Al Shifa hospital is lit up in Gaza City 24 October 2023.
“Hospitals there, particularly Al-Shifa, have come under fire,” Anne Taylor says of Gaza.Source photograph by Mohammed Saber / EPA / Shutterstock
From the time Israel began bombing Gaza following Hamas’s October 7th attack, the charity Médecins Sans Frontières—which is often referred to as M.S.F., or by its English name, Doctors Without Borders—has been documenting the humanitarian disaster in Gaza, where more than eleven thousand people have already been killed, according to the Gaza Health Ministry. I recently spoke by phone with Anne Taylor, the head of mission for M.S.F. in Palestine; she’s based in Jerusalem. She discussed what her organization has witnessed, and what life is like for her staff on the ground. Taylor has been with the organization for two decades, and has worked in a number of conflict zones. During our conversation, which has been edited for length and clarity, we discussed the conditions for M.S.F. employees in Gaza, how the organization tries to avoid politics, and what makes this conflict different from others Taylor has witnessed.

Before October 7th, what was Doctors Without Borders’s role in Gaza?

We’ve had a program there for many years. We worked in various hospitals supporting the Ministry of Health. We did some secondary health care, including surgical work with burns. And we worked in Al-Shifa hospital, in Gaza City. We also had our own private clinic. We had a couple of other clinics that were run alongside the Ministry of Health. And at Al-Awda hospital, and we worked down in the south, at the Nasser Medical Center. So there were various hospitals that we were associated with and some of our own primary health-care facilities as well. That was all before the dreadful things that happened on 7th of October, which seems a long time ago.

And since then it’s just been a very catastrophic situation for the people of Gaza, who are already living in difficult circumstances, and who have been suffering under a strict blockade for sixteen years. They’ve always been under pressure and occasionally have had bombs dropped on them, but it was usually over a period of a few days or weeks. In the current situation, the Israeli military started bombing a very heavily populated area, Gaza City. We have to remember—it’s a small place, around forty-five kilometres in length and between six and twelve kilometres wide, and with over two million people there.

How many of your people are now in Gaza doing medical work?

Right now we have got an existing staff of about three hundred Palestinians. And we rotated back in some international staff. We actually have a team of about thirteen international staff here working in Nasser Medical Center down in the south, a surgical team. So they’re doing work there at this present time.

Have any of your employees been hurt or killed in the bombing?

Yes, we’ve lost current and former employees, and many of our employees have lost family members. It’s been very, very traumatic. There have been a lot of collapses of buildings, so some of our staff have lost families in that way. It’s a very tragic situation.

I know very few people are actually leaving Gaza at this point; I wonder if some of your international employees are trying to get out. Maybe that’s not possible.

When the 7th of October happened, we had twenty-two expats there. So we rotate. We actually took them out, because it was a pretty traumatic experience. And then we brought in a new team. And the idea is that we’ll continue to complement that new team. But you have to understand that Gaza is very, very insecure at the moment. And also there are huge problems around the supply of food, electricity, water, and fuel. We are having real trouble in the north; it’s just being ripped apart at the moment. And, in the south, we are having to try and work around very, very difficult . . . The supply of these things is just not enough. It’s not enough.

Doctors Without Borders has been present in a lot of horrific conflict zones, and I’m wondering how what you’re dealing with now is similar or different from other places you have experienced?

It’s different. And yes, I have worked in conflict zones. And they’re always very nasty. But this is a particularly brutal thing because of the huge number of civilian casualties. And they can’t escape it. They can’t move. They’re told to displace down south. But are we talking about just reducing the area from forty-five kilometres to twenty kilometres in length and trying to put two million people in there, which is . . . It’s just an extraordinary situation. And no, I haven’t seen it.

They haven’t stopped bombing. They’re still bombing. They’ve got troops in there with tanks. And it’s just consistent. It’s well documented. We are seeing it all over the world in all the newspapers and television. So it’s like people know exactly what’s happening. And yet it doesn’t stop. I haven’t seen that before.

Where else have you been stationed?

I’ve been in Congo, I’ve been in Nigeria, Côte d’Ivoire. Gosh. Many. Do you need more?

No. There has been a lot of large-scale violence against civilians in the past two decades in many of these places. So you saying that this is still different is notable.

It’s notable in the sense that to have such a volume of people—civilians—that can’t move very easily. And they’re being bombed and shot at. And I just haven’t seen that type of violence. We are also talking about a population that’s around seventy per cent women and children. And so the figures that we’ve seen around mortality are at more than ten thousand deaths. But with the Ministry of Health now being really decimated, it’s very difficult for them even to track it. But then you know that with ten thousand deaths, that seventy per cent are probably women and children, according to the Ministry of Health. And the number of wounded is very, very high. And there’s also people under the rubble, and we can’t get them out. So the figures are just astounding.

How much are you in contact with people in Gaza? What are you trying to offer them? What are those conversations like?

Well, there’s the duty of care as an employer. We have a whole small department that actually follows all the staff and tries to keep in contact with them to see where they are. Currently, we’ve got staff that are blocked in with their families in Gaza City, and we are finding it very difficult to get them out. And it’s really under wartime conditions. But also they want to work—these are people that are used to working in medical facilities. And we’ve got drivers. But a lot of them are medical people, nurses, and so on. And they also have homes in the north. They don’t actually want to go south, so they’re being forced to go down. But, at the same time, it’s very, very dangerous.

Is part of your job talking to people to offer some psychological reassurance or care?

Yes, it is. It is very traumatic and I don’t think that we even know the extent of it at the moment. It’s early days on one level, because this is not stopping anytime soon. And I think that it’s going to get worse before it gets better. Because to displace the volume of population that’s been displaced, going into areas where there’s not enough housing, they don’t have enough food. They’re really living in difficult circumstances.

The young children, including the ones who aren’t wounded, are going to be very vulnerable toward catching diseases. And with water there that is very brackish, salty, and the kids get diarrhea. So it’s just set up for a longer-term, very sad situation. And that’s without looking at the type of trauma and burns that we’re seeing. So it’s very hard to express the type of violence that’s actually being imposed on these people.

Have your staff had any dealings with either Hamas fighters or I.D.F. soldiers over the past month? And what have those experiences been like?

In terms of the I.D.F. soldiers there, it’s actually not a pleasant experience for the staff. Let’s put it that way.

How does Doctors Without Borders try to do its work while steering clear of politics to the degree that that’s possible?

We are an emergency medical organization. We work for people that are really in a distressed situation. We put our energies into vulnerable people who have very difficult access to good health care, and we stay within those medical boundaries.

We only speak to what we see. If we see it, we can speak about it. And, after that, if that gets politicized, it gets politicized. And, in this day and age, things do become very politicized very easily. But that’s not the purpose of why we speak out. We speak out because we want to actually bear witness and speak about our patients and the people that we are trying to support. And wave the flag to say that this is happening, this is happening. And in this particular case, it should stop. It must stop.

Has your organization been in contact with the Israeli government about the vulnerability of your employees?

Yeah, yeah, absolutely. We are in contact all the time because we actually have to move around and we have to keep ourselves as safe as possible. When we’re making movements, we really, really have to be aware of what the circumstances are. And, of course, with the staff that are staying in our facilities up in Gaza City, we are keeping in touch. We negotiate. We try to work out solutions to be able to bring them out, but it’s very, very difficult when you’ve got combat troops in there and tanks and bombing. And the staff are frightened. They don’t want to walk out under a white flag in that situation when also they’re seen as the potential attackers.

What are those conversations like? Who are you talking to in the Israeli government? Do they seem open or sympathetic to the plight of people on your staff?

We’ve worked in Gaza for many years, and so we’ve always had a working relationship with the Israeli government because they’ve always controlled who goes in and who goes out. We’ve continued on talking about it. They know we’re very unhappy with it, but we still continue to talk and make sure that there are mechanisms in place to keep us safe. When we see the destruction of the whole health sector there—it’s a systematic destruction—we don’t accept it, really.

I can understand why you may want to be careful here. I’m curious whether you feel that the Israeli government is listening. When you call to express concerns about civilians and about your employees, do you feel that the seriousness of this is understood?

Look, we’re not a political body in that way. We talk about what we want to do, the type of work we want, and we talk about what we see. We will take our arguments and we will present them as we feel that we can and should. We’ll say that to them and we’ll say it to you and we’ll say it to the world that this should not be going on. Beyond that . . . yeah.

I imagine you’ve had a lot of experience talking to warring parties in your career. I would imagine that, in those conversations, you’ve heard varying attitudes toward the importance of protecting civilian life. I’m curious how any conversations you might’ve had in the past month would fit into that experience.

For us, it’s always about how to have access to our patients, to have access to the people that are getting hurt. It doesn’t matter who it is, it doesn’t matter what party it is. We will negotiate to have access to the population because that’s our job. We negotiate to be able to work in relative safety wherever we are. In this particular case, where it’s really a full-on violent war, it’s difficult to negotiate the space to work. And, in fact, it’s impossible at the moment in the north of Gaza.

I was trying to give you an opportunity to say, Yes, it’s very clear in these conversations that Israel is very concerned about civilian lives. They feel that this war is necessary, but still they have immense concern and heartbreak every time civilians are killed. That’s not what you’re telling me. That was the reason I kept asking that question.

All right. O.K. You’re putting words in my mouth.

I wasn’t saying you were saying that. I was just saying that it was interesting that you had not said that.

Yeah. Yeah.

Are there any stories that you have from the past month that you would want to share that would explain what you’re dealing with?

I’m not there in Gaza myself, so I can only be talking secondhand about some of the stories that our staff have witnessed. And even our staff have suffered with their families being buried under rubble. They don’t know whether they’re dead or alive, and there’s nothing they can do about it. That’s very heartbreaking. And that’s exactly what’s happening at the moment.

The hospitals there, particularly Al-Shifa, have come under fire. I know it’s been extraordinarily difficult for the medical staff to work there. They’re still working there. There are still people that are very committed to still working. And it is very difficult for us to be able to see really what’s happening at the moment in that hospital with the Israeli soldiers in there.

But we’ll only hear some of these stories afterward to be honest. Often electricity is going out, they are running out of water, running out of painkillers, running out of medical supplies that they need. And they’re having to actually take care of the patients in this situation. And I think it’s quite traumatic for them. But to do it under these circumstances, for me, they’re very brave people. ♦