Gaza: Rafah evacuation order jeopardises medical care for wounded

The war in Gaza has displaced some 1.5 million people to Rafah, in the southern corner of the Gaza Strip. Over the past four months, most of the people now here have been displaced multiple times, carrying what few belongings they have left.

Plastic tents have been erected on every available piece of land, on the streets and open ground in and around Rafah City. Now there is no space left: cars can barely drive through on the overcrowded streets, and even walking can be challenging.

People sheltering in the area have been deprived of their basic needs, including water, food and shelter, and have been subjected to repeated evacuation orders and forced displacement by the Israeli military.

In the recent week attacks have intensified on Rafah and people have started to flee back north towards the Middle Area of Gaza Strip. At the same time, evacuation orders and attacks on Nasser Hospital, in the southern city of Khan Younis, have forced patients undergoing treatment to leave the hospital.

There is no safe place in Gaza; people have nowhere left to go.

Since mid-December 2023, MSF teams in Rafah Indonesian Field Hospital have been supporting the post-operative, inpatient and outpatient departments, providing wound dressings and physiotherapy and carrying out small surgical procedures.

So far, they have provided more than 5,800 consultations and admitted more than 200 patients for treatment. In the outpatient department, some 60 percent of patients seen by MSF teams have trauma injuries. The remaining 40 percent have war-related burns.

More than 40 percent of the outpatient department’s patients are children.

The medical response in Gaza only scratches the surface of people’s overwhelming needs for medical care, with local health officials reporting that almost 70,000 Palestinians have been injured since October 2023.

A humanitarian catastrophe in waiting

In the past week, Israeli authorities have made public their intention to evacuate people from Rafah and launch a ground offensive in the area. Attacks have intensified and people sheltering in Gaza’s far south are living in fear of their lives.

For patients needing continued care for trauma wounds or burns, another forced displacement could result in severe health complications, or possibly death.

“In other hospitals in Gaza, we have seen that when hospitals are evacuated, patients leave on foot, in wheelchairs or even lying in hospital beds,” says Guillemette.

“This can be extremely dangerous for them. When someone with a severely fractured leg starts to walk, it compromises their possibility to regain mobility and can have life-threatening consequences.”

Since the war began, MSF medical teams and their patients have been forced to evacuate nine different health facilities in Gaza, after coming under fire from tanks, artillery, fighter jets, snipers, and ground troops, or after being subject to an evacuation order. Medical staff and patients have been arrested, abused, and killed.

Providing people with medical are and scaling up life-saving humanitarian assistance has been made almost impossible by the intensity of Israel’s bombing and shelling of Gaza, as well as by intense fighting.

MSF teams are extremely worried about the escalations of violence in Rafah and the impending evacuation of the area, where millions of people are sheltering, including the wounded, the sick, the elderly and those with limited mobility.

“People have lost everything – their homes, their loved ones, their basic needs and security   – and now they barely survive, living in muddy plastic tents or on the floors of hospitals and schools, without any belongings,” says MSF project coordinator Lisa Macheiner.

“Rafah and the whole of Gaza need a safe humanitarian response at a much larger scale, which is only possible with a sustained and immediate ceasefire.”

MSF teams continue to provide medical care in Rafah in four hospitals, one clinic and two health posts, and in one hospital in the Middle Area.

However, without an end to relentless bombings and forced displacement, providing humanitarian aid is almost impossible. We reiterate our call for an immediate and sustained ceasefire, which is the only way to put an end to the humanitarian catastrophe unfolding in Gaza.