Dear President Biden,

I am writing to you on behalf of Doctors Without Borders/Médecins Sans Frontières (MSF), our staff, and our patients to urgently request that the United States call for an immediate and sustained ceasefire in Gaza. MSF has delivered medical aid in many high-intensity conflicts over more than 50 years, yet rarely have we encountered such a catastrophic combination of escalating humanitarian and medical needs, ravaged infrastructure, and intentionally limited humanitarian access. We urge you to use your influence to secure an end to the widespread and indiscriminate attacks against civilians, forced displacement, and siege of Gaza. Vital humanitarian aid must be allowed to enter the Gaza Strip at scale.

My colleagues and I, like so many people around the world, were horrified by the attacks on civilians in Israel by Hamas militants on October 7. We are horrified by the ongoing attacks on civilians in Gaza by the Israeli military.

The way Israel is prosecuting this war is causing massive death and suffering among Palestinian civilians and is inconsistent with international norms and laws. Even war has rules. Under these rules, civilians must be protected from violence and have the right to access humanitarian assistance, especially medical care. The medics who provide this care must be protected from the violence of combat, and the places they work are afforded special protected status. Your administration’s stated commitments to international law appear to falter when faced with attacks on civilians in Palestine.

Humanitarians have not been spared from the disproportionate violence of this conflict. Four MSF staff members have been killed and many more injured, the ambulances and health care facilities in which we work have been attacked, and our clearly marked humanitarian vehicles have been destroyed. We have done everything we can to notify parties to the conflict of our locations and activities. The killing of humanitarian workers and the destruction of humanitarian spaces and property may constitute war crimes.

As a medical humanitarian organization, our mandate is to save lives and alleviate suffering. We are specialized in delivering aid in complex settings, but it is impossible for us to operate at scale in Gaza. The level of humanitarian need is beyond the capacity of humanitarian actors to address because we, along with the entire civilian population, are intentionally blocked by Israel from accessing food, water, electricity, and the medical supplies we need to care for our patients.

The siege of Gaza has deprived most of the population of access to essential goods and services. Subjecting an entire population to collective punishment is a war crime under international humanitarian law. The United States Government has urged humanitarian organizations to scale up our response but does not seem to acknowledge that we are also severely affected by the siege. US taxpayers are being called upon to help fund both the destruction of Gaza and the resulting humanitarian needs.

The humane alternative is a multi-party ceasefire, an end to the siege on Gaza, and the lifting of restrictions on humanitarian access. The US government must exert genuine pressure, both publicly and in private, to ensure Israel protects civilian lives and infrastructure. The US government has a responsibility, as a partner and ally of the Israeli government, to ensure that its support is not used to kill civilians, attack hospitals and medical staff, destroy cities, and forcibly displace civilians.

Medics in Gaza are exhausted and overwhelmed by the scale of human suffering they experience every day. Our teams throughout Gaza recount scenes of horror in the hospitals: dead bodies everywhere, people with crushed limbs rescued from collapsed buildings, and orphaned children with severe burns covering most of their tiny bodies. They describe patients screaming in pain because there’s not enough anesthesia. And every day, they go to work for their patients.

They can’t go on like this. No one in Gaza can go on like this. We need a sustained ceasefire now.

Avril Benoît
Executive Director, Doctors Without Borders/Médecins Sans Frontières (MSF) USA,