Israeli obstructions to aid and attacks on humanitarian workers

Doctors of the World’s year in the Occupied Palestinian Territory

At Doctors of the World, we deeply acknowledge and respect the immense dedication of our teams in Palestine. They have chosen to work for the health of communities, driven by a commitment to solidarity and social justice.

Despite the countless challenges, including attacks on their lives and their work, our teams remain on the ground, facing intolerable injustice with resilience. Their unwavering presence in such difficult conditions deserves the highest recognition.

Through their work and testimonies, they shine a light on realities that profoundly challenge our shared moral responsibility. We amplify their voices to raise awareness within our global community and to continue advocating for the respect of human dignity. Our entire organisation stands firm with our teams and their families. We extend our strongest possible support in recognition of their invaluable contribution and steadfast commitment to our shared mission. Their courage and dedication inspire us all.

This year has seen an alarming deterioration of the situation in the Occupied Palestinian Territory. While the International Court of Justice has warned of a risk of genocide, the war is dangerously spreading to the occupied West Bank and Lebanon.  In this report, Doctors of the World reflects on its experience in delivering medical assistance amid aid obstructions, the targeting of civilians and its personnel and shrinking humanitarian space.

The report includes a detailed account of events amounting to the obstruction of Doctors of the World’s humanitarian response in the Occupied Palestinian Territory, covering the period between 7 October 2023 and 24 September 2024.

• For almost a year, heavy bombing and ground fighting by the Israeli military have threatened the lives of Doctors of the World staff in the Gaza Strip. Minimum conditions of safety cannot be guaranteed even within the areas which Israel has unilaterally designated as “humanitarian zones”, which have been repeatedly hit by Israeli strikes. One of our colleagues has been killed and three have been severely injured. Every single one of our staff has experienced one or more family members being killed, in violation of the obligation of parties in conflict to respect and protect both civilians and humanitarian workers¹. Doctors of the World’s premises have been raided and damaged by Israeli forces, despite Doctors of the World clearly following “deconfliction” procedures.
• Both Doctors of the World’s staff and our operations have suffered repeated waves of forced displacement as a result of Israeli military displacement orders. As of September 2024, 92% of Doctors of the World staff are currently forcibly displaced. Doctors of the World operations have been displaced up to three times, first moving from Gaza City to Rafah, and then to Deir Al Balah. In August, part of the operations were again displaced from Deir Al Balah to Khan Younis.
• Doctors of the World staff members continue to act as frontliners and aid providers while they are themselves unprotected, displaced, and deprived of proper food and clothing, surviving in overcrowded conditions vulnerable to bombing, diseases, and the weather.
• Only four trucks containing Doctors of the World aid were able to enter the Gaza Strip over the year. Shipments were blocked for up to two months before they were allowed to enter the enclave.
• In the occupied West Bank, all Doctors of the World teams have reported that restrictions on humanitarian access and movement increased drastically after October 2023. This was due to an increase in settler attacks, the escalation in Israeli military raids against Palestinian communities, and the tightening of Israel’s military infrastructure of movement restrictions.

Israel, as the occupying power, must ensure the adequate provision of food, medical supplies, shelter, and other essential supplies necessary for the survival of the civilian population in the occupied territory². Not only are the Israeli authorities failing in this obligation, they are impeding the lifesaving work of humanitarian actors striving to ensure the survival and meet the basic needs of the civilian Palestinian population.

Gaza Strip

Forced displacement of staff and operations, attacks on premises, and barriers to the provision of medical aid and services

Timeline of obstructions and attacks against Doctors of the World staff and operations

Dire conditions of survival for Doctors of the World’s staff

92% of Doctors of the World’s staff are currently living in forced displacement, with most having been forced to flee at least four times. Doctors of the World’s staff members are living in overcrowded shelters, non-rehabilitated structures, and makeshift tents, all of which fail to meet basic safety and dignity requirements.

“At least 70% of our colleagues have completely lost their homes.” – General Coordinator for Doctors of the World in Palestine

The health of staff members is direly affected by the continuous forced displacement, overcrowded conditions, medical shortages, and lack of clean water, healthy food, clothes, and hygiene materials. Many colleagues have contracted impetigo, chest infections, skin diseases, hepatitis A, and food poisoning. Some members of the Doctors of the World’s teams are suffering from chronic diseases and are unable to find the medication they were taking before October 2023. Three colleagues had babies during the war, in extremely precarious conditions, facing immense challenges in ensuring their survival due to shortages in newborn care items, difficulties with breastfeeding and limited access to baby formula.

As a result of these intolerable conditions of survival, Doctors of the World’s staff members are experiencing protracted physical and emotional fatigue. Every time our teams regain a little stability, new displacement orders force them to start all over again.

“Since 13 October 2023, I have had to flee my house in Jabalia and take shelter in my aunt’s house in Khan Younis. It’s hard to overcome the losses that I have had to endure during the past year. The Israeli army set fire to my house months ago and denied me access to it. I live in a chaotic community without any rule of law and order, without any safety or security. My disabled younger brother lost access to medical care and my family and I lost all connections with most of our friends and relatives. It is impossible for us to obtain any sense of stability, since we cannot stay in one place and have had to evacuate five times because of the Israeli forced displacement orders.” – Doctors of the World Project Officer in Gaza

“It is not easy to see our people living in tents. To hear that every day you have lost one of your relatives, your friends, your belongings. To go to sleep every night not knowing whether you will wake up or not. To return from work without being sure that you will find the place where you are staying intact. It is as if you are alive, but you are not really living. I miss my home, but it has been destroyed, so even if I do go back there, I won’t find my home. We cannot accept that this is our new life.” – Doctors of the World Coordinator in Gaza

The provision of Doctors of the World’s medical services to the population of Gaza is fully dependent on the incredible work of our colleagues on the ground, who have demonstrated their unfailing determination and courage in continuing to deliver healthcare in unacceptable conditions.

Israeli restrictions on the entry of humanitarian aid causing dire shortages for humanitarian operations

The Gaza Strip has been subjected to a 17-year blockade imposed by the Israeli government. On 9 October 2023, Israeli minister Yoav Gallant ordered a “complete siege of the Gaza Strip”. While Israeli military operations are plunging Gaza into the most severe humanitarian crisis its population has ever experienced, Israeli authorities continue to obstruct the entry of aid⁵.

At the onset of the crisis, Doctors of the World purchased drugs and emergency preparedness materials in the occupied West Bank to send to Gaza, as it had done during previous Israeli bombing campaigns against the enclave.

“After October 2023, Israeli authorities did not allow the use of a humanitarian corridor from the West Bank, a territory less than 50 kilometres away, where most of the supplies needed for the Doctors of the World’s emergency response in Gaza were available. We had to wait 11 months for the Israeli authorities to allow our first shipment from the West Bank to Gaza.” – General Coordinator for Doctors of the World in Palestine

Only four trucks containing Doctors of the World’s aid were able to enter the Gaza Strip over the year. All shipments were blocked for up to two months before they were allowed to enter the enclave.

“If the truck is delayed at one of the Israeli crossings, we have to coordinate everything again for the next day. It is a nightmare. The bureaucratic and coordination process is so cumbersome that it in itself constitutes a restriction on humanitarian access.” – General Coordinator for Doctors of the World in Palestine

In late April 2024, a Doctors of the World’s convoy of Primary Health Care (PHC) and Sexual and Reproductive Health (SRH) supplies was prepared to be sent to the Gaza strip but was blocked by the Israeli closure of the Rafah crossing mid-May. Five months later, the supplies could still not reach Gaza due to security and access restrictions at the Kerem Shalom / Karam Abu Salem crossing resulting from the Israeli ground invasion of Rafah.

Israel is classifying certain aid items as “dual-use”, including essential goods such as batteries, vehicles, and water pipes. Without the Israeli blockade and arbitrary measures, Doctors of the Wolrd could be able to send fully equipped mobile medical trucks and construction materials to rebuild health centres in Gaza. In a normal operating environment, Doctors of the World would import trucks, generators, solar panels, diagnostic equipment, fuel, protective materials, communication equipment, and construction materials, all of which are needed to properly address the catastrophic scale of the humanitarian crisis in Gaza.

Due to the obstruction of the entry of aid into Gaza, Doctors of the World’s teams are facing severe shortages of essential drugs, medical, and lab equipment, including antibiotics, treatments for chronic diseases, hygiene materials, clean water, and healthy food. Medical teams on the ground reported a significant increase in cases of malnutrition throughout September 2024, coupled with the ongoing spread of acute respiratory infections, skin infections, and other communicable diseases due to the lack of hygiene materials and the continuous deterioration of survival conditions. Not only do these shortages undermine public health in Gaza, but they also impede the medical response by creating a vicious cycle severely impacting patients’ recovery. Simple infections that would normally heal in a week are deteriorating and taking months, extra medical resources, and supervision to heal.

Movements to provide humanitarian aid and services inside the Gaza Strip are extremely dangerous due to ongoing airstrikes, even in the Israeli-designated “humanitarian” zone. Doctors of the World has to notify Israeli authorities of all its movements inside Gaza, and must coordinate all movements out of the Israeli-designated humanitarian zone, requests which are often delayed or refused⁶. Israeli strikes have targeted aid convoys from organisations including the World Central Kitchen, the World Food Programme, and Anera, demonstrating that coordination with the Israeli authorities does not guarantee safety for humanitarian workers.

WEST BANK

Access to communities restricted by Israeli military obstacles and security threats posed by the Israeli army and settlers

Since October 2023, the Israeli authorities have significantly reinforced the army’s infrastructure of movement restrictions throughout the West Bank. Its 790 military obstacles (checkpoints, military gates, earth mounds, etc.) effectively disrupt public health services, educational institutions, livelihoods, social relations, and humanitarian access⁷. Between 29 April and 23 May 2024, Doctors of the World collected data on restrictions on the movement of the Doctors of the World’s team operating in the northern West Bank. Doctors of the World found that in the span of three weeks, the field team spent at least 21 hours waiting at Israeli military checkpoints, for an average number of six movements with ten staff per day. This amounts to roughly one full working day per week collectively lost for the entire team due to checkpoint delays. In addition, Doctors of the World’s staff often have to take alternative routes, doubling their travel time, to avoid the main roads due to the threatening presence of Israeli settlers or because the communities where Doctors of the World intervenes have been disconnected from the main axes by Israeli military obstacles.

Crossing Israeli military obstacles poses significant security risks. Doctors of the World’s colleagues regularly report experiencing humiliation, harassment, and aggression from Israeli soldiers at checkpoints. In November 2023, at the military checkpoint at the eastern exit of Jericho, Doctors of the World faced a serious threat when, despite prior coordination with the Israeli authorities and obvious display of Doctors of the World’s logos on their vehicle, a soldier reacted to their approach by opening fire. Fearing for their lives, the Doctors of the World’s staff retreated into Jericho and waited several hours before leaving.

Doctors of the World’s movements are regularly restricted due to security threats posed by state-backed settler violence and Israeli military incursions into Palestinian cities and villages. Doctors of the World operates in rural Palestinian communities which are attacked by Israeli settlers every week. Our teams have been stopped by extremist armed settlers, who control documents and demand to know the purpose of our presence while pointing their weapons at Doctors of the World humanitarian workers. INGO access to communities at high risk of forced transfer has deteriorated substantially. Doctors of the World was unable to access any of the Palestinian communities which were forcibly displaced by state-backed settler violence between October and December 2023. Displaced families were only able to receive Doctors of the World’s support after they reached areas that were less attacked, usually in Area A and B communities.

Doctors of the World also provides medical services to Palestinian refugee camps. The danger of intervening in these communities is extreme, as the Israeli army is increasingly escalating military raids on refugee camps and employing more deadly warfare tactics, including airstrikes. Such attacks could be deemed as violating international law enforcement standards, given that these areas are densely populated with civilians.

These raids exacerbate humanitarian needs (forced displacement, destruction of civilian infrastructure, denial of access to medical emergency teams) while preventing the access of aid actors. On 28 August 2024, the Israeli military launched a ten-day raid on Jenin, blocking Doctors of the World’s access. After six days, Doctors of the World was only permitted to intervene in nearby villages with Palestinians displaced by the raid. Doctors of the World was only able to access Jenin city and the refugee camp after the raid ended on 7 September.

Most of the events reported here could amount to violations of human rights and international humanitarian law. Doctors of the World is gravely concerned for the safety and security of the Palestinian population of both Gaza and the West Bank, as well as its own staff. Therefore, Doctors of the World is calling on States with influence over the parties to the conflict to take concrete actions, beyond mere condemnation, to ensure an immediate and permanent ceasefire, at-scale, and unimpeded humanitarian access, and respect for international humanitarian law across the entire Occupied Palestinian Territory.

About Doctors of the World in Palestine

Doctors of the World has been working in the Occupied Palestinian Territory since 1994. In the Gaza Strip, Doctors of the World is currently providing an emergency medical response to address the health needs of the population amid the destruction of healthcare infrastructure, shortages of water, food, and medical supplies, and dire conditions of displacement, which have had a severe impact on health and have increased the risk of epidemics. Doctors of the World is directly operating four primary healthcare centres and is supporting nine medical points operated by local Palestinian partners, providing primary healthcare, sexual and reproductive healthcare, mental health and psychosocial support (MHPSS), nutrition, vaccines, and basic emergency responses such as wound dressing.

In the West Bank, Doctors of the World is providing MHPSS emergency response services to Palestinian victims of the occupation violence. The organisation is operating a mobile medical clinic to improve access to health for vulnerable populations. Doctors of the World is also reinforcing the healthcare capacities of ten primary healthcare clinics, by providing emergency stocks, setting up emergency rooms, and building local capacity.

The obstruction to our operations presented in this report have been further heightened by the restrictions imposed by the Israeli authorities on access by humanitarian workers to the Occupied Palestinian Territory. All INGOs working in the Occupied Palestinian Territory are experiencing restrictions on access imposed by the Israeli authorities on the entry of expatriates into the country and access to different areas of the Occupied Palestinian Territory by national staff. Since 7 October 2023, Israeli authorities have no longer renewed work visas for international staff or permits for national staff, rendering access to the country extremely difficult and submitting staff to potential arbitrary refusals at the border. Between October 2023 and September 2024, two Doctors of the World’s humanitarian workers were refused access at the border and two others were arbitrarily issued tourist visas for only one week. Many expatriate staff are forced to work from outside the country due to this restricted access for humanitarian workers to the Occupied Palestinian Territory.

References

¹  Geneva Conventions Common Article 3, Additional Protocol I Articles 70-73.

²  Fourth Geneva Convention, Article 55, 58.

³  As of 12 September 2024, out of 14,510 patients for whom medical evacuation had been requested since October 2023, only 5,130 (35%) had been evacuated abroad, and only 219 patients had been allowed to leave Gaza by Israeli authorities since the closure of the Rafah crossing in May 2024 (OCHA).

⁴  On 1 December 2023, the Israeli military produced an interactive grid-based displacement map for Gaza, dividing the Strip into 623 “blocks”. Using this grid, the military began issuing displacement orders to Palestinians in various locations throughout the enclave. This grid has been shown to be imprecise, inconsistent, and sometimes contradictory, disorientating civilians and creating panic. (See Forensic Architecture, Humanitarian violence in Gaza, 14 March 2024).

⁵  INGOs operating in Gaza have consistently reported precise examples of the obstruction of aid since July 2024 (Humanitarian Snapshot of 15 July 2024; Humanitarian Snapshot of 30 July, Humanitarian Snapshot of 13 August, Humanitarian Snapshot of 30 August, Humanitarian Snapshot of 10 September).

⁶  Coordinating humanitarian movements with the Israeli authorities consists in giving the reason for the movement and the departure and arrival times, but also the times of each stop (including in the case of Doctors of the World, 15 stops to pick up humanitarian workers), the GPS position of each stop, the identity numbers of the drivers and of each person in the vehicle, and the satellite photo of the route. It is necessary to await the response and if the outcome is negative to suggest an alternative approach in hopes of obtaining validation from the Israeli military authorities.

⁷  In June 2024, Doctors of the World published a case study examining how Israeli military barriers are imposing a stranglehold on Palestinian villagers’ access to healthcare. Doctors of the World, Locked Out of Health, 6 June 2024, accessible at: West Bank: Locked out of health – Médecins du Monde (medecinsdumonde.org)

Lebanon: Doctors of the World responds to the escalation of violence

The escalation of attacks in Lebanon over recent days threatens to plunge the country into a humanitarian crisis, worsening an already fragile situation. Doctors of the World is calling for an immediate de-escalation and is responding to the emergency to protect and assist those affected.

In the past few days, several Israeli strikes on Beirut and southern Lebanon have resulted in 569 deaths, including 94 women and 50 children, and 1,835 injuries. This situation exacerbates the humanitarian challenges Lebanon is already facing, particularly concerning healthcare, access to water, food security, and shelter.

Doctors of the World teams are witnessing significant population displacement as people flee the bombings in the south of the country. This poses a major risk to the health of those forced to interrupt their treatment. Furthermore, these displacements are also putting pressure on the healthcare system, as emergency facilities become overwhelmed.

“We are deeply concerned by the ongoing escalation in the region. We are seeing the same modus operandi as in Gaza: international humanitarian law is not being respected. Strikes are preceded by messages on social media, often vague and leaving too little time for people to seek safety. This situation is unacceptable and endangers thousands of civilian lives.” Jean-François Corty, President of Doctors of the World France

We remind all parties that international humanitarian law protects civilians in conflicts and must be upheld. The distinction between civilians and fighting forces is paramount, and all necessary precautions must be taken to ensure civilian safety. We call on all sides to protect people and healthcare facilities, including medical and humanitarian staff, who are vital in addressing the health needs of the injured and displaced.

In this context, Doctors of the World is mobilising our resources to meet urgent needs. Our teams are ready to provide medical care through mobile units, travelling to the hardest-hit areas and assisting displaced populations. Doctors of the World is also supporting the Lebanese healthcare system. We are working closely with the Ministry of Health to assess needs and provide essential medical supplies and medicines to cope with the influx of patients.

We are also strengthening our partnerships to ensure the continuity of essential healthcare services. The escalation of violence in Lebanon is directly linked to the ongoing conflict in Gaza, and we stress that an immediate and lasting ceasefire is a matter of urgent necessity for both the Palestinians in Gaza and the Lebanese people today.

What has happened in Lebanon?

In recent days, Lebanon has witnessed an escalation of violence marked by intensified airstrikes in the south by the Israeli army and retaliatory fire from Hezbollah on 14 and 15 September.

On 17 and 18 September, two waves of attacks occurred, involving the detonation of portable devices, resulting in over 3,000 injuries and 37 deaths. A targeted attack in Dahye, in Beirut’s southern suburbs, killed 16 Hezbollah members and 35 civilians.

On 21 and 22 September, intense airstrikes hit around 100 sites, causing 492 deaths, including 35 children and 58 women, as well as 1,645 injuries.

A new strike targeted Dahye on 23 September.

Doctors of the World in Lebanon

Doctors of the World has been present in Lebanon since 1990. Our teams, consisting of around 100 people across the country, provide primary healthcare in 9 primary healthcare centres. We also run mental health and support programmes for both refugee and Lebanese populations. Collaboration with local partners ensures access to healthcare and medicines.

Photo copyright © A.Finistre

Polio outbreak in Gaza: Vaccination campaign

The health situation in Gaza continues to worsen. With forced evacuations increasing since mid-August, a case of poliovirus has been detected – the first in 25 years. 640,000 Gazans between the ages of 6 months and 10 years must be vaccinated as quickly as possible. Doctors of the World is leading an emergency response.

Polio is an extremely contagious viral infection, often linked to a lack of clean water and poor sanitation, which can cause paralysis in children and death.

Doctors of the World have carried out over 3,500 vaccinations against type 1 and 3 polio, diphtheria, and tetanus, since May 2024. Vaccinations against type 2 polio began this week. Our teams were able to vaccinate 1,610 children in a single day.

On Sunday, Israel implemented humanitarian pauses to launch a vaccination campaign. While these pauses do allow vaccinations to happen, they are insufficient to fully protect the Gazan population.

The shortage of medical supplies threatens to halt essential services (emergency care, surgeries, intensive care…), endangering the lives of patients and the wounded.

A lasting ceasefire is the one and only solution. 

Mpox: Doctors of the World Takes Action Against the Virus’ Resurgence

Since September 2023, the Democratic Republic of Congo has been at the epicenter of an Mpox outbreak, which the WHO declared a ‘public health emergency of international concern’ on August 14. Doctors of the World, having been alerted to the situation, was already in the area and promptly began their response efforts. Our urgent priorities include a comprehensive strategy that combines both curative and preventive measures.

South Kivu has faced a severe Mpox epidemic, with 3.751 confirmed cases according to regional health authorities. Doctors of the World’s rapid response mission have trained and supported 20 healthcare workers, 65 community workers, and over 350 sex workers. This intervention has enabled to raise awareness among 70,000 people and strengthened the surveillance and the medical response to the epidemic.

‘We are very concerned today because the Mpox virus affects the most vulnerable people first. To save lives, we must act now by vaccinating the population and supporting healthcare systems. Our teams will intervene in 7 key health zones where 86% of cases are concentrated. We will focus on training healthcare workers, enhancing infection prevention and control, supporting psychosocial care and boosting community awareness and surveillance’, affirms Mamadou Kaba Barry, General Coordinator of Doctors of the World in the DRC.

Doctors of the World is already present in six of the seven proposed health zones and collaborates with the local Central Office of the Health Zone. The organization will target the ones where local authorities have already established Mpox treatment centers and will support this existing setup. There, Doctors of the World will be working with people infected by the virus and communities most at risk from Mpox.

In addition to the DRC, Doctors of the World is also active in neighbouring countries, where the epidemic is undergoing the same change in scale: in Cameroon, Burkina Faso, Nigeria and CAR, for example, it is in contact with the Ministries of Health and is already conducting awareness-raising actions. However, the emergence of new clades, coupled with the uncertain availability and high cost of the vaccine, make Mpox a real challenge for already weakened health systems.

On the African continent, taking all strains together, the CDC Africa (African Centre for Disease Control and Prevention) has noted a 160% increase in Mpox cases by the end of July compared to 2023, i.e. almost 19,000 cases and almost seven hundred deaths in thirteen African countries. There is an urgent need for action.

Doctors of the World is therefore calling for all necessary measures to guarantee equitable access to screening, care and vaccines. Health services must be maintained in isolated areas plagued by insecurity. People who are farthest from health facilities must be included in vaccination campaigns. No one should be left out for security, logistical or financial reasons.

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Thumbnail photograph © Alexis Aubin

Press contact

For more information or to arrange an interview: media@doctorsoftheworld.org.uk

Gaza: Humanitarian Operations in a Devastating Landscape

As the humanitarian crisis in Gaza continues to escalate, the situation on the ground remains dire, with millions of Palestinians facing extreme hardship. Doctors of the World has been at the forefront of the emergency response, providing critical medical and mental health support services despite overwhelming challenges.

Current Situation in Gaza

The humanitarian landscape in Gaza has reached a breaking point. A staggering 83% of the Gaza Strip is now subject to so-called “evacuation orders” or has been designated as “no-go zones” by Israeli forces. This effectively means that Gaza’s 2.1 million residents are expected to seek refuge in a mere 17% of the territory—a task that is both logistically and humanely impossible.

The harsh living conditions are exacerbated by severe food insecurity, with nearly half a million people facing catastrophic levels of hunger. Water availability has plummeted by 94% since October 2023, leaving families without access to this most basic necessity. The recent Israeli airstrike on a school in Deir al-Balah on July 27, which claimed the lives of at least 30 people, including children, is just one tragic example of the relentless violence that has devastated civilian life. This school also housed one of Gaza’s primary mental health service providers, a critical resource that has now been lost.

Humanitarian Access Constraints

Humanitarian efforts are severely hampered by numerous access constraints. The Israeli blockade, in place since October 9, 2023, has resulted in acute shortages of essential supplies, including fuel and medical equipment. The ongoing military operations, including attacks on designated “humanitarian zones,” have further complicated aid delivery. Border closures and movement restrictions add another layer of difficulty, while the breakdown of public order increases the risk of looting, making aid distribution perilous.

Key Figures as of July 2024

• 39,145 reported fatalities
• 90,257 reported injuries
• Around 1.9 million internally displaced persons (90% of Gaza)
• 16 hospitals are partially functional out of 36
• 48 primary health care centers are functional out of 107

Doctors of the World: Our Humanitarian Response

In the face of these overwhelming challenges, Doctors of the World remains steadfast in our commitment to providing aid to the people of Gaza. Since the beginning of our emergency response, we have delivered 98,817 consultations across eight operational medical points, with a ninth point expected to open soon.

Our teams, composed of experienced managers, medical professionals, and mental health specialists, are working tirelessly to implement our programs with the highest standards of care, despite the risks and constraints.

Our teams were forced to relocate from Rafah to Dar el Balah due to successive evacuation orders. As hostilities draw nearer, the risk of further displacement looms large, threatening the continuity of our operations. The severe shortage of fuel, medical supplies, and equipment continues to threaten the functioning of the few remaining health facilities. Movement restrictions, particularly since the closure of Rafah, only make things worse.

Our Commitment

Despite these immense challenges, Doctors of the World’s 78 staff members, alongside our network, remain dedicated to delivering critical healthcare and support to the people of Gaza. We will continue to adapt and respond to the evolving situation.

The situation in Gaza is a humanitarian catastrophe that demands urgent and sustained international attention. We call on the global community to support our efforts in advocating for a permanent ceasefire, for unhindered humanitarian access, and for justice.

Doctors of the World statement on High Court case on the use of military site as asylum accommodation.  

Today the High Court will hear a challenge, taken by four people seeking asylum in the UK who have been accommodated in RAF Wethersfield, to Home Secretary’s use of the controversial military site as asylum accommodation.   

The case presents evidence that individuals who are vulnerable, including victims of torture and modern slavery and individuals with significant mental health conditions, are accommodated at the site. The Claimants argue the Home Secretary failed to provide dignified standard of living and that the conditions and regime at Wethersfield are discriminatory and create a real risk of a breach of the European Convention on Human Rights. They also argue the Home Office does not operate an adequate screening system to identify individuals who are unsuitable to be accommodated at a military site.  

Doctors of the World have provided witness statements, based on our experience of delivering medical care to people accommodated in Wethersfield, to assist the court in this case.  

Doctors of the World run a mobile clinic service outside Wethersfield and have provided consultations to over 200 people accommodated in the site, in partnership with Médecins Sans Frontières. Our medical teams have witnessed a mental health crisis unfolding at the site, with 3 in 4 patients presenting with severe psychological distress and 40 percent experiencing suicidal ideation.  

We have also observed a range of safeguarding failures. 75% of patients accessing our clinic were extremely vulnerable or had serious health needs which made them unsuitable for the site according to the Home Office’s own policy. Our attempts to flag people who are at high risk of harm and need to be removed from the site are often not acted upon.  

Anna Miller, Head of Policy and Advocacy, said:  

“Wethersfield is an inappropriate place to put people arriving in the UK in search of protection. The patients we have seen are from countries affected by war or conflict, and almost two thirds have experienced violence or abuse, in some cases torture, trafficking or sexual violence. We can all understand why Wethersfield – which feels like a military prison – is not what people in this situation need to recover.

Witnessing a mental health crisis unfolding at Wethersfield, our doctors have documented the profound impact that the site has on the health of people accommodated there. It’s not surprising that post-traumatic stress disorder and depressive symptoms are the conditions our doctors diagnose most often, but we are also observing alarmingly high levels of suicidal ideation in patients, which aligns with Home Office data showing self-harm and suicide attempts at the site are commonplace.” 

For press inquiries: media@doctorsoftheworld.org.uk

As Israeli attacks on Gaza intensify, Doctors of the World and 12 other INGOs disclose details of aid obstruction impeding their humanitarian operations 

In the past weeks, the Israeli military operation in the Gaza Strip has dramatically escalated, driving the enclave into even deeper levels of devastation. The targeting of a UN school used as a shelter in Nuseirat yesterday, as well as the massacres of Al Mawasi in the so-called “safe zone” and Al Shati in Gaza City on 13 July are the latest attacks against civilians amid an intensification of Israeli bombardments on heavily populated areas. The Israeli army issued new so-called “evacuation orders” against Khan Yunis and Gaza City, triggering additional mass forcible transfers and further squeezing Palestinians into smaller, overcrowded areas that lack the resources to support human life. As a result, the humanitarian catastrophe continues to deepen while obstacles for aid delivery remain dire.

These recent developments exacerbate the humanitarian catastrophe while aid organisations continue to face dire obstacles imposed by the continuation of Israeli military operations on the ground. In the “Gaza Humanitarian Snapshot”, 13 INGOs provide an accurate picture of the immense challenges that impede our humanitarian response in Gaza.

NGOs report that the entry of aid into Gaza has severely deteriorated since the Israeli major ground incursion into Rafah in early May. The southern crossings are either fully closed or logistically unavailable due to the deterioration of security conditions. MSF, NRC, PUI, Doctors of the World (MDM), MC, SC, CARE, HI, and ActionAid report that tons of critically needed aid, intended to be delivered through the southern route, have been stuck for weeks, sometimes months. Aid delivery throughout the North remains limited: while channelling goods from Amman to North Gaza should not take more than 6 hours, it took Oxfam five weeks to enter 1,600 food parcels in North Gaza.

With alarming examples, we explain how our movement to reach those in need inside the Gaza strip is unsafe and restricted: military checks of humanitarian staff screened via cameras or drones at Israeli checkpoints, requirements to notify the Israeli authorities of their movements even within so-called “humanitarian zones”, or staff forced to use donkey carts due to the lack of fuel.

Our concerns for the lives of our staff continue to grow, as their security cannot even be guaranteed within our humanitarian premises. The recent killing of an HI staff and the obligation for Doctors of the World and MSF to leave health facilities due to Israeli attacks and so-called “evacuation orders” are recent examples of the absence of respect for parties to conflict’s responsibilities of ensuring the protection of humanitarians.

After 9 months of a destructive war, it is extremely urgent that the UK and other Third States acknowledge their failure to abide by their obligations to ensure respect for IHL in Gaza, and consider exerting genuine pressure on parties to reach an immediate and lasting ceasefire, the only way to provide humanitarian assistance and protect and save lives in Gaza.

Stripped naked and beaten while police set belongings on fire: Extreme violence against refugees at the Croatian-Bosnian border 

After five years of providing mental health support to refugees at the border between Croatia and Bosnia, Doctors of the World has drawn a grim conclusion: “Under the guise of efficient border policy, Europe turns a blind eye to the lifelong trauma inflicted on children, women, and men. The new migration pact threatens to worsen the situation even further.” 

From 2019 to 2024, Doctors of the World provided mental health support to refugees and migrants temporarily residing in camps in Sarajevo and at the Bosnia-Herzegovina border. Most of these individuals eventually attempt to travel through Croatia to reach Europe. 

It is during this crossing between Bosnia and Croatia that moral compasses and human rights seem to be completely disregarded: “Men, children, and women are stripped naked and pushed into ice-cold water. Their teeth and feet are broken, their clothes and belongings are confiscated or set on fire, and pregnant women are beaten.” 

Every day, our psychologists treated people in and outside the Bosnian reception camps who had experienced traumatic pushbacks. Data shows that these pushbacks are widespread: it is estimated that between 2020 and 2023, more than 25,000 violent pushbacks occurred at the Bosnia-Croatia border. In 90% of these cases, violence was reported, including beatings with sticks, threats with guns, rubber bullet shots, punches, exposure to cold and water, strip searches, and confiscation or destruction of personal belongings. 

Trauma Upon Trauma 

Currently, 65% of the refugees in Bosnia come from Syria, Iran, or Afghanistan: “These are people fleeing violent regimes. The violence they experience here adds to the psychological suffering they have already endured in their home countries and on their journey.” 

The combination of these multiple traumas, poor living conditions, and uncertainty leaves deep scars, as shown by Doctors of the World’s data: “Over the past four years, 32,000 people came through our mental health projects in Bosnia. Among them, anxiety disorders (32%), depressive symptoms (21%), and severe sleep problems (20%) were the most common. 7% reported suffering from suicidal thoughts or excessive use of medication or drugs.” 

New Migration Pact: A New Blow to Refugees 

Despite numerous reports of human rights violations, Europe not only continues to systematically ignore human suffering but goes a step further: “The new migration pact, approved last December, doubles down on drones, barbed wire, border patrols, and detention centers. Meanwhile, there are insufficient guarantees for monitoring and safeguarding human rights.” 

After five years, Doctors of the World is leaving the project due to a lack of funding, which means they can no longer provide nor guarantee the same high-quality mental health care. The humanitarian organization remains active in other European migration hotspots in Croatia, Greece, France, Italy, Spain, and England. 

A Grim Future for Refugees 

Doctors of the World’s withdrawal from the Bosnian project marks a significant setback for the refugees who relied on their support for trauma recovery and healing. As Europe continues to prioritize border control over human rights, the physical and psychological well-being of refugees remains at grave risk. The new EU migration pact, with its focus on surveillance and the criminalisation of refugees, threatens to exacerbate the already dire situation at Europe’s borders and the slow collapse of human rights protections. 

[photo credit: ©Olivier Papegnies] 

Your questions answered by Dr Mohammed Shaheen, Mental Health Doctor in Gaza

Mohammed Shaheen is a mental health doctor with Doctors of the World in Gaza. For the past seven months, he has lived in fear: will his children still be alive tomorrow? Where will the next strike fall? Now a refugee in the Middle Area, he continues his mission to help the population and bears witness to the horror people experience every day.

HAVE YOU HAD TO FLEE RAFAH SINCE THE BEGINNING OF THE ISRAELI MILITARY OPERATIONS? 

No, not me. But before that, I had to move twice. During the evacuation of Khan Younis 4 or 5 months ago, I had to leave the area where I was living for Rafah. Then in February, when the airstrikes started in eastern Rafah, I moved to the Middle Area, to Deir el-Balah where I now live. I am with my wife, my three children, my mother, my two younger brothers, and my little sister.

HOW LONG HAVE YOU BEEN WORKING FOR DOCTORS OF THE WORLD? 

I have been working for Doctors of the World since 2022, it will soon be two years. I am a general practitioner with a master’s degree in mental health. I studied the integration of mental health into general healthcare services, which is why I started working with Doctors of the World as a mental health doctor. This was in Gaza City, in our office which is now destroyed. We provided psychosocial services and support to institutions across the Gaza Strip.

Our work is not about treating headaches or physical conditions, while ignoring patients’ mental health.

WHAT MEDICAL SERVICES DOES DOCTORS OF THE WORLD PROVIDE IN GAZA TODAY? 

Everything has destroyed since the beginning of the war. There is no healthcare system left in Gaza, not enough medical services, medicines, or even places to give consultations and distribute medicines, no emergency services to help people. Doctors of the World started setting up medical points in Rafah in late January. Initially, we mainly provided emergency primary healthcare. Then we added sexual and reproductive health services, maternal and children health, and mental health support, meaning psychological consultations in individual or group sessions at each medical point. This way, we can care for patients who need mental health interventions or refer them elsewhere in Gaza. For this, we coordinate with other organisations or clinics from the Ministry of Health. But since May, everyone is fleeing Rafah too, so we have launched a new medical point in the Middle Area where we provide the same health services. With the evacuation of Rafah, we had to adapt to intervene where there are the most people, the most needs, to respond as best as we can.

HOW DO YOU MANAGE TO FIND MEDICAL SUPPLIES? 

The security situation is dire in Gaza. If people are suffering, we – as an international organisation offering health services and psychological support – also suffer from the insecurity. We have donations from the WHO, for example, and Doctors of the World has also been able to transport medicines to Gaza. But our stock was stolen from our office in Rafah. We are trying to manage the shortage and replenish our stock from other international organisations. But so far, we manage to meet the needs of the people who come to us.

WHAT ARE THE NEEDS OF THESE PEOPLE AND WHAT CAN YOU DO FOR THEM? 

My colleagues in the mental health service are psychologists and mental health workers who provide direct care to patients, organising support and counselling sessions, mental health interventions ranging from psychoeducation to advanced interventions for people who are stressed, depressed, severely suffering from psychosis due to their current living conditions. As a mental health doctor, I oversee the integration of mental health services with doctors, nurses, and psychologists. I help them identify mental health needs during medical exams, refer the most critical patients who need regular follow-up or medications that we do not have in stock to suitable facilities. We also produce training materials for medical staff to respond to this crisis, not only for Doctors of the World but also for other organisations in Gaza, to teach them how to address mental health needs. It is not about treating headaches or physical conditions, while ignoring patients’ mental health. We need to address it.

WHAT ARE THE MOST COMMON CASES YOU ENCOUNTER? 

There are many stress and grief-related disorders. These are normal reactions that become abnormal in certain situations. Like in Gaza, where the violence has been ongoing for too long. It is not just the grief of losing loved ones. It is the pain of losing children, homes, jobs. Everyone in Gaza today suffers from abnormal grief.

Stress symptoms reach extreme levels. We are starting to diagnose multi-traumatic stress disorders. Every day, we encounter significant stress cases, patients suffering from psychomotor agitation, patients with chronic mental disorders, psychotic patients, epileptic patients who need treatments that are unavailable due to shortages. Sometimes we are forced to change the treatment of these people, start from scratch with a new medication while they were being effectively treated for years and their condition was under control. Suddenly they collapse, and we have to find another medication, monitor this treatment, and watch for side effects.

And above all, there is depression. It is everywhere in Gaza at the moment. More than one in five patients we receive has mental disorders. We need to identify these patients and do our best for them. Thanks to our psychologists, we can offer psychological consultations, support sessions, or start short therapy, and prescribe medications. But I assure you there is a real shortage of mental health services in Gaza, and medical services in general. We need enormous help to overcome this situation.

We pray and hope that the fires will cease, that the deaths with stop, that the destruction of what remains will end.

HOW MANY PATIENTS DO YOU SEE EACH DAY? 

When we started with two medical points in Rafah, we could receive 600 to 700 patients per day.

HOW DO YOU MANAGE TO WORK UNDER THESE CONDITIONS, DESPITE THE INSECURITY AFFECTING YOU AS WELL? 

What I want to say here is that even our team suffers from multiple traumas every day. Many of us have lost a loved one, a friend, a family member, we all have lost our homes. And the severe repeated trauma we endure is having to regularly flee from one place to another. Over the past eight months, some of my colleagues have had to move five or six times. So yes, we do our best to help people. We suffer, but we can still help others. We understand what they are going through because we are going through the same thing. We understand their situation, and sometimes this helps to find solutions together. Daily solutions: how to find food, transportation, solve overcrowding problems, hygiene issues, pests that proliferate because there is no wastewater treatment. But we also need help. Our team needs help.

WHAT IS THE CURRENT HEALTH SITUATION IN THE MIDDLE AREA? 

When the Israeli army ordered the evacuation of Rafah, people fled to Deir el-Balah. There is only about fifteen kilometers between Rafah and the Middle Area, but the only road considered safe is the one along the sea, and it is completely packed with cars and carts. It takes two hours to make the journey. The Middle Area has started to become overcrowded. However, the wastewater treatment system, which runs on diesel or fuel, cannot pump the water to the sea due to shortages. The streets are full of sewage. We expect to see outbreaks of diseases, cases of hepatitis A, infectious diseases, skin diseases. Hepatitis A cases, for example, were common among our patients in Rafah. We distributed hygiene guidelines on how to care for the sick, how to break the chain of infection. I believe we will soon have the same cases in the Middle Area because of overcrowding, tent life, and close quarters in the camps.

IS THE MIDDLE AREA STILL THE SAFEST PLACE IN GAZA TODAY? 

According to the evacuation order of Rafah given by the Israeli army, yes, it is the safest area. In reality, we still face indiscriminate bombings, especially in eastern Deir el-Balah. And nothing is entering Gaza. No food, no medicines, no tents. The shortages of everything are starting again. The price of food doubles or triples. Due to the fuel shortage, for example, bakeries cannot operate, and it is impossible to find bread. Everything we still find comes from supplies that entered Gaza in the past months. At the Deir el-Balah market, you will find canned food: white beans, fava beans, canned meat. There is a shortage of fresh food, groceries, vegetables, rice, meat, milk, eggs. I have three children, the oldest is six years old. They have not eaten eggs for two months. We are always looking for solutions to feed them. We try to store some beans. We keep a kilo of rice. But we expect the worst because there is no solution. So many things have been tried. We are losing hope. It is like an infectious disease, everyone in Gaza is losing hope. The Middle Area is not suited for such an influx of population. There is no drinkable water. Even the saltwater used for some hygiene needs, hand washing, and showers is not enough given the number of people in the area. It arrives in homes about once a week to fill containers. People fight for this water. If you can afford to buy it, a thousand liters will cost you 100 shekels, about 25 euros.

WHAT DO THE PEOPLE OF GAZA HOPE FOR TODAY? 

We do not look too far ahead. We try to see the days to come. We pray and hope that the fire will cease, that the deaths will stop, that the destruction of what remains will end. These days, we do not have much faith in the future. We all plan to leave Gaza. Maybe not now, maybe tomorrow, later, in years. Because the lesser destruction caused by previous military escalations ten years ago has not yet been repaired. With what is happening today, we expect it will take a hundred years to solve the problems, rebuild people’s lives, repair homes, shelters, sanitation facilities, wastewater treatment. It is going to take a long time. That is why we are losing hope.

We just want the bombings to stop, to be able to walk in the street, not constantly think that we will die in the next five minutes. There is no school for the children. In the camps, people try to gather the children to play with them, to offer them some support or respite. One of our mental health team members participates in this. But I do not want to send my children there. Nowhere is safe. Even the evacuation orders that say one area is safe and another is not. But it is not just a matter of tanks or ground operations. There are airstrikes and bombings that can happen anywhere, anytime. I am sorry to say this, but I would rather die with my children than have one of them die away from me. My father was ill when the Israeli army conducted its operations in Khan Younis. I had to take him to Al-Aqsa hospital in Deir al-Balah. The only doctor who cared for my father, who treated him, who administered his IV, was me. There was no doctor. No medicine. Nothing. He died in three days. This is not my story. This is the story of all families in Gaza.

Mental health crisis unfolds at RAF Wethersfield Mass Containment Site: Doctors of the World and Médecins Sans Frontières call for urgent site closure

Doctors of the World (DOTW) and Médecins Sans Frontières (MSF) are issuing an urgent call to the UK government to close RAF Wethersfield, a former RAF barracks turned mass asylum containment site, due to severe mental health crises among people accommodated at the site.  

Since November 2023, Doctors of the World, in partnership with Médecins Sans Frontières UK, has been providing medical services to people held at Wethersfield through a mobile clinic stationed outside the site. The men held at Wethersfield are 18 to 65 years old, and often Afghan, Iranian, Syrian, Eritrean, Iraqi or Sudanese. 

The report, based on medical data and observations, highlights the profound impact of the UK government’s mass containment site policy on the health, wellbeing, and dignity of individuals seeking safety, and documents the government’s failure to apply its own policy to protect people with serious physical and mental health needs. Key revelations from the briefing include: 

Men are experiencing mental health crises

Over 74% of individuals accessing medical services at Wethersfield presented with severe psychological distress, with a staggering 41% experiencing suicidal ideation, as well as deliberate self-harm and suicide attempts. The prevalent diagnoses include post-traumatic stress disorder (PTSD) and depressive symptoms. 68% of people accessing the DOTW-MSF medical service had previous experience of violence or abuse. 

Prison-like conditions exacerbate mental health issues

People describe the site as reminiscent of a prison, with limited control over their environment and constant feelings of insecurity. Overcrowding, lack of privacy, and absence of agency contribute to a sense of hopelessness and despair among people, many of whom have endured trauma and violence in their countries of origin and during their migration journeys. 

Protection failures

Recognising sites like Wethersfield are not suitable for those with “the most serious physical and mental health needs,” the Home Office has a policy to screen people before placing them in containment sites. The report reveals that 75% of people accessing the DOTW-MSF medical services were not suitable, under the policy, to be placed at Wethersfield.  

A health service has been commissioned to provide assessments and primary healthcare appointments on weekdays, however there are not sufficient or appropriate services onsite to meet the complex health needs of people at Wethersfield, including a lack of easily accessible therapeutic services for the high level of people with severe mental health needs such as PTSD.  This means emergency and ambulance service are called regularly and people come to the DOTW-MSF service seeking further help.   

Dr. Kate Morgan, clinician, expressed grave concern over the situation, stating, “The men express a constant desire for community, but the nature and design of this site prohibits this possibility. Our patients come to us seeking help and support because this place is unsuitable for healing and good mental health.”

The report underscores the urgent need for a paradigm shift in asylum policy, on medical grounds, emphasising the importance of dignified, community-based accommodation and comprehensive healthcare services. 

Anna Miller, Head of Advocacy and Policy at Doctors of the World, stated, “RAF Wethersfield, like all mass containment sites, is not a place of safety or recovery. It perpetuates harm and trauma, exacerbating people’s mental health conditions. It is imperative that the UK government closes RAF Wethersfield and ends the policy of using mass containment sites.” 

Calls to the UK Government

In response to these alarming findings, DOTW UK and MSF call upon the UK Government to take immediate action: 

• Close RAF Wethersfield: The site must be shut down without delay to prevent further harm to people and uphold their basic human rights. 
• End Mass Containment: The policy of using mass containment sites to accommodate people seeking asylum is fundamentally flawed and must be abandoned in favour of community-based solutions. 
• Ensure Access to Care: People seeking asylum should have access to protection and necessary and appropriate physical and psychological healthcare. 
• Abandon the Illegal Migration Act and Safety of Rwanda (Asylum and Immigration) Act and allow people arriving in the UK to access the asylum system.  

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For media inquiries, please contact: Melanie Delaroche, Doctors of the World Communications and Engagement Manager mdelaroche@doctorsoftheworld.org.uk   

About Doctors of the World (DOTW) 

Doctors of the World fights to defend a fair and universal health system and provides emergency and long-term medical care to people in crisis around the world. Doctors of the World has over fifteen years of experience in providing support to those most vulnerable to healthcare denial and exclusion, including refugees, asylum seekers and migrants in the UK. 

About Médecins Sans Frontières (MSF) 

Médecins Sans Frontières is an international, independent medical humanitarian organisation providing medical and humanitarian assistance to people affected by conflict, violence, epidemics, or excluded from healthcare. MSF has a long history of providing support to people who have been forcibly displaced seeking safety, protection and healthcare including those within Europe. 

World leaders fail to act as Israeli invasion of Rafah worsens humanitarian catastrophe

Photo ©Mohammed Zaanoun

Despite repeated calls on Israel from heads of state, UN officials and humanitarian NGOs to refrain from expanding its ground offensive to Rafah, Israeli troops entered the governorate on May 7. Over 1.5 million people, including 600,000 children, are at serious risk; more than 450,000 Palestinians have fled Rafah since Israel first issued unlawful “evacuation orders” there on May 6. While the Israeli army has already taken control of urban areas inside Rafah, the issuance of new “evacuation orders” on May 11 is setting the stage for further advancement of the military invasion, which will lead to the total collapse of lifesaving services. The Israeli military offensive has interrupted the access of aid to Gaza through Rafah and Kerem Shalom / Karm Abu Salem crossings.

Third States have the responsibility to urgently act in bringing to an end, and pursue accountability for, the Grave Breaches of IHL taking place in Gaza. The first step for Third States in upholding their own legal obligations to ensure IHL is respected is to stop the Rafah invasion, open all land crossings and lift internal barriers for humanitarian access. As the main weapon provider for Israel’s military effort, the United States bears a significant responsibility for Israel’s IHL violations. In addition to halting the transfer of high payload bombs, the US should also use all its leverage to halt the ongoing military operation in Rafah. In fact, all suppliers of arms have to respect the Human Rights Council resolution voted on April 5 calling on them to cease the sale, transfer and diversion of arms, munitions and other military equipment to Israel. All states must act now to ensure an immediate and sustained ceasefire.

The Israeli military’s “evacuation orders” are unlawful and amount to forcible transfer, a grave violation of international humanitarian law (IHL). Israel has ordered hundreds of thousands of Palestinians to flee, without providing civilians and humanitarian actors clear information nor timeframe. IHL sets clear conditions for an evacuation to be lawful: the occupying power must ensure that these displacements are temporary and that displaced persons are provided with satisfactory conditions of hygiene, health, safety and nutrition, and members of the same family must not be separated. Israeli authorities have failed to meet any of these requirements. Already burdened by multiple displacements, people in Rafah are yet again being ordered to flee amidst destroyed infrastructure and streets contaminated by unexploded ordnances. Displaced individuals are seeking refuge in the Middle Area, Khan Younis and Al Mawasi despite high levels of destruction and lack all necessities to sustain life. The concept of “humanitarian safe zones” is void as areas previously designated as such have been targeted by bombing and ground operations. While the relentless bombardment persists in Rafah, airstrikes and ground assaults are escalating in the North, leading to additional  forcible displacement in the enclave.

The Israeli military ground invasion of Rafah is disrupting the humanitarian response, in breach of the UN Security Council resolutions 2720 and2728 as well as the International Court of Justice’s provisional measures ordering Israel to enable the provision of basic services and humanitarian assistance. As a result of Israel’s military activity in the northern governorates in previous months, humanitarian actors have been forced to relocate a significant portion of aid capacities to Rafah, including premises and warehouses. The Israeli offensive is now already forcing part of humanitarian staff and operations to close or to relocate again to other areas under extremely dangerous circumstances. Warehouses containing direly needed lifesaving aid in eastern Rafah remain inaccessible due to the presence of Israeli forces. Medical facilities in Rafah are shutting down one after another.¹

Every hour during which Israeli forces occupy the crossings of Rafah and Kerem Shalom / Karm Abu Salem condemns more Palestinians to starvation and denial of medical care. Israeli forces are completely preventing humanitarian aid and staff from using the Rafah crossing. The heavy militarization around the Kerem Shalom / Karm Abu Salem crossing resulting from the Israeli ground invasion does not provide the conditions for sustained movement of humanitarian convoys. These two crossings constitute the main critical lifeline for entry of aid into the enclave: their closures are plunging Gaza into an even larger humanitarian disaster. While the state of famine has been confirmed by the World Food Program in northern Gaza and the health system sinks deeper into collapse, stocks of critical aid provisions, including food, water, fuel and medical supplies are rapidly depleting. This already resulted in the closure of services essential to civilians’ survival². The extremely limited reopening of the northern crossings or the prospect of a maritime route cannot be used as a rationale to justify diminishing access through southern land crossings. 

The depletion of fuel poses a grave risk of halting  humanitarian operations and basic services. The functioning of the whole humanitarian response depends on fuel, including to address priority needs of more than 1.7 million displaced persons. Urgently prioritizing the immediate entry of fuel is crucial to sustain what remains of Gaza’s devastated health system and humanitarian response.³

Signatories:
ActionAid
Action Against Hunger
American Friends Service Committee (AFSC)
Amnesty International
A.M. Qattan Foundation
Anera
Churches for Middle East Peace (CMEP)
DanChurch Aid (DCA)
Humanity & Inclusion/ Handicap International (HI)
IM Swedish Development Partner
INTERSOS
Doctors of the World / Médecins du Monde International Network
Mennonite Central Committee 
Mercy Corps
Norwegian Church Aid (NCA)
Norwegian People’s Aid
Oxfam
Plan International
Relief International
War Child Alliance

1.  Al Najjar hospital, the largest health facility in the governorate, ceased operations as it is located in the area seized by Israeli forces, and Al Kuwaiti hospital is likely to follow as it is now included in the zone threatened by Israeli “evacuation orders”. ↩︎
2.  Eight out of the twelve bakeries of Southern Gaza, while more throughout the enclave are at risk of shutting operations down due to the lack of supplies and fuel. Medical evacuations have abruptly halted, directly condemning critical patients, including children, to death. ↩︎
3. Of particular concern, at least 10 hospitals, 8 bakeries, 28 ambulances, 23 medical points and 17 primary health care centers could stop operating if fuel is not urgently allowed in the enclave. The lives of babies in intensive care, women with complicated pregnancies and births and trauma patients are hanging in the balance.The dire lack of fuel also endangers telecommunication, which is already negatively impacting humanitarian operations in Gaza. ↩︎