Last Saturday, Doctors Without Borders (MSF) issued a statement unlike any it has made since it was founded more than half a century ago in Paris. Since then, the red and white MSF logo has served as a sign of protection and promise, even in the darkest places.
In all the wars and conflicts I have worked in MSF has earned my deepest respect. Its doctors and staff are always the first to arrive and the last to leave. It operates under bombardment, amid power cuts and in the most difficult wartime conditions. I’ve seen MSF doctors stand up to child soldiers who barged into clinics with assault rifles, and demand respect for their patients. I’ve seen doctors work for days doing amputations on children without rest.
MSF’s clinics in Sudan, Ukraine, Darfur and more than 75 countries worldwide bring crucial care to the most desperate people. In 1999, it quite rightly won the Nobel Peace Prize. Back then, the Nobel actually meant something.
But MSF, like many NGOs operating in devastated Gaza, has now been presented with an impossible choice by the Israeli authorities to provide a list of Palestinian and international staff names or be forced to suspend its operations from March 1. MSF’s permit to work in Gaza expired on December 31 and it now has only weeks left unless it gives up the required information.
In order to re-register, MSF has been harassed and bullied by the Israeli authorities into sharing personal information about its Palestinian staff. MSF stressed that the decision to provide the list came only after “extensive consultations with its Palestinian colleagues” and would be carried out solely with the express consent of the individuals concerned, under strict parameters designed to protect staff safety. This forced decision should not be seen as compliance, it should be seen as coercion.
MSF has said plainly that its goal is to continue providing critical medical care. Without MSF clinics in Gaza, there is no hope. MSF supports one in five hospital beds in Gaza. Last year alone, it handled more than 100,000 trauma cases. MSF serves half a million people through vital support to health and water systems. If MSF is forced to cease operations, the effect will be immediate and catastrophic.
This pressure on healthcare workers illuminates Israel’s fundamental disregard for the protection of civilians. Throughout the brutal, all-out war in Gaza that began after the Hamas-led attacks on October 7, 2023, Israel has bombed hospitals, and killed and wounded more than 1,200 Palestinian healthcare workers, according to one NGO. MSF staff have lost 15 of their colleagues.
The damage to Gaza will take decades to rebuild. The healthcare system is in tatters and MSF is now one of the very few medical organisations still able to operate.
Israel argues that NGO registration is necessary to prevent Hamas infiltration. There are, of course, legitimate security concerns. But this is not about that. This is about control.
Last week, Israeli police and military seized and bulldozed UNRWA offices in East Jerusalem. In December, it was reported that the agency’s UN flag was hauled down and replaced with an Israeli one. Such actions are not about security, they are about subjugation.
If Israel has real, evidence-based concerns about specific individuals, those cases should be dealt with directly. Imposing sweeping, harsh measures endangers medical workers and shuts down care for hundreds of thousands of civilians.
Those of us who can must speak out. Israel’s allies must stop using humanitarian access as a talking point and start treating it as a baseline requirement for normal diplomatic relations. The so-called Board of Peace should make this their first action. But they won’t.
The fear of handing over staff lists is well-founded. We know Israel targets journalists in their homes. We know its soldiers kidnap doctors – there is still no sign of Dr Hussam Abu Safiya, the director of a hospital in North Gaza detained by Israeli forces in December 2024. We know Israeli troops shoot healthcare workers, as they did last March when they killed, then buried, 15 emergency responders in Rafah.
Israel has no qualms about punishing those who do not bow to its demands. Food, medicine and humanitarian supplies have been cut off. MSF has said that since January 1, international staff have been denied entry into Gaza and critical medical supplies blocked; this is on top of the new registration requirements that could halt operations altogether.
This is another attempt not only to control humanitarian operations, but to suffocate Gaza.
MSF is not just any humanitarian actor. It has carried out vast numbers of trauma treatments and outpatient consultations. It also provides essential support such as clean water – the infrastructure without which medicine collapses. If that work is forced to stop, the consequences will be immediate: preventable deaths, untreated infections, amputations that could have been avoided, and childbirth complications that turn fatal.
This is an assault on international humanitarian law, which states clearly that civilians must be protected, the wounded and sick must be cared for, and humanitarian relief must be allowed and facilitated.
Medicine and doctors should never be bargaining chips.
This will not make Israel safer. It will create more chaos and more havoc in Gaza. There is no reserve medical system that could replace MSF. Gaza’s healthcare system has been systematically and relentlessly targeted by Israeli bombs. Last May, the World Health Organisation reported that 94 percent of all hospitals in Gaza were damaged or destroyed, and documented at least 735 attacks on healthcare facilities from October 7, 2023 to June 11, 2025, resulting in 917 deaths and 1,411 injuries, affecting 125 health facilities, including damage to 34 hospitals.
This does not include attacks on WHO and other medical warehouses, such as the strike last July in Deir Al Balah that severely disrupted the delivery of essential medicine and supplies.
Before the war began, I returned to Gaza to visit MSF hospitals. I travelled to several clinics to observe doctors, physiotherapists, psychologists and midwives working under the most difficult conditions, with limited supplies and constant power cuts. To Gazans, MSF represented not just an institution but a lifeline.
Israel should immediately ensure that MSF and other medical organisations can function: allow staff to rotate safely, permit supplies and keep registration rules that do not endanger workers.
MSF has done everything they can. This is about survival.
