frontières (MSF) opened a burn care unit in Atmeh, in northwestern Syria’s Idlib province. It is currently the only facility treating burn patients in northwestern Syria—home to more than more than 4.5 million people, most of whom are displaced.

Abdel Malik, Araour, MSF nurse supervisor, has worked at the clinic since it opened. Dr. Moheeb recently joined the team to develop the reconstructive surgery program. Here, they talk about what they have been able to achieve at the clinic, huge gaps that remain in the health care system, and the unacceptable living conditions that several million people endured for years.

Following Dr. Moheeb around the inpatient department (IPD) is not an easy task. He is constantly on the move with so many patients to see, most of whom are young children, with severe burns. He asks each patient or their relatives: “What happened to you? How did you get burnt? Where are you from? Are you living in a house or in a camp?” He then explains the medical procedures, so that the patients and their caretakers can understand the treatment—as he used to when he was a professor at Aleppo University, before the war.

In the dim light of a hospital room, Amin, 17, is lying on a bed after being shot in both legs by Israeli Forces on 19 November 2023, during a ground and air assault on Jenin refugee camp in the northern West Bank.

Prior to October 7^th in 2023, Israeli Forces had killed 234 Palestinians in the West Bank, while settlers were responsible for nine more deaths. Of these deaths, 52 occurred in Jenin alone.

On 19 June, Israeli forces began conducting air strikes in the West Bank, something that had not occurred since the second intifada in the early 2000s. Far from being an isolated event, this was to become more frequent. On 3 July, during a 48-hour military operation in the densely populated Jenin refugee camp, bombs were dropped from fighter jets and strikes were conducted with drones.

On the ground, the escalation of violence has followed the same trend.  In Khalil Suleiman hospital emergency room, supported by MSF, Israeli Forces launched a tear gas grenade inside the emergency room, compounding the already critical influx of patients. Throughout the military incursion, MSF witnessed the obstruction of ambulances and the targeting of healthcare facilities, elements that have become commonplace in the months that followed.

As the raid began on 19 November, Amin was walking home when an Israeli soldier shot him in both legs. Despite there being a hospital next to the camp, the ambulance could not reach Amin for over two hours as Israeli forces restricted the movement of ambulances, surrounded the hospital, and cut off access to the facility by blocking the main road with armored vehicles.

Bleeding profusely, Amin was picked up from the street by a medical volunteer and taken to one of the few trauma stabilization points in the camp – a simple room with little more than a bed frame or a few medical supplies. The goal was simply to stop the bleeding.

Inside the camp, these trauma stabilization points, established, and run by self-organised local medical volunteers, are the only places where camp residents can receive life-saving medical help. Yet these points have been repeatedly targeted by drone strikes or destroyed and vandalized by ground troops. Israeli Forces are now preventing volunteers from rebuilding the trauma points or establishing new ones according to the camp volunteers.

“The situation here is horrible”, says one of the nurses working in MSF-supported Khalil Suleiman hospital located next to the refugee camp in Jenin city.

“We used to have a football team in the camp. From 20 players in the team, only seven are still alive, many of them have been killed since July 2023. They were young, between 17 and 22 years old”, adds the nurse.

“The situation today in the West Bank and particularly in Jenin is extreme. We see significant unstick in violence against civilians, and it has been increasing rapidly since 7 October. Attacks on health care have increased dramatically and become systematic. The destruction of roads and infrastructure such as water pipes and sewage systems have also been alarming”, says Luz Saavedra MSF coordinator in Jenin.

In the last few weeks, Israeli forces have besieged multiple hospitals in Jenin, creating a direct impediment to health care, and even shot and killed a teenage boy in the Khalil Suleiman hospital compound. The obstruction of healthcare has unfortunately become common practice. During each incursion, various hospitals, including the public one, were surrounded by Israeli forces.

“The lack of respect for hospitals is staggering – since October, we have witnessed the shooting and killing of a 14-year-old boy in the hospital compound, soldiers firing live rounds and tear gas at the hospital several times, paramedics forced to strip and kneel in the street. Aside from the direct violence, the consistent blocking of access to healthcare is also putting the lives of camp residents at risk and appears to have become standard operating procedure for military forces during and following the military raids in Jenin. As obvious as it may sound, we cannot provide treatment for patients who don’t make it to the hospital. People in need must be able to safely access medical services and health facilities need to be protected.”

2023 has been the deadliest year for Palestinians in the West Bank. Amir may have survived this attack, but his future is uncertain. “Anyone can be targeted at any time here. We never know who will be next”, Amir says as he is about to be discharged from the hospital and returned to his home in the camp, now probably in a destroyed street.

The United Nations Security Council must demand an immediate and sustained ceasefire, to lift the siege and ensure unrestricted aid to the entire Gaza Strip. To date, the inaction of the United Nations Security Council and vetoes from member states, particularly the United States, make them complicit in the ongoing slaughter; this inaction has given license to the mass killing of men, women and children.

Since the seven-day truce collapsed, we have witnessed a resumption of indiscriminate killing and of forced displacement at a staggering scale and intensity. In Al Aqsa hospital alone, 1,149 patients were received in the emergency from 1-7 December, 350 of whom were dead on arrival. On 6 December, the hospital received more dead patients than injured.

Our medical staff in the Gaza Strip have witnessed and treated the medical consequences of continued and systematic atrocities over the past eight weeks. Israel’s campaign of indiscriminate killing, denial of food and access to healthcare and repeated forced displacements made conditions for more than two million people unbearable. People are in the street, in the rain, there is little to no sanitation.  We see significant increases in infectious diseases, including diarrhea, acute respiratory infections, skin infections, and outbreaks like hepatitis. Vital humanitarian aid must immediately be allowed to enter the Gaza Strip at scale.

Beirut, Monday 4^th December 2023 – As in most capitals around the world, we stand, on the mobilization day for Gaza designated by Médecins Sans Frontières (Doctors Without Borders), from Beirut, to raise a call to all concerned parties about the urgent need to secure an immediate and sustainable ceasefire in Gaza. The Israeli government must cease its war against Palestinian civilians, halt forced displacement, and end attacks on hospitals and medical personnel. The siege and Israeli restrictions on aid must stop now.

Geneva, Monday 4^th December 2023 – Dear members of the League of Arab States and the Organisation of Islamic Cooperation,

I am writing to you, and to all other leaders in the world, on behalf of Médecins Sans Frontières (MSF) to implore you and the League of Arab States and the Organisation of Islamic Cooperation, to do everything within your power, to ensure an immediate and sustained ceasefire in the Gaza Strip, as the declaration you made in Riyadh recently. The Israeli government should stop the deadly attacks on Palestinian civilians and allow crucial humanitarian aid to enter Gaza.

Though a 7-day truce was the first sign of humanity after weeks of relentless violence, it is by no means a solution of any kind. Any respite for the people of Gaza is welcome, especially if it gave them access to medical supplies, food and water. However, considering the immeasurable needs, these 7 days were not nearly enough to organise the delivery of sufficient aid to meet the immeasurable needs.

My colleagues and I, like so many people around the world, were aggrieved and shocked by Hamas’ attack on Israeli civilians. Now, after seven weeks, words fail us to describe the absolute horror being inflicted on Palestinian civilians by Israel as it carries out incessant and indiscriminate warfare in Gaza for all the world to see.

Israel has shown its blatant and total disregard for the protection of Gaza’s medical facilities. We are watching as hospitals are being turned into morgues and even ruins. They are being attacked by strikes, tanks and guns, encircled and raided, killing patients and medical staff. The World Health Organization (WHO) has documented 203 attacks on health care, including 22 fatalities and 48 injuries of health workers on duty. Medical staff, including our own, are utterly exhausted and beyond despair. They have had to amputate limbs from children suffering from severe burns without anesthesia or sterilized surgical tools. People are dying of pain. Due to forcible evacuations by Israeli soldiers, some doctors have had to leave patients behind and faced an unimaginable choice: their lives or those of their patients. There is no fathomable justification for such atrocious acts.

MSF recently sent an international emergency team to Gaza to support our Palestinian colleagues in bringing medical and surgical capacities in health facilities. Regrettably, the delivery of activities have been severely affected due to the scale of casualties, destruction of infrastructure, lack of essential supplies such as fuel and the ongoing unacceptable violence. We want and ought to be able to do so much more. Today this is just impossible due to the siege and unrelenting generalized warfare being unleashed by Israel.

Three of our MSF staff have been killed, many more have lost family members. Numerous other colleagues have been injured. Other fellow humanitarian organizations have reported dozens of their staff killed.

Gaza, under an Israel-imposed blockade since 2007, is indeed the world’s largest open-air prison. From the start of its military campaign, the Israeli government enforced a “complete siege” on Gaza, banning the entry of water, food, fuel and medicinal supplies for the 2.3 million civilians trapped in the enclave. Added to this, unyielding restrictions have been put on humanitarian access and are preventing much needed aid from reaching anyone who needs it. Subjecting an entire population to collective punishment is a war crime as per International Humanitarian Law (IHL).

We are still witnessing the fundamental principle of humanity being openly disgraced.

Despite Israel’s claims, its all-out assault is not being waged just on Hamas. It is being waged on all of Gaza and its people at any cost. Even wars have rules, but Israel is clearly trading them in for its own military doctrine based on disproportionality. In the early days of this unbearable offensive, the spokesman for Israel’s Defense Forces (IDF) announced that the “emphasis” of this flagrantly excessive reprisal was to be on “damage and not accuracy”. It is safe to say Israel’s actions have spoken louder than their words.

Northern Gaza is being erased from the map. The health system has collapsed. More than 14,000 people have been killed, half of which are children, according to Gaza’s health authorities. That’s one out of every 200 people in Gaza. Tens of thousands are injured. Families are digging their dead loved ones out from under the rubble. At least 1.7 million people have been displaced, according to the United Nations. These civilians have been forcibly ordered to move south but Israel is also bombing that area. Nowhere is safe.

Our emergency team in Khan Younis in southern Gaza, has reported massive influxes of wounded after intense bombing and airstrikes, including on overcrowded squalid refugee camps where people are barely surviving on the sparse humanitarian aid available. If the bombs do not get them, infectious diseases and starvation will.

A sustained ceasefire is the only way to stop the killing of thousands more civilians and allow for the delivery of desperately needed humanitarian aid. MSF also calls for the establishment of an independent mechanism to oversee the adequate flow of humanitarian supplies into Gaza.

Our medical teams in the West Bank have been also reporting attacks on health care with a surge in violence, persecution and harassment, in which over 200 Palestinians have been killed since 7^th October, either by Israeli Defense Forces (IDF) or settlers, according to the United Nations.

We call on you and all other leaders in the world to be part of the solution and exert all means in your power to prevent further carnage.

We urge you to take action to uphold our shared humanity.

The indiscriminate and relentless attacks must stop now.

The forcible displacements must stop now.

The assaults on hospitals and medical staff must stop now.

The siege and restrictions on aid must stop now.

It must ALL STOP NOW.

“We did what we could. Remember us.” These are the words our MSF emergency doctor wrote on a Gaza hospital whiteboard normally used for planning surgeries. When the guns fall silent and the true scale of devastation is revealed, will you and your organisation be able to say the same?

Dr. Christos Christou, President of MSF International