Work in the Palestine Territories has brought both occasional suspensions of activities and a change to MSF methods

In early June, MSF France Executive Director, Pierre Salignon, traveled to Israel and the Palestinian Territories, visiting Ramallah, Nablus and Jerusalem. He met with teams from Médecins Sans Frontières (MSF) and representatives of the Israeli government and the Palestinian Authority to discuss MSF's programs in the West Bank and Gaza Strip, the current working conditions, and the continuation of aid operations.

What are the repercussions for the civilian population of the internal Palestinian conflicts in the Territories?

"The fragmentation of the Palestinian society is not new but has reached an unprecedented level, as witnessed by violence among armed factions, family clans and even within families.

"Many people have been wounded and killed in exchanges of gunfire on the streets of Gaza. Others have been subject to reprisals for their political affiliations, including being shot in the legs.

"Hospitals have not been spared. Skirmishes have occurred inside facilities and patients have been killed in their hospital beds. The population has been held hostage to internal Palestinian battles, as well as to the policy of the international community which does not recognize the elected Hamas government, and has sought to isolate them by denying international financial aid since January 2006.

"This has deepened the dependency of the Palestinian population [for medicine, food and public employees' salaries], condemning them to a poverty and deprivation that worsens daily.

"In mid-May, heightened internal Palestinian divisions resulted in a renewal of tensions and then, in mid-June, in Hamas' armed takeover of the Gaza Strip. This new situation is particularly troubling for residents of the Gaza Strip because the Israeli government is also threatening a total blockade of the area."

What aid is MSF providing in the Palestinian Territories?

"Our work involves providing medical and psychological care to victims of the current conflict and violence in the Palestinian Territories. We are working in Gaza, Nablus and Hebron. But because of the internal Palestinian conflict and incursions by the Israeli army, we have had to suspend our activities on several occasions and, ultimately, to change our methods.

"For example, our psychologists have sometimes had to suspend home visits in Nablus for several days. International staff members in Gaza have been evacuated to Jerusalem. Our Palestinian colleagues have taken charge of following up with families, and avoid travel when conditions are too dangerous. Like the rest of the population, during the height of the violence, our colleagues have sought, above all, to protect themselves and their families. We also donated medicines to hospitals in the Gaza Strip."

Given the worsening situation, what do you expect MSF will be able to do?

"The situation was calmer this week, so an international team managed to enter Gaza to meet with our Palestinian colleagues - some of whom had family members killed during the violence over the last month - to assess the situation. The team will also need to evaluate the health situation and, in particular, the support we can provide to hospitals (including international medical staff, donations of medicines and medical supplies, and financial support for doctors who are no longer being paid).

"More than 630 wounded people have been hospitalized. Some required specialized medical care on site or outside the Gaza Strip. Through our reconstructive surgery program in Amman, Jordan [which works with wounded Iraqis], we may be able to provide appropriate care to certain wounded Palestinian patients, in addition to evacuations currently underway to Israel and Egypt.

"Our team's working conditions remain difficult and dangerous. Palestinians are settling internal scores and firing rockets into Israel, and the Israeli army is conducting military operations in retaliation.

"Even as living conditions worsen, the resentment and frustrations felt towards 'outsiders' place western NGOs at risk of being seen as an auxiliary of Israeli forces and the international community.

"Finally, we are concerned about the continued detention of Alan Johnston, the BBC journalist kidnapped more than three months ago in the Gaza Strip, and about threats from the radical group that says it is holding him for execution. The outcome of this kidnapping could have consequences for the future of our activities."