Gaza City, in the northern Gaza Strip, Palestine, 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. Médecins Sans Frontières (MSF) teams warn that it will be simply 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 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. It’s driving them from their homes and shelters, sometimes multiple times, following a pattern of complete destruction previously witnessed by MSF teams in Rafah.

“Some of our colleagues have been displaced more than 11 times since 2023,” says Jacob Granger, Emergency coordinator for MSF in Gaza.

Makeshift shelters offer little safety as bombing continues, often targeting areas to which survivors had already fled. An estimated one million displaced people now occupy just 15 per cent of Gaza’s territory — and conditions have worsened by the destruction of almost 90 per cent of the Strip’s 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 diarrhoea are spreading in overcrowded, unsanitary living conditions. 

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; those remaining function on the brink of collapse under targeted attacks. Bed occupancy rates have reached 300 per cent at Al-Ahli hospital, 240 per cent at Al-Shifa hospital, and 210 per cent 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, the health authorities report zero stock remaining for over half of essential drugs.  

Medical staff have endured repeated raids, and health workers themselves have been killed, detained or threatened, including an MSF doctor still in detention with no formal charges having been made against him. In the medical facilities our teams support in Gaza City, we are seeing an increased number of wounded people with increasingly serious injuries. Patients who need intensive care are at risk of dying if they are forced to evacuate due to hospital closures. People with disabilities, and people who are sick or wounded, will not be able to evacuate. 

Starvation as a policy

The ongoing siege has triggered a famine: restrictions on food, clean water, medicine, and aid deliveries are causing acute malnutrition rates to skyrocket.

Civilians desperate for aid at distribution points face deadly force; for months, MSF clinics have been responding to mass casualty influxes of wounded people, resulting from Israeli fire at the food distribution sites managed by the so-called Gaza Humanitarian Foundation. 

Ground operations must stop immediately

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

MSF calls for the immediate end to use of evacuation orders as a means of forcible displacement, a lasting ceasefire, and the entry of humanitarian aid at scale.

We ask for the protection of medical facilities and the coordinated movements of humanitarian organisations. The systematic destruction of an entire city and population must end.

We call on 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.