MSF does not currently run medical programs in Israel. This is because we focus on filling the greatest gaps in health care, and Israel has strong emergency and health systems. MSF has offered its support to Israeli hospitals treating large numbers of casualties following attacks by Hamas militants on October 7.

The situation in Gaza has been described by our teams as ‘catastrophic’. The health system has collapsed. Most of Gaza’s hospitals are out of service, as the electrical power and water have been cut off due to a lack of fuel and due to the damage from strikes. Those that are running are continuously under attack, as are ambulances. Patients and medical staff are being injured and killed.

There are very little medical supplies. Surgeons in Al-Shifa Hospital have been operating without anaesthetics or painkillers. Contact with our staff is sporadic; we frequently lose contact with them. We have not been able to contact our staff in Al-Shifa Hospital since 16 November.

The repeated calls by the Israeli forces to evacuate the entirety of the northern Gaza Strip is outrageous; it is a policy of forcible transfer of civilians and patients to make the north of Gaza a free-fire zone. These evacuation orders to hospitals are a death sentence for the gravely sick and injured and implies that medical workers should leave their patients behind. Civilians who remain in the North are still civilians and must be protected as such.

The bombing of Gaza is relentless. One of our colleagues, Mohammed Al Ahel, a laboratory technician, was killed on 6 November when the area near his house was bombed. Two of our staff, Dr Mahmoud Abu Nujaila and Dr Ahmad Al Sahar, and a third doctor, Dr Ziad Al-Tatari, were killed in a strike on Al-Awda Hospital on 21 November. As Israel orders Gazans to flee south, it simultaneously continues its campaign of bombardments in the south, leaving people with no safe place to go.  

A state of siege has been imposed by the Israeli government on all of Gaza, including the withholding of food, water, fuel and electricity. More than 1 million people have had to flee to the south, where they’re crammed into a small area. The displaced are sleeping in rough conditions, with dangerously little levels of food and water; people have been drinking salty water. There is no electricity, and hygiene conditions are extremely poor; some shelters have one toilet for every 600 people. These conditions drastically increase the likelihood of disease outbreaks.

Our activities in Gaza are limited. We are not able to coordinate our usual level of activities or pre-war projects. This is due to the intensity and unpredictability of the bombing and the inability to get new supplies.

While most of our Palestinian colleagues have moved to the south of the Strip, a handful of our doctors and nurses have chosen to remain in northern Gaza. They continue to offer their support to the wounded, including in some MSF-supported facilities and in collaboration with local healthcare staff. We have colleagues providing care in Al-Shifa hospital, as well in Al-Nasser and Al-Quds hospitals.

On 14 November, a new MSF team of 15 people – composed of surgeons, anaesthetists and intensive care specialists, with some coordination and logistical support – entered southern Gaza via the Rafah crossing from Egypt. People in the team come from different countries from all over the world.

For the time being, they will be based in the south of the Gaza Strip to support existing hospitals and Palestinian surgeons, who have been treating, on average, 9 to 10 mostly burn cases per day. Unless there is a ceasefire that we have repeatedly called for, we are aware that our ability to move in the Strip will be significantly restricted.

We are also supporting local health authorities where we can with donations from our medical stock. On 18 October, we donated US$1 million worth of medical stock, including medicines and medical equipment – all we had left – to Al-Shifa Hospital. A limited number of medical supplies we had sent to Egypt for Gazan medical facilities has managed to pass through into Gaza.

Our staff outside of the Strip are working hard on preparing medical and humanitarian supplies to be sent to Gaza when safe access will be guaranteed and open.

MSF is committed to supporting the people affected by the heavy Israeli bombardments and indiscriminate attacks on Gaza. We stand in solidarity with healthcare workers and patients in Gaza.

Israeli armed forces have announced the West Bank as a closed area. Most checkpoints across the West Bank remain closed, exacerbating movement restrictions on people and affecting their ability to access basic services, including food, and medical care.

In West Bank towns, people are experiencing an explosion of violence against them. Jenin has been particularly hard hit, with bombings and incursions by Israeli forces in the refugee camp killing and wounding dozens of people.

In Jenin, our teams report treating patients who showed signs of being tied up and beaten, reportedly by Israeli forces.

Our medical teams at Jenin Hospital have witnessed Israeli forces shooting at the hospital itself, while they’ve also treated medical staff who were shot by soldiers while still in an ambulance. Israeli forces also prevent the ability of ambulances to move around, blocking entrances to the refugee camp.

These attacks on medical care MUST stop.

In Hebron, families have been displaced after violence from Israeli settlers and forces, including having their homes burnt down. Patients in Hebron's old city, known as H2, are facing challenging access to our mobile clinic when it’s there, due to extreme restrictions on movements.

In the West Bank, we maintain activities focused on emergency care, and mental health care in Hebron, Nablus and Jenin.

Hebron: Our mobile clinics in the areas of Masafer Yatta are currently suspended. Our team has prepared medical kits with medications to be distributed to around 40 MSF patients suffering from chronic diseases.

Our medical team has performed phone assessments among Palestinian residents and displaced people, referring those in need of medical, mental health or social services. Mental health services continue to be offered to affected people and communities, mostly remotely.

We have donated medical equipment and kits to Alia Hospital, community focal points in Beit Omar, Al-Rshaydeh, and the emergency care centre in Um El-Khair.

Nablus: Psychological first-aid group sessions are being conducted in three districts in Nablus, Tubas, and Qalqiliyeh.

Jenin: Our teams work at Jenin Hospital, providing emergency and trauma care to the people injured following the almost daily bombing and incursions by Israeli forces, especially at the Jenin refugee camp.

We have donated a tuk-tuk, to allow local paramedics to transport injured patients to hospital, given Israeli forces often block the entrance to the refugee camp and do not allow ambulances to pass. We have also donated drugs and equipment to seven clinics, to prepare for emergency births in the event pregnant women will not be able to reach the hospital.

More than 400 Gazans who had permits to work in Israel are now being held across five detention centres in Jenin. We are providing mental health support to those who have suffered a mental breakdown after learning of the fate of their families in Gaza. We also provide medication for patients with chronic diseases in the detention centres and transport to health centres.

We donated first aid kits to volunteer paramedics in Nur Shams and Jenin refugee camps.

We have teams in Egypt, ready to send medical supplies into Gaza. On 29 October, we sent 26 tonnes of medical supplies – which can cover the needs for 800 surgeries – on a WHO plane to Egypt, under the coordination of the Egyptian Red Crescent, destined for healthcare facilities in Gaza. Upon the cargo’s arrival in Egypt, we have been able to send part of it into Gaza, but sending medical supplies remains difficult due to Israeli restrictions at the Rafah crossing.

We are in contact with the Egyptian authorities and the relevant organisations in Egypt to start activities in Egypt to provide healthcare for injured or sick Palestinian people allowed to exit Gaza, if needed.

• An immediate and unconditional ceasefire that will spare the lives of Gazans and restore the flow of humanitarian aid.
• A lifting of the siege to allow increased and continuous humanitarian supplies to cross into Gaza.
• Protection for civilians and healthcare personnel and facilities on both sides, at all times; hospitals and ambulances are not targets.
• Basic guarantees of safety to enable our teams to move to provide humanitarian and medical services.
• Access to people in need of medical care and humanitarian aid, including the sick and wounded.
• People to be afforded safe access to essential supplies like food and water and health facilities.
• Increased essential humanitarian supplies like medicine, medical equipment, food, fuel and water must be allowed to enter the Gaza enclave.
• Those who wish to leave must be able to do so safely without prejudicing their future option to come back.
• In the West Bank, for Israeli authorities to put an end to the violence and forced displacements of Palestinians.
• Israeli authorities must stop implementing restrictive measures in the West Bank that impede the ability of Palestinians to access basic services, including medical care.