Palestinians evacuating Gaza City in a truck. Palestine, 2025. © MSF
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Palestine: The offensive in Gaza City is a death sentence for one million Palestinians

Without urgent, radical intervention, Gaza faces total annihilation.

Gaza City is facing a humanitarian catastrophe as Israel’s latest military assault escalates, pushing people to the brink and threatening the survival of what remains of the health system. Doctors Without Borders/Médecins Sans Frontières (MSF) teams warn it will be impossible to force one million people – including hundreds of critically ill patients and newborn babies – out of Gaza City and into overcrowded and under-resourced areas in the centre and south of the Gaza Strip.  

This would represent 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. This follows pattern of complete destruction previously witnessed by MSF teams in Rafah, in the south of the Gaza strip. 

 “Some of our colleagues have been displaced more than eleven times since 2023,” says Jacob Granger, MSF emergency coordinator in Gaza.  

Makeshift shelters offer little safety as the bombing continues, often targeting areas where survivors had already fled.  

An estimated one million displaced people 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 diarrhea are spreading in overcrowded, unsanitary living conditions.

A man pushes another man in a wheelchair during evacuation efforts in Gaza City. Palestine, 2025. © MSF

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, while those remaining are functioning on the brink of collapse under targeted attacks. Bed occupancy rates reached 300% at Al Ahli hospital, 240% at Shifa hospital and 210% 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. Meanwhile, 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 growing number of wounded people 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.

View of makeshift shelters for displaced Palestinians. Palestine, 2025. © MSF

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 assistance at distribution points face deadly force. For months, MSF clinics have responded to mass casualties resulting from Israeli fire at the food distribution sites managed by the so-called Gaza Humanitarian Foundation (GHF) – the Israeli-US scheme that has militarized aid distribution.

Palestinians evacuating Gaza City in a truck. Palestine, 2025. © MSF

Israel’s ground operations must stop immediately

Israeli forces aim to push Palestinians out of Gaza City through genocide, ethnic cleansing and creating impossible living conditions. Nowhere is safe and the vastly insufficient quantities of aid are being delivered through routes that are extremely dangerous for civilians. The destruction of critical infrastructure is ongoing and deliberate. 

MSF calls for: 

  • An immediate end to evacuation orders used as a tool of forcible displacement, a lasting ceasefire and the unrestricted entry of humanitarian aid at scale; 
  • For the protection of medical facilities and the coordinated movements of humanitarian actors; 
  • An end to the systematic destruction of an entire city and population; 
  • 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.