MSF operations in Gaza

NASSER HOSPITAL

Nasser Hospital is now the largest surgical center in Gaza, as Al-Shifa Hospital is no longer functioning. MSF staff were forced to flee the facility and leave patients behind after a shell struck the hospital in mid-February 2024 and Israeli forces ordered its evacuation before raiding it.

In mid-May, following the evacuation order of the Rafah Indonesian Hospital due to Israel’s Rafah offensive, MSF relaunched operations in Nasser in collaboration with the Ministry of Health, focusing on orthopedic surgery, burn unit, plastic surgery, general laboratory activities, physiotherapy, and the counseling department. We are now working with 68 inpatient beds and have opened an outpatient department for wound care, providing dressings and physiotherapy sessions for burn and trauma cases. Due to a lack of beds in the inpatient department, we are also running a daycare surgery service for trauma and burn patients requiring small interventions that need anesthesia but not hospitalization for longer than one day.

AL-MAWASI HEALTH POST

MSF is supporting Culture and Free Thought Association (CFTA) in providing pre- and postnatal care as well as sexual and reproductive health care. MSF is running general consultations, management of non-communicable diseases, malnutrition screening and treatment, dressings, and physiotherapy.

The most common illnesses and injuries seen in patients in Al-Mawasi include upper respiratory infections, acute diarrhea, skin diseases, and hypertension.

KHAN YOUNIS PRIMARY HEALTH CARE CENTER  

At this facility, MSF provides outpatient consultations, vaccination, mental health, outpatient therapeutic feeding center, sexual and reproductive health, wound care, physiotherapy, and health promotion. Given the massive influx of displaced people from Rafah into an already packed humanitarian zone, and the lack of health facilities to cover trauma needs, we are currently expanding operations to include an emergency service focused on stabilizing and referring complex cases while managing simpler cases.

AL-ATTAR PRIMARY HEALTH CARE CENTER

The Al-Attar primary health care center addresses the needs of displaced people who have set up tents in the area between Al-Mawasi and Khan Younis. Our staff there provide general medicine, pediatric consultations, emergency care, wound care, prenatal and postnatal care, mental health care, health promotion, and other services based on MSF capacities and people’s needs.

AL QARARA SEXUAL AND REPRODUCTIVE HEALTH CLINIC

MSF is supporting PalMed, a diaspora-based Palestinian medical organization with medications, incentives, and running costs, in providing sexual and reproductive health care and general medical consultations. 

AL-MAWASI ADVANCED PRIMARY HEALTH CARE CENTER

At Al-Mawasi advanced primary health care center, MSF staff are providing outpatient services, including general consultations, vaccination, reproductive health care, dressing, mental health services, and health promotion. The primary health care center includes a 24/7 emergency room to stabilize and refer trauma patients. 

AL-AQSA HOSPITAL

MSF began working at Al-Aqsa Hospital in November 2023 and had to evacuate the facility in January 2024 due to fighting around the premises and evacuation orders that made our pharmacy store inaccessible. Three MSF-supported staff remained on the premises, working autonomously. In February, an MSF team returned to Al-Aqsa and prepared the premises for a return to previous activities. On February 7, wound and rehabilitation care resumed, and the team has been providing acute trauma surgery, advanced wound care, post-operative wound care, physiotherapy, health promotion, and mental health support since then. Access to the pharmacy store has also been re-established.

AL MARTYRS PRIMARY HEALTH CARE CENTER

MSF began working at Al Martyrs primary health care center at the end of February 2024 and provides wound care and malnutrition screening at the facility.

AL HEKKER PRIMARY HEALTH CARE CENTER

In mid-April 2024, MSF opened a new primary health care center in Al Hekker to provide outpatient services, including general consultations, vaccination, reproductive health services, dressing, health promotion activities, and mental health services including psychological first aid, individual and family sessions, and psychoeducation. 

MSF CLINIC

MSF’s former clinic, which is located close to the premises of Al-Shifa Hospital, was heavily damaged in November 2023, making it impossible to resume activities there. Though the MSF office suffered damage, the team managed to rehabilitate the office and resume activities in April 2024. Currently, the team focuses on wound dressing and physiotherapy, but we are progressively scaling up activities to provide more comprehensive services including sexual and reproductive health, general consultations, care for non-communicable diseases, and malnutrition screening.  

A dire lack of drinkable water, poor sanitation, and the destruction of water infrastructure have had dire consequences for people’s health in Gaza, including the spread of diseases and skin infections. Water distribution is therefore an important part of MSF’s response. 

We provide more than 600,000 liters of water per day through desalination at 40 water distribution points in Al-Mawasi, Deir al-Balah, Rafah, and Khan Younis. A new desalination unit in Al-Mawasi provides 30 cubic meters of drinking water per day, and a second is planned to be set up in Deir al-Balah by mid-September, which is expected to deliver 70 cubic meters per day.

In Deir al-Balah and Khan Younis, MSF has been implementing water and sanitation activities in camp shelters through a partnership with the Agriculture Development Association (PARC).This includes building latrines for more than 30,000 people across six camps, distributing hygiene kits for 2,400 families, providing clean drinking water to a population of 25,000 people per day. We also equipped a camp hosting 400 people with disabilities with accessible latrines and showers.

MSF has brought in a total of 73 trucks of supplies into Gaza through the UN. However, bringing supplies into Gaza has been extremely difficult due to administrative barriers, movement restrictions, and lack of crossing options. Since the Rafah crossing closed in early May, there has been a significant decrease in the entry of trucks. 

The collapse of health care infrastructure due to repeated attacks and lack of supplies has made medical care increasingly inaccessible as the overwhelming needs continue to grow. Out of the 36 main hospitals serving over 2 million people in Gaza, 20 are out of service, and those that remain partially functional face severe limitations on the types of services they can deliver. Ongoing attacks and evacuation orders put further strain on the facilities that remain functional.

War wounds, crush injuries, and burns treatment remain an urgent need as Israeli bombardment and attacks continue. But with very little capacity inside hospitals and a dire lack of medical supplies, people aren’t getting the care they need to heal properly or even survive.

Infections resulting from poorly treated wounds are a growing concern, driven by the difficulty wounded people face accessing care and follow-up, shortages of supplies, lack of access to hygiene, and the extremely limited supply of clean water.

Infectious diseases including diarrhea, acute respiratory infections, skin infections, and hepatitis are on the rise due to overcrowding and poor hygienic conditions in camps where displaced people are sheltering, and shortages of medicines and medical supplies.

Starvation is inevitable under the Israeli government’s policy of deliberate deprivation, and we are already seeing the impacts of food insecurity and hunger. According to the Integrated Food Security Classification (IPC), almost half a million people (22% of the population of Gaza) are facing catastrophic levels of acute food insecurity, and the high risk of famine will persist across the whole Strip as long as the war continues and humanitarian access remains restricted.  

In addition to the destruction or closures of once-functioning hospitals, the decimation of infrastructure has created severe obstacles for pregnant women trying to reach medical facilities. Pregnant women are often forced to navigate unsafe routes amid the fighting and without safe transportation—often delaying access to health care and putting them at higher risk of complications. 

“The main health risks for pregnant women are blood-pressure related complications such as eclampsia, hemorrhage, and sepsis—which can become deadly if not treated in time,” says MSF emergency unit health advisor Mercè Rocaspana. “In contexts like Gaza, where the health system has been decimated and has collapsed, late access to care is posing a health risk to pregnant women and their children, with tragic—even lethal [consequences]."