Doctors Without Borders (MSF) secretary general Christopher Lockyear has voiced concern over what he described as an Israeli attempt to push Gaza medical teams into field hospitals instead of established buildings.
The aim, he said, appears to be greater control over who receives treatment, echoing a disastrous aid distribution strategy via an Israeli-US channel that has led to the deaths of dozens of hungry residents.
In an exclusive interview with The National in Abu Dhabi, Mr Lockyear appealed for all nations to use economic, political and diplomatic pressure to stop the "pattern of genocide and ethnic cleansing” in Gaza after the destruction of its health system.
Doctors Without Borders (MSF)
“We are fearful that we could become part of that broader strategy by moving out of these bigger established hospitals into field hospitals,” he said.
“It gives the impression that the situation is manageable because you can run a hospital. But that is a much, much lower capacity than previously. And we don't want to be part of destroying the infrastructure of the society of Gaza."
Israel’s war in Gaza has entered its 20th month, with no signs of slowing down. More than 55,600 Palestinians have reportedly been killed, despite attempts to reach a ceasefire with Hamas.
Israeli officials have made it clear the war will not stop until Hamas is eliminated and the hostages abducted on October 7 are returned, even as hunger threatens two million Gazans.
The health sector has borne one of the heaviest costs. Israel’s army has systematically attacked hospitals and clinics, accusing Hamas of using them as military launchpads and intelligence centres, often with little or no evidence.
“We no longer talk of a health system in Gaza,” said Mr Lockyear. "The health system has been systematically targeted, destroyed. The only remaining partially functional referral hospital, the Gaza hospital itself, we're supporting them.
“We had to move the surgical support out of that hospital just a few days ago. We're working in a series of field hospitals but it's impossible to provide what is needed. There's a major effort there but it's nowhere near what is needed.”
Abuse of humanitarian action
Similar to food, medical equipment has been largely restricted. “We've managed to bring in a trickle of medical supplies over the last few weeks,” said the secretary general. "But the supplies are dwindling. And as a consequence of that, we have to reduce, for example, how often we're changing people's dressings, which increases the rate of infection."
He sharply criticised the aid system now being overseen by Israel, one that has led to the killing of dozens of Palestinians attempting to receive the basics to survive in what he called humiliating circumstances.
“What we're seeing in terms of aid delivery at the moment in Gaza, through the Gaza Humanitarian Foundation, I would say is not humanitarian. This is an approach to aid that we completely reject. Why do we reject it? Well, it's a militarised, politicised form of giving assistance,” he said.
“The way that the Gaza Humanitarian Foundation is carrying out the work in Gaza is following a repeated and systematic abuse of the terms 'humanitarian' and 'humanitarian action'. One member of our staff said the other day, 'you go to these distributions because you're desperate, you may return with a bag of flour, you may return with a shroud.'”
MSF is currently operating in Gaza with a force of about 300, most of them local. But it has lost 11 staff members in the fighting and others face complex situations and endless obstacles to carrying out their work.
Mr Lockyear stressed that humanitarian aid, especially from a medical perspective, is about much more than supplies. “It's about having facilities where there is electricity, running water and fuel,” he explained, all of which barely exist now.
“I would say it's also about having staff who are fed, who have slept, who are able to carry out operations and procedures on people. And we have staff who are themselves in the hospital because of spreading disease, because of hunger, because of starvation," the MSF chief said.
“What our teams are witnessing on a daily basis is patterns of genocide and ethnic cleansing, the destruction of the health system and the destruction of infrastructure as a whole. So this needs to stop. We're appealing to all states to use their economic, political and diplomatic pressure to stop this carnage.”
War on people
With the Israeli war on Iran escalating, there are fears the war in Gaza could be pushed off the radar, even as hundreds remain under fire. More than 250 people have been killed by the Israeli army since Friday, when Israel launched a serious assault on Iran.
Another place at risk of being forgotten is Sudan, where hundreds of thousands have died in the civil conflict.
“It's really hard to get coverage on Sudan at any time, but one of the consequences of what's happening in and around Iran and Israel over the last few days is that they could make it even harder to get eyes on what's happening in Sudan,” Mr Lockyear warned.
“It's been a war on people. The level of violence by both sides of this conflict – or all sides – has been absolutely horrendous. The way this war is being conducted is utterly horrific.
"The health system in Sudan is – I wouldn't say on its knees – it's in a desperate situation and there needs to be humanitarian actors there to support that response.”
From Gaza to Sudan and Syria, recent Middle East conflicts have heavily impacted the operations of leading humanitarian and charity organisations.
“Increasing conflict around the world makes decisions even more complicated, because we have to focus and prioritise even harder," he said.
