Gaza: Evacuation orders and heavy bombing around hospitals leave few healthcare options for civilians
In south Gaza, Doctors Without Borders set up a clinic inside the Rafah Indonesian Field Hospital in December 2023. With its outpatient department and 30 beds, it provides post-operative care to patients displaced from all parts of the enclave to free up beds in emergency rooms in other hospitals. Palestinian Territories, December 2023. © MSF
“We’re gradually being cornered in a very restrictive perimeter in southern Gaza, in Rafah, with dwindling options to offer critical medical assistance, while the needs are desperately growing,” says Thomas Lauvin, Doctors Without Borders Project Coordinator in Gaza.
As the assault on Gaza has progressed, we have had to evacuate several health facilities in the north of Gaza, then in the Middle Area. Today we are limited to mainly working in the south, because we cannot work elsewhere. In short, we’re running out of hospitals. We are forced to leave patients behind.Thomas Lauvin, Project Coordinator
The healthcare system in Gaza has virtually collapsed. The World Health Organization reports that only 13 out of Gaza’s 36 hospitals are still partially functional: nine in the south and four in the north. The two major hospitals in southern Gaza are operating at three times their bed capacity and are running out of basic supplies and fuel.
On 6 January, Doctors Without Borders teams were forced to once again evacuate from a hospital. Our teams left the Al-Aqsa hospital in Gaza’s Middle Area, after Israeli Forces issued evacuation orders for neighbourhoods surrounding the hospital. This forced evacuation restricted our access to our own pharmacy store, demonstrating the deteriorating environment for medical activities.
“Leaving Al-Aqsa hospital and our patients was a devastating decision and our last resort,” says Enrico Vallaperta, Doctors Without Borders Project Medical Referent in Gaza. “Drone strikes, sniper fire and bombardments in the close vicinity of the hospital made the space too unsafe to work in. The volatile conditions leave us feeling incapacitated; there's virtually no secure space to provide even minimal medical care to people”.
Nurses perform dressing changes and healings of wounds in the dressing room of Al-Shaboura clinic in Rafah, Gaza. Palestinian Territories, December 2023. © MSF
Medical facilities and their surrounding areas have repeatedly been hit by Israeli Forces and been subjected to evacuation orders in different parts of Gaza, particularly in the north, making access to, and the provision of, healthcare too dangerous. Several hospitals where Doctors Without Borders was working have been through this situation: the Indonesian hospital in north Gaza had to be evacuated in October. Al-Shifa hospital, Gaza’s largest, was hit and the staff were forced to evacuate in November. Then Al Awda hospital, Doctors Without Borders’s partner hospital since 2018, was hit and three doctors, two of them were among our staff, were killed.
Now, this pattern is repeating itself in the south, which hosts five times the number of people it did before the war, and fewer places to provide people healthcare.
The south of Gaza has been targeted by intense bombing since the November truce broke down and the needs for emergency, surgical and post-operative care are massive in the area. The lack of hospital capacity is depriving patients of adequate treatment and proper hygienic conditions, which result in increasing numbers of infected wounds and medical procedures being carried out in extreme conditions. Beyond critical injuries, many women who underwent c-section are discharged just six hours after delivery to make space for other pregnant women, while some are simply turned away and give birth in tents.
Medical activity manager talking to patients at the Al-Shaboura clinic, Rafah. Palestinian Territories, December 2023. © Mohammad Abed
Doctors Without Borders remains committed to providing medical care in Gaza and calls for the protection of hospitals, medical staff and patients. Our teams are currently providing pre and postpartum care at the Emirati hospital in Rafah, assisting Gazans with physiotherapy and post-operative care at the Rafah Indonesian field hospital, and offering primary healthcare consultations, wound dressing and mental health support at Al-Shaboura clinic, also in Rafah. We’re supporting the European Gaza hospital in a small surgical capacity, and our small team of nurses assist patients in need of wound dressing. In Al Awda in north Gaza and Nasser hospital in Khan Younis, a handful of Doctors Without Borders staff are working in extremely difficult conditions, including lacking food and medical supplies due to airstrikes and nearby fighting.
Doctors Without Borders reiterates our call for an immediate ceasefire that will spare the lives of civilians and restore the flow of humanitarian assistance and re-establish the healthcare system on which the survival of the people of Gaza depends.
Will you support our emergency response work?
Help us provide lifesaving medical care during emergencies by making a donation today.