MSF: The offensive in Gaza City is a death sentence for one million Palestinians

Relentless bombing by the Israeli forces and the advance of the ground offensive are killing hundreds of 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. “Some of our colleagues have been displaced more than eleven times since 2023,” says Jacob Granger, Emergency coordinator for MSF in Gaza. Makeshift shelters offer little safety as bombing continues, often targeting areas to which survivors had already fled. An estimated one million displaced persons now occupy just 15 per cent of Gaza’s territory — conditions worsened by the destruction of almost 90 per cent of water and sanitation systems. “MSF continues to distribute water in the city but, with no water reserves left, if the Israeli forces make drinkable water production and distribution impossible, people will die in a matter of days” says Granger. Outbreaks of disease such as acute diarrhoea are spreading in overcrowded, unsanitary living conditions. 

Health system on the brink

Israel’s offensive is deliberately wrecking Gaza’s healthcare capacity. More than half of the hospitals have been rendered inoperative; those remaining function on the brink of collapse under targeted attacks. Bed occupancy rates reached 300 per cent at Al Ahli hospital, 240 per cent at Shifa hospital and 210 per cent 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 healthcare facilities, while the health authorities report zero stock remaining for over half of essential drugs.

Medical staff have endured repeated raids, 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 forced to evacuate due to hospital closures. People with disabilities, people who are sick or wounded will not be able to evacuate. 

Starvation as a policy

The siege has triggered a famine: restrictions on food, clean water, medicine, and aid deliveries are causing acute malnutrition rates to skyrocket. Civilians desperate for aid at distribution points face deadly force — for months, MSF clinics responded to mass casualties resulting from Israeli fire at the food distribution sites managed by the GHF. 

Ground operations must stop immediately

Israeli forces aim to push Palestinians out of Gaza City through genocide, ethnic cleansing and creating impossible life conditions. 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 use of evacuation orders as a means of forcible displacement, a lasting ceasefire, and the entry of humanitarian aid at scale. We ask for the protection of medical facilities and the coordinated movements of humanitarian actors. The systematic destruction of an entire city and population must end. We call on Israel’s allies to stop arms transfers to Israel immediately and ramp up the pressure to halt the offensive. Without urgent, radical intervention, Gaza faces total annihilation.