[Photo: MSF]

The situation in the occupied Palestinian territories, particularly in Gaza, continues to deteriorate despite ceasefire talks. Medical facilities like Nasser Hospital in Khan Younis struggle to provide care due to power outages and infrastructure failures, leaving over 120 patients needing evacuation.

The Israeli military’s obstruction of medical evacuation efforts, along with restrictions on humanitarian aid, exacerbates the crisis, violating provisional measures issued by the International Court of Justice (ICJ).

Medical charity MSF Security general Christopher Lockyear has warned the UN about Gaza’s children preferring death over witnessing war horrors. He said, “For 138 days, we have watched the systematic obliteration of a health system we have supported for decades”.

He also highlighted the systematic destruction of the health system. Recent attacks on MSF staff and facilities raise concerns about intentional targeting.

He said that just days ago, MSF staff and families faced a tragic attack “in a place they were assured they would be protected”.

Speaking to Radio Islam, MSF Southern Africa’s executive director, Andrew Mews, shares insight into the deteriorating healthcare and humanitarian situation in the Occupied Palestinian Territories (OPT).

Mews emphasised the harsh reality that the healthcare system in Gaza is currently teetering on the brink of collapse.

“In almost 20 years of working in the humanitarian sector and working in a number of conflict zones, what is happening on the ground in Palestine is shocking and nothing like I have experienced before,” he said.

MSF expresses significant concern regarding the increasing number of women resorting to giving birth at home, and amidst widespread displacement, this often entails childbirth taking place in schools and makeshift tents.

“If you are a pregnant woman now in Gaza, your ability to give birth in a facility and receive medical care is almost next to zero,” said Mews.

For over 50 years, MSF has operated in conflict zones and war-torn areas. Mews highlighted that they have very clear rules of engagement in place and protective measures in line with international humanitarian law.

“For instance, we share the GPS coordinates of our hospitals, houses, and medical facilities where we stay and work and mark our residences and clinics with enormous MSF flags. We also inform all sides of the conflict of any of our movements around the Gaza Strip. We are open and transparent about what we do, but despite that, we have been a victim of a number of attacks, which is as a result of extreme negligence and incompetence or worryingly a targeted attack,” he said.

Mews said that working in a conflict is hard enough, but even war has rules, and they are currently not being followed.

According to international law, hospitals are designated as protected spaces, and any party involved in a conflict is strictly prohibited from targeting them unless they can unequivocally demonstrate that the hospital has lost its protected status and qualifies as a legitimate military target.

“Everything we have seen on the ground has shown a very low level of evidence that hospitals have been used by either side to get around the rules of war. But we see systematic targeting shutting down healthcare facilities, making it more difficult to deliver lifesaving care across the Gaza Strip,” said Mews.

Due to the shortage of potable water and the lack of delivery rooms and immunization, MSF is deeply concerned about potential disease outbreaks.

Mews said that the health care system is dysfunctional and certainly not the safe, protective space that is expected when working in a war zone.

Should the potential ground invasion in Rafah happen, MSF is extremely concerned about the humanitarian situation. “If Rafah, which has been one of the safer parts of the Gaza Strip over the last few months, is attacked, then there is nowhere to go and nowhere to hide. Apocalyptic is not too strong a word to say when you have so many people already living in desperate, dire conditions with no access to basic access to food, water and sanitation. This would result in a humanitarian catastrophe,” he asserted.

Maintaining a clinic sustainably and ensuring uninterrupted access to medical supplies is currently impossible.

“We expect 500 to 1000 trucks of humanitarian aid per day to be crossing the border, but we are not even at 10% of that,” he said.

The psychological trauma experienced by the majority of children in the Gaza Strip is beyond imagination. In response, MSF offers both on-the-ground and online psychosocial support to aid workers and residents.

“We have seen MSF tank shells fired into our clinics and our MSF ambulance bulldozed; there is no space in Gaza at all. Everyone living and working in Gaza is currently facing this,” he added.

Mews reiterated the magnitude of the violence continues to shock everyone daily, highlighting the urgent need for intervention and resolution

“Very sadly, there is a new medical acronym that is now being written on patient charts, which is WCNSF; this has become shorthand by the doctors and nurses treating people, which says ‘wounded child, no surviving family’. It is a recognition that not only do we need to treat this child, but we have to find a safe haven after they are discharged because they have no family to go home to. These are stories we don’t hear in other conflicts,” he said.

MSF’s long-term objectives include rehabilitating delivery wards and establishing comprehensive immunization programs to curb the transmission of communicable diseases such as measles. Additionally, there is a pressing need to initiate long-term mental healthcare programs for individuals, particularly children and healthcare workers, who have endured the harrowing experiences of the past few months.

“I would love to say I had an answer to how we can overcome these problems today, but we can see almost 1.7 million are currently displaced from their home, and children are left alone, clearly with the level of mental trauma the entire population has been going through, is going to require a huge investment by the rest of the world to try to pick Gaza back up on its feet once this ends,” said Mews.

MSF calls on the international community to assertively advocate for an immediate ceasefire to facilitate the delivery of humanitarian aid. According to Mews, the people of Gaza, including humanitarian workers, lack safe spaces amidst the ongoing conflict.

LISTEN to the full interview with Muallimah Annisa Essack and MSF Southern Africa’s executive director, Andrew Mews, here.