<h2>Gaza Increasingly Alone: “Aut, Aut to Médecins Sans Frontières”</h2>

Originally published in Italian on Il Gazzettino Vesuviano .

This winter has been extremely harsh for Palestinians. The cold has been severe, the rain seemingly endless. Images of flooded camps and tents submerged in mud overlap with those of continuous explosions. Alongside daily destruction, winter itself has become a slow and cynical weapon.

According to a UNICEF report dated January 20, 2026, at least seven children have died of hypothermia this winter in the Gaza Strip — including newborns and very young children — due to exposure to cold without adequate shelter. A United Nations update cited by Anadolu Agency raises that number to eleven children who died from hypothermia in extreme winter conditions.

These figures are not limited to war-related health risks; they show how winter itself has become lethal for a population forced to live in tents, makeshift shelters, or damaged homes, without protection from cold, rain, and humidity.

To this already extreme scenario, another rupture has now been added: the forced “out, out” imposed on Médecins Sans Frontières.

Médecins Sans Frontières does not operate a single standalone “hospital” in Gaza but is an integral part of the local healthcare system. It currently supports six public hospitals in the Strip — including Al-Shifa, Al-Helou, Al-Aqsa, Al-Ranteesi, and Nasser — by providing medical staff, equipment, and direct management of essential departments and services. In addition, it runs two field hospitals and a network of clinics and primary healthcare points.

Overall, MSF accounts for approximately 20 percent of available hospital beds in Gaza and provides emergency surgery, emergency care, maternal and child health services, vaccinations, psychological support, and access to potable water.

The Israeli government has decided to revoke MSF’s operating license in the Gaza Strip, ordering the organization to cease its activities and leave the enclave by February 28, 2026. The official reason cited is MSF’s refusal to hand over complete lists of its local staff to Israeli authorities, as required under new regulations for international NGOs operating in the area.

According to Israel, this measure is necessary to ensure security, transparency, and to prevent possible infiltrations. MSF, however, argues that providing such information would pose a direct risk to the safety of its personnel in a context where doctors, nurses, and humanitarian workers have already been targeted, threatened, or killed.

In an official statement released on January 30, MSF stated that it cannot share the names of its Palestinian and international staff without clear guarantees regarding how the data would be used and how those involved would be protected. In a conflict where identity itself can become a target, the organization stresses, handing over names would endanger not only staff members but also their families.

The divide is stark: for Israel, the names are a tool of control; for MSF, they represent a potential death sentence. Caught in the middle is a civilian population that is becoming increasingly isolated.

In recent months, many surgical procedures that MSF can no longer perform in Gaza have been redirected to Amman, where the organization operates a fully functional hospital specialized in treating war-related injuries.

This is a necessary solution, but an insufficient one. The immense difficulties Palestinian patients face in crossing borders to reach Jordan inevitably delay access to care, turning medical evacuation into a complex and uncertain process. In many cases, these delays affect treatments that require immediate intervention — particularly in trauma and emergency situations — for which postponed care is no substitute.

The move against Médecins Sans Frontières is not an isolated case. It is part of a broader crackdown affecting dozens of humanitarian organizations active in Gaza, many of which have seen their operating permits suspended or revoked for allegedly failing to meet “essential” requirements as defined by Israeli authorities.

This marks a clear paradigm shift: humanitarian action is no longer regarded as neutral by definition, but as an activity to be monitored, regulated, and subordinated to political and security criteria.

Only a handful of facilities remain operational in Gaza, often under extremely precarious conditions: United Nations agencies, the International Committee of the Red Cross, some local organizations, and segments of Palestinian medical staff who continue working despite shortages of medicines, fuel, and protection. Clean water, disinfection, and uninterrupted electricity are essential to operate life-saving equipment — yet almost none of this is entering Gaza.

MSF has rejected all accusations of opacity or collusion, reaffirming that neutrality and independence are non-negotiable, and that protecting local staff is an integral part of providing care. Its departure further reduces an already overstretched response capacity in a territory where the healthcare system has long since collapsed.

January has passed. February 28 marks a formal deadline, and from that moment on, in Gaza, people will feel even more alone.