Aitor Zabalgogeazkoa during an interview with IPS in Bilbao (Spain). Recently returned from Gaza, this Basque aid worker has spent three decades in the field of humanitarian work. Credit: Andoni Lubaki/IPS
By Karlos Zurutuza
BILBAO, Spain, Aug 19 2025 – It’s 8am when Nasser Hospital in Gaza opens its doors. Aitor Zabalgogeazkoa, Doctors Without Borders’ emergency coordinator in the besieged territory, has already been at work for more than three hours.
“The first thing is to check online where the explosions or gunfire I heard overnight actually took place. That’s when we start organising the day,” says the 61-year-old MSF staffer, during an interview with IPS in Bilbao —400 kilometres north of Madrid. He has just returned home after two months in Gaza.
“By half past eight, the hospital has already reached its daily capacity. Children, women, the wounded… many are left outside because the system is overwhelmed. It’s incredibly hard to manage,” Zabalgogeazkoa explains.
That has been the reality since October 2023, when Israel launched its military offensive on the Gaza Strip, a Palestinian enclave bordering Egypt but cut off from the West Bank, where most Palestinians live.
Gazans living in tents set up on the beach fetch water in jerrycans. Access to even the most basic supplies has become a daily ordeal during the war. Credit: MSF
According to Gaza’s health ministry, the campaign has so far left more than 60,000 dead and 145,000 injured. The vast majority are civilians, including thousands of women and children.
Israel argues its operation is aimed at destroying Hamas’s military capacity — the Palestinian militia and governing authority in Gaza — following the 7 October 2023 attack in which around 1,200 people were killed in Israel and more than 240 taken hostage. Fifty remain in captivity, though only about 20 are thought to be alive.
The UN has warned of an “unprecedented humanitarian crisis,” with more than 90% of the population displaced and swathes of the enclave reduced to rubble. Numerous governments, international organisations and UN human rights experts have called it “genocide.”
“It’s two million people trapped between bombs and hunger, in 365 square kilometres where conditions deteriorate by the day,” says Zabalgogeazkoa.
“Other than the war injuries, the most ordinary things can kill”: if you’re diabetic you’ll lose your foot because there’s no insulin; if you’re malnourished you can’t care for your children… Even being coeliac can kill you.”
A healthcare worker tends to a newborn in an incubator. The lack of fuel also affects hospitals, which rely on generators for electricity. Credit: MSF
“An orchestrated massacre”
The MSF coordinator notes that only two of the four food distribution points run by the Gaza Humanitarian Foundation (GHF) — an organisation backed by the US and Israel but heavily criticised — are still operating.
“Other than the war injuries, the most ordinary things can kill”: if you’re diabetic you’ll lose your foot because there’s no insulin; if you’re malnourished you can’t care for your children… Even being coeliac can kill you.”
“People have to cross war zones to get there, and then chaos breaks out. Many are injured in the stampedes of desperation. In the end, it’s thousands fighting for a few sacks of flour,” he recalls.
A Reporters Without Borders investigation published on 7 August, titled This is not aid, this is an orchestrated massacre, described the centres as “death traps”, called for the programme to be scrapped, demanded the reinstatement of the UN-coordinated mechanism, and urged governments and donors to cut support for GHF.
“Distributions start at nine, but two hours earlier you already hear the gunfire. Israel says there’s no other way to control the crowds, but we come across people with bullets in the head or chest,” explains Zabalgogeazkoa.
Since the offensive began, eight health facilities in Gaza have been targeted by the Israeli army, most of them bombed from the air.
“At Nasser Hospital they killed patients by firing a missile through a window on two occasions. Soldiers also stormed the building and we had to evacuate. We couldn’t return for weeks. It was one of the hospitals where babies were left in incubators, and nothing more was ever heard of them,” he laments.
Fuel shortages to power hospital generators have forced doctors in Gaza to take extreme measures, such as placing several babies in a single incubator. MSF staff have reported cases of up to six infants in one unit.
Even water supply is a major struggle. Zabalgogeazkoa notes that 70% of the urban network is destroyed, so much of the water never reaches its destination.
Israel maintains that Gaza’s hospitals often conceal military targets, including “Hamas command centres” and “tunnel networks.”
The MSF staffer rejects this outright: “They always use the same narrative, also when they kill journalists living in tents set up inside hospitals. For Israel, everyone is Hamas. Were all the journalists they killed Hamas too?”
Gaza residents in a district bombed by the Israeli army. After nearly two years of offensive, the territory has been reduced to rubble. Credit: MSF
“Inconvenient witnesses”
The UN reports that at least 242 journalists have been killed in Gaza since the offensive began — the highest number ever recorded in a conflict. The vast majority were Palestinian, as Israel has barred international press access. The few foreign correspondents who entered did so embedded with Israeli troops and were unable to work independently.
Nothing seems to stem the chain of attacks on local journalists, who bear the responsibility of documenting the horror.
On 30 June this year, an Israeli airstrike destroyed the al-Baqa café, killing at least 41 people, among them Palestinian photographer and filmmaker Ismail Abu Hatab. The café had been a popular meeting place for young people, journalists and artists, and one of the few places where residents could access the internet and charge their phones during the war.
On 11 August, four Al Jazeera reporters and a local fixer were killed when a bomb struck al-Shifa Hospital. The head of UNRWA accused Israel of “silencing the voices exposing atrocities in Gaza.”
“They’re killing journalists one by one. Now almost everything is left to 16-year-olds posting videos on social media with their phones,” says Zabalgogeazkoa, describing it as a “systematic elimination of inconvenient witnesses.”
With Hamas’s leadership decimated and no local government to manage resources or administer justice, the Strip is descending into chaos. “Israel is doing everything it can to bring about the complete breakdown of Gazan society,” he warns.
“Besides, medicines, food, fuel… they are manipulated in a cruel game. Just when supplies are about to run out, Israel allows enough for another three or four days. People are so consumed with survival that they cannot think about anything else,” adds the MSF staffer.
He is due to return to Gaza in mid-September, though he fears conditions will have worsened by then.
On 10 August, Israeli prime minister Benjamin Netanyahu announced the approval of a plan for a full takeover of Gaza as “the fastest way to end the war, eliminate Hamas and free the hostages.”
The announcement drew widespread international condemnation. Few doubt the already dire humanitarian situation will deteriorate even further.
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