Gaza: Suffering beyond imagination

We have visited Gaza at different moments since October 2023 and witnessed an amount of suffering that is beyond imagination. This includes in a zone which Israel unilaterally declared as “humanitarian,” while regularly attacking it. And yet, our colleagues told us the situation is even worse in the north of Gaza—an area which we couldn’t access. Recently, the situation there has simply become a nightmare. 

For weeks now, people in the northern Gaza districts of Beit Hanoun, Jabalia and Beit Lahia have been facing one of the most vicious and violent attacks since the beginning of the war. The area is being heavily bombarded by Israeli forces, who once again choose to indiscriminately attack entire areas, thereby accepting massive civilian losses. At the same time as attacking these areas, Israeli forces are issuing evacuation orders that cannot be obeyed. Among those who try to leave, many people are reportedly exposed to arbitrary detention, while others are being shot at and bombed as they flee. That evacuation orders began being issued 48 hours after the start of the military operation in Jabalia refugee camp last month, only goes to show that Israeli forces had no intention to spare civilians, and that these warnings are merely cosmetic. 

Until recently, several of our own colleagues and their family members were still trapped in these districts and were witnessing this inhumanity first-hand. Two of them are still unable to flee. They are terrified and fear for their lives, and with good reason: on 10 October, our colleague Nasser Hamdi Abdelatif Al Shalfouh was tragically killed by shrapnel injuries to his legs and chest in Jabalia. Some days later, on 14 October, an MSF physiotherapist and his son were injured by shrapnel. On 24 October, an Israeli attack on a building killed Hasan Suboh, another MSF staff member, in Khan Younis, in southern Gaza. Nasser and Hasan are the seventh and eighth MSF colleagues killed in Gaza since 7 October 2023. 

After two weeks of complete siege, Israeli forces are now allowing some trucks to move humanitarian supplies within northern Gaza. But they are still preventing enough aid from reaching the area to meet the massive needs, effectively reducing lifelines for thousands of people. Since October, the level of aid allowed in north Gaza, as well as the whole Strip, has never been so low.

Hospitals are under evacuation orders or directly attacked. In early October, Israeli forces besieged the three main hospitals in north Gaza—Indonesian, Al-Awda and Kamal Adwan—while hundreds of patients were reported to be inside. 

On 22 October, one of our medical staff, who found shelter inside besieged Kamal Adwan hospital, described the situation inside as disastrous, with an overwhelming number of patients and a critical lack of medical supplies or equipment to treat them. This was before the hospital was attacked and stormed by Israeli forces between 25 and 28 October, then repeatedly bombed—including its drugs stock—over the last weeks. 

In north Gaza, medical infrastructure has been dismantled or rendered only partially functioning. This leaves hospitals unable to treat the injured, especially critically injured patients who are therefore condemned to death; we heard harrowing stories of patients dying because of the lack of electricity. During the last weeks of October and the first week of November, the number of medical consultations at the MSF clinic in Gaza City has more than doubled, linked to the arrival of displaced people from north Gaza.  

While the attacks on northern Gaza look particularly ruthless, they appear as the logical continuation of the strategy adopted so far by the Israeli forces in Gaza. Since the start of the war, in response to the brutal massacre carried out by Hamas on 7 October 2023, we have watched in horror as Israeli forces began an indiscriminate bombing campaign. This campaign has been waged while issuing evacuation orders that were built on the lie of the existence of ‘safe zones’, where civilians could seek shelter from the violence. 

Throughout Israel’s campaign of death and destruction, a clear pattern of unimaginable violence has emerged: people in Gaza are asked to make an impossible choice between staying, in defiance of the evacuation orders, being assimilated to legitimate targets and killed, or prevented from meeting basic needs; or leaving and risking their lives, be it during their trip, or at the new destination. At the same time, there is no hope for them to reach a truly safe place outside the Strip, as all Gaza crossing points have been closed since May 2024. We have been repeatedly calling for the reopening of these crossing points—accompanied with guarantees that the right to return for people is granted. 

Over the last weeks, conversations in Gaza have been intense about the so-called ‘Generals’ Plan’ or ‘Eiland Plan’ within the Israeli forces. This is a plan which consists of wiping Palestinians off the northern part of Gaza by either killing them, forcing them out, or starving to death those who stay. The way the ongoing offensive in the north is being waged, and the dehumanising language that Israeli authorities have been using towards Palestinians, reinforce the idea that we are witnessing the execution of this plan.

Atrocity is piling on to atrocity at a level unlike anything we have seen over our working experience with MSF, in some of the most acute humanitarian crises of the last decades. Israel has killed over 43,000 people, including nearly 14,000 children, and has injured more than 100,000 others, according to health authorities in Gaza. Our medical teams have witnessed first-hand the horrors of this relentless bombing campaign; children with burns across their whole bodies and faces, many with crushed limbs after being buried under the rubble for hours, others who had to face amputations without anaesthesia, and body after body being brought to our medical facilities.

The Israeli forces have failed repeatedly and consistently to spare the people of Gaza and continued their annihilation of the Strip, making it uninhabitable. During our visits, even if we expected the worst, we were shocked by the magnitude of destruction: houses, water and electric systems, schools, university, mosques, churches, hospitals, public archives, historical sites all levelled, adding up to more than 66 per cent of the existing buildings, according to the United Nations. Some of our 800 colleagues in Gaza told us how the Israeli offensive has destroyed the social fabric, their hopes, and even their memories; objects, pictures and other links with their past have been destroyed. All the components of a society have been destroyed. 

In January 2024, the International Court of Justice ordered that Israel desist from the killing of Palestinian people, end their forced displacement from their homes, ensure their access to humanitarian assistance, and take all measures within its power to end the destruction of life in Gaza. Ten months later, no tangible effort has been made to prevent a genocide. On the contrary—Israeli forces continue killing people in scores and deliberately obstructing the delivery of aid. 

The vote by the Israeli parliament, the Knesset, on 28 October to ban UNRWA is the latest devastating blow to being able to provide relief to Palestinians. It's past the time that Israel stopped openly disregarding the ruling of the International Court of Justice, and its allies ended their support to Israel’s campaign of destruction of the Palestinians of Gaza.