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What’s happening in Rafah?

A further escalation of the ongoing Israeli military operations in southern Gaza will inevitably kill and maim more Palestinians. Here's why.

A displaced Palestinian family inside their tent in the southern Gaza town of Rafah’s Al-Shaboura neighborhood.

Palestine 2024 © MSF

For approximately seven months, the southern city of Rafah in Gaza functioned as a refuge for more than 1.5 million Palestinians, many of whom fled the conflict and bombardments in other parts of Gaza that have killed more than 36,000 people to date.

That all changed about a month ago when Israeli forces began increasing military operations in Rafah, leaving people once again in constant fear of being killed in a war they were told they would be insulated from in the south.

Shortly after Israeli forces issued evacuation orders and escalated their military activities in Rafah, they seized control of the Rafah crossing and closed it until further notice, blocking people's access to lifesaving goods and supplies and making it near-impossible for humanitarian organizations to sustain lifesaving operations.

Where is Rafah?

Rafah is a city on Gaza's southern border with Egypt. Since the war across Gaza escalated in October 2023, Israeli forces told people to flee areas under attack for “safe zones” in the south, primarily Rafah, as they weren’t actively targeting that region until recently. The Rafah crossing with Egypt is a key entry point for humanitarian aid, despite inconsistent and opaque inspection requirements imposed by Israel. Now no aid can come in, and no one in need of medical evacuation can get out.

How many people are in Rafah?

As Israeli forces told people to flee to “safe zones” in and near Rafah from other parts of Gaza where the conflict was most active, more than 1.5 million did so, setting up makeshift shelters and tents amid unsafe, unhealthy, and deplorable living conditions. They joined approximately 300,000 residents who already lived there. However, given Israel’s current military escalation in Rafah, more than 900,000 people have since fled Rafah for areas they hope will be safer.

Displaced Palestinians flee Rafah, southern Gaza.
Displaced Palestinians leave Rafah after an evacuation order from the Israeli military on May 6, 2024.
Palestine 2024 © MSF

Are Israeli forces’ so-called “safe zones” really safe?

No. On May 26, at least 49 people were killed and 250 were wounded when an Israeli airstrike hit the neighborhood of Tal Al-Sultan in Rafah. Two days later, on May 28, 21 Palestinians were killed and 64 were injured after Israeli forces bombed another tent camp for displaced people in Al-Mawasi.

Civilians are being massacred. They are being pushed into areas they were told would be safe only to be subjected to relentless airstrikes and heavy fighting.

Chris Lockyear, MSF secretary general

“Civilians are being massacred,” said Chris Lockyear, Doctors Without Borders/Médecins Sans Frontières (MSF) secretary general. “They are being pushed into areas they were told would be safe only to be subjected to relentless airstrikes and heavy fighting. Entire families—made up of dozens of people—are crowded into tents and living in extremely difficult conditions.”

Who controls the Rafah crossing?

Israeli forces advanced to the Rafah border crossing and took control on May 7, and since then it has been closed completely until further notice. 

“Everything that is vital for daily life is not entering anymore: no humanitarian aid, no medical supplies, no food, no fuel,” said Aurelie Godard, MSF medical team leader in Gaza.

Prior to the Israeli advance to the Rafah border gate, it took weeks for Doctors Without Borders to deliver supplies into Gaza. An aid box’s journey would start at Al-Arish airport in Egypt, then it would need to cross into Rafah, pass through Israel's Nitzana checkpoint, and then return to Rafah for cross-loading, with multiple scans and inspections along the way. 

Before the current war, an estimated 500 truckloads of supplies entered Gaza every day. By February 2024, this had reportedly dropped to below 100 truckloads per day. It has been extremely difficult to get supplies—including lifesaving medicines, surgical kits, logistical items, and humanitarian aid supplies—into Gaza due to administrative barriers, movement restrictions, and the lack of options for crossings. 

A group of displaced Palestinians getting water from an MSF truck in the southern Gaza town of Rafah’s Saudi neighborhood.
Drinkable water is scarce in Gaza. MSF has provided around 300 cubic meters of clean water a day throughout Rafah and set up a new desalination plant in Al-Mawasi on March 28. Palestine 2024 © MSF

Why is what’s happening in Rafah important?

The evacuation orders and increased military operations underscore the fact that nowhere in Gaza is safe. The only way to protect people in a place without true “safe zones” is by instituting an immediate and sustained ceasefire and ending Israel’s military offensive in Rafah. A ceasefire would prevent more deaths and injuries in Gaza and restore and scale up the flow of humanitarian aid.

How is Doctors Without Borders responding in Rafah?

Since the start of the war in October, Doctors Without Borders teams have been working in Rafah and throughout Gaza, providing surgical support, wound dressing, physiotherapy, vaccination, mental health care, and other essential services. In Rafah, our teams have worked at facilities including the Emirati Hospital, Rafah Indonesian Hospital, and Al-Shaboura Clinic, as well as running several water distribution points for displaced people living in the area. As of mid-May, Doctors Without Borders is operational in three health care facilities in the Rafah area and nearby Al-Mawasi, as well as facilities in other parts of Gaza.

An MSF staff member treats a patient at Rafah Indonesian Field Hospital in Gaza
Youssef Al-Khishawi, an MSF water and sanitation agent, oversees a water distribution from the platform of an MSF truck in the Tal Al-Sultan area of the southern Gaza town of Rafah.

An MSF staff member treats a patient at Rafah Indonesian Field Hospital (left) and a water distribution point in the Tal Al-Sultan area of Rafah (right) in January. Palestine 2024 © MSF

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