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The situation for Palestinians and those trying to help them in Gaza has become hell

24 Apr 25

The situation for Palestinians and those trying to help them in Gaza has become hell

24 April 2025

Palestinian mother shows the skin condition of her little child due to the lack of hygiene and clean water at Khanyounis. Caption
Palestinian mother shows the skin condition of her little child due to the lack of hygiene and clean water at Khanyounis.
© Nour Alsaqqa/MSF

Palestinians in Gaza are enduring one of the darkest chapters of the war since its onset in October 2023. 

 

With hostilities reigniting on March 18th, Israeli forces have intensified their military operations across the Strip, while forcibly displacing people en masse with evacuation orders, and attacks and killings of medical and humanitarian workers. These actions, combined with the ongoing full siege of the Gaza Strip for over 50 days, are not isolated—they represent a systematic effort to dismantle its health system and any effective and principled humanitarian response.

 

Palestine, Khan Younis, sud de Gaza, 13 mai 2024. Les rues autour de l'hôpital Nasser sont inondées d'eaux usées. Tout le système d'évacuation a été endommagé après des mois de combats intenses et de bombardements par les forces israéliennes. Palestine, Khan Younis, south Gaza, May 13, 2024. The streets around Nasser Hospital are flooded with sewage. The entire drainage system has been damaged after months of intense fighting and bombardment by Israeli forces. Caption
Palestine, Khan Younis, sud de Gaza, 13 mai 2024. Les rues autour de l'hôpital Nasser sont inondées d'eaux usées. Tout le système d'évacuation a été endommagé après des mois de combats intenses et de bombardements par les forces israéliennes. Palestine, Khan Younis, south Gaza, May 13, 2024. The streets around Nasser Hospital are flooded with sewage. The entire drainage system has been damaged after months of intense fighting and bombardment by Israeli forces.
© Ben Milpas/MSF

MSF, like most humanitarian actors operating inside Gaza, faces daily operational dilemmas in a very volatile and unpredictable context. Do we move our teams from one place to another without receiving acknowledgement from Israeli forces after we notified them? Do we continue to operate in medical facilities that are being continuously attacked? How do we scale up our activities with no supplies or fuel entering the Strip and critical equipment and infrastructure being bombed?

 

Palestinian family set up a place over the rubbles of their destroyed house to live in Beit Lahia city, north of Gaza strip. Caption
Palestinian family set up a place over the rubbles of their destroyed house to live in Beit Lahia city, north of Gaza strip.
© Nour Alsaqqa/MSF

The situation for Palestinians and those trying to help them in Gaza has become hell. With no end in sight, we are rushing towards the abyss. Israeli strikes are also targeting utility and construction vehicles, including bulldozers, water tankers, and sewage trucks. Without access to such essential tools, we cannot ensure minimum access to clean water and sanitation and prevent further health risks for the population in Gaza.

 

After 15 months Israel‘s war on Gaza, Palestine, and the implementation of the ceasefire on 19 January 2025, displaced Palestinians are attempting to return home to the southern city of Rafah. While people try to rebuild the ruins, Rafah is totally destroyed, with homes, shops, streets and healthcare facilities in ruins and electricity and water systems damaged – and unsafe due to scattered unexploded ordnance in the ruins of buildings. In May 2024, Rafah had the largest concentration of displaced Palestinians in the Strip with an estimated 1.5 million Palestinian living in tents and makeshift shelters. People were living in inhumane conditions, facing disease outbreaks, malnutrition, and the psychological impact of being forcibly displaced multiple times. Médecins Sans Frontières / Doctors Without Borders teams working in Rafah were providing primary health care, mental health support in the Shabboura clinic and supporting pediatric and maternity care in the Ministry of Health Emirati hospital in Rafah. Eventually, MSF teams were forced to close activities and evacuate the area after continuous bombings and evacuations orders by Israeli forces, as the looming threat of a ground invasion by Israeli forces, which began on May 6, 2024. The military operations by Israeli forces led to the emptying of Rafah, mass destruction of the city, and to the closure of the Rafah crossing, severely hindering the delivery of humanitarian aid into the Strip. Rafah was also the home to many of MSF colleagues, many who had fled other parts of the Gaza Strip. Caption
After 15 months Israel‘s war on Gaza, Palestine, and the implementation of the ceasefire on 19 January 2025, displaced Palestinians are attempting to return home to the southern city of Rafah. While people try to rebuild the ruins, Rafah is totally destroyed, with homes, shops, streets and healthcare facilities in ruins and electricity and water systems damaged – and unsafe due to scattered unexploded ordnance in the ruins of buildings. In May 2024, Rafah had the largest concentration of displaced Palestinians in the Strip with an estimated 1.5 million Palestinian living in tents and makeshift shelters. People were living in inhumane conditions, facing disease outbreaks, malnutrition, and the psychological impact of being forcibly displaced multiple times. Médecins Sans Frontières / Doctors Without Borders teams working in Rafah were providing primary health care, mental health support in the Shabboura clinic and supporting pediatric and maternity care in the Ministry of Health Emirati hospital in Rafah. Eventually, MSF teams were forced to close activities and evacuate the area after continuous bombings and evacuations orders by Israeli forces, as the looming threat of a ground invasion by Israeli forces, which began on May 6, 2024. The military operations by Israeli forces led to the emptying of Rafah, mass destruction of the city, and to the closure of the Rafah crossing, severely hindering the delivery of humanitarian aid into the Strip. Rafah was also the home to many of MSF colleagues, many who had fled other parts of the Gaza Strip.
© MSF

Since the war started, Israeli forces imposed imperfect mechanisms to protect civilians and humanitarian workers. But they have been nothing more than smoke and mirrors, with over 50,000 Palestinians killed according to the Ministry of health and at least 409 aid workers killed, according to the UN. Today, even these nominal systems are no longer in place. Evacuation orders by Israeli forces are forcibly transferring Palestinians into densely packed, makeshift zones, and humanitarians have no safety guarantees.

 

A Palestinian mother and her child at Attar Primary health center in Khnyounis receiving a consultation for scabies. Caption
A Palestinian mother and her child at Attar Primary health center in Khnyounis receiving a consultation for scabies.
© Nour Alsaqqa/MSF

The Israeli authorities’ use of aid as a political weapon, coupled with the imposition of arbitrary restrictions on international humanitarian actors, while maintaining the illusion of humanitarian access, is coercing humanitarian and medical actors to compromise on their safety and their principles.

 

 

Words by Franz Luef, MSF Emergency Coordinator in Gaza