Clayton Dalton writes:

On a hazy morning in November, a group of aid workers with Médecins Sans Frontières (M.S.F.), known in English as Doctors Without Borders, crossed into Gaza for a two-month mission. Jennifer Hulse, an emergency physician from the U.K., led a medical team. “We all had as many bags as we could physically carry,” Hulse said. Inside were essential supplies such as surgical tools and engine oil for generators. Her assignment was to help the Gaza Health Ministry restore access to health care in the north, where Israeli attacks had flattened nearly every building in sight.

The team first spent several days at Gaza’s sole remaining hospital focussed on pediatrics—Al-Rantisi, in Gaza City, which was barely operational after Israeli air strikes. The roof had collapsed in places. Doctors were seeing patients in a waiting room with only a few cots. “It was very cold, even inside the buildings,” Hulse told me. When a storm blew through, she mistook thunderclaps for explosions. She learned that parents sometimes arrived with the bodies of infants who seemed to have died of hypothermia. Her team quickly put together a plan to help coördinate repairs, secure new electrical generators, implement a triage system, and organize trainings for staff. “We were just trying to get it functional again,” she said.

Next, Hulse travelled to Jabalia, in the northern reaches of the Gaza Strip, where the situation was even worse. She was driven through rutted streets in which not a single building remained intact. The area had previously been served by several health-care facilities, including a primary-care center—now destroyed—and the Indonesian Hospital, which I visited during a temporary ceasefire, in early 2025. But this past October, as part of another ceasefire agreement brokered by the Trump Administration, Israeli forces effectively divided Gaza in two, pushing the population toward the sea. Nearly all of the surviving health-care facilities in the northernmost area fell on the wrong side of the partition. “No one can reach them now,” Hulse said. To get proper medical care, she went on, an injured person would have to make it to a crossroads and flag down a donkey cart to Gaza City, which could take hours. As a stopgap, the M.S.F. team and Gaza’s health ministry had decided to open a temporary clinic in the area.

Hulse and her colleagues spent several days searching for a suitable location. At one point, she saw a group of children playing on what had once been the roof of a building. They climbed into a cardboard box and slid down the sloped surface as though they were sledding. “There was nothing, absolutely nothing,” she told me. “Even finding a flat piece of ground that wasn’t covered in rubble was difficult.” Still, within a few weeks, they picked a spot, dug latrines, installed generators and water tanks, and erected tents. The clinic was close to the partition, where Israeli soldiers often fired their weapons. The team piled sandbags around the perimeter for protection.

The temporary clinic opened after Christmas, and soon they were seeing up to four hundred patients a day. The staff did their best to treat all sorts of conditions: infections, heart attacks, diarrhea, gunshot wounds, shrapnel injuries. “It was a tiny clinic amid the rubble, and we didn’t always have the medications we needed,” Hulse said. “But people were still so grateful for it.” Meanwhile, about a kilometre away, workers began clearing debris from the old site of the primary-care center, making room for a permanent replacement.

Then, just before New Year’s, the Israeli government released a statement. It had previously instructed all international humanitarian organizations that operated in Gaza to submit detailed information to maintain their registration, including financial statements, the identities of all donors, and a full list of employees, with passport numbers, dates of birth, and, for Palestinians, the names of spouses and children. Organizations that refused would be expelled. “We were briefed on the issue,” Hulse said. “It was really hard to believe it was actually happening.” Thirty-seven organizations—including M.S.F., the International Rescue Committee, the Norwegian Refugee Council (N.R.C.), and Action Against Hunger—received notice that they had failed to comply and would no longer be allowed in Gaza, the West Bank, or East Jerusalem. They were given sixty days to cease operations and withdraw all international staff. [Continue reading…]