From the ground in Gaza: MSF director details what 'loud and clear genocide' looks like

When Claire Magone, director general of Doctors Without Borders (MSF) France, recently arrived in Gaza, she found herself in a “lively nightmare”.

Bomb blasts reverberated around her, even in areas deemed safe in central Gaza, as she tried to support her teams working in a field hospital.

“At every corner, you are exposed to death and loss. Either you die on the spot or you are pushed to the south, where you barely find any space to survive,” she told The National in an interview after leaving the enclave this week.

Her testimony reflects a grim assessment two years into the war. In October 2023, a week after the Hamas attacks and the start of Israel’s war, she released a video describing the carpet-bombing campaign as “dramatic”. Today, for MSF and its director general, that war has become a “loud and clear genocide” against Palestinians.

The Israeli army has killed more than 66,000 Palestinians and wounded at least 169,000 others. Among them are about 20,000 children killed and about 40,000 injured, according to estimates by several charity groups.

For Ms Magone, who co-edited a book about lessons learnt from MSF staff in several regions, one of the most disturbing trends she witnessed is the Israeli army’s attempt to normalise hospital bombings and reverse the burden of proof.

“Each time a hospital has been attacked or surrounded, instead of being held accountable for these attacks, the IDF has asked repeatedly humanitarian workers and medical staff … to justify, to give them a good reason not to bomb hospitals,” she said.

“Proportionality, the principle of precaution and the principle of distinction … have been distorted. They have been distorted to justify attacks on hospitals.”

The result is impunity, she argued. “The total impunity in which the [Israeli military] is conducting that war with the support of western countries is really something that is a new norm.”

Gradual disappearance

Despite the UN Human Rights Council and respected scholars characterising Israel’s war in Gaza as genocide, few countries have taken concrete steps to halt the conflict.

France and several other nations recently recognised Palestinian statehood, while the US administration – which has vetoed every UN Security Council resolution calling for an end to the war – put forward a plan that demands Hamas’s surrender but offers no guarantees that Israel will withdraw.

So far, no Israeli official has been held accountable for the mass killing in the enclave, even those from the military who have publicly stated that the plan was to kill 50 Palestinians for every Israeli killed in the Hamas attacks. The International Criminal Court has issued arrest warrants for Prime Minister Benjamin Netanyahu and former defence minister Yoav Gallant, but many countries are not expected to enforce them.

“As you know, the very plan of Israel regarding the West Bank and also Gaza could be called a genocide for decades,” said Ms Magone. She added that many people have pointed to “the gradual disappearance of the Palestinian population” as evidence of such intent.

But what pushed MSF to adopt that term in the context of Gaza's war, she explained, was “the way the Israeli army had systematically destroyed the health system and … the very social fabric that was supporting civilian life”. She added that there are zero fully functioning hospitals and only 14 out of 36 health structures in the enclave are partly functioning.

Ms Magone, whose recent visit to Gaza was her first since the war began, stressed that calling it genocide carries obligations for the international community. “If they don’t want to have a specific complicity in what’s happening, then the violence must be stopped.”

The US ceasefire plan, currently under revision by Hamas, calls for an immediate halt to the Israeli campaign. However, many western and Arab officials believe that the goal of the current Israeli government, which includes far-right extremists, is far bigger than that.

The government has rejected a Palestinian state, built new illegal settlements, gradually annexed parts of the occupied West Bank, and seized more territory not only in Gaza but also in Syria and Lebanon. Many Israeli officials have called for annexing north Gaza before grabbing the whole territory.

Waiting for a bus

“What is sure is that people are gradually pushed by the bombs and by food and water scarcity further to the south,” said Ms Magone, adding that the entire population of Gaza – around two million people – is being ousted into less than 15 per cent of the land.

“And the end of the story, I would say, seems to be that they will be cornered in one tiny area of the Gaza Strip, which might become the waiting room for mass deportation that is part of Israel's plan,” she added.

Recently, the relentless Israeli offensive in the enclave’s largest urban area, Gaza city, forced MSF to suspend vital medical activities.

“What was heartbreaking for our teams is that we were treating … wounded patients in extremely bad shape. Some of them, we tried to tell them, try to go south where you could find maybe some health care that we cannot provide you any more,” Ms Magone stated.

“They were just asking us: where do you want me to go? There is no space any more in the south,” she added.

The Israeli army “has made life unbearable in the Gaza Strip. And now the population is stuck between those two impossible choices: either dying on the spot or being promised a slow death in the south”.

Last year, MSF carried out a mortality survey among its own healthcare workers in Gaza to measure the human cost of the war. The study revealed that 40 per cent of the family members killed were children.

“The number of children who have been killed, burnt and bombed by the Israeli army is unprecedented in the history of recent conflicts,” Ms Magone said. The total number of people wounded “would not have any functioning health system that could cope with such a number”, she added.

She was speaking to The National on Thursday, the same day an MSF medic was killed and four others were wounded. Omar Hayek, 42, was the 14th MSF staff member to be killed since the start of the Israeli campaign.

“Everywhere you can be struck by a drone, a quadcopter, an air strike,” she said. “But you don't really know what the purpose of that target is. What is true, what is very sure, is that they don't care.”

The MSF team, clearly identified as health workers, was hit by an Israeli strike while waiting on a street for a bus to a field hospital.