Gaza: Five things to know about the dire situation in the south

Following the outbreak of war in early October between Israel and Hamas in the Gaza Strip, Israeli forces have repeatedly pushed people to move from the north of Gaza to the south. 

Today, the humanitarian situation in the south of Gaza is dire and unsafe. 

Intense bombardment and fighting have uprooted over 1.8 million people – around 80 percent of the total population of the Strip, according to the UN. Around one million are being pushed to relocate to the south, where living conditions were already overcrowded and desperate before the current conflict. 

As a week-long truce between Israel and Hamas in Gaza comes to an end, here are five things to know about the current situation in the south – witnessed by Médecins Sans Frontières / Doctors Without Borders (MSF) teams working to provide aid.

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1 | People are living without the essentials

Essential needs are uncovered for hundreds of thousands of Palestinians, and our teams report seeing people queueing for food, water and cooking gas.

Despite the entry of several trucks of aid into Gaza, the needs remain hugely unmet. This includes mattresses, warm clothes for winter, blankets and other items. 

With the Gaza Strip being disconnected from electrical power by the Israeli forces and fuel reserves depleted, all essential services such as health, water and sanitation, and communication, were forced to shut down one by one. 

The complete siege imposed by the Israeli government has deprived the entirety of Gaza’s people of essential supplies, shelter and medical care. 

2 | The few remaining medical facilities are overwhelmed

In southern Gaza, only eight out of eleven healthcare facilities are currently functioning (as of 26 November). 

Hospitals are currently receiving far more people than they normally do in the face of a huge lack of medical resources, water and power. Lack of space is also a problem, because, as in the north, hospitals in the south have become a refuge for thousands of displaced people.

“The entire health system here in Gaza just does not have the capacity to cope with the current situation,” says Marie-Aure Perreaut, MSF emergency coordinator in Gaza. 

“Hospitals are completely overwhelmed with the influx of wounded they've been receiving for the past few weeks.”

In Martyrs Clinic in Khan Younis, where our teams are working, the number of consultations per day has increased from roughly 250 to 1,000. Other hospitals that our teams visited are running out of beds and patients are lying in the hallways waiting to receive treatment.

3 | Extremely high population density is causing health risks

The Gaza Strip is one of the most densely populated areas in the world. Just over two million people reside in the Strip, in an area of 365 km2 (about half the size of New York City). Now, the forced displacement of almost the entire population of Gaza to a smaller, delimited space in the south has pushed that density even higher. 

One million people are crammed into a relatively small area; they can’t move and are entirely dependent on humanitarian aid amid terrible living conditions that are putting people’s health at risk. 

“We're seeing an increasing number of children and women with domestic injuries, mostly from burns and other conditions,” says Marie-Aure. 

“These injuries clearly illustrate the extremely precarious living conditions and the overcrowding of the shelters and the camps.”

With the concentration of people as high as it is now in the south, there is a real risk of infectious disease outbreaks. People living in crowded spaces, with a lack of water and sanitation, and no prevention and surveillance system, is a recipe for disaster for diseases like cholera and measles. 

“Today we received a patient linked to complications of chronic diseases, infections, viruses and bacteria that many people have, due to the overcrowded living conditions in shelters like centres and schools,” says Jameel Awad Allah, an MSF nurse at Martyrs Clinic.

4 | There are huge medical needs to treat war wounds and mental health

In Martyrs Clinic, our teams provide outpatient consultations to children and adults, as well as wound dressings, mostly from blasts and infected wounds. Our teams are also doing triage and referrals of trauma cases to Nasser Hospital. 

Those hospitals that are still operational are overflowing with war-wounded patients. 

“Most of the patients that we receive here are because of the war, from shrapnel or fractures,” says Awad Allah in Martyrs Clinic. “We also have burns patients.” 

On top of the need for surgical, burn and wound care from the bombing and the shelling, our teams are observing basic healthcare needs, such as maternity, general medicine and especially mental health. In Khan Younis, we offer mental health sessions for children and women.

“We are providing mental health support to all people who are here, especially the internally displaced,” says Marwa Abu Al Nour, an MSF psychologist. 

“The most common things I see among children are nightmares, bed-wetting, anxiety, and fear. We try as much as possible to give them support via recreational activities.”

5 | MSF teams are responding across southern Gaza

Today, MSF is working in two hospitals in southern Gaza – Nasser and Al-Aqsa hospitals – and in two clinics in Khan Younis, Martyrs and Beni Suhaila clinics.

In Nasser Hospital, we provide emergency care and surgical treatment, including to patients with traumatic injuries and severe burn injuries. We also support the emergency department and intensive care unit. 

In Al Aqsa Hospital, in the Middle Area, we have started supporting the hospital’s staff. We are working on wound dressings and outpatient consultations for patients with blast injuries and burns. 

In Martyrs Clinic, we provide outpatient and mental health consultations, while we offer basic care, including for wounds, at Beni Suhaila Clinic.