Forcing 1 million people, including hundreds of critically ill patients and newborn babies, out of Gaza City and into overcrowded and under-resourced areas in the center and south of the Strip is a death sentence, Doctors Without Borders/Médecins Sans Frontières (MSF) warns.
Relentless bombing by the Israeli forces and the advance of their ground offensive are killing Palestinians and driving them from their homes and shelters—sometimes multiple times—following a pattern of complete destruction previously witnessed by MSF teams in Rafah more than a year ago.
The makeshift shelters many people are currently living in offer little protection as bombing continues. An estimated 1 million displaced people now occupy just 15 percent of Gaza’s territory—conditions worsened by the destruction of almost 90 percent of water and sanitation systems. Outbreaks of disease such as acute diarrhea are already spreading as people are being forced to live in overcrowded, unsanitary conditions.
“Some of our colleagues have been displaced more than 11 times since 2023,” says Jacob Granger, emergency coordinator for MSF in Gaza. “MSF continues to distribute water in the city but, with no water reserves left, people will die in a matter of days if the Israeli forces make drinkable water production and distribution impossible.”
Health system on the brink of collapse
Israel’s offensive is deliberately wrecking Gaza’s health care capacity. More than half of the hospitals have been rendered inoperative; those that remain are functioning on the brink of collapse amid targeted attacks.
Bed occupancy rates have reached 300 percent at Al Ahli Hospital, 240 percent at Al Shifa Hospital, and 210 percent at Rantissi Hospital. The ongoing escalation in Gaza City is threatening to close 11 of 18 partially functioning hospitals in the Gaza Strip as well as other health care facilities, while health authorities report stockouts of over half of their essential drugs.
Medical staff have endured repeated raids and health workers themselves have been killed, detained, or threatened—including an MSF doctor still in detention with no formal charges against him.
In the medical facilities we support in Gaza City, we are seeing an increased number of wounded with increasingly serious injuries. Patients who need intensive care are at risk of dying if they are forced to evacuate due to hospital closures. People with disabilities and people who are sick or wounded will not be able to evacuate.
Starvation as a weapon of war
Israel’s siege has triggered a famine: restrictions on food, clean water, medicine, and aid deliveries are causing acute malnutrition rates to skyrocket.
Civilians who are, as a result, desperate for aid face deadly force at distribution points. For months, MSF clinics responded to mass casualties resulting from Israeli fire at the food distribution sites managed by the so-called Gaza Humanitarian Foundation (GHF).
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Israeli forces aim to push Palestinians out of Gaza City through genocide, ethnic cleansing, and creating conditions that make life impossible. Nowhere is safe, and the vastly insufficient quantities of aid are delivered through routes that are extremely dangerous for civilians. The destruction of critical infrastructure is ongoing and deliberate.
MSF calls for the immediate end to the use of evacuation orders as a means of forcible displacement, a lasting ceasefire, and the entry of humanitarian aid at scale. We also call on Israel’s allies like the US to stop arms transfers to Israel immediately and ramp up the pressure to halt the offensive.
Without urgent, radical intervention, Gaza faces total annihilation.
