MSF Doctor in Gaza Says Cease-fire Brings Hope, but Challenges Remain

The recent agreement between Israel and Hamas on the initial phase of US President Donald Trump’s peace plan has sparked a sense of relief across the region. The ceasefire has now begun, and the remaining hostages in Gaza are scheduled to be released in the coming days.

Israelis and Palestinians are celebrating the agreement and hope it lays the foundation for a permanent end to the devastating war, which began two years ago after a Hamas-led attack on Israel. The conflict has left Gaza in ruins and is estimated to have claimed more than 67,000 Palestinian lives. Israel has been widely accused of committing genocide in Gaza – where famine was declared in August – and of using aid as a weapon.

There are countless challenges to advancing the peace process while also meeting the needs of those affected by war. In order to gain a better understanding of the situation on the ground at this crucial moment, Foreign policy He spoke with Mathieu Pichet, deputy medical director at MSF, on Thursday. Foreign Policy’s conversation with Bechet took place just hours before the Israeli government voted to approve the “Phase One” deal of the Trump plan, and one day before the ceasefire began.

Bechet is in the field hospital affiliated with Doctors Without Borders in Deir al-Balah after being evacuated from Gaza City amid the Israeli attack there. He provided insights into how Palestinians are responding to the ceasefire agreement as well as the ongoing problems they face on issues ranging from lack of supplies to mental health treatment.

This interview has been edited for length and clarity.

Foreign policy: Firstly, how are you? How is your team?

Mathieu Bechet: So, I’m fine.

The team today is very happy and optimistic regarding the ceasefire. It was on everyone’s face this morning, and this afternoon. But we also mourn our two colleagues who recently passed away. We lost two of our colleagues in a strike on October 2nd.

FP: I’m very sorry. How is the atmosphere on the ground after this deal? Are people optimistic?

MB: Yes, although some bombing continues. But now it’s been a long time and I haven’t heard anything.

When rumors of a ceasefire surfaced last night, we started to hear some happy shooting. This is a way to celebrate, which may not be entirely appropriate, but it shows people’s happiness. And then, of course, with our employees, we could see that they were happy and full of hope.

FP: I recently had to evacuate from Gaza City. What were some of the biggest challenges you faced while doing your work during the Israeli attack and after the evacuation?

MB: The main challenge in Gaza City was security. For this reason, in the end we had to evacuate, because the bombing was constant and everywhere.

The reason for our departure was the arrival of tanks into the city next to our clinic, about 700 meters from our clinic. That was a red line for us and we had to leave.

Security was the main challenge. But of course there is a challenge regarding materials and medicines. Supply shortages – that’s a really big challenge, and that’s everywhere [Gaza] Strips.

FP: What are the areas of greatest demand in terms of equipment and materials?

MB: Sterile gauze. This is the first thing I would say. And also medicine. They are basically basic items. It’s basically the dressing materials and bandages and all those very important items.

FP: Is this shortage largely due to ongoing Israeli restrictions on aid coming into Gaza and on the movement of aid within Gaza as well?

MB: Yes, of course, this is entirely related to those restrictions. The complexity of having a supply channel is certainly a major challenge for all health workers here. This is clear.

FP: Do you hope that this agreement between Israel and Hamas will make it easier to get supplies and help people?

MB: optimistic? Yes. But I don’t know whether this supply issue will still be used as a way to restrict the sector.

We have some hope. There is a ton of material waiting outside the borders. I think we succeeded yesterday in bringing in our materials. But it’s not just about Doctors Without Borders, it’s about the World Health Organization [World Health Organization] And all the other actors. So, I don’t know exactly what this ceasefire will be like in terms of the flow of humanitarian aid. This is of course not only about what is necessary to operate the health sector, but also about food.

FP: Can you talk more about what it was like to evacuate from Gaza City?

MB: I have been in Gaza for about a month. I only spent three or four days in Gaza City. I was supposed to replace one of my colleagues there. We were handing in our mission when our headquarters said, “Okay, guys, now it’s too dangerous, we can’t stay.” Therefore, we had to evacuate the staff and move all our luggage so as not to lose it.

And of course, on the same day we had to see all the patients who were waiting. More than 150 patients were waiting. We had to give them instructions, a few supplies, and explain to them how to keep the bandages on when we weren’t here anymore. This clinic was primarily for wound care. But very complex wounds often affect people of all ages. There were also wounded and malnourished patients. This category of patients has these chronic wounds that often become infected. Malnutrition is one of the comorbidities that does not help in proper recovery.

The situation regarding access to food, when I was there in Gaza City, was very precarious. When you go south, you see more food in the market, but it’s still very expensive. There are children suffering from malnutrition.

FP: How does the situation in Gaza compare to other conflict areas where you have worked?

MB: Last year, I was in Sudan, in Darfur, which is also a painful situation with a large number of displaced people, severe violence, malnutrition, epidemics, etc. So, for me, it’s a bit difficult to compare.

But what is unique here, amid the massive bombardment that people are suffering from, is that they cannot escape. They can’t escape, and that makes them completely unique. The level of technology used to harass and kill is – in my experience over 20 years with MSF – also unique. Everything used for targeting and destruction is enormous. When you enter Gaza City, you are speechless in your car for minutes because you say, “I can’t believe it.” Even if you’ve seen the pictures before.

FP: Just in terms of level of destruction?

MB: Yes, the level of destruction I do not understand, no one understands.

The people have no hope. They say: “It has to stop. Why? Why?” They ask: “Why my daughter? Why my brother? Why my little sister?” It’s unbelievable.

I’ve never seen it, except maybe yet [Haiti] 2010 earthquake, a large number of injured people like that on the street, in the health facility, in the waiting rooms of the health facility. Some of these cases have to be hospitalized, but there are no more beds. Bed capacity is overcrowded.

FP: Can you talk about the mental health challenges faced by Palestinians in Gaza? I can imagine that it is especially difficult for Palestinians who work with NGOs [nongovernmental organizations] Like MSF, they help address a situation that also affects them. They are also starving, facing bombing and losing their families, yet they are trying to help.

MB: Our colleagues openly share their feelings about this. I spoke to someone who works with another NGO – we were discussing ways to collaborate on some issues – and she was saying that if it were just us, we would stay home and cry, but we wake up in the morning just to do our work because the patients are there and that’s what we have to do.

So, they continue. They tell us that work is their way of coping. They are truly heroes working every day.

FP: It is clear that it has been difficult to meet even basic needs in Gaza, including water and food. But mental health is important. Is it difficult for organizations like MSF to address mental health issues in a conflict zone like Gaza?

MB: yes it is. It’s all tape affected.

We try to complement our patient care with our mental health team and psychosocial programs. But we currently do not have an open program that addresses this problem for the entire population, because it is not possible for us. Our target population is our injured patients. Some of our other MSF colleagues are caring for cases of malnutrition in children. They will have this activity that is combined with their medical activity. This is what we do in our organization because it is very difficult to meet this need.

FP: What are your most important priorities during the ceasefire period as more aid flows?

MB: We have different MSF branches here, so we try to complement each other. One of them is responsible for motherhood and children. And the other three, we focus on trauma and burn care[s]. Burn care and trauma care are tremendous. There are also those complex wounds among a large population that need to be addressed. We are working with other organizations to deal with this. So, this is the priority.

I would say the other priority is water. We truck water, which other organizations do as well. Therefore, we provide safe drinking water in different places to the residents.

But I would say that trauma care is still one of the major needs.

FP: Is there anything you would like to say that you think is particularly important for the outside world to understand about the situation in Gaza and what you’re seeing there on the ground?

MB: Wow, so many things.

Frankly, what is shocking – and sorry to repeat myself – is the scale and level of harassment caused by the use of technology such as drones. This includes suicide drones. There are bombs that are supposed to target a specific person, but they kill everyone within 20 meters.

The severity of the killing here, no one understands its meaning. And I think the thing that people need to understand is, why? Why are all these innocent people supposed to die? It is unbelievable that this country uses such advanced military technology to kill and destroy. Why?

And the systematic attack on hospitals. I’m not even talking about schools, I’ve seen a lot of UN-run schools destroyed. Why? It’s crazy.

Sorry, I’m just a doctor. I am not an analyst. But, again, why?