MSF psychologist and translator go meet a patient in Burin village. Some villagors live in remote area and are afraid to leave their house to go to MSF clinics because of settlers attacks.

I run humanitarian operations in Gaza. More aid without a ceasefire isn’t the answer.

The only way to truly save lives in Gaza is to end this extreme violence and the collective punishment of Palestinians.

Jacob Burns
Project coordinator in Gaza MSF

As I type this in the pre-dawn dark of Al-Mawasi—the coastal strip that Israel has designated as the humanitarian zone—I can hear bombs every minute hitting Khan Younis, two miles away in the south of Gaza. The house where I’m staying intermittently shakes with overwhelming force. 

Earlier this week, a team of my colleagues were in Nasser Hospital, where we provide emergency care and surgical treatment, including to patients with traumatic injuries and severe burn injuries. We had been assured by the Israelis that the hospital would not be targeted. Yet, while we were there, leaflets suddenly fell from the sky ordering the immediate evacuation of premises near the hospital, including the road we use to get in and out of the facility. The Israeli army unit that’s supposed to coordinate humanitarian aid was not even aware of the order to evacuate given by combat troops until hours later.

Leaflets suddenly fell from the sky ordering the immediate evacuation of premises near the hospital, including the road we use to get in and out of the facility.

It’s impossible to safely provide the medical aid people desperately need in conditions like these. Hospitals and health care workers should never be a target.

As people have been forced to flee location after location in search of safety in Gaza, many have been left without shelter and are living in terrible conditions. Rafah, the southernmost city in the Strip, is now home to at least 1.2 million people, up from a pre-war population of 300,000. Tents improvised from plastic sheeting line the streets, and the schools are crammed full of people looking for a safe place to sleep. Because there is little or no gas, the land is being stripped of its greenery to feed fires to keep people warm against the winter cold. Clean water and toilets are in short supply, diseases are spreading rapidly due to the crowded conditions and lack of health care services, and food prices have risen to six or seven times their pre-war norm. 

Displaced Palestinian children in a tent in southern Gaza.
Displaced Palestinians in a tent in southern Gaza. Palestine 2023 © Mohammed Abed

Despite these poor living conditions in the south, a steady stream of cars—packed with people and belongings and mattresses strapped to the roofs—have been descending the coastal road following the Israeli military’s order to evacuate parts of central Gaza. These are newly displaced people—another 100,000 already, according to the UN during our morning humanitarian coordination meeting—who will have to try and find somewhere to live in a place where resources are so scarce that aid trucks are being looted every day. 

But the reason why people continue to head south is clear: My MSF colleagues at Al-Aqsa Hospital in the Middle Area received 131 dead and 209 injured people following the Israeli bombing of Al-Maghazi and Al-Bureij refugee camps on the evening of Dec. 24. The images of piles of bodies in white body bags laid out in the hospital courtyard played on a loop in the media. And then the bombing of Khan Younis began again.  

We want to do more to provide aid to people in Gaza, yet the continued bombing and fighting is steadily forcing us into a smaller and smaller corner of the Strip. Conditions here are dire. However, they are not nearly so dire as in those other areas in the north of Gaza that have been cut off from almost all aid for months.

The only way to truly save lives here is for this extreme violence and the collective punishment of Palestinian people to end, and end now.