Dismantled healthcare system
In the past year of the conflict, we have witnessed the worsening of the humanitarian and medical situation of people in Gaza. Bombings are leaving more and more people with traumatic injuries and burns. Communicable diseases, including skin conditions, are spreading. Polio has emerged after more than 25 years. On top of the significant casualty toll are the ‘silent killings’ from chronic illnesses or lack of care; people who have succumbed to conditions that are entirely preventable, or who have had their essential healthcare needs such as dialysis or pregnancy care disrupted due to the conflict.
There is no health system to speak of left in Gaza. Israeli forces have routinely surrounded facilities, given evacuation orders in extremely dangerous conditions for patients and caretakers, and fired upon facilities, patients and medical staff—many of whom have been killed. They’ve raided facilities and arbitrarily arrested humanitarian workers. Since the start of the war, staff and patients from MSF have had to leave 14 different health structures and have endured 26 violent incidents (3.7 per month on average), which includes airstrikes damaging hospitals, tanks being fired at agreed deconflicted shelters, ground offensives into medical centres, and convoys fired upon.
At least 306 aid workers, the vast majority Palestinian, have been killed in Gaza since the start of the war, including seven MSF staff—most recently, we have mourned the loss of Nasser Hamdi Abdelatif Al Shalfouh, a driver for MSF in northern Gaza, who was killed by shrapnel injuries he suffered to his legs and chest on 8 October 2024. We are horrified and devastated by the killing of our colleagues, as well as the hundreds of other healthcare and aid workers over the past year. These incidents show the blatant disregard for medical humanitarian action and international humanitarian law.
The very few hospitals and medical facilities that remain operational cannot cope with the vast medical needs, often leaving patients without lifesaving care. MSF has witnessed patients dying on hospital floors, as hospitals have been overwhelmed and staff face critical shortages of essential supplies. Israeli authorities have on numerous occasions delayed and denied entry for items like oxygen concentrators, which are essential for anaesthesia, as well as surgical equipment and generators, without which it is almost impossible to provide surgical care. According to WHO, an estimated 12,000 people are currently in desperate need of medical evacuation from Gaza.