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What to know about the situation in southern Gaza

As the fighting between Israel and Hamas resumes, here are five things to know about southern Gaza, where MSF teams continue to work.

Patients on the floor at Al Aqsa hospital in Gaza with a sheet.

Palestine 2023 © MSF

UPDATE: After the week-long truce between Israel and Hamas broke on December 1, Israeli forces called for people in areas of central Gaza and Khan Younis to evacuate further south to Rafah. The MSF-supported Martyrs and Beni Suhaila clinics are located in areas under the evacuation order. In the north, Al Awda Hospital, where our colleagues still work, was damaged in a blast just hours after the truce ended. It's one of the only hospitals still functioning in northern Gaza. We need a sustained ceasefire now.

Following the outbreak of war in early October between Israel and Hamas in Gaza, Palestine, Israeli forces have repeatedly pushed people to move from the northern part of the Strip to the south. Today, the humanitarian situation in the south of Gaza is dire and unsafe. Intense bombardment and fighting have uprooted over 1.8 million people—around 80 percent of the total population of the Strip. Around one million people are being pushed to relocate to the south, where living conditions were already overcrowded and desperate even before the current conflict.

As the fighting between Israel and Hamas resumes today after a week-long truce, here are five things to know about the humanitarian situation in southern Gaza, where teams from Doctors Without Borders/Médecins Sans Frontières (MSF) continue to work. 

Displaced people and patients crowd the halls of hospitals in Gaza.
The hallways of Al-Aqsa Hospital. Palestine 2023 © MSF

1. Gaza’s people are still living without sufficient food, water, cooking gas, electricity and other essentials

Our teams are seeing people wait in line for food, water, and cooking gas, while the needs remain uncovered for hundreds of thousands of Palestinians. Despite the entry of several trucks of aid into Gaza, the needs remain hugely unmet. People need mattresses, warm clothes for winter, blankets, and other items, in addition to basic supplies.

Gaza remains without electricity after being disconnected by Israeli forces on October 11, and with fuel reserves depleted, all essential services such as health, water and sanitation, and communication have been forced to shut down one by one. The Israeli government’s complete siege has deprived the entirety of Gaza’s people of essential supplies such as food, water, shelter, and medical care.   

People look for fuel, food and gas near Al Aqsa hospital in Gaza
People often spend hours searching for fuel, food, and gas in Gaza. Palestine 2023 © MSF

2. The few medical facilities that are functioning are overwhelmed

In southern Gaza, only eight out of eleven health facilities are currently functioning, according to UN OCHA on November 26. These facilities are currently receiving far more people than their normal capacity, while facing an immense lack of material, resources, water, and power. Another problem is the lack of space: Like those in the north, hospitals in southern Gaza have become a refuge for displaced people.

“The entire health system here in Gaza just does not have the capacity to cope with the current situation,” said Marie-Aure Perreaut, MSF emergency coordinator in Gaza. “Hospitals are completely overwhelmed with the influx of wounded patients they've been receiving for the past few weeks.”

At Martyrs Clinic in Khan Younis, where our teams are working, the number of consultations per day has increased from roughly 250 to about 1,000 consultations.

Other hospitals that our teams have visited are running out of beds, and patients are lying in the hallways waiting to receive treatment. 

Doctors perform surgery on a patient in a dark room lit by a window at Al Aqsa Hospital in Gaza
Doctors perform surgery on a patient at Al Aqsa Hospital in central Gaza on November 29. Palestine 2023 © MSF

3. Gaza’s extremely high population density is causing health consequences

The Gaza Strip is one of the most densely populated areas in the world. Just over 2 million people reside in the Strip, packed into in an area of about 227 square miles—equivalent to about half the size of New York City. The forced displacement of almost the entire population of Gaza to a smaller, restricted space in the south, has pushed the density even higher. One million people are crammed into a relatively small area; they can’t move and are entirely dependent on humanitarian aid. This crowding, paired with terrible living conditions, is putting people’s health at risk.

“We're seeing an increasing number of children and women with injuries from burns and other conditions,” said Marie-Aure. “These injuries clearly illustrate the extremely precarious living conditions and the overcrowding of shelters and camps.”

Five ways the war in Gaza is impacting Palestinians' health

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A population density as high that in southern Gaza puts people at risk of communicable diseases. People living in crowded spaces—with a lack of water and sanitation, and no disease prevention and monitoring system—is a recipe for disaster for diseases like cholera and measles.

“Today we received a case linked to complications of chronic diseases, infections, viruses, and bacteria that many people face due to the overcrowded living conditions in shelters like centers and schools,” said Jameel Awad Allah, an MSF nurse at Martyrs Clinic. 

MSF staff walk through the halls of Al Aqsa hospital in Gaza.
Dr. Sohaib Safi and Katrien, project medical referent, at Al Aqsa Hospital on November 29. Palestine 2023 © MSF

4. There is overwhelming need for treatment for war wounds and mental health care

At  Martyrs Clinic, MSF teams provide outpatient consultations to children and adults, as well as wound dressings, mostly for infected wounds and those caused by blasts. Our teams are also doing triage and referrals of trauma cases to Nasser Hospital. The hospitals that are still operational are overflowing with war-wounded patients.

“Most of the cases that we receive here are from shrapnel or fractures,” said Awad Allah at Martyrs Clinic. “We also have burns cases.”

On top of the need for surgical, burn, and wound care from the bombing and the shelling, our teams are observing basic health care needs, such as maternal health care, general medicine, and particularly mental health care. In Khan Younis, we offer mental health sessions for children and women.

“We are providing mental health support to all people who are here, especially the internally displaced,” said Marwa Abu Al Nour, an MSF psychologist. “The most common things I see among children are nightmares, bed-wetting, anxiety, and fear. We try as much as possible to give them support via recreational activities.”

A patient receiving a new dressing at Al Aqsa hospital. 29 November 2023, Middle Area, Gaza.
A patient receives a new wound dressing at Al Aqsa Hospital on November 29. Palestine 2023 © MSF

5. MSF teams are responding in hospitals and clinics across southern Gaza

Today, MSF is working in two hospitals in southern Gaza—Nasser and Al-Aqsa hospitals—and in two clinics in Khan Younis, Martyrs and Beni Suhaila clinics.

At Nasser Hospital, we provide emergency care and surgical treatment, including for patients with traumatic injuries and severe burn injuries. We also support the emergency department and ICU.

At Al Aqsa Hospital, in central Gaza, we are supporting hospital staff, working on wound dressings and outpatient consultations for patients with blast injuries and burns.

At Martyrs Clinic, we provide outpatient and mental health consultations, and at Beni Suhaila Clinic, we offer basic health care, such as wound dressings. 

A young girl lies in a hospital bed greeting MSF staff at Al Aqsa Hospital in Gaza.
MSF psychologist Abdalla Salem (left) with Razan Samer Shabet (center), a young girl who lost her whole family in the bombing while she was injured. She has been in the hospital ever since. Palestine 2023 © MSF

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