On January 6, MSF had to evacuate Al-Aqsa hospital due to fighting all around the premises and evacuation orders that made MSF’s pharmacy store inaccessible. Three MSF-supported staff remained on premises, working autonomously. On February 6, MSF team returned to Al-Aqsa and prepared the premises for a full return to previous activities. On February 7, wound care and rehabilitation resumed.
The last remaining main hospital in north Gaza has been crippled and is barely functional. The hospital was struck in early October and at least 5 hospital staff, including two MSF doctors, were killed while caring for their patients. In early December, Israeli forces besieged the hospital, and took control of it on 17 December after heavy fighting and detaining all males above 16 years old– six MSF staff among them.
After the interrogations, most of them were sent back into the hospital and have been working there autonomously since. They report shortages of everything and difficult work conditions. As of February 5, we still have several staff members working here.
Nasser was the main surgical centre in the south of the Gaza Strip, located in Khan Yunis, and had become the largest hospital in Gaza after Al-Shifa was brought to a standstill by Israeli military operations.
The area surrounding Nasser has been under evacuation orders since January 23, following weeks of intense bombing and fighting. This prompted 90 percent of staff to leave, including most MSF staff, though a handful decided to remain on the premises.
International mobile staff left on December 26. Remaining staff describe shortages of everything from beds to anesthetics, fuel, food and water. In late January, 150 patients too sick to move are trapped inside the hospital, the emergency room is open but cannot cope with a large influx of wounded that could result from strikes in nearby areas.
Access to European Gaza Hospital is proving harder every day due to insecurity on the way to the premises and on at least two occasions staff could not reach the hospital. Our plastic surgeon and small team of nurses are seeing between 20 and 30 patients a day for a change of dressings, and working in the operational theater providing debridement, flap surgery and sutures.
Many of these patients are children with trauma and severe burn injuries, who were wounded at the beginning of the war and now have their wounds infected due to lack of medical care.
Rafah Indonesian Hospital
MSF supports the outpatient department at Rafah Indonesian Field Hospital, taking care of patients in post-operative care, all showing war-related wounds, with wound dressing, physiotherapy, and other small procedures to relieve the patient load from Nasser, European and An-Najar hospitals. Inpatient activities were scaled up to 60 beds in January and include one procedure room to do small surgical interventions (skin graft, debridement, removal of external fixators). Outpatient activities now run 6 days a week with about 150 consultations a day, providing dressing, physiotherapy, and counselling.
MSF is supporting the Emirati maternity hospital with medical supplies, staff including gynecologists, nurses and hygienists working in round-the-clock shifts. MSF team is offering postpartum care and managing complications in pregnancies. While deliveries are managed by the Emirati hospital team. The teams built an extension of the maternity department in the parking lot of the hospital to increase the postpartum department’s capacity to 20 beds, as of January 15, allowing more patients to receive proper monitoring post-delivery. 4 to 6 more beds will be added in the coming week.
After MSF staff was forced out of Al-Shifa hospital on 18 November due to repeated attacks by Israeli forces, two nurses returned to the premises to assist with medical procedures on a voluntary basis, before leaving in early February as strikes approached the hospital again.
On 22 January, staff reported that medical activities at Al-Shifa hospital are very limited as 50,000 displaced people have sought shelter inside the facility making it difficult to run operations. The ER department is open but overcrowded with hospitalized patients War wounded suffering from burns or gunshot injuries are there along with patients with chronic diseases. Shortages in fuel, in medicine, food, and water continue to cripple the medical response.
Since MSF staff were forced to leave Indonesian hospital at the outset of this war due to increasing bombardment in the area and progressive ground invasion of Israeli forces, we cannot provide any updated regarding this facility or the situation inside. We are not aware whether there are any patients or hospital staff still inside the Indonesian hospital.
Primary health care centers
MSF was forced to suspend support to Martyrs and Beni Suhaila clinics, where we had been providing basic health care, wound dressings, and mental health consultations after Israeli forces ordered people to evacuate the areas on 1 December.
MSF operational in An-Najar hospital since January 22nd, with 1 IMS and 4 Palestinian staff (three surgeons and two nurses), performing surgeries and wound care and getting ready to scale up activities.
On 9 December, MSF restarted working at Al-Shaboura clinic in Rafah, gradually scaling up activities with 31 staff. MSF team is providing outpatients services, including general consultations, reproductive health services, dressing, mental health services including psychological first aid, individual and family session, and psychoeducation and health promotion activities. We’re also performing systematic malnutrition screening among children under 5 and pregnant and lactating women in Al-Shaboura clinic.
Water and sanitation
MSF Teams are supporting two water distribution points in Al-Mawasi near the OCB health post and in the informal camp of internally displaced people. Distribution began on January 30th, and provides 7,600 liters of water to 5,067 people six days a week.
MSF teams are also supporting 9 water distribution points, all near informal camps of internally displaced people (including one site near Qatari hospital, and another near Shaboura clinic). In total, the teams are providing 110,000 liters/day to 20,625 beneficiaries (around 3,500 families) with each family receiving 32 liters/day, but still struggling to provide enough per person.
MSF sent over 75 tons of medical supplies (mainly surgical and dressing kits) into Gaza in three deliveries – one in October, one in November and one in January. These supplies are primarily being used at Nasser Hospital, while some were delivered to the Rafah Clinic, the European Hospital and Shaboura clinic. Bringing supplies into Gaza has been extremely difficult due to administrative barriers, movement restrictions, and a large backlog of trucks at the border.
Reports of widespread looting in Gaza have been confirmed by MSF teams who witnessed some of these incidents. This is a sad reminder of how difficult the situation is and how desperately Gaza needs a much larger, steady flow of essential items and humanitarian supplies.