Al Shifa medical complex is in ruins after 14 days of siege by the Israeli forces. © MSF
The role of hospitals
Damaged walls at the entrance of MSF office in Gaza city. © MSF
“Hospitals are not targets and must remain safe spaces.”
Hospitals and other medical facilities are meant to be places of emergency assistance and healing for the injured and sick. However, is this the case in practice?
On 7th October, 2023, a new wave of conflict erupted between Israel and Palestine in the Gaza Strip, resulting in countless civilian casualties and displacement. Hospitals were supposed to be a safe haven for the sick and injured, but as soon as the conflict erupted, Al-Awda Hospital and Indonesian Hospital in the north were among the first targets, setting the tone that even medical facilities are no longer safe in this fight.
As the conflict escalated, Israel imposed a blockade on Gaza and civillians have been collectively punished. Other hospitals in Gaza faced the same fate of aerial bombardment and destruction. Al-Shifa Hospital, the biggest hospital in the Strip, was hit multiple times in one day, destroying the maternity ward and outpatient clinics. In 2024, Nasser Hospital and multiple other hospitals have also been targeted, leaving some of them in ruins.
With the number of patients skyrocketing due to the conflict, the already fragile healthcare system in Gaza has been pushed to its limits; and because of the destruction of medical facilities, people in Gaza can hardly access the most basic of emergency services. Even wars have rules - fighting and attacks should stop at the hospital gates. Attacks on healthcare facilities are a gross violation of International Humanitarian Law, and those who turn a blind eye to them are complicit. The international community need to urgently step up, stop further attacks and hold the relevant authorities accountable.
Hala Ismael Al-Talla was forced to leave her home in the Nuseirat refugee camp in Gaza’s Middle Area after the house she lived in with her family was shelled. Her right leg was broken and she was taken to Al-Aqsa Hospital, but then the Israeli military jeoperdised the safety of medical staff and patients with threats of attacking the hospital. Hala had to flee to Rafah. She endured enormous pain to reach Rafah Indonesian Hospital. Unfortunately, two of her toes suffered necrosis and required amputation.
Hala is just one of the countless people affected by the attacks on medical facilities by the Israeli military. Drone strikes, tank shellings, sniper fire and soldier shooting all contributed to the varying degrees of destruction of hospitals in Gaza. These attacks exacerbated the chaos in overcrowded hospitals and worsened an already-dire situation.
The conflict has caused a sharp increase in medical demand, and attacks on hospitals by the Israeli military have not only prevented proper treatment for the injured but also abruptly interrupted other medical care.
Mahra (alias) was pregnant and went into labor in January. She searched for an obstetrician at the Emirati hospital to help her give birth, but the delivery rooms were full. Sadly, Mahra had to return to the cold weather outside the hospital and gave birth in a makeshift tent. Her new-born baby didn’t make it. With the collapse of Gaza’s healthcare system, the majority of hospitals have completely shut down, only a small number of patients and medical staff who could not be evacuated or voluntarily chose to stay remains. For example at Nasser Hospital, according to the United Nations, as of the end of February there were 130 patients and at least 15 medical staff grounded at this facility still, having already ran out of water and electricity, and with only very little food available.
*Figures from WHO as at 13th May
Only 15 of 36 hospitals in the Gaza strip are partially functioning
Bed occupancy rate in Gaza
functioning hospitals is up to
439％
Gaza hospitals and the attacks they sustained (Until Late-May)
Only showing some of hospitals and medical facilities supported by MSF in Gaza
(Click on the icon on the map to learn more)
Fully evacuated – No MSF staff working
MSF conducting medical activities alongside non-MSF medical workers
The facility is shut down or cannot operate
MSF's support to medical facilities in the south
(as of late May)
Civilians and frontline aid workers in Gaza had no choice but to evacuate to the southern city of Rafah as the Israeli military continued with their indiscriminate bombing and destruction of medical facilities. With the Israeli army started intensifying its offensive in Rafah in May, MSF’s support work in various local medical facilities has been hugely affected.
Rafah Indonesian Field hospital
- Supported post-operative care for trauma and burn patients since December
- Outpatient and inpatient care, conducting around 130 consultations a day
Situation in May:
Forced to suspend support
El-Emirati Maternity Hospital
- Postpartum care, managing complications of pregnancy, and expanding the Obstetrics and Gynaecology department
- The hospital has admitted 6,053 patients since January
Situation in May:
Handed over to the Ministry of Health
Al- Shaboura clinic
- Outpatient services, including general consultations, vaccination, wound dressing, mental health services
- Systematic malnutrition screening of children under 5 and pregnant women
- More than 36,000 medical consultations had been conducted
- since January
Situation in May:
Forced to close
Al-Mawasi Health
posts(3 locations)
- Outpatients services, including general consultations, vaccination, wound dressing, mental health services
- Conducted over 43,000 consultations since January, treating patients with upper respiratory infections, diarrhea, hypertension and skin diseases
Situation in May:
Two of them still operating; One forced to close
Tal al Sultan Trauma
Stabilization Point
Situation in May:
Forced to close
The war in Gaza is still ongoing. Visit msf.hk for the latest developments
Article 19 of the
Geneva Convention (I):
Fixed establishments and mobile medical units of the Medical Service may in no circumstances be attacked, but shall at all times be respected and protected by the Parties to the conflict. Should they fall into the hands of the adverse Party, their personnel shall be free to pursue their duties, as long as the capturing Power has not itself ensured the necessary care of the wounded and sick found in such establishments and units.
The responsible authorities shall ensure that the said medical establishments and units are, as far as possible, situated in such a manner that attacks against military objectives cannot imperil their safety.
The devastating impact of Gaza's “silent killings”
In a report released in April this year, MSF drew on medical data and patient testimonies to demonstrate that the decimation of the healthcare system in Gaza had led to the silent killing of many.
Aside from the myriads of war-wounded across the Strip, diabetes patients are also unable to receive essential treatment as hospitals shut down dialysis departments; similarly, pregnant women and patients suffering from malnutrition and chronic diseases such as hypertension have all seen their conditions deteriorate, or even lost their lives, when access to the special care they need is almost non-existent.
“Destroying hospitals is equivalent to killing patients.
There is no difference at all between them.”
—— Pong Chiu, vice president of MSF Hong Kong Board
In the midst of the intense offensive on Rafah by the Israeli forces, Chiu once again called for an immediate and sustained ceasefire in Gaza.*
As the hospitals collapse, the healthcare efforts of countless medical staff to the patients over the years also shatter like the rubble of these health structures, in the blink of an eye. It is impossible for any of us to recuperate and fill the hollow of health needs there in just a few weeks or even months.
“I'm sorry, but you could add 1,000 field hospitals, you're not going to be able to replace the hospital system. The healthcare system that was in Gaza before the war.”
—— Dr Amber Alayyan, MSF Deputy Programme Manager for the Middle East
When hospitals struggle or even collapse
What's NEXT?
Let there be aid
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On Track to Save 2024
Highlight
Coinciding with the 30th year of MSF Hong Kong, our signature event “On Track to Save” was reintroduced in a new format-as a running race for the first time! Set against a backdrop resembling the flood-prone regions of South Sudan, this change allowed participants to feel the challenge faced by medical teams who safe lives in the country.
The event featured races of various lengths – 10km, 3km, and a 1km fun run – catering to all ages and individuals. This event, held on 17 March at the Main Dam of Tai Mei Tuk Plover Cove Reservoir, successfully united over a 1,000 participants in solidarity with MSF’s works. We are grateful to everyone who contributed to the success of this impactful occasion.
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