What Tomorrow Will Bring — In the West Bank, Palestinians left reeling by the violence of the Israeli occupation

In the occupied West Bank, decades of Israeli restrictions and deadly violence have shaped Palestinians' daily lives and access to essential services. The situation has worsened since the all-out war in Gaza began in 2023. A total of 1,109 Palestinians – at least 243 of them children – have been killed by Israeli forces and settlers in the occupied West Bank and East Jerusalem, as of 3 July. Seventy-four people have been killed this year alone. 

For many women in the West Bank, daily life is shaped by uncertainty, movement restrictions and obstacles to healthcare. In Nablus, where MSF provides mental health care, patients say those challenges have only grown since Israeli authorities denied registration to numerous international humanitarian organisations, including MSF.

Rana has five living children, including a baby who is a few months old. Two of her daughters, twins, have severe disabilities. In 2011, Rana's two-year-old daughter, who had disabilities, fell ill. The family lived in Azzoun Atma and had no car. No taxis were running. The village, an enclave in the Qalqilya governorate hemmed in by settlements and separation walls, has only one entrance: a gate that the Israeli army opens for only a few hours a day. That night, it was closed.

From her windows, she says, “the first thing you see is the wall. Then the settlements.” Surrounded by Israeli settlements and the separation wall, Azzoun Atma has effectively become a dead end.

A few months ago, about to give birth, Rana had to bring herself to take the road at night. “I first went to Qalqilya,” she recounts. “They wrote me a referral letter saying I had to go to Nablus. But it was night-time. My husband and I thought about it for a long time, and in the end, we took the risk.” She was afraid, for herself and for her unborn child. This time, all went well. “The greatest achievement, these days, is getting home safe and sound,” she says. 

As of December 2025, OCHA documented 925 movement obstacles that permanently or intermittently restrict the movement of 3.4 million Palestinians across the West Bank, including East Jerusalem. Settler violence, in particular, has changed scale: at least 3,088 attacks were recorded over 2023 to 2025, compared with around 1,860 over 2021 to 2023, according to the Office of the United Nations High Commissioner for Human Rights*.

Rana’s case, having lost her daughter, is far from isolated. 

With the Israeli authorities’ refusal to register 37 international humanitarian organisations, including MSF, in early 2026, things have become more difficult for the organisation. 

Deploying international staff is now impossible for MSF. The Palestinian teams in the West Bank are nonetheless supported remotely from Amman, in Jordan.

Unable to guarantee the safety of its teams outside the city, MSF has concentrated all its activities on the single clinic in Nablus, where patients are seen in person, and suspended all its mobile activities, notably in Qalqilya and Tubas. If Rana wants a mental health consultation, she has to make the journey from Azzoun Atma to Nablus, a particularly difficult undertaking. 

“Mental health work is done face to face. Not over the phone,” says Shorouq Al-Madmooj, a social worker who has worked with MSF for 22 years. “We want our patients to come to Nablus to receive care, because they need it. But at the same time, we do not want to put them in danger.”

What Shouruq has observed among MSF’s patients, over the years, is an erosion.

Psychological disorders are appearing at an ever-earlier age. In the youngest, they take the form of bed-wetting or hyperactivity, driven by “the anxiety of military incursions.” 

Mariam is 25. She comes from Nur Shams camp, in Tulkarem, in the northern West Bank, and the road from there to Nablus, she says, is “difficult, full of detours, very long, exhausting.” She recently emerged from a long period of depression. “After the war began [the Israeli offensive on Gaza in 2023], I felt the urge to change something, to do something I was capable of.”

She took one training course after another: first aid, first responder, advanced first aid, then an emergency medical services exam sat alongside nursing students, with a high score. She ended up accompanying the ambulances during incursions into the camp, to help the wounded. “Even with our vests, there was no protection for paramedics, journalists or anyone else,” she says. “People were being killed in their own homes, simply for looking out of a window.”

On 21 January 2025, two days after a ceasefire took effect in Gaza, the Israeli army launched the military operation “Iron Wall” in the West Bank.  Within weeks, almost all the inhabitants in the camps were displaced. Mariam was one of them. Sheltering for a time in Bal’a, a nearby village, she learned one day that soldiers had taken over the family home and declared it a military zone. 

According to satellite imagery analysed by the UN, about 35 per cent of Nur Shams had been destroyed as early as May 2025. When Mariam was able to return, she found her house badly damaged but still standing, unlike her sister’s, who now lives with her. 

Since January 2025, more than 33,000 people have been displaced from the Jenin, Tulkarem and Nur Shams camps and their surroundings, according to UNRWA.

This policy has daily consequences for Rana, who has to give up many medical appointments, but also more ordinary outings: “Before, we used to come to Nablus every week. Now, maybe once a year. We could run into settlers, and they could throw stones at us.”