Gaza’s silent killings: New MSF report denounces destruction of healthcare system
Gaza’s healthcare system has been devastated, with men, women and children at increasing risk of acute malnutrition and with their physical and mental health deteriorating rapidly.
This is according to a new report by Médecins Sans Frontières / Doctors Without Borders (MSF) titled Gaza’s Silent Killings: The Destruction of the Healthcare System and the Struggle for Survival in Rafah.
More than six months into the war in Gaza, the devastation extends far beyond those killed by Israeli bombardments and airstrikes. The report describes the massive struggle faced by Palestinians in Gaza to access medical care and warns of large numbers of preventable deaths caused by disruptions to critical healthcare.
“How many children have already died of pneumonia in overwhelmed hospitals?” asks Mari-Carmen Viñoles, Head of MSF Emergency Programmes.
“How many babies have died because of preventable diseases? How many patients suffering from diabetes are left untreated? What about the deadly consequences of the closure of kidney dialysis units in attacked hospitals? These are the silent killings of Gaza not reported in all this chaos, caused by the collapse of the healthcare system across Gaza.”
MSF teams working in Rafah report that the decimated healthcare system and inhumane living conditions also raise the risk of disease outbreaks, malnutrition and the long-term impact of psychological trauma.
MSF warns that a military incursion in Rafah, on top of the current humanitarian crisis in Gaza, would be an unfathomable catastrophe and calls for an immediate and sustained ceasefire.
Living conditions driving disease
Living conditions in Rafah today are not conducive for survival, says the report, drawing on medical data and the testimony of patients.
There is a desperate shortage of clean water for drinking or bathing, while rubbish and raw sewage accumulate in the streets in this tiny wedge of land now hosting more than one million people who were forcibly displaced from the north of Gaza.
Across just two of the primary healthcare centres run by MSF in the Al-Shaboura and Al-Mawasi areas, our teams are providing an average of 5,000 medical consultations every week, many linked to people’s sub-standard living conditions.
Over 40 percent of these consultations are for patients with upper respiratory tract infections. MSF has also seen an increasing number of suspected cases of hepatitis A.
In the last three months of 2023, cases of diarrhoeal illnesses reported among children under five were 25 times higher than during the same period in 2022.
And, between January and March 2024, teams treated 216 children under five for moderate or severe acute malnutrition – a condition which was almost entirely absent before the current conflict.
Maternity and mental health
With hospitals overwhelmed with trauma patients, people with other types of medical needs, such as pregnant women with complications and people living with chronic diseases, are often unable to receive the care they require.
In Emirati Hospital, where MSF is supporting the postpartum department, medical teams struggle to deal with close to 100 deliveries a day, five times more than before the war.
In MSF’s clinics, consultations for hypertension, diabetes, asthma, epilepsy and cancers have been increasing as patients seek monitoring and medication. However, if their condition worsens and they require specialised medication or equipment, which are increasingly difficult to obtain in Gaza, little can be done for them.
Many medical referrals in Gaza today are delayed or are simply not possible.
The mental health of Gaza’s population – including medical staff – is also in tatters. Most patients arriving at MSF clinics have symptoms related to anxiety and stress, including psychosomatic and depressive conditions.
Some people caring for family members with severe mental health disorders have resorted to excessive sedation to keep them safe and prevent them from harming themselves or others, due to the lack of specialised services still functioning in Gaza.
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“Absurdly impossible”
For MSF, trying to support Gaza’s devastated healthcare system has been extremely challenging due to the insecurity. MSF has also faced substantial challenges bringing medical supplies and humanitarian aid into Gaza due to delays and restrictions by Israeli authorities, which are described in detail in the report’s annex.
“As an international emergency medical organisation, we have the expertise and the means to do much more and scale up our response,” says Sylvain Groulx, MSF Emergency Coordinator.
“Palestinian medical staff are highly skilled and only need to be given the means to work in acceptable and dignified conditions to treat and save lives. But today all this remains absurdly impossible.
“Without an immediate and sustained ceasefire and the entrance of meaningful humanitarian assistance, we will continue to see more people die.”
MSF and the Israel – Hamas conflict
An unprecedented humanitarian crisis is unfolding in Gaza. MSF teams have worked to treat the wounded and supply overwhelmed hospitals as indiscriminate airstrikes and a state of siege threaten millions of men, women and children.
Médecins Sans Frontières / Doctors Without Borders (MSF) is horrified by the events that began on Saturday 7 October – both the brutal mass killing of civilians perpetrated by Hamas in Israel, and by the massive attacks on Gaza now being pursued by the Israeli military.