In 2022, MSF activities in Palestine included the following:
- 6,567 people treated for burns and trauma in Gaza
- 536 number of patients in individual psychotherapy/counseling in Hebron
- 9,276 medical consultations provided in Masafer Yatta and Hebron’s Old City
- 142 number of patients received in Nablus, Qalqilya, and Tubas
Israel-Gaza war response
As of December 28, MSF is operational in six hospitals and one primary health care facility in Gaza, mainly in the south and central part of the Strip (called the Middle Area). Our teams are providing surgical care, wound care, physiotherapy, outpatient consultations, and mental health services to people impacted by the war and the worsening humanitarian catastrophe.
The last remaining main hospital in north Gaza, Al-Awda has been barely functional. The hospital was struck in early October and at least five hospital staff, including two MSF doctors, were killed while they were caring for their patients. In early December, Israeli forces besieged the hospital and took control of the facility on December 17 after heavy fighting. On the 17th, Israeli forces temporarily arrested and interrogated men and boys over 16 years old, including six MSF staff members. Most were sent back into the hospital and told not to move.
As of December 27, we still have several staff members working at Al-Awda, but the hospital is running out of supplies, while doctors, patients, and family members face the threat of being shot by snipers if they try to leave the facility.
Since the last MSF staff members left Al-Shifa Hospital on November 18, we cannot provide any updates regarding this facility or the situation inside. However, on December 16, the World Health Organization (WHO) conducted an assessment and reported hundreds of patients in dire condition, thousands of internally displaced people still inside the compound, and a severe shortage of food and safe water.
MSF staff were forced to leave the Indonesian Hospital in October due to increasing bombardment in the area and the progressing ground invasion by Israeli forces. For this reason, we cannot provide updates regarding this facility or the situation inside at this time.
At Al-Aqsa Hospital in central Gaza, MSF teams administer wound dressings and conduct outpatient consultations for patients with blast injuries and burns, and we support the operating room with surgical capacity, as well as the Deir Al-Balah health center.
In December 2023, MSF teams treated 955 patients for wounds and burns (81 percent were war-related injuries), conducted 883 procedures and 564 physio-education sessions, provided mental health care to 796 patients, and reached 564 people through health promotion activities.
Our staff at Al-Aqsa—roughly 50 people including three international staff—have reported heavy, almost non-stop fighting in the vicinity of the hospital since the truce broke on December 1, and have received an average of 150 to 200 injured people daily. On some days, we have received more dead than injured.
On December 25, Al-Aqsa Hospital reported admitting 209 injured patients and 131 dead after the bombings of Al-Maghazi and Al-Bureij refugee camps that day. About half of the admissions were women and children. The last days of December saw an even larger spike in injuries and deaths, peaking at 357 injured and 155 dead on December 28.
Located in Khan Younis, Nasser Hospital is the main surgical center in southern Gaza. The area has been under steady bombardment since December 1, and Nasser Hospital often receives dozens of dead and wounded people at a time during mass-casualty events.
MSF teams at Nasser Hospital provide emergency and surgical treatment to patients with traumatic injuries and severe burns. Our activities have adjusted continuously to the security conditions. As of December 27, a number of MSF’s Palestinian staff members continue to work in the hospital.
On December 17, the maternity ward in Nasser Hospital was reportedly hit by a flare fired by Israeli forces that killed one patient and injured six others.
Since December 6, MSF has been supporting the European Hospital in southern Gaza with limited surgical capacity. We are now increasing our support by reinforcing the surgical team and providing wound dressings.
Our small team of nurses at the European Hospital sees 35 to 50 patients each day for a change of dressings. Many of the patients are children with trauma and severe burn injuries who were wounded at the beginning of the war and now have infections due to the lack of medical care and supplies.
Rafah Indonesian Hospital
MSF is supporting the outpatient department at Rafah Indonesian Hospital (not to be confused with the Indonesian Hospital in northern Gaza) with wound dressing, physiotherapy, and other small procedures to relieve the patient load from Nasser, European, and Al-Najjar hospitals. Inpatient activities include 30 beds in the first week of January 2024.
MSF has recently started supporting Al-Emirati Hospital with medical supplies and staff, including gynecologists, nurses, and hygienists working round-the-clock shifts. Our teams have also supported the clean-up of the maternity ward and provide medical and hygiene supplies. MSF staff started to receive their first patients at this hospital on December 13, including pregnant women with medical complications. The team is also working on expanding the ward to 24 beds, and have secured food for patients through the World Central Kitchen.
Primary health care centers
MSF was forced to suspend support to Martyrs and Beni Suhaila clinics, where we had been providing basic health care, wound dressings, and mental health consultations after Israeli forces ordered people to evacuate the areas on December 1.
On December 9, MSF restarted its work at Al-Shaboura Clinic, which had been closed since the beginning of the war. Half of the patients suffer from respiratory tract infections due to prolonged exposure to cold and rain and poor hygiene conditions. We are also seeing many cases of diarrhea. MSF teams at Al-Shaboura clinic also provide prenatal and mental health consultations.
In the first week of reopening (December 9 to 14), we provided 1,132 consultations, over 200 wound dressings, and psychological consultations to 133 patients. We now see an average of 300 patients each day at the clinic. Children under five years old make up 19 percent of general consultations, and 22 percent are children between 5 and 15 years old.
Water and sanitation
In addition to medical activities across Gaza, MSF teams are also supporting 20 water distribution points near informal camps where internally displaced people are sheltering. We are providing a total of 80,000 liters of water per day, but it remains a challenge to provide enough water for each person.
MSF sent over 50 tons of medical supplies (mainly surgical and dressing kits) into Gaza in October and November. These supplies are primarily being used at Nasser Hospital, though the Rafah Indonesian Hospital, European Hospital, and Al-Shaboura Clinic also received supplies. A third shipment of 25 tons is currently in Egypt pending permission to cross into Gaza. Bringing supplies into Gaza has been extremely difficult due to administrative barriers, movement restrictions, and a large backlog of trucks at the border.
Reports of widespread looting in Gaza have been confirmed by MSF teams who have witnessed some of these incidents. These events illustrate the desperation of people struggling to survive in Gaza and why a much larger response is needed, with a steady flow of essential items and humanitarian supplies.
MSF is maintaining operations in the West Bank, focusing on providing emergency care, primary health care via mobile clinics, and mental health care in Hebron, Nablus, and Jenin.
In Hebron, our teams provide mental health services including psychological first aid, counseling, and psychotherapy, as well as a hotline system for referrals to facilities for medical and mental health care and social services. MSF has made donations of surgical kits to Alia Hospital in Hebron, and first-aid kits to community focal points in Beit Omar, Al Rshaydeh, and the emergency care center in Um El Khair. We also support and train medical staff at Al Mohtaseb Hospital in Hebron.
Palestinians in the West Bank have seen increasing disruption to medical access as a result of escalating violence and additional movement restrictions since October 7. In response, MSF has progressively expanded operations to provide health care to people who are unable to reach medical facilities. As of November 2023, MSF mobile clinics are reaching six new locations, serving a total of 10 areas outside and inside Hebron's Old City, as well as in the remote villages of Masafer Yatta in the southern West Bank. Current activities focus on providing medical care through mobile clinics, mental health support, capacity building in emergency response, advocacy, and protection.
In addition to the expansion of medical activities since October 7, the MSF team has boosted health promotion activities in Hebron, along with the distribution of relief items, hygiene kits, and food parcels to people affected by violence and forcible displacement, including Palestinians from Gaza who are currently displaced in the West Bank.
We continue to offer psychological individual and group therapy and psychiatric consultations in Nablus and Qaqliliya despite challenging circumstances, particularly with regard to movement restrictions in the area imposed by Israeli forces. Movement restrictions in the West Bank predate the current war in Gaza but have since intensified, further disrupting Palestinians’ access to health care.
In Jenin refugee camp, our team supports emergency medical response at Khalid Suleiman Hospital and has donated drugs and equipment to seven primary health care centers for emergency deliveries in anticipation of road blockages preventing women in labor from reaching the hospital to give birth. In the camps of Jenin and Nur Shams in Tulkarem, we have donated first aid bags to volunteer paramedics so they can stabilize patients during active hostilities and keep them alive until they can reach a hospital.
Currently, MSF has a base in Egypt where we facilitate the transit of our internationally mobile teams and supplies. Our teams in Egypt are ready to send more medical supplies into Gaza when they are allowed to safely do so. We are also in contact with the Egyptian authorities and other relevant actors in Egypt to start providing health care for injured or sick Palestinians allowed to exit Gaza for medical treatment.