Consultation de suivi à l'hôpital de campagne indonésien de Rafah. Decembre 2023 © MSF

Gaza: Evacuation orders and forced displacement jeopardise continuity of care for wounded

On Wednesday, February 21, 2024

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Over the past week, attacks have intensified in Rafah and residents have begun to flee northwards towards the Gaza Strip's median zone. At the same time, evacuation orders and attacks on Nasser Hospital in the southern town of Khan Younis have forced patients undergoing treatment to leave the hospital. There is no safe place in Gaza; people have nowhere to go.

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 people in Rafah 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.

Camp de personnes déplacées à proximité de l'hôpital de campagne indonésien de Rafah. Décembre, 2023 © MSF

Trauma injuries and burns require long-term treatment

At Rafah Indonesian Field Hospital, MSF teams are treating people for war-related trauma injuries and burns that require continued, sustained care.

Most patients with injuries need dressing changes at least twice a week, as well as antibiotics, pain killers and constant medical care,” says MSF medical coordinator Guillemette Thomas.

“If the injury is severe, the patient also needs physiotherapy to avoid losing the functionality of the injured limb.”


Entrée de l'hôpital de campagne indonésien de Rafah. Décembre 2023 © MSF

Most of MSF’s patients are staying in tents or public buildings turned into shelters, where their dire living conditions make it almost impossible to keep open wounds clean, resulting in infections. This high risk of infections is one of the main issues for injured patients in Rafah. Without proper medical treatment, infections can spread through the body, to the bones, causing a lot of pain and leading to death if left untreated.

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 per cent of patients seen by MSF teams have trauma injuries; the remaining 40 per cent have war-related burns. More than 40 per cent of the outpatient department’s patients are children.

Patients à de l'hôpital de campagne indonésien de Rafah. Décembre, 2023 © MSF

Pending humanitarian catastrophe as attacks escalate in Rafah

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.

Patient à l'hôpital de campagne indonésien de Rafah. Décembre, 2023 © MSF

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 Thomas 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 lifesaving 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 evacuatio 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.”


Camp de personnes déplacées à proximité de l'hôpital de campagne indonésien de Rafah. Décembre 2023 © MSF

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 and relentless bombings, 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.

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