Gaza-Israel War

Escalation of violence in Gaza

Conflict escalation
Decades of conflict exploded on 7 October 2023 as Hamas attacked Israel. Hostilities in Gaza and Israel are ongoing, and violence in the West Bank has surged.

Growing humanitarian needs
More than 2 million people are currently trapped in the Gaza strip with no access to food, water, electricity and medicines. 

Displaced people
More than 1.9 million people have been displaced within Gaza.
 

Hospitals are overwhelmed
The number of injured in need of urgent medical assistance far exceeds the capacity of the health system.
 

Nowhere is safe in Gaza.

Israel’s unrelenting and indiscriminate strikes have reduced most of Gaza to rubble and debris. Since the beginning of the war, more than 41,500 Palestinians have been killed, and more than 96,000 injured. More than 10,000 people are missing or buried under rubble in Gaza.

After a year of war in Gaza, people's lives have been destroyed and people are left with unmet medical and humanitarian needs. As many as 1.9 million people in Gaza—90 per cent of the population—are estimated to be forcibly displaced and living in unsafe, unhealthy conditions without adequate shelter, food, water and medical care. The ongoing offensive and the evacuation orders have further reduced access to healthcare in an already decimated health system. 

The suffering of Palestinians trapped Gaza can no longer be put into words. For a year, Israel's government, Hamas, and world leaders have catastrophically failed to agree and impose a sustained ceasefire in Gaza. We are calling for an immediate and enduring humanitarian ceasefire in Gaza and Israel to prevent further civilian deaths and allow aid workers unrestricted access to provide lifesaving medical care. 

MSF is calling for an immediate and enduring humanitarian ceasefire in Gaza and Israel to prevent further civilian deaths and allow aid workers unrestricted access to provide lifesaving medical care.

The current situation in Gaza

As of October 2024

October marks a harsh milestone of one year since the escalation of war in Gaza. For the past 12 months, MSF teams have witnessed the worsening of the humanitarian and medical situation of people in Gaza. Living conditions are horritic, and communicable diseases, including skin conditions, are spreading. Israeli forces have conducted indiscriminate attacks which fail to distinguish between military targets and civilian lives, which have resulted in the destruction of crucial healthcare infrastructure and personnel and the bloodshed of civilians. The scale of horror that has often been inflicted upon the youngest has been clearly reflected in the words of our medical colleagues. They speak of new acronyms to describe unfathomable trauma, such as WCNSF: wounded child, no surviving family. They witness children dying alone despite medical efforts, they describe scenes where it becomes difficult to identify body parts.

The war in Gaza is having a far-reaching impact, fuelling further insecurity and an increased number of attacks in the West Bank. Already, it has resulted in an escalation of fighting into Lebanon and northern Israel and may spiral into a full-blown regional conflict. In the West Bank, Palestinians continue to endure unprecedented wave of coercive measures, including systematic and severe movement restrictions imposed by Israeli authorities, and increased violence by settlers and Israeli forces, all impacting their humanitarian and medical needs. More than 693 Palestinians have been killed in the West Bank since 7 October 2023. 

The people in Gaza need an immediate and sustained ceasefire. International Humanitarian Law principles are being repeatedly violated, and humanitarian aid is systematically being impeded. Failure to have a ceasefire so will cost more lives and be yet another stain on the collective conscience. 
 

The recurrent forced displacement of the population and Israel's attacks on densely populated areas continue to expose the absence of any safe space in Gaza. Up to 1.9 million people—90 per cent of the Gazan population—have had to flee their homes since the escalation of war in October, with some having fled up to ten times seeking safety. Areas Israel designates humanitarian zones have been repeatedly bombed by Israeli forces have including gathering sites where displaced people shelter, which were formally registered as ‘deconflicted’ by Israeli forces, and all warring parties continue fighting in densely populated residential areas. 

People are now crammed into a small area of the Strip of Al Mawasi, living in inhumane conditions with nowhere else to flee, awaiting and fearing the next strike. These people have had no food, water, shelter and little or no access to healthcare.  Malnutrition is now a reality, communicable diseases are spreading, clean water is scarce, and harsh weather is making life conditions worse. The unhygienic and appalling living conditions are directly impacting people’s health with issues related to the lack of water and sanitation, such as skin infections (e.g. scabies) and gastro-intestinal disorders, which are amongst the main diseases treated by MSF teams in our supported healthcare centres. 

"We are treating children with illnesses related to their dire living conditions, but when they leave the hospital they return to the same place that is making them ill," says Sakib Burza, MSF hospital director. "It's a viscous cycle that can only improve with a ceasefire."

Providing healthcare is becoming virtually impossible in Gaza, as not even places of healthcare are safe from the bombs. The health system in Gaza is being dismantled just as the needs are exploding, with devastating consequences for Palestinian people. Medical centres or humanitarian delivery systems that have been destroyed are being replaced by less effective, improvised options. MSF staff and patients have had to leave 14 different health structures and have endured 26 violent incidents. According to the World Health Organization, nearly 1000 health workers and at least 306 aid workers have been killed since the beginning of the war—including seven MSF staff.

Contrary to the repeated public communications of the Israeli authorities, humanitarian aid has been denied or severely impeded since the beginning of the war, making it near impossible to provide even basic healthcare. Israeli’s blockade and continued obstruction of aid delivery have made it close to impossible for Palestinians to access vital goods, such as fuel, food, water and medicines. Those trapped are facing catastrophic levels of acute food insecurity, leading to a high risk of famine that will persist across the Gaza strip for as long as humanitarian access continues to be restricted. MSF has been unable to get essential medical supplies into the Gaza strip since the end of April. This is not a logistics problem; it is a political problem.

Palestinians in Gaza are suffering every day from an all-out destructive military campaign that blatantly ignores the rules of war. Without an immediate and sustained ceasefire, and the entrance of meaningful humanitarian assistance, we will continue to see more people die.

Polio detected in Gaza

Poliovirus was detected in July 2024 in environmental samples from Khan Younis and Deir al-Balah (South and Central Gaza). Three children presenting with suspected acute flaccid paralysis (AFP), a common symptom of polio, have since been reported in the Gaza Strip.

Since the start of the war, routine vaccinations have been disrupted because of the destruction of the Gazan health system by the Israeli forces, with health facilities unable to provide vaccinations. Due to the impact of the conflict, routine immunisation coverage (for the second dose of inactivated polio vaccine) dropped from 99 per cent in 2022 to less than 90 per cent in the first quarter of 2024, according to the World Health Organization. As a result, most children born since 7 October have not received vaccinations, such as polio, measles and diphtheria.

In August, according to the Ministry of Health one infant boy was diagnosed with poliovirus type 2—the first confirmed case, as the Gaza Strip has been polio-free for the last 25 years. The humanitarian community has warned about the possibility of re-emergence of polio for the last ten months: this milestone represents yet another threat to the children in Gaza.

As the Ministry of Health and the United Nations launched a large-scale polio vaccination campaign in Gaza, MSF teams have provided logistical and organisational support in five health facilities across Deir Al Balah, Central Gaza, and Khan Younis, south Gaza. The campaign successfully vaccinated 570,000 children under 10 years old in the first two weeks of September.

Israeli authorities have agreed to a series of military pauses in fighting in Gaza during the vaccination campaign. However, these efforts are only a drop in the ocean in the response to the severe humanitarian needs of the population in Gaza. The only solution is an immediate and sustained ceasefire to ensure the safety of civilians, allow more supplies to enter Gaza, and provide the population with proper humanitarian aid and access to healthcare.

Residents search for survivors in the destruction caused by airstrikes in Gaza. © MSF

Residents search for survivors in the destruction caused by airstrikes in Gaza. © MSF

How MSF is responding

The needs in Gaza are immense. Over the last ten months, sieges and evacuation orders on various hospitals have pushed our activities into an ever-smaller territory and are limiting our response. Humanitarian aid in Gaza is severely lacking; the work we are able to do is only a drop in the ocean of need. 

Our teams are offering surgical support, wound care, physiotherapy, maternity and paediatric care, primary health care, vaccination, and mental health services, but sieges and evacuation orders on various hospitals are pushing our activities onto an ever-smaller territory and limited response. MSF teams are also providing water distribution.

More than 700 locally hired staff and 35 internationally mobile staff have supported our work in Gaza since October 2023. Six MSF staff members have been killed.

MSF currently operates in two hospitals—Al-Aqsa hospital and Nasser Hospital—and eight healthcare facilities.

What are the medical needs MSF is seeing in Gaza?

Accessing health care has become increasingly difficult for the wounded and the sick in Gaza, adding to an already shocking toll from this war. In addition to the scores killed and wounded since 7 October, needs are growing as the displaced population is pushed towards the Egyptian border in Rafah. Malnutrition is looming, communicable diseases are spreading, clean water is scarce and winter weather is making life conditions worse for people who were not able to take warm clothes when the war began. 

Infections resulting from poorly treated wounds are rising fast, putting lives at risk. The risks of infection are incredibly high because of the conditions that people are forced to live in and the fact that there just isn’t the capacity and ability to provide the in-hospital care that these patients truly need. 

The World Health Organization also reports an increase in infectious diseases including diarrhea, acute respiratory infections, skin infections, and outbreaks like hepatitis. As food and water shortages worsen, 40 per cent of Gaza’s people are at risk of famine, according to UNRWA. Pregnant mothers struggle to find access to delivery rooms due to crowded hospitals, leading to stillbirths or births in terrible conditions for both mother and child.

Due to the unprecedented number of wounded in Gaza, the severity and complexity of injuries, and continuing extreme violence and siege, we need to be able to provide safe and medicalised passage to health facilities outside of Gaza for patients who need it and choose to do so. Palestinians who are medically evacuated must retain the right to return home to Gaza as required under international human rights law. 

MSF’s mental health teams have been addressing the psychological toll of the war and forced displacement on children’s emotional wellbeing in Gaza after nearly three months of siege and bombardment. Children have been exposed to extremely traumatic episodes with some patients recovering from physical injuries and some having lost their family members. 

How long has MSF been working in Palestine?

MSF began working in Palestine in 1989 and has run medical programs in Gaza for more than 20 years. 

Working in three hospitals and several outpatient clinics, we offer comprehensive care for people suffering from burns and trauma, which includes surgery, physiotherapy, psychological support, occupational therapy and health education. 

Since 2018, we have also been running a reconstructive surgery programme in northern Gaza. MSF’s project is crucial since Gaza’s local healthcare system is overstretched and underfunded, and deeply impacted by over a decade of blockade.

Since we currently only run programs in Palestine, our reporting is rooted in the direct witnessing of our patients and staff on the ground there. However, we have offered support to Israeli hospitals treating casualties from these attacks.

Why is MSF not working in Israel?

We are a humanitarian organisation, which means we treat everyone who needs help, but our resources are not unlimited: we focus them where they are needed the most. 

The Palestinian healthcare systems, both in the West Bank and the Gaza Strip, have been crippled by over 70 years of occupation and over ten years of blockade. They are unable to meet the basic health needs of their respective populations. 

MSF offered support to Israel in response to the 7 October Hamas attacks but this was respectfully declined as Israel has an excellent healthcare system.

Why is MSF speaking out about the conflict in Gaza?

One of the central pillars of our identity is to bear witness and call attention to the problems driving emergency needs in the places where we provide humanitarian assistance.

We have a long history of speaking out and advocacy when governments or other actors implement policies that threaten the health and safety of our patients or our staff, for example in conflicts in Syria, Yemen, and Afghanistan.

International humanitarian law and the rules of war require militaries to distinguish between civilians and combatants and prohibit attacks that cause disproportionate harm to civilians and civilian objects. The way Israel is prosecuting this war is causing massive death and suffering among Palestinian civilians and is inconsistent with these norms and laws.

Medical facilities and their surrounding areas have repeatedly been attacked or subjected to evacuation orders by Israeli forces, making access to healthcare extremely dangerous for patients and putting the lives of medical staff at risk. This compels us to speak out and demand an immediate ceasefire.

Why are your statements so critical of Israel? Why are you not talking about Hamas?

We were horrified by Hamas’ massacre in Israel on 7 October, and we are horrified by Israel’s response. As humanitarians, we grieve for all civilian lives lost, and the vast majority of the victims of this conflict are civilians, including many elderly people, women and children. Violence against civilians is never justified, and all civilians deserve protection.

MSF’s reporting is based on what our patients and staff tell us they are seeing on the ground in Gaza, where the Israeli military campaign and siege have had devastating consequences. The healthcare system has collapsed, and hospitals have run out of drugs, medical supplies, and fuel for generators. People have limited access to food, water, shelter, and electricity. And the death toll continues to rise. 
 

Why is MSF calling for a ceasefire? Aren’t you a non-partisan organisation?

We are calling for a sustained ceasefire because widespread and indiscriminate attacks on civilians—including attacks on healthcare—have made it impossible to deliver the humanitarian assistance needed in Gaza.

MSF offers medical humanitarian assistance to people based solely on need, irrespective of race, religion, gender, or political affiliation. As an organisation, we focus on filling the greatest gaps in healthcare.

We have no agenda except to go where we are needed and treat patients and we are struggling to do so right now in Gaza due to the lack of drugs, medical supplies and fuel for generators.

How does MSF respond to critiques that it is anti-Israel or anti-Semitic?

MSF takes any allegation of anti-Semitism extremely seriously. At any given time, MSF has approximately 68,000 people working in our projects and headquarters. Any form of bigotry or discrimination by MSF staff is unacceptable.

We do not believe that criticism of Israeli government policies is equivalent to anti-Semitism.

MSF speaks out when governments or actors implement policies that are harmful to the health and safety of our patients or our staff. The way Israel is prosecuting this war is causing massive death and suffering among Palestinian civilians and putting our staff at risk. This is inconsistent with the norms and laws of war.

No state is above criticism.

As humanitarians, we grieve for all civilian lives lost, and the vast majority of the victims of this conflict are civilians, including many elderly people, women, and children. Violence against civilians is never justified, and all civilians deserve protection.

What is MSF’s relationship with Hamas in Gaza?

MSF works with the Ministry of Health in Gaza. We coordinate our work through them. When it comes to ensuring the safety of our teams in Gaza, we maintain contact with the Ministry of Interior in Gaza, just as we maintain contact with the Israeli authorities. 

MSF works in more than 70 countries around the world. Wherever armed conflict is present, we maintain contact with all actors to safeguard our teams and activities.

 

Our update to the UN Security Council

 

Where we're responding

North Gaza

Al-Shifa Hospital

Evacuated — No MSF staff
Following a 14-day operation by Israeli forces which ended on April 1, the hospital was left in ruins and is no longer functional. There is no possibility for MSF to resume its activities in the near future.  

MSF clinic (Gaza city)

MSF facility with MSF staff – Now functional, reopened July 2024
MSF's clinic close to the Al-Shifa hospital premises was heavily damaged in November 2023, forcing it to close until July 2024. Since reopening, primary healthcare activities have been launched at the Gaza clinic and include general consultation, non-communicable diseases and malnutrition screening. In addition, since beginning of August 2024 and according to health care needs assessments, our teams have started developing sexual and reproductive health activities, following up pregnant women for antenatal and postnatal care, providing gynaecological consultations and family planning.

Gaza's middle area

Al-Aqsa Hospital, Deir Al Balah

Ministry of Health facility with MSF staff
MSF began working in Al-Aqsa hospital on 26 November 2023. On 6 January 2024, MSF had to evacuate Al-Aqsa hospital due to fighting all around the premises and evacuation orders that made MSF’s pharmacy store inaccessible. On 6 February, MSF team returned to Al-Aqsa and prepared the premises for a return to previous activities. On 7 February, wound and rehabilitation care resumed, and the team has been providing acute trauma surgery, advanced wound care, post-operative wound care, physiotherapy, health promotion and mental health support since then. Access to the pharmacy store has also been re-established. Activities also include malnutrition screening and referral. 

Al Martyrs Primary Health Care Centre, Deir Al Balah

Ministry of Health facility with MSF staff
MSF team provides wound care and malnutrition screening activities at the PHCC. MSF began working in this facility at the end of February 2024.

Al Hekker Primary Health Care Centre

MSF facility with MSF staff
In mid-April 2024, MSF opened a new primary healthcare centre in Al Hekker to provide outpatients services, including general consultations, vaccination, reproductive health services, dressing and minor surgery, mental health services including psychological first aid, individual and family sessions, and psychoeducation and health promotion activities. Services also include malnutrition screening and an ambulatory therapeutic feeding centre. 

Deir Al Balah Field Hospital 

Ministry of Health facility with Ministry of Health and MSF staff
As a response to the destruction of the health system in Gaza, MSF teams opened a field hospital in collaboration with the Ministry of Health. An emergency department, outpatient department, inpatient department and operating theatre are open with 28 beds available.  

Deir Al Balah Modular Field Hospital

MSF facility with MSF staff
The field hospital opened with outpatient activities and will expand from a capacity of 20 beds to 110 beds, including an emergency department and will extend to paediatric activities. In its first two weeks of activity, the hospital treated over 2,000 patients. 

South Gaza

Nasser Hospital, Khan Younis

Ministry of Health facility with MSF staff
Nasser hospital is now the largest surgical centre in Gaza, as Al-Shifa hospital is not functioning anymore. MSF staff were forced to flee and leave patients behind after a shell struck the hospital in mid-February 2024 and Israeli forces ordered the evacuation of the facility before raiding it. 

In mid-May, following the evacuation order of the Rafah Indonesian hospital due to the Rafah offensive, in collaboration with the Ministry of Health, MSF relaunched operations in Nasser, focusing on orthopaedic surgery, the burn unit, plastic surgery, general laboratory activities, physiotherapy and counselling department. 

We are currently working in the Trauma/Ortho/Burn Unit of Nasser Hospital and are running two Operation Rooms, 65 inpatient beds and four beds in intermediate care. We are also running daycare surgery service (three days per week) for trauma and burn patients requiring small interventions that require anaesthesia but no hospitalisation for more than one day due to a lack beds in the inpatient department and the high bed occupancy rate since July 2024. In addition, we also managed an outpatient department for wound care, providing dressings and physiotherapy sessions for burn and trauma cases. Besides these activities, MSF supports mother and childcare in Nasser hospital, including teo paediatric wards and an outpatient department, delivery, pre- and post-partum wards, paediatric intensive care unit and a newborn intensive care unit, paediatric and maternity emergency rooms, mental healthcare. 

Mid-June, MSF also opened an inpatient therapeutic feeding centre for malnourished children. Nasser’s maternity is one of the sole functional maternities in the South of Gaza. Moreover, MSF started supporting MoH with providing prophylaxis for close contacts. For hepatitis, we've seen a slight decrease in patients, but unfortunately are still receiving severe cases.   
 

Al-Mawasi Health Post in Khan Younis

Private health facility with MSF staff
MSF is supporting CFTA (Culture and Free Thought Association) in providing pre- and post-natal care as well as sexual and reproductive healthcare. MSF is running general consultations, management of non-communicable diseases, malnutrition screening and treatment, dressings and physiotherapy.  The most common illnesses and injuries seen in patients in Al-Mawasi include upper respiratory infections, acute diarrhoea, skin diseases, and hypertension.  

Khan Younis Primary Healthcare Centre in Khan Younis

MSF facility with MSF staff
MSF provides OPD consultations, vaccination, mental health, ambulatory therapeutic feeding centre, midwife/sexual and reproductive healthcare, wound care and physiotherapy, and health promotion. Given the massive influx of population from Rafah into an already packed humanitarian zone, and the lack of health facilities to cover trauma needs, we are currently expanding to include a lightweight emergency service focused on stabilising and referring more complex cases while managing simpler cases.  

Al Attar Primary Healthcare Centre in Khan Younis

MSF facility with MSF staff
The primary healthcare centre is located between Al Mawasi and Khan Younis to address the needs of the local population who have set up tents in the area, offering services such as general medicine, paediatric consultations, vaccination, emergency healthcare and wound care, antenatal and postnatal care, mental healthcare, health promotion, malnutrition screening and ambulatory therapeutic feeding centre, and other services based on MSF capacities and population needs. 

Al Qarara clinic in Khan Younis

Private health facility with PalMed staff – No MSF staff
MSF is supporting PalMed, a diaspora-based Palestinian medical organisation, with medications, incentives and running costs, to provide sexual and reproductive health care and general medical consultations (wound dressing, skin infections, non-communicable diseases, etc.). 

Al-Mawasi Advanced Primary Health Care Centre in Rafah

MSF facility with MSF staff
MSF staff are providing outpatient services, including general consultations, vaccination, reproductive health care, dressing, mental health services, and health promotion. The primary healthcare centre includes a 24/7 emergency room to stabilise and refer trauma patients. It also provides malnutrition screening and ambulatory therapeutic feeding centre. 

The West Bank

West Bank

MSF is maintaining operations in the West Bank, focusing on providing emergency care, primary health care via mobile clinics, and mental health care in Hebron, Nablus, Jenin and Tulkarem.

Hebron

Current activities include operating 15 mobile clinics and providing support to five primary health clinics, with support including primary health care, non-communicable diseases, sexual and reproductive healthcare and maternal health, implementation and support of the maternity ward increase in Halhul Hospital, mental health support, capacity building in emergency response, as well as advocacy and protection. We are supporting various hospitals with donations and first-aid kits and training to community focal points in Beit Ummar, Al Fawwar camp, Al Arroub camp, Al Rshaydeh, and Umm al Kheir. We also trained medical staff in Al Mohtaseb Hospital, Halhul, Dura, and Yatta Hospital in Hebron area.

Since October 2023, MSF has expanded its response to 15 mobile clinics covering the areas outside and inside Hebron's Old City, but also in Dura and in the remote villages of Masafer Yatta in the Southern West Bank. Besides, MSF increased health promotion activities, and the distribution of relief items, hygiene kits and food parcels, portable toilets and pipes installations to displaced people, and West Bank residents affected by violence and forcible displacement.
 

Nablus

MSF continues to provide psychological therapy, sexual and gender based violence case management and psychological consultations in Nablus, Qalqiliya and Tubas despite the intensified movement restrictions by Israeli forces since October 2023. In collaboration with the Palestinian Union of Social Workers and Psychologists (PUSWP), MSF started in March, the third cohort of intern training for eight psychologists, and the interns will do 770 hours of theoretical and practical training in MSF clinic.

MSF is also training volunteers from the Palestine Red Crescent Society (PRCS) volunteers as first aid providers and first responders in the governorates of Nablus, Tubas, and Qalqilya. MSF has equiped six stabilization points (Ministry of Health and PRCS) across Nablus, Qalqiliya and Tubas, to mitigate access constraints for patients and ambulances. 

In April, MSF began a training for doctors and nurses in the emergency room in three different hospitals (Nablus, Tubas and Qalqilya) to increase the capacity of Ministry of Health staff to respond to trauma cases. 

Since July, MSF is providing primary healthcare with a mobile team in six identified locations (two in Qalqilya governorate and four in Nablus governorate) supporting existing primary healthcare centres amidst challenges in HR, access and availability of medications.
 

Jenin and Tulkarem 

MSF teams in Jenin and Tulkarem continue capacity building of first responders. This includes training and donations to volunteer paramedics in Jenin, Tulkarem and Nur Shams refugee camps, so they can stabilise patients during IF incursions in case ambulances are not able to reach them. Trainings have been extended also into the community, as the violence of incursions makes the work of the volunteer paramedics increasingly dangerous. Stabilization points situated in MoH Primary Health Care Centres have received clinical supplies and training for staff with a focus on bleeding control.  In the aftermath of the largest incursion from the Israeli Forces in the West Bank since 2002, at the end of August, MSF donated bottled water, water tanks and some basic supplies such as diapers and basic medication as people were cut off from shops and services for nine consecutive days in Jenin and during multiple shorter incursions in Tulkarm.

In mental health care, MSF provides group sessions and psychological first aid (PFA) in communities, facilitates crisis intervention sessions and PFA trainings for medical staff, and provides individual consultations in Khalil Suleiman Hospital. Additionally, we support Gazan workers stranded in the West Bank since October 2023.

Large scale activities

Water and Sanitation

Currently, MSF is distributing 624,000 litres of water per day through desalinisation process in more than 40 water points in Al Mawasi, Khan Younis, Rafah, and Deir El Balah. We are continuously working to increase this quantity, as drinkable water is a scarce source.  

Since February 2024, in partnership with the Agriculture Development Association (PARC), MSF is implementing water and sanitation activities in camp shelters in Deir El Balah and Khan Younis. This includes building latrines for more than 30,000 people located in 6 camps as well as providing Hygiene Kits and water treatment units. The partnership also includes supporting a camp hosting 70 families (400 people) of people living with disabilities with the needed sanitary facilities (accessible latrines and showers).  

At the end of March 2024, we set up a new desalination plant in Al-Mawasi with a capacity of 35.000 liters per day. In Al Attar, a desalination plant was set up with a capacity of 40,000 liters per day. Two more are being set up in Deir Al Balah, with an expected delivery of 70,000 liters per day, and will be functional in October.

MSF Supplies/Logistics

Since October 2023, MSF provided from their international supply centers 5,200 m3 or 636 tons of logistic and medical equipment. This represents 30 full planes or 130 trucks which included 2 field hospitals.

Currently items that are critical for our operations and difficult to enter into Gaza are: generators (all sizes), desalination stations and motor pumps (to provide drinkable water and for hygiene in the medical facilities), oxygen concentrators, autoclave (for sterilisation), vehicles and communication items (satellite and radio equipment) necessary for ensuring the security of our staff inside Gaza. 

MSF teams in Gaza are facing critical shortages of essential medicines and equipment. 

Supplies

Currently, we have a rear base in Egypt to facilitate the transit of our international supplies, and we have a supply emergency team based in Amman, through which we will try to send supplies into Gaza. As of end of June 2024, MSF had brought seven international cargos, a total of 73 trucks, into Gaza through United Nations.

The closure of the Rafah border crossing, following Israel’s offensive in the south of Gaza in early May, coupled with the endless red tape imposed by Israeli authorities, have dramatically congested the flow of humanitarian aid through the Kerem Shalom entry point. This has led to massive queues of trucks and perilous delays in the delivery of humanitarian assistance across Gaza. Even when aid can finally enter the Strip, insecurity, including looting of trucks, often does not allow humanitarian organisations to get it where it is desperately needed.

MSF teams in Gaza are facing critical shortages of essential medicines and equipment. Our teams have been unable to bring any medical supplies into Gaza since the end of April.

Gaza maps

Attacks on healthcare facilities and staff

In the past 12 months, healthcare facilities have been subjected to evacuation orders and been attacked, besieged and raided. Medical staff and patients have been arrested, abused and killed while caring for patients. This includes seven of our own staff: 

  • Lab technician Mohammed Al Ahel, killed in November 2023 in an airstrike with members of his family;
  • Volunteer nurse Alaa Al-Shawa, shot in the head during a planned evacuation of an MSF convoy in November 2023;
  • Doctors Mahmoud Abu Nujaila and Ahmad Al Sahar, killed following a strike on Al-Awda hospital in November 2023
  • MSF UK Board associate trustee Reem Abu Lebdeh, believed to have been killed at her home in Khan Younis along with members of her family in December 2023. 
  • Physiotherapist Fadi Al-Wadiya, assassinated just outside our clinic in Gaza City while cycling to work. Five other people were killed in this attack, including three children.
  • Driver Nasser Hamdi Abdelatif Al Shalfouh, killed after sustaining injuries in his legs and chest in October 2024.
  • Skilled labourer Hasan Suboh, killed in an attack while sheltering with his family in October 2024. 33 other people were also killed in this attack, including 14 children.

Several family members of our MSF staff have also been killed and a number of our staff members remain unaccounted for. MSF has yet to receive accountability or any admission of responsibility for the killings, maiming, or the dehumanisation of our staff and patients.

The duty of treating the sick and wounded, and the correlating protection of medical personnel and facilities, is at the core of International Humanitarian Law (IHL). Providing healthcare is becoming virtually impossible in Gaza, as no place, not even places of healthcare, are safe from the bombs. 

Attacks on healthcare facilities
  • 6 May – an MSF-supported stabilisation point was stormed during a violent raid by Israeli forces in Tulkarem and Nur Shams camps in the West Bank. Volunteer paramedics trained by MSF were harassed and no longer feel safe in providing lifesaving care to patients.
  • 21 April – an MSF-trained paramedical volunteer was shot in the leg while on duty during a three-day incursion in Tulkarem and Nur Shams refugee camps in the West Bank. Due to the hostilities, it took him seven hours to reach the hospital.
  • 1 April – After a 14-day long operation by Israeli forces in and around Al-Shifa hospital, the hospital has been left in ruins and out of service. An MSF clinic in the vicinity of the hospital was also badly damaged. Hundreds of people were killed, including medical staff, and mass arrests of medical staff and other people took place in and around the hospital.
  • 31 March – an Israeli airstrike hit the yard of MSF supported Al Aqsa hospital compound just outside of the emergency room where many internally displaced people were sheltering. Many people were killed and injured. After the attack, part of the MSF team had to stop providing care.  
  • 27 March – an airstrike hit a greenhouse near Al Shaboura clinic, an MSF supported facility in Rafah. Several people reportedly were killed in the attack, despite a United Nations Security Council Resolution requiring a ceasefire being passed on 25 March. No MSF staff or patients were hurt. 
  • 13 March – the Israeli military conducted operations in Jenin. At the MSF-supported Khalil Suleiman Hospital, people standing in the hospital courtyard were fired on. 6 people were wounded by the ER door, 2 of whom died.  
  • 2 March - a shell struck a shed next to the main entrance of Al-Emirati hospital in Rafah, killing 2 people and injuring several people.
  • 20 February - an Israeli tank fired on a house sheltering MSF colleagues and their families, killing the daughter-in-law and wife of one of our colleagues, and injuring seven people.
  • 15 February - a shell struck the orthopedic department; staff members fled the compound leaving behind several patients. One MSF staff was detained at a checkpoint by Israeli forces and is still in their custody.
  • 22 January - Nasser Hospital in Khan Yunis is surrounded by fighting, bombing, and evacuation orders. Strikes are killing people as close as 150 meters from hospital entrance, staff report.
  • 8 January -  MSF “Lotus” shelter in Khan Yunis was struck by a tank shell, killing 5-year-old daughter of MSF staff. Over 125 MSF staff and their families are relocated to Rafah.
  • 6 January - Al-Aqsa Hospital is evacuated after fighting gets close and evacuation orders put MSF pharmacy inside exclusion area. A sniper bullet broke through the intensive care unit wall on 5 January.

2023

  • 17 December - Israeli forces take control of Al Awda hospital after a 12-day siege. Males over 16 years old are taken, stripped and interrogated – six MSF staff among them. After the interrogations, most of them are sent back into the hospital and told not to move. The same day, the maternity ward of Nasser hospital is hit by the casing of Israeli “illumination rounds”. One patient is killed, others are wounded.
  • 12 December - an MSF surgeon is injured inside Al-Awda hospital by a shot fired from the outside. 
  • 5 December - MSF staff in Al Awda report that the hospital is facing a total siege. In the following days two members of medical staff at the hospital (not MSF staff) are shot and killed by the snipers.
  • 1 December - hours after the truce ended, a blast damages Al Awda hospital.
  • 24 November - a minibus sent from south Gaza to attempt another evacuation of MSF staff and their relatives in the north is destroyed by the Israeli forces.
  • 21 November - a strike on Al Awda Hospital kills Dr Mahmoud Abu Nujaila and Dr Ahmad Al Sahar from MSF, and another doctor, Dr Ziad Al-Tatari.
  • 18 November - an MSF evacuation convoy is targeted by Israeli sniper fire, two people are killed including an MSF volunteer. Two days later, the MSF cars from the convoy are destroyed by a bulldozer and Israeli heavy military vehicles under the eyes of our colleagues sheltering in the MSF guesthouse. The Israeli forces also damage the MSF clinic by pushing the vehicles against its perimeter wall, which fell down. Part of the clinic caught fire.
  • 15 November - Al Shifa hospital is stormed by the Israeli ground troops. All remaining MSF staff had left the hospital about one week earlier.
  • 3 November - An ambulance is hit and destroyed outside Al Shifa hospital, many people killed.
  • 30 October - MSF-supported Turkish-Palestinian Friendship hospital in Gaza is hit by a projectile, causing damage to the building. The hospital stops functioning when it runs out of fuel on 1 November.
  • 13 October - Israeli forces give two hours to evacuate MSF-supported Al-Awda Hospital. The hospital was not hit, but damaged by nearby bombing.
  • 11 October -  Airstrike close to Al-Awda Hospital, where MSF has been operating since 2018 – some ceilings are damaged etc, but the hospital continues to function.
  • 10 October -  MSF Gaza clinic damaged by an Israeli airstrike; no staff injured.
  • 7 October - Airstrike next to the MSF-supported Indonesian hospital – the blast from the strike ignites oxygen canisters in the hospital causing damage and killing a nurse from the hospital (not MSF). 

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