One year ago, people in Gaza began holding weekly demonstrations, known as the March of Return, near the fence with Israel. In response, over the course of the protests, people are being shot by Israeli forces, resulting in horrific injuries. The medical, human and financial toll in the blockaded enclave has become unbearable as thousands of people have been left to cope with devastating wounds. Despite the efforts of the Ministry of Health in Gaza and the few organisations on the ground, the needs vastly exceed the available capacity.

Gaza has become completely abandoned in the last year, as the more than 6,500 people shot by Israeli forces during the protests have been largely left to their fate. Suffering from complex and severe wounds – mostly to the legs – many of these people are now waiting with diminishing hope for comprehensive treatment. Searching for help in a health system ruined by more than a decade of Israeli blockade, they have also been abandoned by the different branches of the Palestinian authorities, stuck in a political stalemate where the medical needs of people fall to the bottom of the authorities’ agendas.

The situation in Gaza is medically and financially under-resourced and is more than can be managed by the healthcare staff present in the blockaded strip, despite the efforts from the Ministry of Health and the few other health organisations involved in the response. MSF has tripled our capacity in Gaza since the beginning of 2018 but we are overwhelmed by the scale of how much the teams have been left to take on.

These are not simple wounds that can be easily stitched up. Huge chunks of legs have been blown out and the bones within shattered. These people need repeated surgeries to just clean and close their wounds. Many wounds are infected, preventing reconstructive surgery that is in any case available only to a tiny few in Gaza.

We have opened inpatient departments, added staff to our surgical teams, and care for hundreds of people daily in our clinics. Yet still we lack the number of beds necessary to treat these patients, as well as the number of doctors with the expertise required to tackle drug-resistant infections or to perform the complex surgeries needed to fuse bones back together.

All of the authorities responsible for Gaza – on both the Israeli and Palestinian sides – must fulfil their duty to take concrete action to improve the situation in Gaza while the fate of thousands remains in question.  Adding to an already-heavy toll, violence continues along the fence and recent weeks have seen a further escalation of tension in the area. We are not naïve about the current political situation but these health needs must be answered. We are also disappointed with the lack of action by the international community, despite our repeated calls for support.

The risk is that we leave thousands of people to their fate: in pain, facing amputations, and a lifetime of disabilities. These effects will not be confined to those shot, however but will ripple outwards in a society already brought to the brink of collapse by the blockade. Further misery beckons for a people trapped by a series of political spats that have little to do with them.