Children under 15 years old made up almost a third of outpatients treated for wounds in field hospitals run by Médecins Sans Frontières (MSF) in Gaza last year, statistics published in The Lancet reveal.
The figures were released by MSF in correspondence with the respected medical journal and come from six health facilities in Gaza supported by the international medical NGO. The facilities are predominantly in the south and centre of the devastated territory.
More than 90,000 outpatient consultations involving wounds were carried out at the facilities in 2024. Bombs, shelling or shooting was involved in just under half of these, MSF said.
The death toll in the Israeli offensive launched following the Hamas raid into Israel in October 2023 has risen to more than 62,000, according to a count by the ministry of health in Gaza that is used by much of the UN, and which the British government says is a “reasonable figure”. Of these, more than half are women or children.
The proportion could be higher. Figures from a classified Israeli military intelligence database indicate five out of six Palestinians killed by Israeli forces in Gaza have been civilians, the Guardian revealed last week.
Israeli officials say they take all “feasible” precautions to avoid civilian casualties and accuse Hamas of using civilians as human shields.
On Monday, Israel twice struck Nasser hospital, the last functioning public hospital in southern Gaza, killing 20 people, among them five journalists. Witnesses said the second strike came just as media and rescue crews arrived 15 minutes after the first bombing.
Statistics of people wounded during the Israeli offensive have received less attention. More than 150,000 have been injured, according to the Gaza health authorities.
“Explosive weapons are designed to be used in open battlefields, but are increasingly being used in urban areas,” MSF said. “The makeshift shelters in which people live following frequent displacement offer almost no protection against explosive weapons, and especially their secondary effects such as blast, shrapnel, and incendiary impact.”
In two MSF hospitals, nearly 60% of lower-limb wounds were related to explosive weapons, often with open injuries to bone, muscle, or skin, the organisation noted.
MSF said: “Most immediate fatalities occur at the scene of impact and thus are not captured in our data. Under-reporting of both injuries and deaths could be prevalent in vulnerable populations who are often not able to move away from sites of impact such as infants, children, people with disabilities, and older adults.”
The harsh conditions of life in Gaza, where much of the population live in makeshift tents, and basic infrastructure such as sanitation systems or roads has been destroyed, contribute to the burden on the few functioning health facilities in the territory.
Just over half the wound care-related conditions recorded by MSF were injuries due to unsafe living conditions, domestic accidents, and road accidents.
MSF said it was facing critical shortages of essential supplies and was rationing food for patients being cared for in its facilities to only one or two meals daily.
“It is likely we will not be able to offer any food for our patients in the coming weeks. MSF reiterates our call for an immediate and standing ceasefire … We urge the Israeli government to directly allow and protect impartial and unrestricted medical aid into Gaza,” the organisation said.
Israeli authorities said they facilitated the entry of medical supplies to Gaza. Earlier this month a spokesperson for Cogat, the ministry of defence agency responsible for administering Israeli restrictions, told the Guardian that, since the beginning of the war, more than 45,000 tonnes of medical equipment had been transferred to the Gaza Strip by 3,000 trucks. UN agencies and doctors who have worked in Gaza have said that there is a critical shortage of medical supplies, which NGO Physicians for Human Rights have attributed to the “limited and delayed flow of humanitarian aid permitted by Israeli authorities”.
The Hamas attack into Israel which triggered the conflict killed 1,200, mostly civilians. About 250 people were abducted.
