2023 has been marked by one humanitarian crisis after another. From the large-scale displacement caused by the Ukraine war to increased gang violence in Haiti, intensified conflict in Sudan, severe devastation brought by the Turkey-Syria earthquakes and by Cyclone Mocha in Myanmar, and dire situations that force people such as the Rohingya to make risky sea journeys, the world has been witnessing an array of devastating events. Each crisis, distinct in its nature, has led to enormous human suffering and urgent humanitarian needs.

At the moment, the world's focus is on the absolute horror of war in Gaza which has resulted in massive humanitarian needs, with women and children bearing the brunt of the conflict, and civilians being killed and trapped in an unrelenting cycle of violence and despair. Doctors Without Borders / Médecins Sans Frontières (MSF) has been a crucial presence in Gaza, providing emergency and surgical care, burns treatment, and other medical services. 

Gaza's hospitals have been pushed to a breaking point, with Doctors Without Borders staff continuing to provide medical care amid intense bombings, deteriorating security and attacks against medical facilities and personnel. Three of our medical staff have been killed, while the rest are utterly exhausted and beyond despair. Yet, they continue to do what they can to provide medical services, including being forced to amputate patients’ limbs, especially children, often without anaesthesia and sterilised surgical tools, just to save their lives

In the north of Gaza, where conditions are dire, we have been forced to leave the Indonesian hospital at the outset of the crisis. At Al-Shifa and Al-Awda hospitals, we are gravely concerned for the safety of our patients amid the very dynamic situation. Over the past 10 weeks, Al-Awda has been besieged, damaged in strikes, and medical staff have been killed in blasts. The hospital is now out of essentials like general anesthetic and oxygen. At Al-Aqsa hospital in Gaza’s middle area, our doctors are providing emergency surgery and outpatient care to victims of the recent bombings of Al-Maghazi and Al-Bureij refugee camps, half of whom are women and children. The team strives to maintain effective hygiene protocols and lower the risk of infection despite a lack of essential supplies and equipment.

In the south, we support at least four hospitals and more recently reopened one clinic to respond to the immense needs. While we have an international emergency team in place to support our Palestinian colleagues, our activities are severely limited due to the sheer scale of needs, lack of access to essential supplies, damaged infrastructure, widespread insecurity, and forced evacuation orders.
A crucial aspect of Doctors Without Borders’ work in Gaza has been dealing with the challenges of evacuating wounded and sick people, often trapped in hospitals under attack. This dire situation highlights the constant violation of medical ethics, human rights and international humanitarian law. 

In the West Bank, Doctors Without Borders’ teams are seeing a significant increase in violence.  While we continue to run medical activities, and support facilities such as the Khalil Suleiman Hospital,  our teams also bear witness to the obstruction of ambulances, the blocking of access to healthcare, and the systematic targeting of health facilities. This means that we cannot provide treatment for patients who cannot come to our facilities, and that the hospitals themselves cannot anymore be considered as safe spaces.  

In Ukraine, Doctors Without Borders’ response has been comprehensive since the full-scale invasion began on 24 February, 2022. Our teams are focusing on treating patients near the front lines, running mobile clinics, and using a medical evacuation train to transport patients from overburdened hospitals to safer facilities. In Eastern Ukraine, particularly in Donetsk Oblast, Doctors Without Borders supports hospitals with donations, training, and emergency response teams, and runs ambulances for patient referrals. Mental health support and specialised care, including sexual and reproductive health services, have been intensified in Zaporizhzhia and Kyiv. In Apostolove hospital, Doctors Without Borders provides direct surgical support for trauma injuries.

Doctors Without Borders’ operations in Western Ukraine focus on outpatient departments and mobile clinics, concentrating on internally displaced patients with chronic diseases. In Uzhhorod and Ivano-Frankivsk, our teams have conducted thousands of medical consultations and provided training sessions on decontamination, mass casualties, and mental health to local health professionals.

Unfortunately, two of our supported hospitals in Donetsk and Kherson regions in Ukraine have recently been targeted in a space of a week, collectively claiming the lives of two people and forcing our teams to temporarily suspend our activities.

The comprehensive and adaptive response by Doctors Without Borders in various Ukrainian regions, as well as our critical work in war torn Gaza, despite targeted attacks, highlights our unwavering commitment to providing essential medical care and support in the face of adversity. Our efforts aim to alleviate the suffering of those affected by conflict, ensuring that healthcare remains accessible even in the most challenging environments. In both Gaza and Ukraine, and in our various projects around the world, we remain committed to supporting people trapped in conflict and disasters, where healthcare systems have crumbled. Our interventions have been lifesaving, yet the needs are overwhelming, and the crises are far from over. The conditions in both Gaza and Ukraine are harrowing, with hospitals overwhelmed, supplies running low, and civilians facing unimaginable choices.

As we usher in a New Year, for many, it symbolizes hope and new beginnings. But for those ensnared in these conflicts, the turn of the year does not turn the tide of their suffering. Now, more than ever, is the time to bolster our humanitarian efforts. As we continue to navigate these tumultuous crises, the risk of diminished funding looms large, threatening to force organisations, including Doctors Without Borders, into agonising decisions about cutting support for critical lifesaving projects.

This is why we call on you to stand with us as a testament to the enduring spirit of humanity. Our mission transcends beyond providing medical aid; it's about holding onto hope in the darkest of times. Let us remember – every contribution, every act of support, adds a ray of hope to the lives overshadowed by conflict. Let us not falter in our commitment to those who rely on us the most.

The generous support of our donors allows Doctors Without Borders to continue our lifesaving work in Gaza, Ukraine and around the world. Help us provide medical assistance to patients in need by making a donation today  https://donate.doctorswithoutborders-apac.org/?appeal=year-end-oped-article

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*Paul McPhun is currently the Director for South-East & East Asia Pacific of Doctors Without Borders.

** The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the position of Astro AWANI.