Speaking out on the state of Gaza

Despite the ceasefire that came into effect on 10 October 2025, the genocide in Gaza has not stopped. In the month after the ceasefire, more than 300 people were killed, and more than 760 were injured, according to the Gaza Ministry of Health. Among the MSF staff working in Gaza are Australians who have been speaking to media back home, so that more people understand the scale of the trauma and the enormous needs still unmet.    

On a tiny patch of land in southern Gaza, more than one million people are being forced to survive in dire living conditions. Combined with civilian infrastructure and a health system largely demolished by Israeli forces, it makes an ideal setting for the spread of infection and illness. Plummeting food insecurity due to Israel’s aid blockade beginning in March caused mass starvation. MSF has seen record rates of acute malnutrition in our clinics. And Israeli attacks have continued.

“I would like Australians to know that this isn’t a ceasefire. I would like Australians to know that this is still a genocide that’s been disguised as a ceasefire,” medical activity manager Thienminh Dinh told the ABC in November, after returning to Gaza for her second assignment there in 2025.

Dinh is one of several Australians working with MSF in Gaza who are speaking out about what they are seeing. They all make clear that the situation demands a stop to the violence and a massive scale-up of assistance of every kind. Living conditions are desperate. Without improvements in water, sanitation, shelter and nutrition, more people will die from preventable causes. Without sufficient medical supplies and equipment, providing essential services and restoring Gaza’s devastated health infrastructure will be impossible.

“They are living in tents, and I use the word ‘tents’ very lightly. They are shelters made from pipes that have been found, and from plastics,” Dinh said. “These people don’t have any electricity, they don’t have access to reliable water, and they don’t have reliable access to food. They do seek treatment in hospital, but they have to walk kilometres to seek that treatment, and often we don’t have the medication.”

Many mothers, malnourished themselves, struggle to breastfeed their babies due to an array of factors, and ready-to-use infant formula is in short supply. The ceasefire has enabled more deliveries of aid, but delays and restrictions have kept assistance far short of what is needed. 

“There’s an assumption that people in the Gaza Strip will simply return to their normal lives, but this is really quite far from the truth,” project medical referent Kaylene Tomkins told the Australian Associated Press (AAP) shortly after the ceasefire took effect. “The reality on the ground is completely different. What we see is the lives that people once knew are gone, and it’s unlikely that this is going to return anytime soon.”

Medical coordinator Kate Charlton spoke to ABC News from Gaza in October. “We’re seeing a range of different skin disease, which is resulting from a lack of hygiene and clean living conditions,” she said. “Even more worryingly, we’re seeing people with very simple wounds that are becoming very badly infected. On top of that, in our inpatient facilities we have people with complex traumatic injuries from violence, having very delayed wound healing, severe infections, which are really difficult to manage.”

The harsh living conditions compromise people’s ability to recover from physical trauma. “When patients are malnourished, beyond seeing them look like skeletons, they don’t have the proteins that they need,” Dinh said. “They don’t have the sugars, the micronutrients, the selenium and zinc needed for their body to actually lay down tissue.”

Access to any treatment is extremely limited. The systematic targeting of Gaza’s healthcare system by Israeli forces – bombing hospitals, raiding medical facilities and endangering the lives of staff and patients – has shattered the medical infrastructure. The few remaining hospitals are overwhelmed and undersupplied.

“We’re working in a system on the brink of collapse. Many of the primary and secondary healthcare facilities have been directly targeted, and we see this continuous flow of patients that don’t have access to care elsewhere,” Tomkins said.

The situation is especially difficult for thousands of people with amputations or disabilities. Before returning to Gaza in November, Dinh talked with the AAP. “This conflict has created the largest generation of amputees. They will need rehab. Access to prosthetics is non-existent, and we’re running low on crutches, as well,” she said. “We have patients who’ve been made quadriplegics and paraplegics because shrapnel has torn through their spines. These are patients who will need lifelong care.”

She also pointed to the suspension of chronic disease management as another critical gap. “There’s a massive backlog in cancer care. The single ministry of health care facility that specialises in cancer care was closed in 2023,” she said.

And then there is the psychological and emotional injury from enduring so much death, violence, displacement and deprivation. “Only now we’re beginning to witness the true extent of the mental health crisis in Gaza, as people who have been living in this prolonged state of acute trauma can finally start to grieve,” Tomkins said.