Gaza, Barcelona, Brussels, Paris — Médecins Sans Frontières (MSF) is horrified by the brutal mass killing of civilians perpetrated by Hamas, and by the massive attacks on Gaza, Palestine, now being pursued by Israel. MSF calls for an immediate cessation to the indiscriminate bloodshed, and the establishment of safe spaces and safe passage for people to reach them as a matter of urgency. People must be afforded safe access to essential supplies like food and water and health facilities. Essential humanitarian supplies like medicine, medical equipment, food, fuel, and water must also be allowed to enter the Gazan enclave. To facilitate this, Rafah border crossing with Egypt must be opened and bombings on the crossing point must cease.

Some 2.2 million people are currently trapped in the Gaza strip, where indiscriminate bombing has turned a chronic humanitarian crisis into a catastrophe. More than 300 MSF staff are in Gaza, some of whom have lost homes or family members; it has been near-impossible for them to move.

“The fighter jets are demolishing entire streets block by block,” says Matthias Kennes, MSF Head of Mission in Gaza. “There is no place to hide, no time to rest. Some places are being bombed on consecutive nights.”

“We know what it was like in 2014 and in 2021, thousands died. Each time, our medical colleagues go to work, not knowing if they will see their homes or their families again,” continues Kennes. “But they say this is different. This time, after five days, there have already been 1,200 deaths. What can people do? Where are they supposed to go?”

Millions of men, women and children are facing a collective punishment in the form of total siege, indiscriminate bombing, and the pending threat of a ground battle. Safe spaces must be established, humanitarian supplies must be allowed into Gaza. The wounded and sick must receive medical care. Medical facilities and personnel must be protected and respected; hospitals and ambulances are not targets.

The siege imposed by the Israeli government, including the withholding of food, water, fuel, and electricity is unconscionable. Following 16 years of military blockade of the Gaza strip, the medical facilities within are already weakened. This siege leaves no respite for patients caught up in the fighting, nor for medical staff. It represents an intentional block on life-saving items; the entry of these supplies and key medical staff must be facilitated urgently.

“In Ministry of Health hospitals, medical staff report that they are running out of anaesthetics and painkillers,” says Darwin Diaz, MSF Medical Coordinator in Gaza. “On the MSF side, we moved medical supplies from our two-month emergency reserves to Al-Awda hospital and now we have used three weeks’ worth of stock in three days.”

MSF staff, including medical personnel, have been extremely restricted in their movements since Saturday. They are unable to obtain safe passage to support Palestinian medical colleagues working day and night to treat the injured. People playing no role in the hostilities do not have a safe haven to go to. Our teams are witnessing a level of destruction that may already exceed previous escalations. Two of the hospitals MSF supports, Al-Awda and the Indonesian Hospital, have both sustained damage in airstrikes, while our own clinic sustained some damage in an explosion on Monday.

Today MSF is running a standalone clinic, and supporting Al-Awda hospital, Nasser hospital, and the Indonesian hospital in Gaza. MSF reopened an operational theatre in Al-Shifa on 10 October to receive burn and trauma patients. We have also donated medical supplies to Al-Shifa hospital and will continue providing support to hospitals. Our teams in Jenin, Hebron and Nablus are actively assessing the medical needs in the West Bank, as violence there is escalating. At least 27 Palestinians have been killed in settler attacks and clashes with the Israeli military.

Civilians, civilian infrastructure and healthcare facilities must be protected at all times. MSF calls on the Government of Israel to cease its campaign of collective punishment against the entirety of Gaza. Israel and Palestinian authorities and factions must establish safe spaces. The entry of humanitarian assistance, food, water, fuel, medicine, and medical equipment to the Gaza Strip must be facilitated urgently. The failure to do so will cost more lives.