Patients sit at a clinic in Gaza City run by Médecins Sans Frontières, known by its French initials MSF, on December 31, 2025.

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GAZA CITY, Gaza Strip — Mohamed Ibrahim wants to run and play soccer again, but the 14-year-old has undergone three surgeries since he was run over this summer while trying to get food from an aid truck for his starving family.

A nurse at this clinic in Gaza City is changing the gauze on his right leg. He winced in pain.

“Please focus on us and calm your mind,” she tells him. “I’m sure you’ll be fine.”

“It hurts,” the boy cries. Unable to hold back his tears, he burst out, saying, “I can’t! I can’t!”

The clinic is run by Médecins Sans Frontières, also known by its French initials MSF, an international aid organization that provides life-saving care in conflict zones around the world. However, this clinic and 19 other MSF medical facilities and medical hubs in the Gaza Strip are facing enormous pressure, and some may be forced to close.

Israel has banned MSF and dozens of international aid groups, preventing them from bringing aid workers and international staff to the Gaza Strip and the occupied West Bank under new security and transparency rules that took effect on January 1.

“This is a disaster. An absolute disaster,” Ibrahim’s mother, Neama Abu Ghanim, says of Israel’s decision.

She told NPR that before coming to the MSF clinic, her son had spent months unable to sleep due to pain, even though he had been treated at several hospitals in the Gaza Strip that were still partially functional. Gaza’s health system has collapsed after two years of war.

“When I came here, they gave me medication to help me sleep for just a few hours at night, which helped me a lot,” she says.

On December 31, 2025, Mohamed Ibrahim, 14, is cared for by his mother as he receives treatment at an MSF clinic in Gaza City. This comes after he was run over by a truck while trying to get food during last summer’s famine.

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In addition to tens of thousands of people killed, more than 171,000 Palestinians were injured in Israeli attacks during the war, according to the Gaza Health Ministry. Many of them seek treatment at clinics such as those run by MSF.

At an MSF clinic in Gaza City last week, NPR witnessed doctors treating an 8-year-old girl whose arm was severely burned in an Israeli airstrike and encouraging her to move her wrist, where scar tissue had formed. Another young girl was in a room with colorful building blocks to support her mental health. A young man was riding an exercise bike for physical therapy. Some people were tested in wheelchairs.

The aid organization claims it treated about 1 million people, half the population, in the Gaza Strip last year.

Foreign staff and assistance are prohibited

Israel’s decision to ban MSF and other aid groups means it can no longer bring international staff and aid groups to Gaza or the West Bank. With dwindling supplies and no international expertise, they will be forced to rely solely on exhausted local staff.

MSF told NPR that it currently has 1,100 staff in the Gaza Strip, about 50 of whom are foreign workers. The group says all requests to Israel in recent days to bring aid to Gaza and to deploy new personnel to Gaza have been rejected.

Loai Harb, a Palestinian nurse at MSF’s clinic in Gaza City, says she sees complex cases every day, many of which require multiple surgeries and months of treatment.

“I try to give my patients the best care because I know there is nowhere else they can get this type of care,” Herb said, adding that there is a waiting list of people willing to receive it.

Israel insists Gaza is not dependent on MSF activities

Israel has announced it is banning around 40 international aid agencies from entering the Gaza Strip and West Bank, citing failure to meet new security and transparency standards.

a Partial list of prohibited aid organizations The decision was announced by Israel last month.

In addition to MSF, the organizations include Oxfam, which has been working on desalination and clean water, the Norwegian Refugee Council, which has overseen supplies for tents and shelters, Mercy Corps, which has distributed food and basic aid, Save the Children, which has supported maternity care, and Rahma Worldwide, which has brought doctors from the United States to volunteer at hospitals in Gaza.

The Israeli government says these organizations do not fully disclose the identities and roles of their employees. This requirement was introduced after the deadly Hamas-led attack on Israel on October 7, 2023. Israel says the new rules are aimed at preventing aid exploitation by Hamas.

More than 50 international aid organizations responded in unison. open letter, It states that employees’ personal data cannot be provided to parties to the conflict.

They also noted that over the past two years of war, more than 400 aid workers have been killed in Israeli attacks on Gaza.

Pascal Coisard, MSF’s Jerusalem emergency coordinator, told NPR that the aid organization had been trying for months to understand what this personal information of local staff would be used for, but had not received a clear answer.

“We have raised concerns with the Israeli authorities about sharing the staff list, because it is not yet clear to us what they will use it for,” she said.

Israel said the aid organization was given “a full 10 months to regularize its authorization, which it failed to do.”

A war-injured Palestinian man sits near an exercise bike used for physical therapy at an MSF clinic in Gaza City, December 31, 2025.

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MSF has been working in the Palestinian Territories since 1989. During the war, 15 staff members were killed in Israeli military attacks in the Gaza Strip. The clinic was also bombed.

Israel condemned the two murdered MSF workers: associated with armed groupsone said he was a sniper. MSF denies the allegations and says it will never knowingly employ anyone involved in extremist activities. It said Israel’s ban was a violation of international humanitarian law and aimed at blocking access to aid.

The Israeli Ministry, which is overseeing MSF’s deregistration, said the group “abandoned neutrality” and that “its humanitarian assistance in Gaza does not depend on its presence.”

Countries and UN agencies call on Israel to lift ban

The joint statement states that all major united nations agencies Activists in Gaza have called on Israel to lift its ban on international aid groups, warning that this would undermine the small progress made in a ceasefire that began in October. They say it will also hurt efforts to help people survive another winter in rain-soaked makeshift tents. Several children have died from hypothermia in recent weeks, according to Gaza’s Ministry of Health and hospital records.

Ten countries, including the UK, France and Canada, said Israel’s ban was “unacceptable”. They said a third of Gaza’s medical facilities are run by international aid groups.

Israel insists that the ban on these dozens of aid organizations will not adversely affect aid entering Gaza.

COGAT, Israel’s military arm that oversees the entry of supplies into Gaza, said that “the organization’s attempt to portray Gaza’s humanitarian system as dependent on its personnel is divorced from the reality on the ground.”

International staff provide explanation of Israeli attack

As Israel continues to ban independent access to international news organizations, many of the now-banned aid groups also provided critical accounts of what was happening in Gaza during the war.

Under Israel’s new registration requirements, an aid organization’s license could be revoked if it engages in “illegal activities against Israel or legal persecution of the IDF.” [Israeli] soldiers, denial of the Holocaust, or denial of the atrocities of October 7th. ”

Many of these aid organizations have published detailed reports on Israeli aid restrictions, and international staff and health workers have provided first-hand reports from Gaza. These have been widely cited in the media and could be used in international tribunals against Israel fighting charges of genocide and war crimes.

A young Palestinian child injured in an Israeli airstrike is taken in by his father at an MSF clinic in Gaza City on December 31, 2025.

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20 aid organizations participated in September signed the letter After a UN commission determined that Israel had committed genocide in Gaza, Israel denied it and stood by its findings, saying UN officials had seen traumatized children, people missing limbs, and starving families.

At least 15 of the 20 organizations that signed the letter are among those currently banned by Israel.

MSF also Detailed report about what it called “systematic killings” of Palestinians by Israeli forces trying to get food from the U.S. and Israeli-backed Gaza Strip. This report, published at the height of the experts said it was starvationcalled it a “death trap”, citing medical data and testimonies from an MSF field clinic near the Gaza Humanitarian Foundation compound.

MSF said: statement After the Israeli ban was announced, an Israeli team said that if the accounts of what they saw with their own eyes in Gaza were offensive to some, “the blame lies with those who committed these atrocities, not those who speak about them.”

Batrawi reported from Dubai, United Arab Emirates.