All MSF international staff have been forced to leave following Israeli authorities’ decision to deregister 37 NGOs from operating in Palestine. We remain committed to providing assistance in Palestine for as long as possible with our Palestinian staff.
My first time in Gaza was between November and December 2024. I returned in November 2025 as a nurse activity manager and stayed for almost four months, until February 26, when all international staff from NGOs affected by de-registration were required to leave.
I extended my stay when we learned that international replacements would not be allowed in by Israel. As nursing manager for the south of Gaza, I visited and oversaw several facilities in the south and also traveled to the north to oversee one of the hospitals we support there, Al-Helou, as well as the clinic in the Al-Zaytoun area of Gaza City.
The threat of attack never disappears
Even during what’s been called a ceasefire, it has never truly felt like the fire has stopped. Drones were constantly overhead. You could hear airstrikes every day. The number of mass casualties may have decreased compared to before the agreement, but violence never disappeared.
What I saw this time was even more destruction. The health system is devastated. Fewer buildings standing. More tents. More families displaced and squeezed into ever-shrinking areas. The situation is inhumane, and every day we see the medical consequences for people in Gaza due to the conditions they are forced to live in.
We see respiratory infections: pneumonia, bronchiolitis, children exposed to winter cold in makeshift tents without heating. We constantly treat cases of acute gastroenteritis because clean water remains scarce. People queue every day just to collect water, as they have been doing for more than two years. Skin diseases are widespread due to overcrowding and lack of hygiene.
The need for wound care is overwhelming. At one point, we were performing up to 900 dressings per week. Many of these wounds are months old — injuries that never healed properly. I treated 18- and 19-year-olds who are now paralyzed from spinal gunshot injuries, confined to beds, developing pressure ulcers that easily become infected in these living conditions.
Thousands need medical evacuation
We also see many patients with external fixators still attached to their limbs, waiting for surgeries that cannot be performed inside Gaza. Medical evacuations are extremely limited: 18,500 patients, according to the World Health Organization, need specialized care that simply does not exist in Gaza, but they are not allowed to leave.
I cannot forget Mohamed, a 3-year-old boy with chronic malnutrition and complex medical needs. We treated him with therapeutic milk, and he improved, but once he returned home, his condition deteriorated again. The last time I saw him, he had lost significant weight because he was refusing the peanut-based product used to treat malnutrition outside the hospital. He has celiac disease and has other special dietary needs. He is still waiting for evacuation. Without access to care outside Gaza, children like him may not survive, no matter how much effort we put in.
Our Palestinian staff live through this same reality. They endure the same insecurity, shortages, and psychological pressure as everyone else. The threat of attack never disappears.
Our Palestinian colleagues are the ones carrying MSF’s response forward. But supporting them remotely will never be the same as standing beside them — bearing witness to, and supporting those who have kept a devastated health system going after more than two years of relentless work.
As I sat on the bus leaving Gaza, I had a knot in my throat. Every time we return, the destruction is worse. This time, I left wondering what it will look like if we are allowed back, and when.
Since January 1, 2026, MSF has not been able to enter any supplies into Gaza. Since the end of February 2026, all our international staff have been forced to leave Gaza following Israel’s decision to deregister MSF and 36 other NGOs from operating in Palestine. This will have catastrophic consequences for people who depend almost entirely on humanitarian assistance — including water, food, health care, sanitation, education. The needs are enormous.
Palestinians ask us to speak about what we have seen, about how they are living, about the continuous violence and blockade that shape every aspect of their lives.
That is what I can do now. Speak. And hope that one day MSF — and all the other organizations — will be allowed to work freely, because Palestinians in Gaza desperately need it.
