"The residents of Gaza City face an impossible choice: stay and endure a military offensive, or abandon everything and head south."

Testimony of Jacob Granger, Emergency Coordinator for Doctors Without Borders, currently based in Deir el-Balah, Gaza

What we know from our teams in Gaza, who continue to operate two hospitals and two clinics, in addition to distributing water, is that fewer and fewer humanitarian workers remain there due to the military operation and pressure from the Israeli government to force the population and humanitarian organizations to leave the city.

A month ago, it was estimated that Gaza City had a population of approximately one million. All of them live in extremely precarious conditions. Food and water are lacking, as is access to basic medical services. These conditions make it extremely difficult for the population to move south and leave Gaza, especially given the large number of people and the lack of infrastructure and space to accommodate all of them.

For just over a week, we have observed an intensification of Israeli bombardments, as well as an advance by ground troops. Our teams on the ground are therefore receiving more wounded, dead, and traumatized people. We are also seeing population displacement. It is very difficult to estimate the number of people who have managed to leave Gaza City for the south, but it is also true that many others cannot leave the city due to lack of shelter.

The population must choose between remaining in a shelter—whether a tent or part of a building, which is almost always overcrowded—and enduring the military operations in Gaza City, or abandoning all their belongings in the north and attempting to move south to find land on which to resettle.

It must be understood that the so-called "humanitarian zone" that the Israeli authorities have designated in the south, in Khan Younis, covers approximately 42 square kilometers. More than two million people are expected to be concentrated there. For comparison, Manhattan (New York, USA) covers approximately 58 square kilometers and has a population of 1.6 million. And anyone can easily see the difference between Gaza and Manhattan: in the Gaza Strip, there are virtually no buildings left, the majority of the population lives in overcrowded tents, and the Israeli authorities do not allow enough tents to shelter Gazans. 

Currently, the population of Gaza City faces an impossible choice: stay and endure a military offensive, or abandon everything and attempt to move south, where there is no more space and where moving there entails enormous economic costs. More than 70% of Gaza's population has no regular income. Access to money is very difficult, and moving costs thousands of dollars.

The needs MSF is seeing in Gaza today are dire: food, water, and medical care. In one of our remaining clinics, we are seeing increasingly severe cases. Al Shifa Hospital, the largest hospital still operating in the north, has a bed occupancy rate of 250%. Furthermore, access to medical supplies is very limited and insufficient to provide essential medical care to the population.

Access to clean water is increasingly restricted, and a growing number of people cannot meet this basic need. Yet, the most basic need of the entire population of the Gaza Strip is security. Today, there is nowhere safe, neither in the north nor in the south of the Strip. We need security; we must put an end to Israeli military activities.

MSF is working to meet needs to the maximum of its capacity, albeit very limited. We are seeing an increase in needs due to the lack of access for humanitarian actors to Gaza City. For now, we continue to distribute water, support two hospitals, and run two clinics, one for primary care and the other for trauma and physiotherapy.

It is clear that operating in Gaza is extremely dangerous due to the lack of security guarantees from the Israeli government. I see colleagues, both international and Gazan, risking their lives every day to provide water and essential health services to the people of Gaza. We demand that the international community and the Israeli government guarantee access for humanitarian actors and humanitarian aid in general to the Gaza Strip, and to Gaza City in particular.

Currently, the only obstacle to the entry of humanitarian aid into Gaza City is the Israeli government. Food supplies are 50 km from any point in the Gaza Strip. Humanitarian actors have the capacity to deliver this aid if these obstacles are removed.