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MSF operations in Gaza

Information on MSF activities in Gaza, the West Bank, and Egypt in response to the ongoing humanitarian catastrophe.

A group of displaced Palestinians waits in front of Abed Al-Salam Yassin company in the Tal Al-Sultan area of the southern Gaza town of Rafah.

Doctors Without Borders/Médecins Sans Frontières (MSF) has been working in Gaza for 35 years and our teams continue to provide lifesaving medical aid as the war enters its fifth month. With both local Palestinian staff and international teams operating throughout Gaza, MSF is providing lifesaving medical care and humanitarian relief at a time of unimaginable suffering. Our work includes surgical support, wound dressing, physiotherapy, vaccination, mental health care, and other essential needs.

Gaza before the war

The Gaza Strip is a 141 square mile territory surrounded by walls and fences and under the constant control of the Israeli authorities. With 2.3 million people, it has one of the highest population densities in the world. Every aspect of life in Gaza is impacted by the ongoing blockade and constant threat of violence. 

Since 2006, Gaza has been under blockade—meaning the entry and exit of people and goods are strictly controlled by Israel, including clean water and vital supplies. The blockade has limited the supply of essential medicines—particularly during the COVID-19 pandemic—which has led to alarming rates of antibiotic resistance

Frequent escalations of violence have taken a heavy toll on people’s health and wellbeing, as well as infrastructure like health care and education. The current war in Gaza has been the longest and most devastating.

A disabled Palestinian man who was amputated after the Great March of Return in Gaza uses crutches.
Mohamad Soliman Mohamad Saad was shot in the leg during the Great March of Return in 2018. After he underwent 10 operations to try saving his leg, MSF advised amputation. “Thankfully I felt no stigma, because my wife and family have always shown me love. Without doubt my wife was the number one reason I was able to overcome the challenges of the amputation." Palestine 2022 © Giles Duley

Medical and humanitarian needs

The medical needs in Gaza are immense. Many people need urgent assistance—including people trapped under rubble, pregnant women who are about to deliver, and the elderly. Civilians are not able to access care for war wounds, crush injuries, and burns when they need it most. And massive displacement, dire living conditions, and an urgent lack of food and safe water are putting people at further risk and fueling the spread of infectious disease.

MSF activities in Gaza

Extremely volatile conditions on the ground mean that we have had to continually adapt our operations as more facilities come under attack or are subjected to evacuation orders by the Israeli army. Today, MSF mainly operates in the south of Gaza.

AL-AWDA HOSPITAL, NORTHERN GAZA
Status: Evacuated (though MSF and MSF-supported staff continue to work autonomously)


The last remaining main hospital in northern Gaza is barely functional. On November 21, two MSF doctors, Dr. Mahmoud Abu Nujaila and Dr. Ahmad Al Sahar, and another doctor, Dr. Ziad Al-Tatari, were killed in a strike on Al-Awda Hospital. In early December, Israeli forces besieged the hospital and took control of it on December 17 after heavy fighting. Israeli forces detained and interrogated all men and boys over 16 years old, including six MSF staff members. Most were sent back to the hospital and have been working there autonomously since. Our colleagues report that everything is in short supply and work conditions are difficult.  

AL-SHIFA HOSPITAL, GAZA CITY
Status: Evacuated


After MSF staff were forced out of Al-Shifa Hospital on November 18 due to repeated attacks by Israeli forces, two nurses returned to the premises to assist with medical procedures voluntarily, before leaving in early February as strikes approached the hospital again. On January 22, our staff reported that medical activities at Al-Shifa Hospital are very limited as 50,000 displaced people are sheltering inside the facility, making it difficult to run operations. The ER department is open but overcrowded with hospitalized patients, including those with war wounds, burns, and gunshot injuries, along with patients with chronic diseases. Shortages of fuel, medicines, food, and water continue to hinder medical response. 

INDONESIAN HOSPITAL*, NORTHERN GAZA
Status: no MSF staff


MSF staff were forced to leave the Indonesian Hospital at the outset of the war due to increasing bombardment in the area and Israel’s progressive ground invasion. We cannot provide any updates on this facility or the situation inside, and we are not aware of any patients or hospital staff still inside.

*Not to be confused with the Rafah Indonesian Field Hospital in south Gaza

AL-AQSA HOSPITAL, KHAN YOUNIS
Status: Active MSF operations


On January 6, MSF had to evacuate Al-Aqsa Hospital due to fighting around the premises and evacuation orders that made MSF’s pharmacy inaccessible. Three MSF-supported staff remained on the premises, working autonomously. On February 6, an MSF team returned to Al-Aqsa and prepared to resume our previous activities. On February 7, we resumed wound care and rehabilitation activities. 

NASSER HOSPITAL, KHAN YOUNIS
Status: Evacuated, though some MSF staff remain working voluntarily


Nasser Hospital was the main surgical center in the south, and had become the largest hospital in Gaza after Al-Shifa was brought to a standstill by Israeli military operations in November. The area surrounding the hospital has been under evacuation orders since January 23, following weeks of intense bombing and fighting. This prompted 90 percent of staff to leave, including most MSF staff, though a handful decided to remain on the premises. Remaining staff describe shortages of everything from beds to anesthetics, fuel, food, and water. In late January, 150 patients too sick to move were trapped inside the hospital. The emergency room is open but cannot accommodate a large influx of wounded that could result from strikes in nearby areas. 

EUROPEAN GAZA HOSPITAL, KHAN YOUNIS
Status: Active MSF operations


It is becoming more difficult to access the European Gaza Hospital every day due to insecurity near the premises. Our plastic surgeon and a small team of nurses are seeing between 20 and 30 patients a day for a change of wound dressings, and are working in the operating theater providing debridement, flap surgery, and sutures. Many of the patients are children with trauma and severe burn injuries who were wounded at the beginning of the war and have since developed infections due to lack of medical care. 

RAFAH INDONESIAN FIELD HOSPITAL, RAFAH
Status: Active MSF operations


MSF supports the outpatient department at Rafah Indonesian Field Hospital, treating patients with war wounds in post-operative care through wound dressings, physiotherapy, and other small procedures to relieve the patient load from Nasser, European, and An-Najar hospitals. Inpatient activities were scaled up to 60 beds in January and include one procedure room for small surgical interventions such as skin grafts, debridement, and the removal of external fixators. Outpatient activities now run six days a week with about 150 consultations a day, including wound dressing, physiotherapy, and counseling. 

AL-NAJJAR HOSPITAL, RAFAH
Status: Active MSF operations


MSF has been operating in An-Najar Hospital since January 22nd, with three surgeons and two nurses performing surgeries and wound care and preparing to scale up activities. 

EMIRATI MATERNITY HOSPITAL, RAFAH
Status: Active MSF operations


MSF is supporting the Emirati Maternity Hospital with medical supplies and personnel including gynecologists, nurses, and hygienists working round-the-clock shifts. The MSF team provides postpartum care and manages pregnancy complications, while deliveries are managed by the hospital’s staff. The teams built an extension of the maternity department in the parking lot of the hospital to increase the postpartum department’s capacity to 20 beds, allowing more patients to receive proper monitoring post-delivery. We plan to add another four to six beds this week. 

Al-SHABOURA CLINIC, RAFAH
Status: Active MSF operations


On December 9, MSF restarted activities at Al-Shaboura Clinic, gradually scaling up activities with 31 staff. The MSF team provides outpatient services, including general consultations, reproductive health services, wound dressing, mental health care including individual and family sessions as well as psychological first aid and psychoeducation. We’re also screening children under five for malnutrition, as well as pregnant and lactating women.

Overview

By the numbers: Al-Shaboura Clinic

  • Between January 20 and 26 at Al-Shaboura Clinic, we performed a total of 3,347 consultations and began routine vaccination activities. Children under five years old made up 18 percent of general consultations, and 21 percent were children between 5 and 14 years old. 
  • As a result of prolonged exposure to cold and rain, and poor hygiene conditions, 43 percent of patients had respiratory tract infections and 8 percent had diarrhea.
  • Among gynecological consultations, 33 percent of patients had anemia while 22 percent had genitourinary infections.
  • Of patients receiving wound dressing care, 38 percent showed signs of infection
  • Though it is still a small percentage, we’re seeing a gradual increase in the number of patients with malnutrition. Among children under five received at Al-Shaboura between January 6 and 26, we detected 12 patients with severe acute malnutrition and 23 with moderate acute malnutrition.  
AL-MAWASI HEALTH POST, RAFAH
Status: Active MSF operations


We have established a primary health care mobile clinic inside two trucks in Al-Mawasi, where teams conduct about 400 consultations each day. Our team also conducts health promotion activities there to assess medical needs, particularly among elderly people. The MSF team also provides outpatient services, including general consultations, wound dressing, mental health care, and health promotion. Between January 20 and 26, we performed a total of 1,948 medical consultations, with 14 percent of conditions seen in children under five years old, and 26 percent seen in children between 5-14 years old. About one-third of patients had respiratory tract infections due to prolonged exposure to cold and rain and poor hygiene conditions, and 16 percent were diarrhea cases. 

MARTYRS, BENI SUHAILA, AND MASCAT CLINICS
Status: MSF activities suspended


After Israeli forces ordered people to evacuate the area on December 1, we were forced to end our support to Martyrs and Beni Suhaila clinics, where we had been providing basic health care, wound dressing, and mental health consultations. 

MSF is supporting two water distribution points in Al-Mawasi, near the health post and in an informal camp for displaced people. Since January 30, we have provided 7,600 liters of water to 5,067 people six days per week. 

MSF teams are also supporting nine water distribution points, all near informal camps of internally displaced people, including one site near the Qatari Hospital and another near Al-Shaboura Clinic. In total, we are providing 110,000 liters of water each day to 20,625 beneficiaries (around 3,500 families). 

Between October and January, we were able to send over 75 tons of medical supplies into Gaza, mainly surgical and dressing kits. These supplies are mainly being used at Nasser Hospital, though some were delivered to the Rafah clinic, the European Hospital, and Al-Shaboura Clinic. Bringing supplies into Gaza has been extremely difficult due to administrative barriers, movement restrictions, and a large backlog of trucks at the border.

MSF activities in the West Bank

The war in Gaza has reverberated in the West Bank, where increasing settler violence against Palestinians and movement restrictions have impacted mental health and access to care. More than 500 Palestinians were killed by Israeli forces and settlers last year—including 199 deaths before October 7—making 2023 the deadliest year ever in the West Bank.

Mobile clinics

MSF runs 10 mobile clinics and supports four primary health clinics in the Hebron area. We have expanded activities at our mobile clinics to bring health care to people who are unable to reach health facilities due to increasing disruptions to medical access during active hostilities. Our mobile clinics now reach a total of 10 locations, including Hebron’s Old City, surrounding areas, and remote villages in the southern West Bank such as Masafer Yatta.

Hospitals

We support various hospitals in the Hebron area through donations and increasing capacity, including the maternity ward and emergency room at Halhoul Hospital and the emergency room at Moktaseb Hospital. We have also trained and supported medical staff at Al Moktaseb Hospital, Hal-Hul, Dura, and Yatta Hospital.

Relief and other support

To support emergency response during active hostilities, we have distributed first-aid kits to community focal points in Beit Omar, Al Rshaydeh, and the emergency care center in Um El Khair. MSF teams have expanded health promotion activities and the distribution of relief items, hygiene kits, and food parcels to displaced Gazans and West Bank residents affected by violence and forcible displacement.

We continue to offer individual and group psychotherapy sessions as well as psychiatric consultations in Nablus, Qalqiliya, and Tubas, despite movement restrictions imposed by Israeli forces, which were already an impediment to health care access but have intensified since October 7. We have also provided first aid and first responder training for 300 volunteers with the Palestine Red Crescent Society (PRCS) in the Nablus area.

Our teams are supporting the emergency rooms at Khalil Suleiman Hospital in Jenin and Thabet Thabet Hospital in Tulkarem, both run by the Ministry of Health. We have equipped volunteer paramedics in Jenin, Tulkarem, and Nur Shams refugee camps with donations and training so they can stabilize patients during active hostilities and keep them alive until they can reach a hospital.

In December, we set up stabilization points in pre-existing health facilities and trained staff on trauma care to support the Ministry of Health’s emergency response planning.

In both areas, we support existing mental health care services, including for Palestinian workers from Gaza who have been stranded in the West Bank since having their work permits in Israel revoked after October 7. 

What MSF is calling for

MSF is calling for an immediate and sustained ceasefire between all parties involved to halt the death and destruction and allow for the urgent delivery of humanitarian aid. Any leaders with influence (not limited to the US, UK, Canada, EU, the League of Arab States, and Member States of the Organization of the Islamic Cooperation) must exert all their influence to push for a ceasefire. Members of the United Nations Security Council, particularly the US, must stop failing the people of Gaza and demand an immediate and sustained ceasefire, the lifting of the siege, and unrestricted aid for the entire Gaza Strip. 

While the only solution to restore access to health care in Gaza is a sustainable ceasefire and a proper humanitarian response, there are an unprecedented number of wounded people requiring complex and sustained medical care not available in Gaza. There are 6,000 people on waiting lists to be evacuated for tertiary care, according to OCHA. Due to the severity and complexity of their wounds and the extreme violence and siege conditions in Gaza, they need safe and medicalized passage from Gaza to other countries where they can receive care. Any evacuation must be conducted without prejudice to Palestinians’ right to return. 

Hospitals, health care facilities, patients, and medical staff have been constantly under attack, or have come under fire with little or no regard for their safety. The duty of treating the sick and wounded, and the corresponding protection of medical personnel and facilities, is at the core of international humanitarian law and must be upheld. 

Evacuation orders continue to put patients, staff, and displaced people sheltering inside health facilities at risk. Accessing health care has become increasingly difficult for the wounded and the sick, adding to an already shocking toll from this war. None of the health facilities that remain functional in any capacity can accommodate mass casualties, such as those following a bombing, due to damage from strikes and fighting, and orders to evacuate areas around hospitals and clinics. 

MSF is calling on Israeli forces to end the systematic siege of medical facilities across Gaza, and to protect medical staff along with civilians, including patients and people sheltering inside facilities because they have nowhere to go. All parties involved must sustain and reinforce the fragile health care system in Gaza, including through the protection of the few remaining functioning hospitals, and ambulances. 

For more than four months, Palestinians in Gaza have been deprived of essential needs such as food, water, shelter, fuel, and electricity, as well as health care, due to Israel’s total, inhumane siege of the entire Gaza Strip. Any supplies allowed into Gaza so far have been negligible compared to the immense needs. Even before this war, Gaza was heavily reliant on foreign aid after years of blockade. As Israeli forces continue to push Palestinians towards the Egyptian border, the needs are only growing—malnutrition is looming, communicable diseases are spreading, clean water is scarce, and winter weather has made conditions worse for people without warm clothes or sufficient shelter. 

MSF is calling on the Israeli authorities to lift the inhumane and unlawful siege of Gaza and allow humanitarian organizations to provide life-saving aid across Gaza, safely and without impediments and at a scale to meet medical needs. International humanitarian law requires Israel, as the occupying power in Gaza, to ensure that the basic needs in terms of food, water, shelter, and health care are provided. The UN Security Council must call for a sustained ceasefire and unimpeded humanitarian access to the entire Strip. All parties to the conflict must provide basic guarantees of safety to humanitarian workers, health care personnel, and first responders so they can continue saving lives without risking their own.