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Gaza: A health system reduced to ashes

14 Feb 2025

Médecins Sans Frontières / Doctors Without Borders (MSF) teams are now able to reach the north of the Strip, which was previously besieged by Israeli forces, to assess the medical and humanitarian needs. Our colleagues no longer recognise their own neighbourhoods, hospitals have been razed, and people are settling in the rubble of their homes with no other shelter to face the winter conditions.

Caroline Seguin, emergency coordinator in Gaza, shares her insights from North Gaza.

Sunset over the ruins of Gaza city. | 28 January 2025 © Nour Alsaqqa/MSF

What is the situation in the North?

In the North Governorate, the level of destruction is total, it’s a flat land. I’ve never seen anything like it in my life. Our Palestinian colleagues are no longer able to recognise their own neighbourhoods, some were in shock, others literally collapsed.

In Gaza City we were already shocked by the level of destruction, but then we went northern to Jabalia, and we couldn’t say a word. There is nothing there anymore. Only ruins and the smell of death everywhere because of the dead bodies still trapped under the rubble.

What is the state of the health system?

There is no health system anymore in the northern part of the Strip. Kamal Adwan hospital has been razed, while Al Shifa, Al Awda and Indonesian hospitals are seriously damaged and only partially functioning. We were utterly shocked to observe that in Indonesian hospital every medical machine seemed to have been deliberately destroyed; they were smashed to pieces, one by one, to make sure no medical care could be provided anymore. You have to ask, what is the motivation of such action? These machines are made to save people’s lives, mothers, fathers, children. It’s devastating to see the state of these hospitals.

The provision of medical care is largely insufficient compared to the needs of the hundreds of thousands of people living in the area. For example, between North Gaza and Gaza City, there are only six paediatric intensive care beds compared to 150 before the war and number of patient hospital beds has plummeted from 2000 to 350.

An MSF vehicle beside ruined buildings in Jabalia. MSF teams are now able to reach the north of the Strip, which was previously besieged by Israeli forces, to assess the medical and humanitarian needs. | 1 February 2025 © MSF

What about the supply situation?

The flow of vital supplies has improved since the ceasefire, but the level of needs is so high that people are still lacking basic items. The need for food, water, tents and shelter materials in this area remains critical. Water shortages are a real challenge given the high level of damage to water facilities and because they are in inaccessible locations in the buffer zones. Our teams have started water trucking activities in Jabalia and Beit Hanoun and they repair damaged boreholes, but this is a temporary solution and is not sufficient for the massive needs. The problem is that because of the war we have located our activities in the south and it now takes time to redeploy them to the north.

After four weeks since the implementation of the ceasefire, we are still not seeing the massive scale up of humanitarian aid needed in northern Gaza. The humanitarian community is failing to provide vital services to a population in dire need of humanitarian and medical support. Both Israel and international actors need to urgently ensure the delivery of vital supplies such as shelter and food and to increase the capacities for its distribution.

What is the reality for people in northern Gaza today?

People are living in dire conditions. They try to settle as best they can on the ruins of their houses but it’s extremely difficult. The winter weather means people have to face very cold temperatures, heavy rains and strong winds, and they don’t even have walls around them to protect themselves. They don’t have access to healthcare, decent housing or water.

However, the conditions they had to face during the 15 months of war, being displaced and living in tents were even worse. After this hardship, people need to reunite with their loved ones and want to stay and rebuild their lives. Many of them have no intention of leaving. It is essential to ensure consistent safe and secure delivery of humanitarian assistance to people who have suffered unimaginable trauma.

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Gaza: A health system reduced to ashes

What is the situation in the North?

What is the state of the health system?

What about the supply situation?

What is the reality for people in northern Gaza today?

Will you support us?

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