OPINION PIECE: Amid continued attacks, siege, and blockade, Israel is destroying conditions of life in Gaza
By Christopher Lockyear, Secretary General of Doctors Without Borders (MSF)
The Israeli military is destroying the conditions of life in Gaza. Fourteen months of repeated attacks on Palestinian civilians, the dismantling of the healthcare system and other essential infrastructure, the suffocating siege, and the systematic denial of humanitarian assistance demonstrate this.
People in Gaza barely survive apocalyptic conditions. Nowhere is safe, no one is spared – and there is no exit from this shattered enclave, as documented in our latest report, "Gaza: Life in a death trap.” This is why my colleagues in Gaza and nearly 70,000 other MSF staff urgently call for an immediate ceasefire to save lives and enable the needed massive scale-up of humanitarian aid. Israel must stop its targeted and indiscriminate attacks against civilians, and its allies must act without delay to protect the lives of Palestinians and uphold the rules of war.
The recent military offensive in north Gaza starkly illustrates the brutal war the Israeli forces wage on Gaza, and we are seeing clear signs of ethnic cleansing as Palestinians are forcibly displaced, trapped, and bombed. What our medical teams have witnessed on the ground throughout this conflict is consistent with the descriptions provided by an increasing number of legal experts and organizations concluding that genocide is taking place in Gaza. While we don't have legal authority to establish intentionality, the signs of ethnic cleansing and the ongoing devastation—including mass killings, severe physical and mental health injuries, forced displacement, and impossible conditions of life for Palestinians under siege and bombardment—are undeniable.
In response to the horrific attacks carried out by Hamas and other armed groups in Israel on October 7, 2023—in which 1,200 people were killed and 251 people were taken hostage—Israeli forces are crushing the entire population of Gaza. Israel's all-out war has reportedly killed more than 45,000 people, according to the Ministry of Health, including eight of my MSF colleagues. The number of excess deaths linked to the war is likely much higher due to the impacts of a collapsed healthcare system, disease outbreaks, and severely limited access to food, water, and shelter.
Israeli forces have on numerous occasions prevented food, water, and medical supplies from entering the Strip, as well as blocked, denied, and delayed humanitarian assistance. Some 1.9 million people—90 per cent of the entire population of the Strip—have been forcibly displaced, many forced to flee multiple times. Fewer than half of Gaza's 36 hospitals are even partially functional,l and the healthcare system lies in ruins. From October 2023 to October 2024—MSF staff alone have endured 41 attacks and violent incidents, including airstrikes, shelling, and violent incursions in health facilities; direct fire on our shelters and convoys; and arbitrary detention of colleagues by Israeli forces. MSF medical personnel and patients have been forced to evacuate hospitals and health facilities on 17 separate occasions. Warring parties have fought near medical facilities, endangering patients, caretakers, and medical staff.
Meanwhile, Palestinians' physical and mental health injuries are overwhelming, and the needs continue to grow. MSF-supported facilities have carried out at least 27,500 consultations linked to violence and 7,500 surgical interventions. People are suffering from war wounds as well as chronic diseases, made worse when they cannot get access to essential healthcare services and medicines. Israel’s forced displacement has pushed people into unbearable and unhygienic living conditions where diseases spread rapidly. Children have not had crucial immunizations, leaving them vulnerable to diseases like measles and polio. We have seen an increase in the number of malnutrition cases, but it is impossible to carry out malnutrition screenings due to widespread insecurity and the lack of proper deconfliction measures.
Despite all of this, Israel has made it even more difficult for people to be medically evacuated. During the closure of the Rafah crossing in early May 2024 and September 2024, Israeli authorities only allowed the evacuations of 229 patients— just 1.6 per cent of those who needed it at that time. A mere drop in the ocean of needs.
The situation in northern Gaza is especially dire after Israel's recent scorched earth military offensive that has depopulated large areas and reportedly killed almost 2,000 people. The northern part of the Strip, specifically Jabalia camp, has been besieged again by Israeli forces since October 6, 2024. Israeli authorities have dramatically reduced the quantity of essential aid authorized to enter the north. In October 2024, supply volumes reaching the whole Gaza Strip hit its lowest point in a year: a daily average of 37 humanitarian trucks entered in October 2024, well below the 500 humanitarian trucks entering before October 7, 2023.
We call on states, particularly Israel’s closest allies, to end their unconditional support for Israel and fulfil their obligations to prevent genocide in Gaza. On January 26, the International Court of Justice ordered Israel to take “immediate and effective measures to enable the provision of urgently needed basic services and humanitarian assistance to address the adverse conditions of life faced by Palestinians in the Gaza Strip.” Israel has taken no meaningful action to comply with the court order. Instead, Israeli authorities continue to actively block MSF and other humanitarian organizations from providing lifesaving assistance to people trapped under siege and bombardment. MSF teams need immediate and safe access to northern Gaza to deliver humanitarian aid and medical supplies to hospitals.
The total destruction of Palestinian life in Gaza must stop.
On 18 November 2023, an MSF evacuation convoy came under fire in Gaza city. Two people were killed in what immediately appeared as a deliberate attack against clearly identified MSF cars. Both were family members of MSF staff, one of them was also a volunteer supporting MSF medical teams at Al-Shifa hospital. Location: Gaza |Date: 01/12/2023 | Photographer: MSF
Photograph taken inside Nasser Hospital, after a siege by the Israeli forces. At the end of January, the Israeli forces issued evacuation orders for the entire area and surrounded the hospital, which found itself at the centre of intense fighting for several weeks. Location: Gaza | Date: 23/04/2024 | Photographer: Ben Milpas
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About Doctors Without Borders (MSF)
Doctors Without Borders (MSF) is a global network of principled medical and other professionals who specialise in medical humanitarian work, driven by our common humanity and guided by medical ethics. We strive to bring emergency medical care to people caught in conflicts, crises, and disasters in more than 70 countries worldwide.
In South Africa, the organisation is recognised as one of the pioneers of providing Antiretroviral Treatment (ART) in the public sector and started the first HIV programmes in South Africa in 1999. Until today, the focus of MSF’s interventions in the country has primarily been on developing new testing and treatment strategies for HIV/AIDS and TB in Eshowe (Kwa-Zulu Natal) and Khayelitsha (Western Cape).
In Tshwane, we run a migration project, and we offer medical and psychosocial care to migrants, refugees, and asylum seekers, who struggle to access public health services under South Africa’s increasingly restrictive.
Previously we offered free, high-quality, confidential medical care to survivors of SGBV in Rustenburg.
To learn more about our work in South Africa, please visit this page on our website (www.msf.org.za). To support MSF’s work:
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