Gaza: Five reasons why this ceasefire is not a ceasefire.
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Ozan Agbas, Médecins Sans Frontières (MSF) Emergency Manager for Palestine
Nine months on, Palestinians are still pulling children from under the rubble in Gaza. Families are still burying their dead. And the space in which two million people are expected to survive has shrunk to less than a third of the size it was three years ago. This is not a ceasefire: it's the same structural violence under a different name.
It is a continuation of the genocide that is calibrated to be violent enough to keep the suffering of Palestinians every day, yet silent enough to avoid triggering international outrage. This is a ceasefire that still kills, confines, and denies aid. It doesn't dismantle the mechanisms of violence; but normalises the continued disregard for Palestinian lives.
Amid this uncertainty and ongoing violence, our Palestinian colleagues have continued to run field hospitals, treat injured patients, provide mental health support, distribute water and provide general healthcare to people in Gaza.
1. The killing has not stopped.
According to Gaza's Ministry of Health, 1,185 Palestinians have been killed and 3,816 injured since the so-called ceasefire was announced on 10 October, 2025. This is roughly one Palestinian killed or injured every hour and 20 minutes: for nine months straight. As of 19 June, over 265 children have been killed according to UNICEF. Israeli forces continue to carry out daily strikes across Gaza, while expanding their area of control everyday.
For MSF staff in Gaza, the line between treating patients and becoming one is terrifyingly thin.
On 16 July, an Israeli strike near an MSF clinic in Al-Mawasi sent four injured people to our teams. The following day, two apartment buildings housing our staff in Gaza City were struck without warning, trapping families inside as explosions shattered windows. In one building, rubble and bodies crashed into the lower-floor apartment of an MSF staff member.
The same day, MSF teams in Deir al-Balah, central Gaza, treated 12 people, seven of whom were children, who were injured after Israeli forces struck a funeral in Al-Nuseirat. In total, this strike killed eight people and injured 20. Among those killed was an MSF staff member’s 21-year-old son, our colleague got the news while working in another emergency room.
These were not isolated incidents, merely a snapshot of 48 hours in Gaza.
A ceasefire should mean our emergency rooms are no longer filled with people wounded by war. Nearly two years after MSF established its field hospital in Deir al-Balah, and nine months after the ceasefire announcement, our teams are still receiving war-wounded patients.
2. Confinement of Palestinians has become another weapon.
The yellow line, negotiated as part of the ceasefire under the guise of safety, has instead become another mechanism of Israeli forces’ control and violence, dividing the Gaza Strip and confining Palestinians to an ever-shrinking area.
The yellow line is moving. It is neither clearly marked nor fixed, shifting westward whenever Israeli forces decide it should. Without negotiation, warning, and with no right to expand.
Just this week, one mother told our teams that her 14-year-old son, who has Downs syndrome, was shot five times by Israeli snipers near the yellow line while he was playing near his home. The yellow line has become a moving boundary that confines people and exposes them to continued violence – with impunity.
When the so-called ceasefire was announced, Israeli forces controlled roughly half of Gaza. Today, almost two million Palestinians are confined to approximately 30 per cent of the Strip.
A ceasefire should ensure that hostilities are paused, weapons are silenced. and that people are safe from strikes across the Strip. Using it as a weapon of war and reinforcing the confinement to a fraction of Gaza cannot be justified.
Around 90 per cent of people have been forcibly displaced, many multiple times, and most are living in overcrowded tents or makeshift shelters. Scabies, respiratory infections, rat bites, and other diseases are rife.
When strikes are not enough to force people out, overcrowding, disease, and deprivation are left to do the rest: a slower method of making the same third of Gaza unlivable for the people trapped inside it.
3. Homes continue to be destroyed, and people are forced to flee.
The destruction of homes and psychological warfare of insecurity did not stop with the announcement of the ceasefire.
East of the Israeli forces controlled yellow line, homes and entire neighbourhoods continue to be levelled. West of it, in the shrinking areas where Palestinians are confined, Israeli strikes continue to hit tents, shelters, and the few buildings still standing.
By the time the ceasefire was signed, around 60 per cent of Gaza's population had already been made homeless, with roughly 77 per cent of housing units damaged, most of those destroyed outright, and roughly 1.9 million Palestinians were forcibly displaced, often more than once.
Today, almost a million Gazan’s live in tents or makeshift shelters, according to Norwegian Refugee Council, most without reliable access to clean water, electricity, healthcare or necessities. Yet Israeli forces continue to destroy what little shelter remains and issue so-called evacuation orders that force people to flee again.
Like everyone else in Gaza, our colleagues are often given only moments to leave when these displacement orders are announced by Israeli forces. They abandon what few belongings they have left, with nowhere safe to go. Even on nights without orders, uncertainty remains. Families go to sleep not knowing whether they will wake to another displacement order or another strike.
The sudden and arbitrary orders for people to flee their homes and shelters continue to be used as a tool of psychological warfare by Israeli forces. Repeated displacement and lack of security is not a consequence of the military campaign. It has become one of its defining features, ensuring that Gazan's never feel safe regardless of a ceasefire.
4. Aid has become another tool for military gain.
Humanitarian aid should never depend on the terms of a ceasefire. As an occupying power, the Israeli state has an obligation by international law to ensure Palestinians in Gaza have access to aid, regardless of political negotiations, military agreements or conduct of hostilities.
Instead, aid continues to be used as an intentional and conditional, used as an instrument of oppression. Supplies continue to be delayed by shifting restrictions at crossings, and aid is folded into ceasefire negotiations as though they are political concessions, and the phases of so-called ceasefire implementation itself are used as a cycle to weaponise aid: treating aid as leverage rather than a legal obligation. Recalling last year’s deadly aid schemes, such as the Gaza Humanitarian Foundation distribution points, only heightens our concern about what may follow if these plans are implemented.
Emergency aid is withheld or delayed on the premise that recovery and reconstruction will follow, yet nine months in, there is still no meaningful plan, and emergency aid continues to be restricted by Israeli authorities. Rather than fulfilling its obligations as the occupying power, Israel has instead deregistered international humanitarian organisations, including MSF, forcing international staff to leave Palestine and blocking medical cargo from reaching people in need. In their place new proposals have emerged to confine Palestinians to tightly controlled camps, where access to shelter and aid would be contingent on being inside militarised enclosures supervised by Israeli-approved forces.
People’s emergency needs go unmet, while recovery itself is held hostage to the same political and military calculations that are already restricting aid. Each stage is used to justify withholding the other, all while Palestinians' survival is hanging by a thread, and they cannot return to their homes, rebuild their communities, and recover with dignity.
5. Psychological wounds continue to be inflicted.
The ceasefire has not brought about the safety, stability, or predictability that healing requires.
Across Gaza, MSF teams continue to see overwhelming levels of grief, anxiety, sleep disturbance and psychological distress in both adults and children. Rather than easing, these symptoms continue to accumulate under ongoing airstrikes, displacement, and deteriorating conditions. Some patients, including mothers, tell our teams they are experiencing suicidal thoughts.
For Palestinians, a ceasefire would mean conditions for people to grieve, begin rebuilding their lives, and recover from the violence they have endured. That has not happened in Gaza.
Psychological healing cannot happen while bombs continue to fall, with the constant sound of drones overhead, only interrupted when a strike hits the ground. People live in fear of not knowing if they, their family or their neighbours are going to live through the day.
The protection of civilians does not begin when a ceasefire is signed. Civilians must be protected and aid facilitated during active hostilities as well. Nine months into this so-called ceasefire; the wounds of war are not only unhealed: they are still being inflicted.