Gaza: This is not aid.

A new MSF report, This is not aid. This is orchestrated killing, documents the horrors witnessed by MSF staff at two clinics that regularly received mass influxes of casualties following violence at sites run by the GHF, an Israeli-US proxy that has militarised food distribution. 

Between 7 June and 24 July 2025, 1,380 casualties, including 28 dead, were received at MSF’s Al-Mawasi and Al-Attar clinics in southern Gaza, located near the GHF-run distribution sites. During those seven weeks, our teams treated 71 children for gunshot wounds, 25 of whom were under the age of 15. Faced with no alternatives to find food, starved families frequently send teenage boys into this lethal environment, as they are often the only males in the household physically able to make the journey.

Patients have also included a 12-year-old boy hit by a bullet that had passed all the way through his abdomen, and five young girls, one of whom was only 8 years old and suffered a gunshot wound to her chest.

“Children shot in the chest while reaching for food. People crushed or suffocated in stampedes. Entire crowds gunned down at distribution points,” says Raquel Ayora, MSF General Director. “In MSF’s nearly 54 years of operations, rarely have we seen such levels of systematic violence against unarmed civilians.”

“The GHF distribution sites masquerading as ‘aid’ have morphed into a laboratory of cruelty,” says Ayora. “This must stop now.”

An initial analysis of the gunshot wounds among patients arriving at the Al-Mawasi clinic found that 11 per cent of the gunshot injuries were to the head and neck, while 19 per cent were to areas covering the chest, abdomen, and back. By contrast, people arriving from the Khan Younis Distribution Centre were far more likely to arrive with gunshot wounds to the lower limbs. The distinct patterns and anatomical precision of these injuries strongly suggests the intentional targeting of people within and around the distribution sites, rather than accidental or indiscriminate fire.

“We’re being slaughtered. I’ve been injured maybe 10 times,” says Mohammed Riad Tabasi, a patient who was treated at the MSF Al-Mawasi clinic. “I saw it with my own eyes, about 20 corpses around me. All of them shot in the head, in the stomach.”

In May, Israeli authorities sought to dismantle the UN-led humanitarian response and replace it with a militarised food distribution scheme operated by GHF. All four GHF-run distribution sites are in areas under full Israeli military control, and “secured” by private American armed contractors. The GHF has been touted by the Israeli and US governments as an “innovative solution” – a supposed answer to their unproven claims of aid diversion in Gaza and unfounded accusations of UN failure. The sites are nothing but a deadly scheme, institutionalising the Israeli authorities’ starvation policy of Gaza that started on 2 March, with the full siege they imposed on the Strip as part of their ongoing genocidal campaign. 

The way this scheme operates attempts to strip people of their dignity. Over the seven weeks, MSF teams treated 196 patients with injuries following chaotic scrambles at the GHF distribution sites. Patients included a five-year-old boy with severe head injuries and a woman who died of asphyxiation, likely caused by the suffocating crush of a crowd.

People who manage to secure any food rations at the sites often face the risk of violent looting and theft of aid by other starved people. Our medical teams were required to add a new acronym to their patient registry: BBO – Beaten By Others. This refers to people injured either in the crush of the crowd or by being beaten and robbed of their supplies immediately after receiving them. It is dehumanisation by design.

“On 1 August, the same day the US special envoy to the Middle East visited GHF sites, 15-year-old Mahmoud Jamal Al-Attar was killed around the Al-Shakoush GHF site while trying to get food,” says Aitor Zabalgogeazkoa, MSF emergency coordinator in Gaza. “He arrived at the MSF Al-Mawasi clinic after being shot in the chest.”

“We treat only a fraction of the total number of people killed and injured at these sites. There is no other way to describe the murder of children as anything but intentional,” says Zabalgogeazkoa. “Despite the condemnations and calls for dismantling it, the global inaction to stop GHF is baffling.”

Between 27 July – 2 August, 186 people with wounds from gunshots, shrapnel or assault and stabbing were treated in MSF’s Al-Mawasi or Al-Attar clinics after being wounded at GHF sites. Two of them died. On 3 August MSF clinics received three more wounded people, one who had been shot in the neck and two with shots to the head.