Escalation in the Middle East
MSF is alarmed by the dramatic escalation in conflict across the Middle East-wide region. We call for the protection of civilians, as well as hospitals, health facilities, and other essential infrastructure.
In late February, US and Israeli forces carried out airstrikes against Iran which were followed by retaliatory actions that have impacted multiple countries across the region. On 8 April, a ceasefire was announced and while it has been violated by both sides since its declaration, it currently remains in effect. US-Iran talks, covering issues including Iran's nuclear programme, sanctions, and longer-term peace arrangements, are ongoing.
Since then, violence has expanded across the region, affecting both urban cities and surrounding areas. Airstrikes, missile attacks, and other hostilities have increased insecurity for communities already living in fragile contexts. Despite the ceasefire, the situation remains fragile and the humanitarian consequences of weeks of active conflict continue to unfold.
The regional escalation has affected Medecins Sans Frontières (MSF), also known as Doctors Without Borders, operational environment across the Middle East, although the level and nature of the impact vary significantly between countries. The most direct and severe effects are being felt in Iran and Lebanon, where active hostilities, heavy airstrikes, and large-scale displacement are ongoing. In other countries where MSF operates such as Iraq, Jordan, Palestine, Yemen and Syria, the escalation has had more indirect operational consequences.
Overall, the escalation has created a more volatile operational environment for MSF across the Middle East, affecting security conditions, staff mobility, humanitarian access, and supply chains, with airspace closures and instability around the Strait of Hormuz are further compounding these challenges. Simultaneously humanitarian and healthcare needs among affected populations continue to increase particularly related to displacement, psychological distress, and growing barriers to accessing healthcare.
MSF's regional logistics hub in Dubai, which plays a critical role in coordinating supply and operational support across the Middle East, has faced challenges as a result of instability around the Strait of Hormuz. Disruptions to shipping routes have forced the rerouting of medical supplies through alternative channels, at considerably higher cost. These pressures are compounded by rising prices globally for essential goods and freight. Despite these constraints, MSF continues to move medical supplies across the region, prioritising uninterrupted delivery of care to the people who need it most.
MSF remains committed to reaching people in need across the region, whatever the operational challenges.
MSF footprint in the region and our preparedness and response to the escalation
MSF runs a wide network of medical and humanitarian programmes across the region including Iran, Iraq, Jordan, Lebanon, Syria, Palestine, and Yemen; providing essential healthcare to people affected by conflict, displacement, and limited access to services through hospitals, clinics, and mobile medical teams. MSF also has three regional hubs in Amman-Jordan, Beirut-Lebanon, and Dubai-UAE, supporting regional supply and operational needs.
With the current escalation, MSF teams across the Middle East are scaling up preparedness measures and adapting their activities in response to evolving needs, while maintaining essential medical services where access allows.
Since 28 February
281.42 tonnes
of medical supplies have been dispatched to countries throughout the Middle East, including Iraq, Iran, Lebanon, Palestine, Israel, Jordan, Syria, and Yemen. Across the region, MSF has strengthened its operational readiness through contingency planning, supply pre-positioning, expanded warehousing, staff training, and the deployment of additional mobile services. Where primary routes have been disrupted, supplies are being moved through alternative channels, though at higher cost.
Country-by-Country
Operational response across the region
In Lebanon
Activities span several regions including Beirut, Tripoli, Baalbek-Hermel, Saida, South Lebanon, and Nabatiyeh, through standalone clinics, mobile medical units, and support to primary healthcare centres and hospital wards.
Since the escalation began on 2 March, MSF has launched a nationwide emergency response across Lebanon. A ceasefire came into effect on 17 April, bringing some relief, but the situation remains fragile: violence has not completely ended, particularly in southern Lebanon, where communities continue to face destruction, displacement, and ongoing attacks.
On the ground, MSF mobile medical teams have expanded into areas of southern Lebanon that were previously inaccessible, including around Nabatiyeh and Sour/Tyre, providing primary care, mental health support, and reproductive healthcare. MSF is also reinforcing several hospitals in Beirut, Sour, Nabatiyeh, and Qana with medical supplies, fuel, and in some cases, emergency room doctors, as health facilities remain overwhelmed by mass casualty incidents.
Beyond direct medical care, MSF has distributed tens of millions of litres of water, conducted tens of thousands of medical consultations, and provided mental health support to tens of thousands of people across the country.
The humanitarian situation remains severe. The majority of displaced people have not been able to return home, with large parts of southern Lebanon under ongoing evacuation orders and many communities facing widespread destruction. Medical needs, including chronic disease management, mental health, and reproductive care, continue to grow, while access to healthcare remains constrained in many areas.
In Jordan
MSF runs specialized and hospital-based services- the reconstructive surgery programme in Amman. The hospital provides complex surgical care, rehabilitation, and mental health support to war-wounded patients from across the region.
With the current escalation, the medical evacuations to the MSF Reconstructive Surgery Programme have been suspended, affecting patients from Gaza, Yemen, and Iraq who require specialized treatment. Some patients who completed treatment are also unable to return home due to travel disruptions. These delays risk worsening conditions for patients requiring specialized surgical care. The ceasefire has since contributed to a more stable security situation in Jordan, with airports functioning normally and no attacks reported since it came into effect. However, the movement of patients into Jordan for treatment remains affected by border restrictions, and the situation continues to be closely monitored.
In Iraq
MSF operates projects in Mosul and Baghdad, delivering services including maternity care, paediatrics, neonatology, outpatient consultations, mental health support, and tuberculosis and women's health services.
With the current escalation, MSF operations have been partially disrupted. The project in Baghdad has been suspended since early March 2026, and the team has relocated to Erbil, while the Mosul project continues to operate. Although access to healthcare has not yet been significantly affected, the escalation is expected to have broader impacts on safety, economic conditions, and mental wellbeing, which may indirectly increase healthcare needs.
In Gaza and the West Bank
The regional ceasefire has not meaningfully improved conditions on the ground in Gaza or the West Bank. Airstrikes and civilian casualties have continued, Israeli forces have expanded their military control of the Strip, and the obstruction of humanitarian aid persists, with devastating consequences for the civilian population.
MSF continues to provide critical medical and mental health care in an already overstretched system, where access to healthcare remains severely constrained.
The escalation has worsened humanitarian conditions in Gaza and the West Bank. Israel closed all crossings into Gaza at the end of February, suspending medical evacuations and preventing thousands of patients from accessing specialized treatment outside the territory. Although some crossings later reopened for limited supplies, Rafah remains closed and humanitarian access remains highly restricted.
In the West Bank, intensified military operations, increased settler violence, and checkpoint closures have limited movement between cities, delaying access to healthcare and disrupting humanitarian operations. MSF temporarily suspended some activities, including mobile clinics in Hebron, while staff have faced movement restrictions and psychological stress due to security alerts and nearby attacks.
In Syria
Syria represents one of MSF's largest operational footprints in the region, with activities across 11 of the country's 14 governorates. MSF operates or supports 10 hospitals and 21 clinics, complemented by mobile clinics and partnerships with the Ministry of Health. Services include emergency and primary healthcare, maternal and newborn care, treatment for chronic diseases, nutrition programmes, mental health services, and water and sanitation activities. The response also includes rehabilitation of health facilities, capacity-building for medical staff, and humanitarian relief distributions for displaced communities.
The regional escalation has had indirect humanitarian consequences in Syria, including cross-border population movements. Tens of thousands of Syrians displaced in Lebanon have crossed back into returned to Syria due to intensified Israeli airstrikes in Lebanon during the initial phase of the escalation. While most MSF activities continue as planned, operations in Daraa were temporarily suspended due to security risks from falling debris related to the escalation. Airspace disruptions and travel restrictions have also affected staff rotations and movements, causing short-term staffing constraints. MSF teams are monitoring humanitarian needs at border crossings and remain prepared to scale up support if the number of arrivals increases.
The ceasefire in Lebanon has since slowed cross-border movement, and the gradual reopening of Syrian airspace, including Damascus International Airport and resumed UNHAS flights between Damascus and Aleppo, has improved staff mobility and supply routes. The situation nonetheless remains fluid, with pockets of volatility persisting in parts of the country. MSF teams continue to monitor needs at border crossings and are prepared to scale up if conditions change.
In Yemen
MSF operates across several governorates, with projects in Al-Qanawiss and Ad-Dahi (Hodeida), Al-Qaida (Ibb), Hajjah city and Abs (Hajjah), as well as additional activities in Aden, Taiz (including Mocha, Mafraq al-Mocha, and Khawkha), Amran (Khamer), and Saada (Haydan). MSF runs and supports multiple hospitals and primary healthcare centres, alongside emergency response activities in several locations. Our teams provide essential medical services such as primary healthcare; emergency care, surgical care, maternal and child health, treatment of malnutrition, and mental health and psychiatric care, while maintaining strong emergency preparedness capacity, with trained response teams across six governorates ready to respond to mass casualty incidents, disease outbreaks, and peaks of malnutrition.
The recent escalation between the US, Israel, and Iran has not directly impacted MSF activities or staff in Yemen, and operations continue as planned. While the regional ceasefire has brought a degree of de-escalation, it has not translated into lasting stability for Yemen. The most immediate concern is the indirect impact on people's living conditions and access to care: rising global prices are already increasing the cost of essential goods such as food, fuel, and healthcare, further straining vulnerable communities. At the same time, airspace disruptions and flight restrictions continue to affect supply routes and staff movement, with some freight operators reluctant to operate in the current environment. While no major operational disruption has been observed so far, any further escalation; especially if Ansarallah becomes directly involved; could significantly worsen both the humanitarian situation and MSF's ability to deliver care.
MSF remains committed to providing medical care based on need, wherever access allows.