Leaving Gaza: A Medical Evacuation

• Across our facilities in Gaza last week, 25 per cent of children and pregnant women screened for malnutrition were malnourished.
• What is happening in Gaza is the deliberate starvation of people, manufactured by the Israeli authorities.
• The Israeli authorities must allow food and aid supplies into Gaza at scale.

The Israeli authorities’ deliberate use of starvation as a weapon in Gaza, Palestine, continues, seeing hunger reach unprecedented levels, with patients and healthcare workers themselves now fighting to survive, Médecins Sans Frontières (MSF) warns.

MSF staff are receiving an increasing number of malnourished patients at our clinics, while they themselves struggle to find sufficient food. 

Across screenings of children aged six months to five years old, and of pregnant and breastfeeding women, at MSF facilities last week, 25 per cent were malnourished.

At the MSF clinic in Gaza City, in the north of the Strip, the number of people enrolled for malnutrition treatment has quadrupled since 18 May, while rates of severe malnutrition in children under five have tripled in the last two weeks alone.

This is not just hunger – it is deliberate starvation, manufactured by the Israeli authorities. The weaponisation of food to exert pressure on a civilian population must not be normalised. The Israeli authorities must allow food and aid supplies into Gaza at scale.

“We see the dire consequences of these shortages in Gaza on a daily basis in our clinic,” says Caroline Willemen, project coordinator at the MSF clinic in Gaza City.

“We are now enrolling 25 new patients every single day for malnutrition. We see the exhaustion and the hunger in our own colleagues.”

Meanwhile, hundreds of people seeking desperately needed aid continue to be attacked by Israeli forces and private security contractors at food distribution sites run by the Israeli proxy, the Gaza Humanitarian Foundation (GHF).

“What we are seeing is unconscionable; an entire people being deliberately cut off from food and water, all while the Israeli forces commit daily massacres as people scramble for scraps of food at distribution sites,” says Amande Bazerolle, MSF head of emergency response in Gaza.

“Any shred of humanity in Gaza has been wiped out in the ongoing genocide.”

In the last two months, more than 1,000 people have been killed and over 7,200 injured, according to the Ministry of Health, as they attempted to collect aid, including a large proportion at the distribution sites of the GHF, which is backed and funded by the US government.

Despite these sites being set up to avoid aid diversion, they have done nothing to reduce the existence of looting.

“These food distributions are not humanitarian aid, they are war crimes committed in broad daylight and presented to the world with compassionate language,” says Dr Mohammed Abu Mughaisib, MSF deputy medical coordinator in Gaza.

“Those who go to the Gaza Humanitarian Foundation’s food distributions know that they have the same chance of receiving a sack of flour as they do of leaving with a bullet in their head.”

In addition to people wounded at GHF sites, our teams have treated dozens of patients from recurrent massacres by Israeli forces as people wait for flour from trucks that pass by.

“In the emergency room of Sheikh Radwan clinic a few days ago, dozens of patients came in, both dead and wounded,” says Willeman. “These were people who had approached trucks for flour and were ruthlessly shot by Israeli forces.”

That day, MSF and Ministry of Health medical teams at the clinic, in north Gaza, treated 122 people with gunshot wounds who had been fired on while waiting for flour; an additional 46 people were dead on arrival.

To make matters worse, in the last week, community kitchens who provide food to patients and medical staff in hospitals have struggled to do so, some shutting down for days at a time.

Even if they can deliver, it is only one meal a day of plain rice for patients who need nutrient-rich food to heal properly, and often nothing for staff. This is no longer about what people can afford. There is barely any food available in most of the Strip.

As prematurely born babies fight for their lives, medical teams in Gaza, Palestine, lack essential equipment such as ultrasounds, incubators, and even premature infant formula, to keep them alive.

Dr Joanne Perry, our medical team leader, shares her experience treating premature babies in Al-Helou hospital’s neonatal intensive care unit (NICU), in northern Gaza.

It started with two babies sharing one incubator – this is already completely unacceptable and shocking to see. Then it increased to three, and last week we saw five babies in one incubator.

With all the attacks on healthcare facilities, today there are just 36 incubators in northern Gaza, compared to 126 before October 2023.

Having several babies sharing one incubator increases their chances of infection. The immune systems of newborns, especially premature ones, are not yet developed.

To support the neurodevelopment of premature babies, we use rolled blankets or other soft materials to create a boundary around the infant, mimicking the supportive environment of the womb. This is called the nesting technique.

This position helps stabilise the baby’s posture, reduces excessive limb movements, and promotes physiological and behavioural stability. 

One reason we are seeing so many premature babies is because of the deterioration of their mothers’ health.

This is my third time in Gaza over the past year, what’s different now is that pregnant mothers are severely underweight, severely anaemic. This can contribute to complications during pregnancy – including premature labour. 

Additionally, pregnant women are living in horrible conditions: in overcrowded shelters or tents, with almost no access to clean water for washing.

Many have no access to prenatal care due to limited functioning facilities and repeated displacement. This means risky pregnancies often go undetected until complications arise – sometimes too late.  

We see premature births and babies born with health issues that might have been preventable with even the most basic monitoring, such as diagnosing pneumonia or cardiac abnormalities, which can be then successfully medicated.

But we don’t have the equipment in the NICU (neonatal intensive care unit) – no ultrasounds, no x-rays, and often not even the blood tests we need.

The medical team in Al-Helou faces endless challenges every day. Fuel comes on top of the list, as all of Gaza’s hospitals run on diesel generators. Fuel shortages lead to power cuts, which kills oxygen-dependent newborns in the NICU. 

Sadly, on Monday night (14 July 2025) a baby, who could have survived, was lost, because the power went out and therefore the oxygen supply was cut off.

The lack of supplies is another major issue. They are so limited that we have to extend time between diaper changes, which can lead to rashes.

We are always about to reach the end of the baby formula supply. We promote breastfeeding, and we’re proud to be a breastfeeding-friendly hospital, but in this situation, many mothers can’t stay to feed their babies every few hours – they often have to take care of the rest of their families, or don’t have enough money for transportation and need to walk back and forth for hours.

It’s heartbreaking. Having a baby should be a moment of joy and hope – but now, for so many families in Gaza, it’s clouded by stress and fear.

Despite all the obstacles, the team is working together with dwindling resources to provide the best care possible to these newborn babies.

Médecins Sans Frontières (MSF) joined a statement with more than 100 other organisations to sound the alarm that lifesaving aid must enter Gaza, Palestine.

As the Israeli government’s siege starves the people of Gaza, Palestine, aid workers are now joining the same food lines, risking being shot just to feed their families.

With supplies now totally depleted, humanitarian organisations are witnessing their own colleagues and partners waste away before their eyes.

Exactly two months since the Israeli government-controlled scheme, the Gaza Humanitarian Foundation, began operating, more than 100 organisations are sounding the alarm, urging governments to act: open all land crossings; restore the full flow of food, clean water, medical supplies, shelter items, and fuel through a principled, UN-led mechanism; end the siege; and agree to a ceasefire now. 

“Each morning, the same question echoes across Gaza: will I eat today?” said one agency representative.

Massacres at food distribution sites in Gaza are occurring near-daily. As of 13 July, the UN confirmed 875 Palestinians were killed while seeking food, 201 on aid routes and the rest at distribution points.¹ Thousands more have been injured.

Meanwhile, Israeli forces have forcibly displaced nearly two million exhausted Palestinians with the most recent mass displacement order issued on 20 July, confining Palestinians to less than 12 per cent of Gaza.² 

The World Food Programme warns that current conditions make operations untenable.³ The starvation of civilians as a method of warfare is a war crime.

Just outside Gaza, in warehouses – and even within Gaza itself – tonnes of food, clean water, medical supplies, shelter items and fuel sit untouched, with humanitarian organisations blocked from accessing or delivering them.

The Government of Israel’s restrictions, delays, and fragmentation under its total siege have created chaos, starvation, and death. An aid worker providing psychosocial support spoke of the devastating impact on children:

“Children tell their parents they want to go to heaven, because at least heaven has food.” 

Doctors report record rates of acute malnutrition, especially among children and older people.⁴ 

Illnesses like acute watery diarrhoea are spreading, markets are empty, waste is piling up, and adults are collapsing on the streets from hunger and dehydration.

Distributions in Gaza average just 28 trucks a day, far from enough for over two million people, many of whom have gone weeks without assistance.

The UN-led humanitarian system has not failed, it has been prevented from functioning.

Humanitarian agencies have the capacity and supplies to respond at scale. But, with access denied, we are blocked from reaching those in need, including our own exhausted and starved teams.

On 10 July, the European Union and Israel announced steps to scale up aid.⁵ But these promises of ‘progress’ ring hollow when there is no real change on the ground.

Every day without a sustained flow means more people dying of preventable illnesses. Children starve while waiting for promises that never arrive.

Palestinians are trapped in a cycle of hope and heartbreak, waiting for assistance and ceasefires, only to wake up to worsening conditions. It is not just physical torment, but psychological.

Survival is dangled like a mirage. The humanitarian system cannot run on false promises. Humanitarians cannot operate on shifting timelines or wait for political commitments that fail to deliver access.

Governments must stop waiting for permission to act. We cannot continue to hope that current arrangements will work.

It is time to take decisive action: demand an immediate and permanent ceasefire; lift all bureaucratic and administrative restrictions; open all land crossings; ensure access to everyone in all of Gaza; reject military-controlled distribution models; restore a principled, UN-led humanitarian response, and continue to fund principled and impartial humanitarian organisations. States must pursue concrete measures to end the siege, such as halting the transfer of weapons and ammunition.

Piecemeal arrangements and symbolic gestures, like airdrops or flawed aid deals, serve as a smokescreen for inaction.

They cannot replace states’ legal and moral obligations to protect Palestinian civilians and ensure meaningful access at scale. States can and must save lives before there are none left to save.