In Hebron, a picture of life under violence and occupation

“Israeli soldiers search our houses day and night, and vandalize and arrest people without any warning,” said Alma*, a Palestinian woman whose apartment was destroyed by Israeli soldiers a few days ago—not in Gaza, but in Hebron, the largest Palestinian city in the occupied West Bank.

The city of Hebron, with its pervasive climate of intimidation and coercion, paints a picture of life under occupation in Palestine: suffocating movement restrictions, forced evictions and home demolitions, search-and-arrest operations, disruption of schooling, and the continuous, increasing presence of settlers and the Israeli military.

“Since October 7, things have been much worse,” Alma explained. “There's no mercy. People in my community are deeply affected and live in constant fear.”

West Bank violence and restrictions intensify as Gaza war rages

The Israel-Gaza war has exacerbated the violence and restrictions imposed on Palestinians in the West Bank. As of January 2, United Nations OCHA has recorded that at least 198 Palestinian households comprising 1,208 people, including 586 children, have been displaced amid settler violence and access restrictions in the West Bank since October 7.

“Immediately after October 7, we could already see how things took a darker turn,” said Simona Onidi, Doctors Without Borders/Médecins Sans Frontières (MSF) project coordinator in Hebron. “People’s access to basic services, including shops and health care, has been heavily restricted. The provision of health care has also been disrupted. Due to the severe movement restrictions and risk of violence for both patients and medical staff, we observed a 78 percent reduction of medical consultations performed by our team in October 2023, compared to the previous month."

A Palestinian woman in a red jacket holds her child.

Palestine 2023 © Laora Vigourt/MSF

"In the early morning, soldiers came to our house with a bulldozer and destroyed it. It happened fast. We barely took things with us. Now we have nowhere to go. What can we do? If we build, they will destroy it."

Nesma, MSF patient from south Hebron

In Hebron’s old city, located in the Israeli-controlled area known as H2, unpredictable restrictions on entries and exits impact all aspects of life for the Palestinians living there. H2 has long been one of the most restricted areas within the West Bank, with 21 permanent checkpoints operated by Israeli forces that regulate the movement of Palestinian residents and pose significant barriers to health care workers trying to access the area.

In the first weeks following the start of the Israel-Gaza war in October, Israeli forces imposed further movement restrictions, limiting the opening of checkpoints to only a few days per week, for only one hour in the morning and one hour in the afternoon. At times, Palestinians haven't been allowed to leave their homes for four consecutive days, not even to take out the trash or open their windows to breathe in fresh air.

A Palestinian woman speaks to an MSF staff member at a mobile clinic in the occupied West Bank.

Palestine 2023 © Laora Vigourt/MSF

"People in this area have been here for a long time, and Israeli settlers and army are kicking them out one by one, by putting pressure on them, restraining access, cutting water pipes, destroying their houses, and so on. But they have nowhere to go."

Fatima, MSF patient in Umm Qussa, Masafer Yatta

“I cannot compare the level of intensity today to before [the war],” said Aliyah*, a Palestinian woman from Tel Rumeida in H2. “It’s as if the Israeli settlers and army have no limits.”

Aliyah is pregnant, which presents additional challenges when trying to access care. “This morning, the soldiers [at the checkpoint] asked me to pass through the X-ray machine three times. I asked not to go through, for the safety of my baby, but they wouldn't listen."

“We are all terrified,” added Salma*, another resident of H2. “People think that the situation in Gaza will happen in the West Bank. Are we next? We just don’t know when.”

The back of a Palestinian woman holding her child.

Palestine 2023 © Laora Vigourt/MSF

"Settlers and soldiers will come at night, knock, and yell at their doors. This has always happened but since the war, these intrusions are almost daily. Can you imagine the level of stress and insecurity this creates?"

Aliyah, MSF patient from Tel Rumeida, Hebron

“I cannot compare the level of intensity today to before [the war],” said Aliyah*, a Palestinian woman from Tel Rumeida in H2. “It’s as if the Israeli settlers and army have no limits.” Aliyah is pregnant, which presents additional challenges when trying to access care.

“This morning, the soldiers [at the checkpoint] asked me to pass through the X-ray machine three times. I asked not to go through, for the safety of my baby, but they wouldn´t listen—as if they didn’t even believe that I am pregnant.”

"We are all terrified,” added Salma*, another resident of H2. “People think that the situation in Gaza will happen in the West Bank. Are we next? We just don’t know when."

Desert outside of Hebron, West Bank in occupied Palestine. — As obstruction to health care access has increased since October 7, MSF teams have run mobile clinics to reach people in isolated areas. Palestine 2023 © Laora Vigourt/MSF

Movement restrictions that spare no one—not even the sick

There is only one medical facility run by the Palestinian Ministry of Health for patients with acute and chronic conditions in the H2 area of Hebron. Since October 7, however, staff from the Ministry of Health have not been permitted to access the area, leaving people without health care. For patients with chronic conditions in particular, the lack of follow-up to ensure the continuity of care is a major concern. Now, MSF is the only organization that can operate in the area.

"No cars or even ambulances are allowed inside H2,” said Nadia*, also a Hebron resident. “What if you’re pregnant and about to deliver? You need to walk to the top hill of the checkpoints and pray that the soldiers will let you pass easily. It isn’t because it's a medical [issue] that you suddenly have rights.”

An MSF staff member treats a Palestinian child patient in Hebron, occupied West Bank. — An MSF doctor examines a child in one of the mobile clinics set up by MSF. Palestine 2023 © Laora Vigourt/MSF

In the remote mountainous desert outside of Hebron, the people of Masafer Yatta have been under extraordinary pressure from Israeli authorities and settlers to leave the area. Evictions, home demolitions, and movement restrictions have also intensified there since the recent escalation, and have drastically impeded people’s access to health care.

“We are seeing patients who haven't seen a doctor for weeks or months,” said Juan Pablo Nahuel Sanchez, an MSF medical activity manager. “The most common conditions are respiratory infections and chronic illness. Medication is expensive, and without health insurance, patients have no way to pay for it.”

MSF continues to offer mental health services including psychological first aid, counseling, and psychotherapy for those affected by the situation. Our psychologists are seeing a clear deterioration in people’s mental health.

Israeli security cameras outside Palestinians' homes in Hebron.

A Palestinian woman looks at the rubble left of her home after it was demolished by Israeli forces.

Israeli security cameras monitor the homes of Palestinians in Tel Rumeida, Hebron (left); rubble left from a home demolished by Israeli forces near Nablus. Palestine 2023 © Samar Hazboun

“What is striking here is that we’re not only treating post-traumatic stress disorders, but ongoing trauma,” said one MSF psychologist. “People are experiencing ongoing exposure to traumatic events daily, making it difficult to find relief.”

A person doesn’t have to be old enough to grasp the scope and impact of violence and occupation to experience the effects on their mental health. Even infants and toddlers are showing symptoms of anxiety, such as bedwetting, nightmares, and isolation.

“It breaks my heart to raise children in this environment,” said Aliyah. “You know what my daughter told me the other day? ‘Mom, I am so scared.’ And she is only two years old.”

An MSF staff member takes the temperature of a patient in Hebron, Palestine. — “People in this area have been here for a long time, and Israeli settlers and army are kicking them out one by one," said Fatima. Palestine 2023 © Laora Vigourt/MSF

About MSF in the West Bank

MSF has been present in the West Bank since 1988, with current activities in Hebron, Nablus, and Jenin. Our teams run mental health programs with outreach activities, provide medical services and basic health care via mobile clinics, hold capacity-building activities, and train health facilities and hospitals for mass-casualty response, emergency response plans, and patient triage.

In addition to expanding medical activities since October 7, our teams have increased health promotion activities in communities along with the distribution of relief items, hygiene kits, and food parcels for Palestinians displaced from Gaza and West Bank residents affected by violence and forcible displacement.

*Names changed to protect personal security