Mila Font: "Widespread and indiscriminate attacks on civilians, medical personnel and health facilities must cease immediately"

How would you describe the current situation of the health system in Gaza and how has this affected your ability to provide medical care?

No health system in the world can cope with the volume of injuries, types of wounds and medical conditions that we see on a daily basis in Gaza. That's almost 34,000 people killed and more than 76,000 injured according to data as of April 17.

The health system in Gaza before the war was not perfect, but it was quite robust, now what we are seeing is a systematic and deliberate destruction of the health system. What we are seeing will have repercussions not just now, but for years, even decades.

The types of injuries, amputations will require prosthetics for generations to come, for the next 5 to 10 years at least. We are talking about an entire socioeconomic system wiped out; just from the ramifications of what these emergency amputations will mean.

What is the most significant impact you have observed in Gaza as a result of Israel's indiscriminate attacks?

Before the war there were 35 hospitals in Gaza, now there are potentially 11 semi-functional centers, if you can call them functional. But there are so many displaced people living in the hospitals, seeking shelter in them, that there is not even space for patients.  The laboratory system in Gaza has been totally wiped out; it's not functioning at all.

Now what we are seeing is a systematic and deliberate destruction of the health system. What we are seeing will have repercussions not just now, but for years, even decades.
If we looked at the hospital system before, for example, we wouldn't necessarily have had to perform these life-saving amputations, because we would have had a system that worked. Immediate reconstructive surgery to save those limbs would have been possible.

What are the main challenges your medical teams face on the ground as they work to save lives in the midst of conflict?

Since the beginning of this war, nearly 200 humanitarian workers (176 UNRWA workers) have been killed, including five members of our Médecins Sans Frontières staff. Many of these aid workers were killed while treating patients or sheltering with their families.

Is this pattern of attacks intentional or indicative of reckless incompetence?

It is a war fought without rules. That these attacks on humanitarian workers are allowed to occur is a political choice. The Government of Israel faces no political cost. Instead, its allies allow this brutality with impunity and provide even more weapons that maim and kill civilians indiscriminately.

Can you share a specific experience that illustrates the work you are doing to help those affected by the conflict in Gaza?

A 7-month-old girl arrived at the Al Aqsa Emergency Department wrapped in a survival blanket and covered in blood and urine. The night before, her entire family was killed when their home was attacked at dinnertime. The little girl joins the thousands of WCNSFs this war has created.
In December the acronym WCNSF (short for 'wounded child with no surviving family) was new to all of us, now it is so common that we have a standard operating procedure for it. This little girl joins the thousands of WCNSFs this war has created.

How have you managed to adapt and continue to provide medical care in such difficult and dangerous conditions?

Since March 11, MSF has been operating in three hospitals (Al Aqsa hospital, Indonesian field hospital in Rafah and El-Emirati maternity hospital), a primary care center (Al-Shaboura clinic) and two health centers in Al Mawasi in the Rafah area. Our activities are mainly carried out in southern Gaza.  
Our teams provide surgical support, wound care, physiotherapy, postpartum care, outpatient consultations, vaccination and mental health services, but the repeated and systematic sieges of several hospitals are reducing our activities to a shrinking territory and limiting the response.

What are the most urgent medical needs you are trying to address in Gaza at the moment?

Ninety-nine percent of the injuries our teams see in the medical centers in Rafah, in the southern part of Gaza, are blast injuries. The patients, the civilians, are in buildings or in tents when bombs hit their homes and they are buried by the rubble. There are crush injuries to the abdomen and thorax. Legs and arms have to be amputated. There are also fires and patients suffer severe burns.

And the problem with that is that no health system, in the world, can cope with the volume of injuries and the types of injuries and the medical conditions that we see on a daily basis in Gaza.

What role does the provision of clean water and sanitation play in your medical response in the midst of the crisis in Gaza?

Already six months of war have destroyed or damaged at least half of Gaza's water and sanitation facilities: 70% of the Strip's population now drinks salinized or contaminated water. The lack of clean water adds to the suffering of hundreds of thousands of people and increases the risk of disease outbreaks in Gaza. 

In a normal situation, a person needs between two and three liters of clean water a day, now, with the current shortage, the average for a family of six is just one gallon of water (3.8 liters, just over half a liter per person), well below the minimum recommended by the WHO.
MSF teams are distributing more than 200,000 liters of water each day for some 6,000 families. However, this is just a drop in the ocean of needs in this area.

How does the lack of medical resources and surgical supplies affect your organization's ability to provide adequate care to patients?

There is a lack of anesthesia, pain medication, people being amputated with a little paracetamol, no antiseptics, no water, can't clean wounds...Discharges are given when normally they would not be given, but we have to make room.
Hospitals are collapsed because of the number of war wounded and with trauma and other conditions they cannot be treated. Pregnant mothers, chronic patients, children with daily and respiratory diseases due to poor living conditions are deprived of care because the health system is collapsed. And of course the amount of medical supplies that are entering through the few open border crossings is totally insufficient. That is obvious. Before the war there were 500 trucks coming in every day, now the daily truckloads are around 90. However, humanitarian aid is much more than counting trucks. It is moving supplies safely. It is security at the distribution point. It's running hospitals, which are more than four walls and a roof. It's water, electricity, fuel and communications.

What message would you like to convey to those who want to help but are not sure how to do so or what impact their contribution would have?

More than six months after the war started, the conclusion is that we have tried, and we keep trying every day, but the reality is that we cannot. We are not able to. We are not allowed to bring any significant humanitarian aid to the people of Gaza.

What we are asking for is very simple and clear. The widespread and indiscriminate attacks on civilians, medical personnel and health facilities must stop immediately. The Israeli authorities must allow the unimpeded flow of humanitarian aid to the people of Gaza. And, above all, there must be an immediate and durable ceasefire. And to those who want to know more about the situation and support our work, you can do so through our website and our social media channels.