Palestine

Gaza

The Gaza Strip is a 141 square mile territory surrounded by walls and fences and under the constant control of the Israeli authorities. With 2.3 million people, it has one of the highest population densities in the world.

Every aspect of life in Gaza is impacted by the ongoing siege and constant threat of violence. Over the years, recurrent escalations of violence have taken a toll on people’s health and well-being, as well as on infrastructure like health care and education. Gaza has also been under blockade since 2006, with Israel controlling the entry and exit of people and goods, including clean water and essential medicines, which has led to alarming rates of antibiotic resistance.

All-out war continues

The current war has turned Gaza’s chronic humanitarian crisis into a catastrophe. Israeli authorities have delayed or denied the entry of food, medical supplies, drugs, and humanitarian aid, and what little supplies that have been allowed to enter are far from sufficient to meet the massive and escalating needs. On August 22, 2025, the United Nations-coordinated Integrated Food Security Phase Classification (IPC) system officially declared famine in Gaza governorate, in the north of the Gaza Strip. Famine thresholds are expected to be crossed in Deir al-Balah and Khan Younis governorates by the end of September.

Nowhere is safe in Gaza. So-called “safe zones,” including camps for displaced people, have come under attack, as have health facilities. Over 1,000 health workers have been killed, according to the Ministry of Health, and OCHA reports 417 humanitarian workers killed. Among them are 12 MSF staff members, some killed while on duty or while sheltering with their families.

Since the war started, MSF teams have had to leave 20 health structures and have endured 41 violent incidents, including airstrikes damaging hospitals, tank shells fired upon agreed deconflicted shelters, ground offensives in medical centers, and attacks on our convoys. These attacks, along with the ongoing siege and sudden evacuation orders, have stifled the urgently needed humanitarian response in Gaza at a time the needs are more dire than ever.

West Bank

The war in Gaza has reverberated in the West Bank, where Israeli military incursions and displacement have increased since October 2023.

A growing number of attacks on medical personnel and facilities have been reported to MSF teams, including attacks on hospitals, destruction of makeshift medical sites in refugee camps, and the harassment, detention, injury, and killing of first responders and medical workers by Israeli forces. Our teams are seeing ambulances carrying critical patients being blocked by Israeli forces at checkpoints, medical facilities surrounded and raided during active operations, and health care workers subjected to physical violence while trying to save lives.

Increasing violence and insecurity

Palestinians in the West Bank face severe movement restrictions imposed by Israeli forces, including road closures, prolonged delays at checkpoints, and the installation of new gates at village entrances. These restrictions also obstruct Palestinians’ access to health care. In a July 2024 survey conducted by MSF in the Hebron governorate, over 43 percent of patients reported being stopped at Israeli military checkpoints on their way to our clinic, and 28 percent reported experiencing harassment or violence from soldiers or settlers on their way to receive MSF services.

The same year, MSF teams saw an increase in different types of violence and hardship faced by our patients in the Hebron area, with 65 patients who reported the destruction of personal property (a 117 percent increase compared to 2023), 219 who were incarcerated or detained—nearly a quarter of all patients.

Forced displacement

Across the West Bank, settler violence and Israeli incursions continue to displace Palestinians. Israeli forces have emptied and destroyed, in part or in whole, the refugee camps of Jenin, Nur Shams, and Tulkarem, forcibly displacing tens of thousands of Palestinian refugees while preventing others from returning.

As a result of mass displacement, thousands of Palestinians in the north of the West Bank are living without proper shelter, essential services, or access to health care. People lack basic commodities such as diapers and other hygiene products, food, water, fuel, and electricity. Increasing state-backed settler violence is also displacing families.

MSF calls on Israel to end the violence against medical staff and patients, and for the cessation of attacks on health facilities that obstruct medical personnel from performing lifesaving duties, and patients from accessing the care they need.

Due to the blockade of humanitarian and medical supplies, the health system faced critical shortages of drugs and other vital goods, and people were trapped without access to the most basic services such as water and food, greatly increasing their medical needs. Our teams treated numerous newborn babies and children under one year old for severe conditions, including respiratory tract infections, linked to their appalling living conditions, and malnutrition. Overcrowded, unsanitary environments and the lack of safe water, soap, or showers increased the incidence of skin diseases, gastrointestinal disorders and disease outbreaks, as shown by the resurgence of polio.

In North Gaza, the siege and relentless attacks carried out by the Israeli forces in October 2024 were a clear illustration of the indiscriminate nature of the war. In December, our advocacy team published Gaza: Life in a Death Trap, a report in which we stated that we were witnessing clear signs of ethnic cleansing, as Palestinian life was being wiped out in the north.

We repeatedly called for a sustained and immediate ceasefire in Gaza, for urgent and  unhindered access for humanitarian aid to support Palestinians, and for all parties to the conflict to respect and protect medical facilities.

Gaza war response

Throughout 2024, MSF scaled up and adapted our medical activities in Gaza, offering a wide range of services including multidisciplinary care for patients with burns and trauma injuries—comprising surgery, physiotherapy and psychosocial support—as well as maternal and neonatal care, basic health care, sexual and reproductive health care, mental health support, and treatment for non-communicable diseases.

However, massive challenges and constraints related to supplies, displacement, and destruction of infrastructure are limiting our activities. Our teams continue to adapt to the extremely volatile conditions on the ground, and have successfully evacuated 13 war-wounded children and their caretakers to Amman, Jordan, for comprehensive rehabilitative care at our Reconstructive Surgery Hospital.

In addition to responding to war-related trauma, MSF teams are also treating patients with chronic conditions and diseases arising from lack of water and sanitation, among other health needs exacerbated by the war. We also support vaccination campaigns, including for polio, which reemerged in Gaza for the first time in decades in the summer of 2024 as a result of the destruction of vital infrastructure and disruption of routine vaccinations. 

Water and sanitation

Between January and mid-March 2025, our teams produced over 2 million liters of clean water and distributed over 36 million liters across Gaza. During the ceasefire, MSF started water distribution in northern Gaza, including Jabalia camp, where aid had been blocked for months.

In Deir al-Balah and Khan Younis, MSF has been implementing water and sanitation activities in camp shelters through a partnership with the Agriculture Development Association (PARC). This includes building latrines, distributing hygiene kits, and providing water treatment units. We also equipped a camp hosting 400 people with disabilities with accessible latrines and showers, and distribute clean drinking water.

However, restrictions on the movement of supplies have limited the response. Between January 2024 and early March 2025, only 28 percent of the 1,700 water and sanitation items MSF requested under the dual-use system were approved by Israeli authorities. Many items are in bureaucratic limbo, with responses from authorities averaging up to 60 days—some exceeding 200. In November 2024, Israeli authorities approved an MSF desalination unit after an 85-day wait. But even approved supplies can be turned away at border crossings.

Humanitarian aid and medical supplies 

Since October 2023, MSF has provided 636 tons of logistic and medical equipment from our international supply centers—as much as 30 planes or 130 trucks full. However, some supplies critical to our operations and the security of our staff have been difficult to transport into Gaza, including generators, desalination stations and motor pumps, oxygen concentrators, vehicles, and equipment for communication. 

For the latest on our operations in the Strip, see how we’re responding to the war in Gaza.

West Bank

Israeli forces and settlers have increased their use of extreme physical violence against Palestinians in the occupied West Bank since the war started in Gaza. During 2024, Israel also introduced more measures that restrict movement, which severely obstruct access to health care and exacerbate the already dire living conditions. Israeli forces carried out increasingly violent and longer incursions, particularly in the north of the territory. At the end of August, they launched a nine-day military incursion in Tulkarem, Jenin, and Tubas, the most intense since the 2022 intifada, in which 39 Palestinians were killed. These incursions, along with settler violence, movement restrictions, and financial hardship, resulted in the largest forcible displacement of Palestinians in decades.

Our teams witnessed a rapid escalation of violence, with more ambulances carrying critical patients blocked at checkpoints, medical facilities surrounded and raided, and health workers subjected to physical violence, with many killed.

MSF continues to provide emergency care, basic health care via mobile clinics, and mental health services in Hebron, Nablus, Tubas, Jenin, Tulkarem, and Qalqilya. Our mental health teams observed that constant fear of longer and unpredictable incursions and attacks by Israeli forces and settlers took a significant toll on people’s mental health, heightening feelings of hopelessness and anxiety. In the refugee camps, we conducted first-aid training for paramedic volunteers, and donated vehicles for paramedic services and essential relief items to support trapped communities.

Access to health care remains a huge concern. In response, our teams increased the number of mobile clinics around Nablus and in H2, a highly restricted area in Hebron city. In areas such as Masafer Yatta in the south, settler violence reached unprecedented levels, with Palestinians seeing their homes, farms, and cattle burned or destroyed. Israeli forces also demolished houses, forcibly displacing families and leaving them destitute.

At the end of 2024, humanitarian operations, including MSF's, continued to face severe restrictions, limiting our ability to address the immense needs of people living in Gaza and the West Bank.