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Six months of siege and bloodshed in Gaza

“We never imagined that this war would be different."

A group of Palestinians in front of smoke from a building destroyed by Israeli airstrikes in Gaza.

Palestine 2023 © MSF

Last updated on April 15, 2024

After six months of war, conditions on the ground in Gaza are more dire than ever.

More than 32,000 Palestinians have been killed, with thousands more buried under the rubble. Nearly 76,000 people are injured, many with life-altering amputations and burns that require long-term care for recovery. Starvation has set in across the Strip, particularly in the north, while the most basic necessities—food, water, electricity, fuel—remain in scarce supply due to Israel’s tightened blockade and restrictions. 

At the same time, the lack of protection for medical and humanitarian workers makes the provision of aid nearly impossible. Health facilities all over Gaza have been attacked, besieged, and bombed, and doctors, nurses, and other medical staff have been arrested, detained, and killed, including Doctors Without Borders/Médecins Sans Frontières (MSF) team members. The Palestinians of Gaza have endured this catastrophic reality for six months.

Wreckage after Israeli airstrikes in Gaza in October 2023.
Devastation caused by airstrikes in Gaza in October 2023. Palestine 2023 © MSF

Hamas attacks Israel, and Israeli forces strike back in Gaza

October 7

The militant group Hamas launches a major attack on various sites in Israel, including civilian gatherings and villages. The Israeli government responds with a massive counteroffensive in Gaza, launching a barrage of airstrikes. MSF offers support to Israeli hospitals and donates medical supplies to hospitals and health facilities in Gaza to respond to medical needs. 

The same day, the blast from an airstrike that hit next to the MSF-supported Indonesian Hospital ignites oxygen canisters in the hospital, causing damage and killing a nurse (not an MSF staff member). 

An Israeli airstrike damages MSF’s clinic. No staff are injured.

October 10
Displaced Palestinians in Gaza during Israeli siege and bombardment in October 2023.

Displaced Palestinians. Palestine 2023 © MSF

One million residents of northern Gaza given 24 hours to evacuate

October 13

The Israeli military warns more than one million people living in northern Gaza to evacuate within 24 hours and move to the southern part of the territory. Overnight, MSF’s international staff members based in northern Gaza relocate to the south, as well as some Palestinian staff, though others—notably medical staff—remain in the north to try to treat sick and wounded people. The evacuation order includes people inside Al-Awda Hospital, where MSF staff are working. 

As the evacuation order expires, MSF again calls on all parties to the conflict to ensure the protection of civilians

October 14

MSF calls for immediate ceasefire in Gaza

October 26

MSF calls on all parties to the conflict for an immediate ceasefire to save lives and for lifting the siege to restore the flow of humanitarian aid into Gaza, including essential items such as fuel.

Palestinian children line up for water during Israel-Gaza war of 2023.
Children line up for water on October 12. Palestine 2023 © MSF

MSF internationally mobile staff cross into Gaza via Rafah

November 1

All international MSF staff who had been unable to leave the Gaza Strip since October 7 successfully cross the Egyptian border via the Rafah Crossing. This occurs following negotiations for foreign passport holders and international aid workers to cross. A number of severely injured patients are also allowed to cross to receive critical care, but there are over 20,000 injured people in Gaza with limited access to health care due to the siege.

An ambulance is hit outside Al-Shifa hospital in Gaza City on November 3.

Ambulance hit and destroyed outside Al-Shifa Hospital

November 3

MSF lab technician Mohammed Al Ahel killed

November 6

Mohammed Al Ahel was at his home in Al Shati refugee camp on November 6 when the area was bombed and his building collapsed, reportedly killing dozens of people, including Mohammed and several members of his family. He was a laboratory technician and had been working with MSF for two years.

Hospitals under attack

November 11

Hospitals in Gaza are under relentless bombardment, including the Al-Shifa Hospital complex, which has been hit several times, including the maternity and outpatient departments, resulting in multiple deaths and injuries. MSF teams and hundreds of patients are still inside Al-Shifa. MSF urgently reiterates its calls to stop the attacks against hospitals, for an immediate ceasefire, and for the protection of medical facilities, medical staff, and patients.

Israeli forces storm Al-Shifa Hospital

November 15

The day prior, bullets were fired into one of three MSF premises located near Al-Shifa hospital and sheltering MSF staff and their families—over 100 people, including 65 children.

UN Security Council adopts Resolution 2712

November 15

The resolution demands that all parties to the conflict comply with their obligations under international humanitarian law, and calls for “urgent and extended humanitarian pauses and corridors throughout the Gaza Strip for a sufficient number of days to enable, consistent with international humanitarian law, the full, rapid, safe, and unhindered humanitarian access.”

“The unacceptably jumbled and sluggish process finally led to the adoption of a text that does not come close to reflecting the severity of the humanitarian catastrophe in Gaza,” said MSF International President Dr. Christos Christou. “Today’s resolution fails to acknowledge just how necessary a sustained cessation of hostilities is to save lives and to enable humanitarian assistance. Humanitarian pauses, extended though they may be, are not enough.”

Destroyed vehicles in MSF convoy attack in Gaza
Destroyed vehicles pictured on November 20. Palestine 2023 © MSF

MSF convoy attacked, killing staff member

November 18

An MSF evacuation convoy is targeted by Israeli sniper fire, killing two people, including MSF nurse Alaa Al Shawa. Two days later, our colleagues sheltering in the MSF guesthouse witness a bulldozer and Israeli military vehicles destroy the MSF cars from the convoy. Israeli forces also damage the MSF clinic by pushing the vehicles against its perimeter wall, which fell down. Part of the clinic caught fire.

A whiteboard at Al-Awda Hospital in Gaza with a message from an MSF doctor: Remember us
A destroyed whiteboard in Al-Awda Hospital with a message from an MSF doctor in Gaza: Remember us.

A message written by MSF's Dr. Mahmoud Abu Nujaila before he was killed in a strike on Al-Awda Hospital on November 21, 2023. Palestine 2023 © MSF

MSF doctors killed in strike on Al-Awda Hospital

November 21

A strike on Al-Awda Hospital kills two MSF doctors, Dr. Mahmoud Abu Nujaila and Dr. Ahmad Al Sahar, and another doctor, Dr Ziad Al-Tatari. 

Before his death, Dr. Abu Nujaila wrote a message on a whiteboard in the hospital normally used for planning surgeries: “Whoever stays until the end will tell the story. We did what we could. Remember us.”

An evacuation leaflet from the Israeli forces for Gaza.

Leaflets dropped by Israeli forces around Nasser Hospital ordering the evacuation of the area on November 24. Palestine 2023 © MSF

Week-long truce goes into effect

November 24

The same day, Israeli forces destroy a minibus attempting another evacuation of MSF staff and their relatives in the north.

MSF UK board member killed during Israeli offensive in Khan Younis


Reem Abu Lebdeh, an associate trustee of the MSF UK Board and former staff member in Gaza, is believed to be dead. Though the exact circumstances and date of her death remain unclear, we believe she was killed along with members of her family at their home in Khan Younis in southern Gaza. Some members of her family remain unaccounted for.

Hours after truce ends, blast damages Al-Awda Hospital

December 1

Al-Awda is one of the only hospitals functioning in northern Gaza after indiscriminate bombing has decimated the area.

Palestinians search for survivors in the rubble left by an Israeli airstrike on Gaza in October 2023.
Residents search for survivors in the destruction caused by airstrikes in Gaza. Palestine 2023 © MSF

MSF USA executive director Avril Benoît sends an open letter to President Biden

December 4

“Dear President Biden,” the letter reads, “I am writing to you on behalf of Doctors Without Borders/Médecins Sans Frontières (MSF), our staff, and our patients to urgently request that the United States call for an immediate and sustained ceasefire in Gaza.”

Al-Awda Hospital siege

December 5

MSF staff at Al-Awda Hospital report that the hospital is facing a total siege. In the following days, two medical staff (not MSF staff members) are shot and killed by snipers.

MSF-USA staff hold signs at a vigil calling for ceasefire at United Nations in New York.

United States 2023 © Christopher Lee

MSF USA holds vigil for colleagues killed in Gaza at UN headquarters in New York

December 6

MSF calls US veto of Gaza ceasefire resolution “a vote against humanity”

December 8

The United Nations Security Council fails to adopt a resolution demanding a ceasefire in Gaza—blocked by a veto from the United States. The Security Council held an emergency meeting to discuss the humanitarian catastrophe in Gaza. This followed a letter from the UN Secretary-General invoking Article 99 to call on the Security Council to prevent further escalation and end this crisis.

In addition to demanding an immediate humanitarian ceasefire, the draft resolution tabled by the United Arab Emirates reiterates the Security Council's demand on all parties to comply with their obligations under international law, notably with regard to the protection of civilians in Palestine and Israel. "The US veto makes it complicit in the carnage in Gaza,” says Avril Benoît, executive director of MSF USA.

MSF surgeon is injured inside Al-Awda Hospital by a shot fired from the outside

December 12
A displaced Palestinian woman with her children outside a makeshift tent in Gaza.
A displaced Palestinian woman and children at a camp in Rafah, southern Gaza. Palestine 2023 © MSF

UN General Assembly votes to demand Gaza ceasefire 

December 12

The United Nations General Assembly votes overwhelmingly to demand a humanitarian ceasefire in Gaza. At the special emergency session, 153 nations vote for the ceasefire resolution and only 10 vote against it—including Israel and the United States; 23 nations abstained. 

The emergency meeting and vote are held after Egypt and Mauritania invoke Resolution 377, which allows the General Assembly to take action immediately if there is a lack of unanimity on the UN Security Council on matters that maintain international peace and security. The invocation of Resolution 377 followed a veto on Friday by the United States that blocked a UNSC resolution calling for an immediate humanitarian ceasefire in Gaza.

Israeli forces take control of Al-Awda Hospital 

December 17

After a 12-day siege, Israeli forces take control of Al-Awda Hospital. Men and boys over 16 years old are stripped and interrogated, with six MSF staff among them. The same day, the maternity ward of Nasser Hospital is hit by the casing of Israeli “illumination rounds,” killing one patient and wounding others.

MSF appeals to US Sec. Defense Lloyd J. Austin III

December 20

MSF joins 13 other humanitarian, human rights, and protection of civilians organizations in an appeal to Secretary of Defense Lloyd J. Austin III calling for the US to take urgent steps to protect the more than two million civilians suffering under relentless bombardment and siege conditions in Gaza. The joint letter, organized by the Center for Civilians in Conflict, expresses deep concern for civilians harmed by US-supported Israeli military operations in Gaza. Urgent action must be taken to prevent further US complicity in staggering civilian death and destruction.

A Palestinian man charges his phone on the hood of a car in Gaza, where electricity has been cut off by Israel.
Gaza has been under an electricity blackout for much of the past six months. Palestine 2023 © MSF

UN Security Council adopts watered-down resolution that fails to address needs

December 22

After days of negotiations and delay, the United Nations Security Council adopts a resolution demanding the parties to the conflict allow and facilitate safe and unhindered humanitarian access at scale to Palestinian civilians in Gaza. The final resolution is a watered-down version of the original draft, containing only a vague call for steps to be taken to “create the conditions for a sustainable cessation of hostilities.” The resolution also requests the UN secretary general to appoint a coordinator to facilitate the flow of aid into Gaza. 

“Today’s Security Council resolution falls painfully short of what is required to address the crisis in Gaza: an immediate and sustained ceasefire,” says Avril Benoît, executive director of MSF USA. “This resolution has been watered down to the point that its impact on the lives of civilians in Gaza will be nearly meaningless.”
An MSF staff member treats a patient at Rafah Indonesian Field Hospital in Gaza

Palestine 2024 © MSF

MSF sets up clinic at Rafah Indonesian Field Hospital


At the MSF clinic inside Rafah Indonesian Hospital, MSF teams provide post-operative care to Palestinians displaced from all over Gaza to free up beds in emergency rooms in other hospitals.

Al-Aqsa Hospital is evacuated

January 6

A strike on an MSF shelter in Khan Younis kills the five-year-old daughter of an MSF staff member

January 8
View of a windshield of a car driven to Al-Shifa Hospital in Gaza City

Driving from southern Gaza to Al-Shifa Hospital in Gaza City. Palestine 2024 © Aurélie Godard/MSF

MSF visits Al-Shifa Hospital for first time since evacuation

January 22

Aurélie Godard, head of MSF’s medical activities in Gaza, visits Al-Shifa Hospital as part of a supply convoy organized by the United Nations. "We managed to pass the checkpoint which separates north and south Gaza at the beginning of the afternoon, and immediately afterwards, our two cars and the fuel truck were surrounded by a crowd of young people in need of water and food, as both are in short supply. They were really disappointed that we were only transporting fuel."

Evacuation around Nasser Hospital

January 23

Following weeks of intense fighting, Israeli forces order the evacuation of the entire area surrounding Nasser Hospital. 

The day prior, as fighting raged in Khan Younis, MSF staff inside Nasser Hospital reported the ground shaking and the difficulty of evacuating medical staff and patients. 

ICJ issues provisional measures

January 26

International Court of Justice (ICJ) issues provisional measures ordering Israel to prevent and punish acts of genocide and to take steps to improve the humanitarian situation in Gaza.

Israeli forces besiege Al-Amal Hospital in Khan Younis

January 27

Two hundred people, including patients and staff, are stuck inside.

The Emirati hospital, Rafah, Gaza: Displaced, pregnant, and living in a tent.
A baby born at the Emirati Maternity Hospital in southern Gaza in January. Palestine 2024 © MSF

Pause in funding for UNRWA causes alarm

January 29

MSF is deeply alarmed by the decision of the United States and other countries to suspend their funding to the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) as the humanitarian crisis in Gaza has reached catastrophic levels. UNRWA is a lifeline for millions of Palestinians in Gaza Strip, the West Bank, and the wider region. Cutting this funding and any additional limitations on aid will result in more deaths and suffering in Gaza as people there are in desperate need of more aid, not less. Humanitarian organizations are already grappling to meet even a fraction of the urgent needs in Gaza, including those related to medical care, food, and shelter.

Israeli naval gunfire hits UNRWA food convoy waiting to go to northern Gaza

February 6

Israel announces Rafah military operation

February 9

MSF is deeply concerned about the safety and wellbeing of the nearly 1.5 million Palestinians who are currently living in the Rafah area after the Israeli government directs its military to carry out a major operation in Rafah and evacuate civilians.

"Israel’s declared ground offensive on Rafah would be catastrophic and must not proceed," said Avril Benoît, executive director of MSF USA. “We call on the government of Israel to immediately halt this offensive, and to all supporting governments like the United States to take concrete action to bring about a complete and sustained ceasefire. Political rhetoric is not enough."

An injured Palestinian man in a wheelchair returns to his tent.
Palestine 2024 © MSF

Shots fired at Nasser Hospital as staff and patients are trapped inside

February 10

MSF staff report shots fired at people inside Nasser Hospital. Two people are killed and five others injured, including one nurse who is severely wounded. Medical staff are afraid to move within and around the hospital due to fear of being shot. Israeli forces continue operations in the immediate vicinity of Nasser Hospital, trapping people inside the building and preventing anyone from entering the facility to access care. 

Palestinians crowded into the streets of Rafah in southern Gaza.

Rafah's population has more than tripled since the start of the war, as people flee bombings in northern and central Gaza.

Palestine 2023 © MSF

Israeli forces order displaced people to evacuate Nasser Hospital

February 13

Israeli forces order the evacuation of thousands of displaced people sheltering inside Nasser Hospital. Medical staff and patients are told they can remain in the building, with one caretaker per patient. Many people are afraid to leave the hospital because shots were fired at the building and at people trying to leave the compound.

Nasser Hospital orthopedic department shelled

February 15

MSF staff are forced to flee Nasser Hospital after the orthopedic department is shelled by Israeli forces, killing and wounding an undetermined number of people. One staff member is detained by Israeli forces at a checkpoint and later released on April 4 without charges.

Damaged interior of MSF's shelter in Al-Mawasi in Khan Younis, Gaza, after an Israeli attack.
Damaged windows at the MSF shelter in Al-Mawasi, Khan Younis, Gaza.

Attacks make it almost impossible to sustain medical humanitarian activities in Gaza. Palestine 2024 © MSF

Israeli forces attack MSF shelter in Al-Mawasi

February 20

An Israeli tank fires on a house sheltering MSF staff and their families in Al-Mawasi, Khan Younis, killing two people and injuring six more. Bullets are also fired at the clearly marked MSF building, hitting its front gate, exterior, and the interior of its ground floor.

UN Security Council again fails to adopt ceasefire resolution

February 20

The United Nations Security Council once again fails to adopt a resolution demanding an immediate ceasefire in Gaza—blocked by a veto from the United States. In addition to demanding an immediate humanitarian ceasefire, the draft resolution, tabled by Algeria, also calls for the opening of border crossings, the delivery of aid, and compliance with international law pertaining to the protection of civilians. It is the third time the US has vetoed a Council resolution calling for a ceasefire in Gaza since the start of the war.

Christopher Lockyear, secretary general of Médecins Sans Frontières (MSF), holds up an image of the destroyed MSF shelter in Al-Mawasi in Khan Younis, Gaza, at a UNSC briefing.

MSF Secretary General Christopher Lockyear at the United Nations in New York on February 22. 2024 © UN Photo/Loey Felipe

MSF Sec. General calls for urgent action in UN address

February 22

When addressing the UN Security Council at its monthly meeting on Gaza, Christopher Lockyear, MSF secretary general, calls for an immediate and sustained ceasefire and the unequivocal protection of medical facilities, staff, and patients. 

"Meeting after meeting, resolution after resolution, this body has failed to effectively address this conflict,” Lockyear said. “We have watched members of this Council deliberate and delay while civilians die. This death, destruction, and forced displacement are the result of military and political choices that blatantly disregard civilian lives. These choices could have been—and still can be—made very differently.”

More than 100 Palestinians killed waiting for food aid

February 29

At least 118 Palestinian civilians are killed and at least 760 injured after Israeli forces open fire on civilians waiting to get food from aid trucks at the Al-Nabulsi roundabout to the west of Gaza City.

“We are horrified by today’s news from Gaza City," says Isabelle Defourny, president of MSF in Paris. “MSF staff were not present during the incident, and due to poor telecommunications service we are unable to reach our medical staff still working in hospitals in the north of Gaza. However, we know that the situation in Gaza—particularly in the north—is catastrophic."

Displaced Palestinians wait in line to get safe drinking water in the Tal Al-Sultan area of the southern Gaza town of Rafah.
Displaced Palestinians wait in line for water in Rafah on January 21. Palestine 2024 © MSF

US announces plans to build temporary pier in Gaza

March 7

President Biden announces plans for the US military to build a temporary pier on the coast of Gaza in the Mediterranean Sea to help deliver humanitarian aid. 

"The US plan for a temporary pier in Gaza to increase the flow of humanitarian aid is a glaring distraction from the real problem: Israel’s indiscriminate and disproportionate military campaign and punishing siege," said Avril Benoît, executive director of MSF USA. "The food, water, and medical supplies so desperately needed by people in Gaza are sitting just across the border. Israel needs to facilitate rather than block the flow of supplies. This is not a logistics problem; it is a political problem. Rather than look to the US military to build a workaround, the US should insist on immediate humanitarian access using the roads and entry points that already exist."

Five people are killed by airdropped aid boxes when parachutes fail to open

March 8
Destruction left after Israeli forces' siege of Al-Shifa Hospital in Gaza in March 2024.

Given the extent of the destruction, people in the north of Gaza are left with even fewer health care options amid increasing medical needs. Palestine 2024 © MSF

Military operations at Al-Shifa Hospital

March 18

Staff sheltering near Al-Shifa Hospital in Gaza report heavy fighting nearby as Israeli forces announce a military operation inside and around the facility. An MSF staff member says he heard drones, tanks, and shelling near the hospital in the early hours of March 18 and witnessed a fire rising from Al-Shifa's main building. He also says there were clashes around the MSF clinic and office in Gaza City.

MSF pediatrician describes horrific conditions in Gaza at UN 

March 19

Dr. Amber Alayyan, pediatrician and Palestine medical program manager for MSF, describes the dire needs of the devastated health care system in Gaza to the United Nations in New York, calling for the protection of health care workers and immediate access to vulnerable people in northern Gaza.

Humanitarian organizations send joint letter to President Biden

March 23

Following a new policy directive from President Biden, National Security Memorandum 20, in which US security partners must provide written assurances that they will use US security assistance in accordance with international law and facilitate humanitarian assistance, MSF joins other humanitarian organizations in an open letter urging the use of all means available to relieve the suffering, in accord with the humanitarian principles of humanity, impartiality, neutrality, and independence.

“As humanitarian organizations operating in Gaza, it is our experience that the humanitarian response in Gaza, including US funded humanitarian assistance, has been consistently and arbitrarily denied, restricted, and impeded by the Israeli authorities," the letter states.

UN Security Council finally passes ceasefire resolution

March 25

After more than five months, the UN Security Council finally passes a resolution calling for an immediate ceasefire to the conflict in Gaza during the month of Ramadan, which ends on April 9. The resolution passes with 14 votes in its favor. The United States—which has vetoed several ceasefire resolutions—abstains, making the passage of the resolution possible. The resolution also calls for the immediate and unconditional release of hostages and “the urgent need to expand the flow” of aid into Gaza.

"This is a constructive step that must be followed by action, but a two-week ceasefire is not nearly enough time to respond to the overwhelming humanitarian needs," says Avril Benoît, executive president of MSF USA. “We repeat our urgent demand for a sustained ceasefire now.”
MSF staff talk to patients at Al-Shaboura clinic in Rafah in the south of Gaza.

MSF Medical Activity Manager Sara talks to patients at Al-Shaboura Clinic in Rafah. Palestine 2023 © MSF

Airstrike near Al-Shaboura clinic

March 27

MSF staff in Rafah witness an airstrike in the vicinity of Al-Shaboura clinic. No casualties were reported among our patients or medical personnel, as the clinic was closed at the time of the attack.

Israeli airstrike hits a yard in front of Al-Aqsa Hospital

March 31
Destruction at Al-Shifa, Gaza’s largest hospital, which is now out of service.
Given the extent of the destruction, people in the north of Gaza are left with even fewer health care options amid increasing medical needs. Palestine 2024 © MSF

Israeli forces leave Al-Shifa Hospital in ruins

April 1

Al-Shifa Hospital in northern Gaza is left in ruins after a 14-day long operation by Israeli forces in and around the facility. According to the World Health Organization (WHO), 21 patients have died since the hospital came under siege, and about 107 other people remained trapped inside as of March 31, including four children and 28 people in critical condition. Gaza’s largest hospital is now out of service.

How MSF is responding to the war in Gaza