What is the situation in the town of Rafah?
Crossing Rafah is a striking experience: the city is full of displaced people, the streets are packed, people are building makeshift shelters directly on the footpaths, on roundabouts, in front of shops, while newly displaced people arrive from the north every day. There are throngs of people around bakeries, cash machines and water points - which are in desperately short supply - with crowd movements and, unfortunately, episodes of violence and people fighting. The sound of Israeli drones can be heard constantly. The tension is palpable, and, in the distance, you can see the ongoing bombing of Khan Younis and the columns of smoke billowing from it, while deadly bombardments frequently hit Rafah, particularly at night.
To what extent are hospitals spared from the fighting?
Hospitals are often considered by people to be safer places, despite a number of dramatic episodes around and in some of these hospitals. For example, MSF teams were forced to leave Al-Aqsa hospital, located in the Middle Area of Gaza, on 6 January, following an order from the Israeli armed forces to evacuate the adjacent neighbourhoods. Sniper fire, drone strikes and bombing made the situation untenable. In the south, so far, we see some bombs falling right next to health facilities, with windows being blown out, for example. On 17 December, the maternity ward at Nasser Hospital was hit by gunfire, killing one patient and injuring others. Last week, there was extremely intense bombardment around the European hospital, with one bomb falling every minute for hours on end. They were falling all around the hospital. This makes access extremely difficult and dangerous for Gazans seeking treatment. Last week, around the European hospital, there was extremely intense bombing, with bombs falling every minute for hours. They were falling all around the hospital. Working in such a tense environment is extremely difficult. Many of our staff were also forced to move. For the most part, they have been forced to flee zones of fighting or bombardment. The stress level of our teams is very high. When you spend a night hearing bombs, even if you're not directly affected, you don’tsleep. We work with teams who are often traumatised and, in any case, very affected by the whole situation. From a security point of view, we are at the limits of what we can do. We have given the Israeli forces the coordinates of the health facilities where MSF works and the buildings where the teams are staying, but there is no guarantee that they will not be hit by a bomb or tank fire. On 8 January, an Israeli army shell tore through the building housing around 100 MSF team members and their families in Khan Younis. The shell failed to explode, which would have resulted in real carnage. The daughter of a colleague died as a result of her injuries. She was five years old. Three other colleagues were injured. The town of Rafah is also gradually being squeezed as the Israeli army advances southwards towards the Egyptian border. As a result, the humanitarian space, or quite simply the area where it is possible to move around, is becoming smaller and denser.
What are MSF's activities at Rafah Indonesian field hospital?
We have opened a trauma and burns clinic. We do very few direct admissions and most patients are referred from a hospital. In the vast majority of cases, they have been victims of a bombing, the collapse of a building or the blast of an explosion. They have received first aid, undergone often life-saving operations and now need to be hospitalised for a relatively long time, due to the nature of their wounds and the risk of infection. Some patients have suffered serious fractures, sometimes open fractures, requiring external fixators. Our main task is to prevent their wounds from becoming infected. Without such care, these patients could die. They could develop serious infections that could lead to gangrene, amputations or generalised septicaemia. In addition to their physical injuries, these patients have suffered significant moral trauma. They are staggered by the violence of their injuries and are often in a state of hyper-vigilance. They are worried and shocked and don't speak. We see this in our patients, but also in many people we meet in the street: they are stunned. Many of them have been forced to move several times, to take refuge in a place that has been attacked again. And when they arrive in the far south of Gaza, they find a completely congested city where the atmosphere is heavy with anxiety and fear.