MSF Response: War on Gaza

MSF currently operates in two hospitals (Al-Aqsa hospital, Nasser Hospital), one clinic in Gaza City, and five healthcare facilities, including one in Al-Mawasi in Rafah, two in Khan Younis, and two in Gaza’s Middle Area.  

Our teams are offering surgical support, wound care, physiotherapy, post-partum care, basic healthcare, vaccinations, and mental health services. However, systematic sieges and evacuation orders on various hospitals are pushing our activities onto an ever-smaller territory and limiting our response.

South Gaza

Nasser hospital, Khan Younis – Nasser hospital is now the main surgical centre in the Gaza Strip. Working with the Ministry of Health, we focus on providing orthopaedic surgery, and working in the burns unit, providing plastic surgery, general laboratory activities, physiotherapy and counselling department. We also offer day surgery, provide care in the maternity and neonatal wards, and have opened an inpatient therapeutic feeding centre

Al-Mawasi health post, Rafah – Our staff are providing outpatient services, including general consultations, vaccinations, reproductive health care services, pre- and post-natal care, changing dressings, physiotherapy sessions, mental health services, and health promotion. We also screen and treat malnutrition, and treat non-communicable diseases.  

Al-Mawasi advanced healthcare centre, Rafah – We provide outpatient services, including general consultations, vaccinations, reproductive healthcare, wound dressing, mental health services, and health promotion. Our facility also features a 24/7 emergency room for stabilizing and referring trauma patients.

Khan Younis healthcare centre, Khan Younis – We provide outpatient consultations, vaccinations, mental health services, outpatient treatment for malnutrition, sexual and reproductive healthcare, wound care, physiotherapy, and health promotion.  

Al-Attar healthcare centre, Khan Younis – Opened in mid-June 2024, we offer a range of services, including general medicine, paediatric consultations, emergency healthcare, wound care, antenatal and postnatal care, mental healthcare, health promotion.

Al-Qarara sexual and reproductive health clinic, Khan Younis – We support a clinic which aims to enhance sexual and reproductive healthcare, as well as general medical consultations, with medications, staff incentives, and running costs.  

Middle Area

Al-Aqsa hospital, Deir Al-Balah – we provide trauma surgery, advanced wound care, post-operative wound care, physiotherapy, health promotion and mental health support.  

Al-Martyrs clinic, Deir Al-Balah – an MSF team provides wound care and malnutrition screening.  

Clinic, Al-Hekker – we provide general consultations, vaccination, reproductive health services, and change wound dressings. We also provide mental health services, including psychological first aid, individual and family counselling sessions, and psychoeducation and health promotion activities.  

North Gaza

MSF clinic (near Al-Shifa), Gaza City – In our clinic close to Al-Shifa hospital, our team provides wound dressings and physiotherapy.  

Water and Sanitation

Currently, we distribute over 600,000 liters of water daily through more than 40 water points in Al Mawasi, Khan Younis, Rafah, and Deir El Balah, and are working to increase this supply. A desalination unit in Al Mawasi provides 30 m³ of drinking water daily.

In partnership with PARC, we are implementing water and sanitation activities in camp shelters in Deir El Balah and Khan Younis, including building latrines for over 30,000 people in six camps, distributing hygiene kits to 2,400 families, and ensuring clean drinking water for 25,000 people. We are also equipping a camp for 70 families with accessible sanitary facilities.

Supplies/logistics

As of end of June 2024, MSF had brought seven international cargo loads, a total of 73 trucks, into Gaza through the United Nations. The Rafah crossing point, formerly the main functional entry point for humanitarian organisations, has been closed since early May. 

In the West Bank, we are maintaining activities focused on emergency care, basic healthcare via mobile clinics, and mental health care in Hebron, Nablus, Tulkarem, and Jenin.

Hebron  

In Hebron district, we provide medical care through 15 mobile clinics. With medical staff, we also support four clinics, the maternity ward and emergency room in Halhul hospital, and emergency room in Al-Mohtaseb hospital. We provide mental health services, and donations to hospitals and first-aid kits to community focal points in Beit Ummar, Al-Rshaydeh, and to the emergency care centre in Umm al Kheir. MSF teams train medical staff in Al-Mohtaseb, Halhul, Dura, and Yatta hospitals.

Nablus  

In Nablus district, we provide psychological first aid in both individual and group sessions in Nablus, Tubas, and Qalqiliyeh.

We also provide training to local psychologists and to medical and paramedical volunteers for the Palestinian Red Crescent.

Jenin and Tulkarem

MSF teams provide training to staff in the emergency rooms of the Ministry of Health-run hospitals Khalil Suleiman in Jenin and Thabet Thabet in Tulkarem. We also train medical and paramedical staff, primarily in ambulances, to provide first aid and lifesaving care.

We equip volunteer paramedics in Jenin, Tulkarem and Nur Shams refugee camps with donations and training, so they can stabilise patients during active hostilities in case ambulances are not able to reach them.  

MSF staff also provide individual and group mental health sessions and psychological first aid in communities and in Khalil Suleiman hospital. 

MSF in Lebanon is collaborating with health partners to train medical personnel in various hospitals as part of the Ministry of Public Health’s emergency plan. The training encompasses patient triage, responses during conflicts, and managing significant injuries to enhance emergency preparedness. MSF has successfully conducted sessions in Tyre, Saida, Zahle, Hermel, and Baalbeck hospitals.

Furthermore, MSF in Lebanon is actively supporting and organizing advocacy and communications activities to highlight the situation in Gaza and the work MSF is undertaking. As part of these efforts, MSF is also arranging mobilization solidarity events in both Cairo and Beirut.

We have teams in Egypt, ready to send medical supplies into Gaza. On 29 October, we sent 26 tonnes of medical supplies – which can cover the needs for 800 surgeries – on a WHO plane to Egypt, under the coordination of the Egyptian Red Crescent, destined for healthcare facilities in Gaza. Upon the cargo’s arrival in Egypt, we have been able to send part of it into Gaza, but sending medical supplies remains difficult due to Israeli restrictions at the Rafah crossing.

We are in contact with the Egyptian authorities and the relevant organisations in Egypt to start activities in Egypt to provide healthcare for injured or sick Palestinian people allowed to exit Gaza, if needed.

The situation in Gaza has been described by our teams as ‘apocalyptic’.  

Israeli forces continue to carry out widespread attacks disproportionately impacting civilians. Palestinians in Gaza are suffering each day from an all-out destructive military campaign that blatantly ignores the rules of war. The recurrent forced displacement of people and Israel’s attacks on densely populated areas, even those designated by Israel as “safe” or “humanitarian zones”, continue to expose the absence of true safety in Gaza.

The ongoing Israeli offensive on Rafah is making the delivery of humanitarian assistance and provision of medical care near impossible. The closure of the Rafah crossing is jeopardising the lifeline for thousands of people and the humanitarian response, leaving stocks, including fuel, food, medicines, and water, dangerously low.

Half of all displaced people crammed in the south live in appalling conditions, in temporary structures made of a few pieces of wood banged together and covered in plastic sheeting. Many people sleep in the streets or in open areas. They struggle to find enough water to meet their hygiene needs. The Integrated Food Security Phase Classification has released a report warning that famine is imminent. We are seeing the impacts of widespread food insecurity and hunger.

On 24 May, the International Court of Justice ordered Israel to halt its offensive on and reopen the Rafah crossing. It is another confirmation of how catastrophic the situation is and of the desperate need for humanitarian aid to be scaled up immediately.

Northern Gaza remains isolated, receiving negligible amounts of humanitarian aid in contrast to the actual needs. According to OCHA, Israeli authorities have facilitated only half of the planned humanitarian assistance missions to northern Gaza up until June. The rest were impeded, denied access, or cancelled due to logistical, operational or security reasons.

Ongoing offensives across multiple locations of Gaza at the same time and repetitive evacuation orders further reduce access to healthcare in an already decimated and collapsed health system. People are left with almost no options for basic medical care. Staff and patients from MSF have had to leave 14 different health structures and have endured 26 violent incidents since 7 October, which includes airstrikes damaging hospitals, tanks being fired at agreed deconflicted shelters, ground offensives into medical centres, and convoys fired upon.

Israeli armed forces have announced the West Bank as a closed area. Most checkpoints across the West Bank remain closed, exacerbating movement restrictions on people and affecting their ability to access basic services, including food, and medical care.

In West Bank towns, people are experiencing an explosion of violence against them. Jenin has been particularly hard hit, with bombings and incursions by Israeli forces in the refugee camp killing and wounding dozens of people.

Over 5,000 Gazan workers have sought refuge in the West Bank. An unspecified number of Palestinians from Gaza were previously arrested by Israeli Forces when Israeli authorities cancelled their permits and many of them are still missing.

In Jenin, our teams report treating patients who showed signs of being tied up and beaten, reportedly by Israeli forces.

Our medical teams at Jenin hospital have witnessed Israeli forces shooting at the hospital itself, while they’ve also treated medical staff who were shot by soldiers while still in an ambulance. Israeli forces also prevent the ability of ambulances to move around, blocking entrances to the refugee camp.  

In Hebron, families have been displaced after violence from Israeli settlers and forces, including having their homes burnt down. Patients in Hebron old city, known as H2, are facing challenging access to our mobile clinic when it’s there, due to extreme restrictions on movements.

These attacks on medical care MUST stop.

• We ask world leaders and organisations to exert their influence in favour of a ceasefire that will spare the lives of Gazans and restore the flow of humanitarian aid.
• We ask Israel to lift the siege to allow increased and continuous humanitarian supplies to cross into Gaza.  
• Protection for civilians and healthcare personnel and facilities on both sides, at all times; hospitals and ambulances are not targets.
• Basic guarantees of safety to enable our teams to move to provide humanitarian and medical services.
• Access to people in need of medical care and humanitarian aid, including the sick and wounded.
• People to be afforded safe access to essential supplies like food and water and health facilities.
• Increased essential humanitarian supplies like medicine, medical equipment, food, fuel and water must be allowed to enter the Gaza enclave.
• Those who wish to leave must be able to do so safely without prejudicing their future option to come back.
• In the West Bank, for Israeli authorities to put an end to the violence and forced displacements of Palestinians.  
• Israeli authorities must stop implementing restrictive measures in the West Bank that impede the ability of Palestinians to access basic services, including medical care.
• Airdrops and sea routes are no alternative to aid delivery by land

We call all on States, in particular the US, UK, and allied EU Member States, to do everything in their power to influence Israel to adopt a ceasefire and to stop supporting the ongoing siege and the continuing attacks against civilian and civilian infrastructures in Gaza.