Over a year of relentless attacks on health care in Palestine

2023

• October 7: Immediately following Hamas’ attacks, Israeli forces struck the Indonesian Hospital in Beit Lahia and an ambulance in front of Nasser Hospital in Khan Younis, killing a nurse and an ambulance driver and injuring several others. 
• October 10: An Israeli airstrike damaged MSF’s clinic in Gaza City; no staff or patients were injured. 
• October 11: An airstrike hit close to Al-Awda Hospital in Jabalia, where MSF has been operating since 2018; some ceilings caved in as a result of the blast, but the structural integrity of the hospital was maintained and it continued to function. 
• October 13: Israeli forces gave two hours’ notice to evacuate the MSF-supported Al-Awda Hospital. Our medical colleagues wheeled patients on gurneys into the street in an effort to get them to other hospitals, with little success. MSF condemned the evacuation order and highlighted the need to protect medical workers and patients. Eventually staff and patients remained in the hospital. 
• October 17: In Gaza City, a strike hit the parking lot of Al-Ahli Arab Hospital, where an MSF doctor was operating, reportedly killing hundreds of people. In the days leading up to the incident, the hospital director had received warnings from Israel. MSF condemned this strike and initially attributed responsibility to Israel. However, even today it remains uncertain who bears responsibility for this act. An independent investigation is the only way to determine the responsibility for this attack.
• October 30: A projectile hit the MSF-supported Turkish-Palestinian Friendship Hospital south of Gaza City, causing damage to the building. The hospital stopped functioning when it ran out of fuel on November 1. 
• November 3: An Israeli airstrike outside Al-Shifa Hospital in Gaza City hit and destroyed an ambulance convoy, which also killed many people. MSF unequivocally condemned this attack. 
• November 15: Israeli ground troops stormed Al-Shifa Hospital. All remaining MSF staff had left the hospital about one week earlier.
• November 18: An MSF convoy seeking to evacuate staff and their families was fired upon, killing two people including an MSF colleague. All elements point to the responsibility of the Israeli army for this attack. Two days later, an Israeli bulldozer and heavy military vehicles destroyed the MSF cars from the convoy in full view of our colleagues sheltering in the MSF guesthouse in Gaza City. The vehicles also damaged the MSF clinic by ramming its perimeter wall, which collapsed. Part of the clinic caught fire as a result. 
• November 21: A strike on Al-Awda Hospital killed Dr. Mahmoud Abu Nujaila and Dr. Ahmad Al-Sahar from MSF, and another doctor, Dr. Ziad Al-Tatari. While we have spoken to all parties to the conflict, seeking accountability for these killings, none has been forthcoming, and it is not possible to say what happened with absolute certainty. An independent assessment should be conducted onsite to determine responsibility.
• November 24: As the only vehicles available to staff and their family members sheltering in the MSF guesthouse and clinic in Gaza City had been destroyed, our teams based in the south of Gaza sent more vehicles to Gaza City to attempt another evacuation. However, they were also hit by bullets while approaching the MSF clinic and the movement was canceled. Later, they too were destroyed by the Israeli forces in the early hours of November 24 . 
• December 1: A temporary truce between Israel and Hamas in the Gaza Strip took effect from November 24, 2023 to November 30, 2023. Hours after the truce ended, a blast damaged Al-Awda Hospital. 
• December 5: MSF staff in Al-Awda reported that the hospital was facing a total siege. In the following days, two medical staff members at the hospital (not MSF staff) were reportedly shot and killed by snipers outside. 
• December 12: An MSF surgeon was injured inside Al-Awda Hospital by a shot fired from the outside. 
• December 14: In Khalil Suleiman Hospital, Jenin (West Bank), our colleagues supporting the hospital witnessed Israeli forces shoot and kill a teenage boy in the hospital compound, following the abuse of paramedics who were forced to strip and kneel in the street. 
• December 17: Israeli forces took control of Al-Awda Hospital after a 12-day siege. Males over 16 years old were taken, stripped, and interrogated—six MSF staff among them. After the interrogations, most of them were then sent back into the hospital and told not to move. The same day, Israeli tracer bullets hit the maternity ward of Nasser Hospital. One patient was killed; others were wounded. 

2024

• January 6: MSF had to evacuate Al-Aqsa Hospital in Deir al-Balah as fighting between Israeli forces and Palestinian armed groups approached. Israeli evacuation orders also put MSF’s hospital pharmacy inside the exclusion zone, making it inaccessible. A sniper bullet was fired through the intensive care unit wall on January 5. 
• January 8: An Israeli tank shell struck the MSF “Lotus” shelter in Khan Younis, killing the five-year-old daughter of an MSF staff member and wounding three people. Over 125 MSF staff and their families were then relocated to Rafah.
• January 22: Nasser Hospital in Khan Younis was surrounded by fighting, bombing, and subjected to evacuation orders. Airstrikes killed people as close as 150 meters from the hospital’s entrance, according to MSF staff present. 
• February 15: A shell struck the orthopedic department at Nasser Hospital; staff members fled the compound, leaving behind several patients. One member of MSF’s staff was detained at a checkpoint by Israeli forces and has since been released. 
• February 20: An Israeli tank fired at an MSF shelter in Al-Mawasi, Khan Younis, killing the daughter-in-law and wife of one of our colleagues, and injuring seven people. 
• March 2: A shell struck a shed next to the main entrance of the MSF-supported Emirati Hospital in Rafah, killing two people and injuring several more. 
• March 13: The Israeli military conducted operations in Jenin (West Bank). At the MSF-supported Khalil Suleiman Hospital, people standing in the hospital courtyard were fired on. Six people by the ER door were wounded, two of whom later died.
• March 27: An airstrike hit a greenhouse near Al-Shaboura clinic, an MSF-supported facility in Rafah. Several people were reportedly killed in the attack, despite the passage of a United Nations Security Council Resolution requiring a ceasefire on March 25. No MSF staff or patients were hurt.
• March 31: An Israeli airstrike hit the yard of the MSF-supported Al-Aqsa Hospital compound just outside of its emergency room, where many internally displaced people were sheltering. Many people were killed and injured. After the attack, part of the MSF team had to stop providing care. 
• April 1: After a 14-day long operation by Israeli forces in and around Al-Shifa Hospital, the hospital was left in ruins and is out of service. An MSF clinic in the hospital’s vicinity was also badly damaged. Hundreds of people were killed, including medical staff, and mass arrests of medical staff and other people took place in and around the hospital.
• April 21: An MSF-trained paramedical volunteer was shot in the leg while on duty during a three-day incursion in Tulkarem and Nur Shams refugee camps in the West Bank. Due to the hostilities, it took him seven hours to reach the hospital.
• May 6: An MSF-supported stabilization point was stormed during a violent raid by Israeli forces in Tulkarem and Nur Shams camps in the West Bank. Volunteer paramedics trained by MSF were harassed and no longer feel safe providing lifesaving care to patients.
• May 12: The intensification of the onslaught by Israeli forces on Rafah, southern Gaza, forced MSF to stop providing lifesaving care at Rafah Indonesian Field Hospital. The 22 patients who remained in the hospital were referred to other facilities, as we could no longer guarantee their safety.
• May 23: Al-Awda Hospital in Gaza was forced to temporarily close following a four-day siege by Israeli forces. On May 19, the hospital was surrounded by tanks, and staff and patients were forced to take cover under tables and beds as bullets and shelling smashed windows. MSF’s official partnership with Al-Awda Hospital, which started in 2018, ended in December 2023 but some MSF staff have continued to support the hospital on a regular basis even after that date.
• May 28: The MSF Tal Al Sultan stabilization point that was opened on May 15 in Rafah and had since then been responding to many casualties and trauma cases, had to be evacuated due to extreme violence in the area.
• May 30: Israel’s offensive in Rafah forced the closure of an MSF primary health care center in Al-Mawasi in which our teams used to conduct around 400 consultations a day.
• June 25: MSF colleague, Fadi Al-Wadiya, was killed by an Israeli strike along with several people while going to work at the MSF clinic in Gaza City. The day after his killing, the Israeli authorities shared several posts on social media accusing Fadi of involvement in military activities in Gaza. MSF took these allegations very seriously and asked the Israeli authorities for clarifications about the circumstances of his killing. Only an independent investigation can establish the facts.
• July 8: The MSF clinic in the north of Gaza was forced to temporarily close from July 8 to 18, after Israeli forces issued an evacuation order for parts of Gaza City. MSF teams continued to provide patient care until the last minute, before fleeing the area that came under heavy fire.
• July 22: A strike hit near the main entrance of the MSF-supported Al-Aqsa Hospital’s emergency room in Deir al-Balah, central Gaza.
• August 4: Strikes hit tents for displaced people in the compound of the MSF-supported Al-Aqsa Hospital, Deir al-Balah, central Gaza. According to the Ministry of Health, three people were killed and 18 injured.
• August 25: An explosion approximately 800 feet away from Al-Aqsa Hospital triggered panic with many choosing to leave the hospital. As a result, MSF considered whether to suspend wound care, while trying to maintain lifesaving treatment. Of around 650 patients, only 100 remained in the hospital, with seven in the intensive care unit, according to the Ministry of Health.
• September 5: An Israeli strike hit a displacement site within the compound of the MSF-supported Al-Aqsa Hospital in Deir al-Balah, central Gaza. According to the Ministry of Health, four people were killed and 16 were wounded and treated at the hospital.
  
  Also on September 5, the scale and intensity of Israel's nine-day incursion in Jenin was unprecedented. Israeli forces obstructed access to health facilities, blocking and targeting ambulances. In the MSF-supported Khalil Suleiman Hospital, which was surrounded by Israeli Forces since the start of the incursion, electricity and water supplies were compromised and the medical team was forced to halt dialysis operations, key for the treatment of kidney failure. In Tulkarem, after the withdrawal of Israeli forces, MSF teams heard disturbing reports from an MSF-trained volunteer who was beaten and interrogated by Israeli authorities.
• October 7: In the early hours, the compound of the MSF-supported Al-Aqsa Hospital, Deir al-Balah, was once again hit by an Israeli strike, while another strike hit a tent in the street only 40 feet away from the hospital. Eight people injured in these strikes were treated at the hospital.
• October 14: An Israeli airstrike targeted an area housing displaced people inside the MSF-supported Al-Aqsa Hospital compound in Deir al-Balah, resulting in 65 wounded and five dead. Tents of displaced people caught on fire while people were sleeping. The hospital treated 40 patients, including 10 children and eight women, many of them with severe burns. An additional 25 injured patients had to be referred to other health facilities due to the lack of capacity in the hospital.
• October 26: MSF orthopedic surgeon, Dr. Mohammed Obeid, was detained by Israeli forces along with several medical staff from Kamal Adwan Hospital in northern Gaza during a military operation targeting the hospital. 
• November 9: An Israeli airstrike targeted once again an area housing displaced people inside the Al-Aqsa Hospital compound in Deir al-Balah, Gaza. MSF teams assisted in treating eight wounded in the emergency room.
• November 13: An Israeli airstrike hit the densely populated zone of Al-Mawasi, only 800 feet away from an MSF health care clinic. MSF did not receive an official evacuation order from Israeli forces. MSF staff and about 500 patients and caregivers who were present that day had only a few minutes to flee the facility, which was later found with equipment destroyed and shrapnel damage to the desalination plant.
• December 3: In Tubas, West Bank, Israeli forces raided and opened fire inside the Turkish Hospital, which we collaborate with. According to information gathered by our team, five non-MSF medical staff were detained, and one person was wounded. Medical staff on site were threatened at gunpoint and subjected to aggressive questioning while patients were told to stay still, or they would be shot and killed.
• December 17: Intense fighting in Al-Mawasi, southern Gaza, forced MSF teams to temporarily close a health care facility, due to the insecurity, and more than 30 MSF staff were trapped in the office due to bombings and heavy shootings. Twelve MSF staff members and their families were trapped in their homes.