When hospitals become islands: Gaza City’s medicine sits under siege
The hum of generators and the small, precise language of triage have been replaced by a different vocabulary in Gaza City: encircled, suspended, evacuated. Across neighborhoods where clinics once pulsed with the quiet rhythm of life-saving routines, silence — heavy and bureaucratic — has settled like dust.
Doctors Without Borders (MSF), a presence in Gaza for years, announced it had to halt activities in the city as Israeli forces tightened their grip. The decision landed like a physical blow to a population already reeling from months of bombardment and mass displacement.
“We cannot deliver care when the doors to our clinics are surrounded by armed men,” said Amir Haddad, the fictive name I gave to the MSF emergency coordinator I spoke to for this piece. “This is not a pause for paperwork — it is a pause for life. Babies in neonatal units, people with sepsis, those with complex wounds: they are now out of reach.”
The official statements from the Israeli military describe a different picture: over the past day, they say, the air force struck more than 140 targets across the Gaza Strip, hitting what the army calls tunnel shafts, military infrastructure, and “terrorists.” The rhetoric of precision collides with the visible reality of broken homes and toppled electrical poles, and with the human stories in between.
What it looks like on the ground
Near Al-Shati refugee camp, a child walked barefoot through a field of twisted rebar and concrete—searching. A toppled utility pole had left a web of cables across the dust. A neighbor, a woman in her 40s, held a frayed blanket and told me, “We look for anything that was ours—shoes, photos, a spoon. Sometimes it is only a memory we find.”
Over several weeks, an estimated 700,000 Palestinians have fled Gaza City since late August, according to statements by the Israeli military. The UN humanitarian office records a displacement figure of 388,400 people since mid-August; most of them came from Gaza City. The discrepancy between such figures is a reminder that statistics here are often moving targets, changing with every convoy and every siren.
Human resources stretched to a breaking point
Before the suspension, MSF teams ran clinics that treated everything from childbirth complications to combat wounds. Those services are now frayed at the edges. “We created makeshift neonatal wards in buses,” said Layla Mansour, a pediatric nurse who asked to be quoted under a different name. “We taped plastic over broken windows, we prayed for supplies to arrive. To stop our work is to leave those prayers unanswered.”
Health figures from Gaza’s health ministry — which the UN regards as generally reliable despite being Hamas-run — paint a grim picture. Nearly 65,549 Palestinians have been killed during the ongoing military operations over the past two years, the ministry reports, the majority civilians. The October 7, 2023 attacks that ignited the current round of carnage left at least 1,219 people dead in Israel, most civilians, according to tallies compiled by news agencies from Israeli sources.
Numbers do not capture the texture of suffering, but they do chart the scale. Hospitals without electricity, clinics without staff, and families packed into single tents tell a story that cannot be summarized in statistics alone.
Voices under the loudspeaker
In New York, Prime Minister Benjamin Netanyahu used the international stage to vow to “finish the job” against Hamas — rhetoric the Israeli government said it broadcast back into Gaza via loudspeakers and phone messages. Residents I spoke to, huddled in tent camps or shadowed by concrete slabs, were unconvinced.
“No, we didn’t hear them,” said Fatima, a displaced mother of six in the coastal tent city of Al-Mawasi. “If they wanted us to listen, they could have sent help, not threats. We hear the bombs, not their speeches.”
Not everyone hears the same things at the same time. Two journalists working in southern Gaza told me they had not received any calls or heard the broadcasts. Whether or not the messages were sent, their intended effect — to intimidate, to fracture resolve — met a counterforce: people who are too busy surviving to be swayed by political theater.
Living compressed: the human architecture of displacement
“We are piled on top of each other,” said Hassan Abu Amir, a 50-year-old whose family of ten now sleeps in a single tent. “My elderly in-laws sleep by the door, my children in the middle. There is no privacy, no space for breath.”
On the Mediterranean strip where displaced families have gathered, the tents form a near-continuous line of human habitation, a temporary city with markets, makeshift schools, and endless queues for water. The overcrowding fuels illness—respiratory infections, diarrheal disease—and the lack of surgical capacity means that injuries become chronic disabilities.
International humanitarian law is supposed to protect civilians and medical units. “The laws of war are clear: medical facilities and personnel must be safeguarded,” said Dr. Miriam Adler, a legal scholar specializing in humanitarian law at an international university. “When clinics are encircled or forced to close, the consequences are both immediate and durable: increased death rates, prolonged disability, and social collapse.”
What the world can see and what it chooses to do
How should distant capitals react? Can sanctions, diplomatic pressure, or humanitarian corridors change the calculus of an urban battlefield? These are not rhetorical questions for those who have no choice but to inhabit that city.
“We have begged for corridors, ceasefires, corridors for evacuation and resupply,” said a UN official who spoke on condition of anonymity. “The problem is not only permission. It is security. You cannot ask medical workers to walk into a zone that changes every hour.”
There are pockets of solidarity. Small NGOs, local volunteer groups, and international donors are trying to fill gaps. Yet the scale of displacement and damage — the numbers, the smoldering ruins — overwhelm the usual toolbox of humanitarian assistance.
Reflections from the rubble
Walking past a makeshift tent hospital, I watched a nurse cradle a sleeping infant whose mother had been wounded days earlier. “We stitch what we can, we feed what we can, and sometimes, we tell the story of the person we lost,” she said, voice low. “This is not just a war of armies. It is a war on everyday life.”
What does it mean when medicine must retreat? For a global audience, the images may flicker past: a clip on a newsfeed, a headline, a statistic. But beneath the headlines are lives, stubborn and ordinary—people who cook over small stoves, children who draw with charcoal, elders who hum old songs while a neighbor scrapes a pot clean.
Will the international community treat this as another cycle of attrition, or will it see the human contours and demand durable change? How do we balance the call for security with the imperative of protecting the vulnerable? These are the questions that linger when ambulances stop running and clinics fall silent.
In the twilight near the coast, an old man told me, “We have lived through sieges and silence. We will live if you do not forget us.” For journalists, diplomats, and readers alike, remembering may be the first step toward a response that honors both law and humanity.
How you can stay informed and help
- Follow verified humanitarian organizations (MSF, ICRC, UN OCHA) for updates and needs lists.
- Support reputable aid channels that deliver medical supplies and shelter materials directly to civilian populations.
- Engage with reporting from local journalists and aid workers to hear the lived realities behind the numbers.
We cannot unmake the damage already done, but we can refuse to let these places be reduced to a single statistic. Listening, sustaining aid, and pressing for the protection of medical services: these are the small acts that, multiplied, keep the heart of a city beating.
