For the past month, Palestinian medics have risked their lives and safety to treat Gaza’s wounded. Despite widespread, indiscriminate, and incessant bombardment by Israeli forces, our colleagues have continued working under fire.

With limited access to food, water, electricity, essential medicines, and medical supplies, they have persevered. On the rare occasions when we are able to connect over the phone—between communications blackouts and frequent movements to avoid attacks—they recount scenes of horror in the hospitals: dead bodies everywhere, people with crushed limbs rescued from collapsed buildings, orphaned children with severe burns covering most of their tiny bodies. They describe patients screaming in pain because there’s not enough anesthesia. All the while, they’re worried about being killed themselves as hospitals and ambulances are hit by airstrikes. And every day, they stay for their patients.

They can’t go on like this. No one in Gaza can go on like this. We need an immediate ceasefire. Humanitarian pauses are not enough

US President Joe Biden said yesterday that there is currently “no possibility” of a ceasefire between Israel and Hamas in the Gaza Strip, and his administration has been suggesting so-called “humanitarian pauses” instead. The White House said that Israel has agreed to daily four-hour pauses of military operations in parts of northern Gaza to allow humanitarian aid to come in and to allow civilians to flee.

But humanitarian pauses are not enough. People in Gaza have been under siege and near constant bombardment for weeks, clinging to survival. The needs for medical care and essential supplies are massive. It makes no sense to briefly pause the war to allow in limited humanitarian aid, only to then resume the intense bombardment that is driving massive humanitarian needs. An immediate ceasefire is the only humane option.

How many more civilians will be killed before the world says enough?

We urge President Biden to wield all the influence and power of the US government to help secure a ceasefire and stop this devastating spiral of violence in Gaza, which threatens to engulf people living across the region. The US government has been staunchly supportive of Israel’s military operation. It has also expressed concerns about mitigating the impact of the conflict on civilians, calling on the Israeli government to conduct its military operations within the bounds of the laws of war. The horrors unfolding before our eyes in Gaza show that these calls are going unheeded. Working purposefully to reach a ceasefire is the most effective way to ensure the protection of civilians.

As a medical humanitarian organization working in more than 70 countries, Doctors Without Borders/Médecins Sans Frontières (MSF) has operated in some of the world’s deadliest conflict zones. It is impossible for us to run our medical operations in Gaza as we usually do without protections afforded to humanitarians under international law. Israeli defense forces have struck hospitals, ambulances, and refugee camps in the course of this war on Hamas. On Monday, one of these strikes killed a dear colleague, Mohammed Al Ahel, who worked with MSF as a lab technician and was at home with his family in Al Shati refugee camp in Gaza City when the area came under bombardment. His building collapsed, killing Mohammed and several members of his family.

The situation in Gaza is becoming more disastrous each day

So far, more than 10,800 Palestinians have been killed in Gaza, according to the Ministry of Health—mostly women and children. The scale of human suffering should shock the world’s conscience. While some aid has trickled in, Israel’s siege on Gaza has deprived the entire population of adequate access to food, water, electricity, and fuel. This is collective punishment, which is prohibited under international humanitarian law. The Israeli military has ordered all civilians to leave northern Gaza, and has ordered the evacuation of entire hospitals full of sick and wounded people who could never survive the journey.

Palestinian medics are working under horrendous conditions to continue to try to provide medical care where and when they can. This week, MSF managed to get some urgently needed medical supplies into Gaza, in coordination with the Egyptian Red Crescent and Palestine Red Crescent Society. We have international teams ready to go in. We have run medical programs in Gaza for 20 years and want to be able to continue this vital work.

In Gaza City, people have told us they are afraid to go to hospitals because they are either attacked or at risk of being attacked at any time.

The situation in Gaza is only becoming more disastrous each day. In Gaza City, people have told us they are afraid to go to hospitals because they are either attacked or at risk of being attacked at any time. Early on Friday, Al-Shifa Hospital was reportedly hit by a projectile. The source and extent of the damage could not be immediately verified.

“I was heading to Al-Shifa Hospital to work this morning when the facility was hit. All of us were horrified, some of us threw ourselves to the ground,” said Maher Sharif, an MSF nurse. “I saw dead bodies, including women and children. This scene was horrific and made all of us cry. Medical staff were terrified, trying to save their lives and their families."

In recent weeks, Al-Shifa Hospital—the biggest hospital in the Gaza Strip—has been overcrowded with patients. Without enough hospital beds, many people were being treated on the floor. Most of the operating rooms are no longer functional, and the hygiene situation is alarming. Mothers who just gave birth are malnourished and can’t produce milk to feed their babies, putting them at risk of starvation. Tens of thousands of displaced people have been sheltering outside Al-Shifa for safety.

WCNSF: Wounded child, no surviving family

Our colleagues describe taking care of so many wounded children, often arriving scared and alone, with no relatives. They use a disturbing acronym to identify these children who need special attention: WCNSF, wounded child, no surviving family.

We are seeing children who are coming in with the majority of their bodies burned. These are extremely severe injuries that are hard to treat effectively even in high-resource settings, yet MSF has been able to provide specialized burn care to patients at Al-Shifa Hospital for years. Our doctors have experience treating children who are fighting for their lives. In these situations, they say children need two main things: They need pain relief and they need the security of their families. Today, too many children in Gaza don’t have either of those things. The world is watching

Our organization was founded on principles that include bearing witness and speaking out about what we see in our clinics and hospitals. Every day our staff are being interviewed by the media and asked about the situation on the ground. And every day we recount the horrors our teams are witnessing. The entire world is watching, and yet the killing of innocent civilians continues.

The truth is that our colleagues are running out of words to describe the extent of the pain and suffering in Gaza right now. How do we remind the world that these people on their television screens—bloodied and laid out on hospital floors, rescued from under the rubble of bombed-out buildings—are human beings, with dreams and lives and loved ones? How many more civilians will be killed before the world says enough?

As humanitarians, we stand with our colleagues and our patients in Gaza to call for an immediate ceasefire now to save lives.