AMMAN, Jordan / JERUSALEM —

Médecins Sans Frontières, or Doctors Without Borders, warned Wednesday that Israel is progressively restricting the space available to Palestinians in the Gaza Strip while conditions needed for survival continue to deteriorate amid ongoing violence, restrictions on essential supplies and the destruction of health care and vital infrastructure.

The medical charity said Israel's so-called Yellow Line, initially presented as a temporary military withdrawal position under a ceasefire arrangement, has increasingly become a fortified military boundary, with military positions, earth berms and continued demolitions.

According to MSF, Israeli forces now control or occupy about 65% of the Gaza Strip, with the Yellow Line continuing to move westward and forcing Palestinians into an increasingly confined area.

MSF said people living near the line face the risk of being shot when approaching it, while its medical teams continue to treat people with gunshot wounds sustained in areas nearby. The organization also said insecurity around the line has disrupted humanitarian operations, including water deliveries.

“The Yellow Line cannot be treated simply as a line on a map,” said Amande Bazerolle, MSF’s head of emergency response in Gaza. “It has become a mechanism of encirclement and ethnic cleansing, while cutting communities off from the infrastructure, healthcare, water and other essentials they need to survive.”

MSF said violence has continued across Gaza despite the ceasefire. In June and July alone, its teams treated more than 1,200 cases of violent trauma, including blast injuries, burns, gunshot wounds and injuries resulting from physical assaults.

Over the past three years, MSF said its teams have treated more than 200,000 trauma cases, including injuries caused by intentional violence. The organization said Israel’s military offensive has killed more than 74,000 people in Gaza, including more than 20,000 children.

As Palestinians are concentrated into increasingly smaller areas, families are facing overcrowding and inadequate access to clean water, sanitation, shelter and health care, MSF said. The conditions are contributing to the spread of disease.

MSF said its teams have treated more than 11,000 cases of skin diseases, including scabies, since the beginning of the year, as well as more than 1,500 cases of chickenpox in June and July.

The organization said it distributed about 2.1 million liters of drinking water a day in August, but warned that humanitarian needs remain far greater than what can be met under current restrictions.

“Most people have less than six liters of domestic-use water per day and limited access to basic hygiene items such as soap and detergent,” said Dr. Murad Asaliyya, MSF’s medical activities manager in Gaza.

“We are treating gastroenteritis, acute respiratory infections, a lot of skin conditions, hepatitis, bacterial skin infections, scabies and lice,” he said.

Asaliyya also said medical supplies remained in severe shortage, including products needed to treat scabies.

MSF said Gaza’s health care system has deteriorated sharply over the past three years, with hospitals facing shortages of basic supplies and patients struggling to obtain essential medicines and treatment.

Restrictions on supplies such as engine oil and spare parts have also affected the infrastructure needed to operate hospitals, ambulances and water systems, the organization said, adding that generators are breaking down and water distribution operations have been reduced.

MSF said the destruction of Gaza’s health care system, along with damage to more than 80% of structures across the territory, would have long-term physical and psychological consequences and make recovery more difficult.

The organization said the crisis extends beyond Gaza.

Since 2023, MSF said, settler attacks, Israeli military operations and raids, home demolitions, movement restrictions, settlement expansion and the displacement of Palestinians have intensified across the occupied West Bank and East Jerusalem.

Patients treated at MSF clinics have reported home demolitions, attacks by settlers and the theft of livestock, the organization said.“It will take generations to recover from the harm that has already been done over the past three years, and in the preceding decades, while the excruciating consequences of Israel's ongoing genocide are still being felt every day,” Bazerolle said.

“Destruction, displacement and deprivation have become normalised — practices Israel is carrying out with impunity,” she said, calling on governments to act to stop what she described as the destruction and killing, prevent ethnic cleansing and ensure Palestinians have access to the means of survival.

MSF's characterization of Israel's actions as genocide and ethnic cleansing reflects the organization's assessment and language in its statement. Israel has rejected accusations that it is committing genocide in Gaza and has said its military operations are aimed at Hamas and other armed groups, rather than the Palestinian population.