There were five bullets, says Mohammed Abu Saeed. At the beginning of January, an Israeli quadcopter drone fired at the family’s tent near the “Yellow Line” from close range despite the ceasefire. The bullets ripped through the roof before hitting Abu Saeed in the shoulder and his 12-year-old daughter Kinsi in the hip. “Her screams shocked me so much that I didn’t feel my own injury at first,” remembers her father.
The Palestinian rescue service was unable to approach the site near the Israeli positions. The injured Abu Saeed carried his bleeding daughter himself for a mile and a half until paramedics took the girl to a hospital.
A month later, Abu Saeed, who used to work as a lawyer, is at Kinsi’s bedside in the field hospital of the aid organization Doctors Without Borders (MSF) in al-Sawaida in central Gaza. After two operations, the wounds became infected again. Abu Saeed is hoping for help for his daughter from MSF. However, if it goes to Israel, the aid organization has to dismantle the tents by the end of February and stop working in Gaza.
Kinsi looks tired from under a fleece blanket, her left leg is in a splint. “The bullet injured the pelvic bone and intestines and left a large wound when it exited,” explains Palestinian MSF doctor Murad Asalija. “We want to operate on the colon today.” Further interventions may be necessary later.
At least 170,000 people in Gaza have been wounded in Israeli attacks since the Hamas attack on October 7, 2023. And more are added during the official ceasefire. More than 500 Palestinians were killed within four months. Israel’s army controls more than half of the Gaza Strip along a “Yellow Line” marked with concrete blocks and shoots anything that comes near. “Every three to four days we see injuries from drones or snipers,” says Belgian emergency doctor Emily Vandamme, who works for MSF in the emergency room at Al-Aqsa Hospital.
Only 40 percent of Gaza’s medical facilities are partially operational, according to the World Health Organization (WHO). A majority of the more than 2 million residents live in tents. The import of food and tent material has increased slightly, but the onset of winter has hit people hard. At least eleven children are said to have frozen to death in the past few months. Many medications continue to be blocked.
If they close it will cost people their lives and my daughter’s hope
Mohammed Abu Saeed, resident of Gaza
“Kinsi wished she would die if she could never walk again,” says Mohammed Abu Saeed. The MSF doctors took time for her and explained the treatment. The girl showed confidence again. “If they close, it will cost people their lives and my daughter’s hope.”
With the end of the fighting, humanitarian aid should have flowed into Gaza. Israel is obliged under international law to support humanitarian organizations, the International Court of Justice (ICJ) found in October. Instead, at the end of December, Israel announced Doctors Without Borders and 36 other aid organizations to no longer issue a work permit. These include some of the best-known aid organizations in the world such as Oxfam and Terre des Hommes.
More than 2,000 people seeking help shot dead
The ostensible reason for this is bureaucratic: Israel demands lists of all local employees in order to rule out connections to militant groups. MSF and other groups refuse. Israel’s army has killed more than 1,700 health system workers since the start of the war, including 15 MSF employees, the organization writes.
It was to be expected that the Israeli authorities would take their threats seriously: around a year earlier, Israel had banned the UN Palestine Relief Agency (UNRWA), the most important local aid organization with 13,000 employees. Instead, the government relied on the Gaza Humanitarian Foundation (GHF). As a result, more than 2,000 people seeking help were shot at their chaotic distribution points, the majority by the Israeli army.
Israeli diaspora minister and right-wing nationalist Amichai Chikli repeatedly accused Doctors Without Borders of “employing terrorists.” As with UNRWA, a few cases are enough to convict the entire organization. MSF stated that it never knowingly employs anyone involved in military operations. Every employee is checked. “Any connection to an armed group would pose a serious threat to our staff and patients.”
It is doubtful whether MSF’s relent would have been enough for approval. The Israeli authorities are concerned about more: According to the new guidelines for NGOs, applications can be rejected for political reasons, for example if an employee has “called for a boycott of Israel”. From this point of view, the composition of the list also makes sense: MSF and other rejected NGOs have in common that they have criticized Israel’s actions in Gaza.
Blocked aid supplies
“We are neutral and don’t take sides,” says Will Edmond, emergency relief coordinator for MSF, by phone from Gaza. “But it’s important to talk about what we see here.” Because Israel has denied independent access to Gaza for international media for two and a half years, reports from humanitarian aid workers are important sources of information.
An employee of another organization spoke anonymously about an approach in which aid organizations had to choose between political statements and help. “We usually see this kind of approach in autocratic states to restrict civil society.”
But what impact will this have on the humanitarian situation in Gaza? Israel downplays the importance of Doctors Without Borders: The organization only runs “two of fifteen field hospitals” and has brought hardly any aid supplies to Gaza since the ceasefire began.
In the field hospital in al-Zawaida, Doctor Asalija counters: Israel is blocking 45 MSF transports outside Gaza. Above all, however, the focus of NGOs is on local aid, while the import of aid goods is often carried out by UN organizations. A spokeswoman said MSF carried out 23,000 operations and 800,000 medical consultations last year. In six hospitals, they also support local staff, train Palestinian colleagues or operate their own departments, such as children’s intensive care units.
There are 18,500 seriously ill people waiting
“No one is irreplaceable,” says MSF emergency relief coordinator Edmond. “But hardly anyone in the health sector can cover our range, from primary care in mobile health points to specialized surgical procedures and their follow-up care.” Edmond also leads the MSF water treatment program, which provides drinking water to almost a third of the people in Gaza. “We are the second largest water supplier after the national authorities.”
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The medical consequences of the destruction in Gaza go beyond war injuries, as in the case of Muna Basheer from Deir al-Balah. For a year now, the 20-year-old has been getting sore spots from which a disease is eating into her tissue, right down to the bones. In the field hospital she sits on one of the beds with bandages on both hands. A nurse cleaned the wounds. “Tomorrow they have scheduled an operation for me to remove several tendons,” she says. After that she won’t be able to move her hand anymore. Reconstructive procedures are only possible outside of Gaza.
“Without a laboratory, we cannot diagnose diseases like this,” says Doctor Asalija. However, the import of laboratory technology was rejected: “The antibiotics that we prescribe sometimes don’t work.”
The demands would increase: Broken sewage systems and the constant shortage take their toll. “During the war we often had life-saving interventions, but now many patients come with long-term consequences.” Time is running out to reverse paralysis. In addition, there are chronic diseases, epilepsy and diabetes, for which there are hardly any medications.
According to the WHO, around 18,500 seriously ill people are waiting for treatment abroad. At least 900 are believed to have died since Israel captured Rafah in May 2024. Mohammed Abu Saeed also wants his daughter Kinsi to leave the country: “She should be able to walk again.” On Monday The border crossing in Rafah opened again for passenger transport. However, initially only five patients were allowed to leave.