We ran out of things like gauze, saline, paracetamol and gloves
Riccardo Defrancesco is a nurse activity manager with Médecins Sans Frontières (MSF) and in November 2024 travelled to Gaza for the first time … “We ran out of things like gauze, saline, paracetamol and gloves”.
Having worked in war zones in Afghanistan, Iraq, Sierra Leone and Libya, I felt like I had relevant experience to offer. I supported local staff at MSF’s Al Zawaida field hospital in Deir al-Balah, central Gaza. The hospital provided orthopaedic, general and plastic surgeries.
Most of the patients were civilians who were either close to explosions or whose house had been targeted directly. They came in with burns, limb fractures, amputations or abdominal injuries requiring surgery. All the surgeons were from Gaza – in fact 95% of the 350 staff were local Palestinian.
We were there just to support and facilitate. The field hospital had been built only a few months earlier with 28 beds, even patients per tent. The plan was to increase capacity to 70 – we had the staff, but not the supplies.
That was the main struggle: shortages. In the six weeks I was there we ran out of fundamental things like gauze, saline, paracetamol and gloves. Saving limbs and reconstruction surgeries would normally be possible in a humanitarian setting, but here we didn’t have all the instruments.
Treating burns is always hard but here we lacked some antibiotics and had no microbiology lab to test blood for bacteria. When burns – often on children – covered more than 20% of the body, the mortality rate was quite high.
Every day we had to calculate how much electricity our essential machines needed. We couldn’t shut down the blood freezer or ICU lights
Fuel was another major problem. With no power infrastructure in Gaza [Israel cut off all power supplies in March 2025 and has repeatedly destroyed power plants], a generator was the only way to produce electricity. But to service this every few months, which, in ordinary times cost around $1,000, now cost $50,000.
Every day we had to calculate how much electricity our essential machines needed. We couldn’t shut down the blood freezer or the ICU lights, but machines to measure vital signs were replaced by manual checks.
We were not the heroes. The Palestinian nurses, doctors, surgeons, cleaners, electricians, plumbers – everyone running the hospital – were. They came into work happy, despite being targeted, displaced every few months, and despite colleagues and family being killed and injured.
Statement by Physicians for Human Rights, Israel
On October 13, 2023, six days after the Hamas attack of October 7, the Israeli military ordered the evacuation of 22
hospitals in Gaza City and the northern Gaza Strip. That day marked the start of an unprecedented assault on Gaza’s health system.
Israel has systematically targeted medical infrastructure across the Gaza Strip, attacking 33 of 36 of Gaza’s hospitals and clinics depriving them of fuel and water. More than 1,800 of Gaza’s medical staff have been killed or detained.
Physicians for Human Rights in Israel released a position paper that documents this assault for what it is: a deliberate, cumulative dismantling of Gaza’s health system, and with it, its people’s ability to survive.
This, they state, amounts to genocide. Israel’s bombing of hospitals, destruction of medical equipment, and depletion of medications have made medical care – both immediate and long-term – virtually impossible. The system has collapsed under the weight of relentless attacks and blockade.
