It has been over a month since the Hamas attacks on southern Israel and the ensuing Israeli assault on Gaza began. The consequences for civilians have been disastrous – 1,200 people killed in Israel on October 7 and, in the month since, nearly ten times as many, 11,000 Palestinians, killed in Gaza, most of them women, children and the elderly. This number is likely an undercount, especially since the Palestinian Ministry of Health has had trouble getting accurate casualty counts. Last month, I wrote a piece for The Nation warning that a public health catastrophe was unfolding in Gaza, one that would put as many as two million people at risk of death, disease and starvation due to Israel withholding of food, fuel and water and the IDF’s attacks on medical facilities. Since then, the situation has only become more dire.
Last week, the Israeli army raided Al Shifa hospital in North Gaza. They reportedly destroyed equipment and medicines and detained and interrogated Palestinians – all under a dubious pretext that the hospital was used as a Hamas “command and control node,” a claim backed by the White House, but disputed by human rights organizations. They also reportedly destroyed water pipes while digging a trench, putting dialysis patients in the hospital at risk – one has died already. After scouring the complex for hours, all the IDF had to show for it were a few guns that were allegedly found in the hospital—a scene that CNN later said appeared to have been rearranged before new crews arrived. Before the hospital was stormed, Israel’s Ministry of Foreign Affairs posted a video of a woman claiming to be a nurse at Al Shifa who said she had seen militants in the hospital stealing fuel and medicine. That video was deleted and is now understood to have been staged. Now, the IDF has released video it claims were tunnels underneath or near the hospital itself.
Regardless of what the IDF claims, it does not change Israel’s obligation under international law to avoid civilian casualties and targeting medical facilities. Even if there were tunnels underneath the hospital, that does not justify besieging a hospital filled with the sick, injured and dying.
Prior to the raid, things were already dire at Al Shifa. Premature babies were taken out of their incubators as oxygen supplies run out; some died before being rescued by the WHO. Bodies were piling up in and around the hospital for days, creating unsanitary conditions, because people feared going outside to bury them as people have been shot outside the hospital. Children are malnourished and dehydrated and according to the WHO, as of November 10th, there have been more than 50,000 causes of upper respiratory tract infections, more than 30,000 cases of diarrhea, and 12,000 skin rashes, among other diseases. People have been forced to flee to southern Gaza having just finished surgery or having just given birth. Some people are no longer able to access surgery at all. Many of Gaza’s hopsitals, including Al Shifa, are out of service and as of November 16th, Al-Ahli hospital officials reported that the hospital was being besieged by Israeli forces. Al-Ahli is the last functioning hospital in the Strip. These are just some of the horrors of the medical situation in Gaza – there are just too many to list.
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Still, despite the dire circumstances Gaza’s medical workers continue to work to save lives. One of those doctors was Dr. Hammam Alloh, a nephrologist in Gaza. During an interview with Democracy Now, host Amy Goodman asked Alloh why he did not leave Al Shifa hospital and flee south. Alloh responded that he could not abandon his patients, that he went to medical school to think more than just about his own life. Just days later, Alloh was killed in an airstrike near the hospital on November 11th.
While medical workers in Gaza conduct lifesaving operations in gut wrenching conditions and beg for the world to intervene, the American medical and health establishment has turned their backs on them. As many have pointed out, the health care establishment in the United States did not mince words when condemning Russia’s attack on Ukraine. But in this case, the official reactions of American medical associations to the health catastrophe in Gaza have largely ignored the material conditions on the ground in favor of statements and articles that blame the Palestinians for their own situation and defend Israel’s “right to defend itself”. This was more or less the position the American Public Health Association (APHA) took in the statement it released on November 3rd. Despite titling the statement “Public health implications of the Israel-Hamas war,” the statement did not actually mention any of the public health impacts that are affecting Palestinians on the ground and instead offered condemnation of Hamas and defense of Israel’s bombing campaign. An article published in the Journal of the American Medical Association (JAMA) called for health professionals to speak out against war crimes but ultimately only condemned Palestinian militants for allegedly using hospitals as operational bases and using human shields—rather than the Israeli forces for bombing them.
These statements are grounded in a fundamental distrust of Palestinian medical workers. Rather than listen and believe their testimonies, the medical and health establishment ignores them or chooses to believe Israeli narratives that provide cover for IDF attacks on hospitals. The White House went even further – initially casting doubt on the numbers health officials in Gaza were reporting because Palestinian ministries are Hamas affiliated. This is an extension of how Palestinians are dehumanized in the media and by western governments. These workers are risking their lives to save patients and are being treated with the utmost disrespect.
But there are some in the United States who are listening. Some medical and public health workers, often part of the younger generation of professionals, are forcing the conversation. At a meeting of the American Medical Association’s house of delegates on November 11, medical students and residents overwhelmingly supported a motion that would have the AMA issue a statement for a ceasefire. Despite this, the motion was roundly defeated by the full body. To this date, the AMA has only issued a tepid statement in support of medical neutrality. At the APHA conference, which was held in Atlanta on November 12th-15th, the organization passed a motion in which APHA affirmed its support for and called on President Biden to support a ceasefire – despite APHA’s leadership’s earlier statement on the issue.
These groups should follow the lead of the World Health Organization and Doctors Without Borders, both of which have called for a ceasefire in Gaza, as the Palestinians in Gaza face health conditions that can be best described as medieval. The urge to appear reasonable and put out a “both sides” view on the political situation obscures the asymmetric reality of the health catastrophe. It is not Israelis who face mass death, disease, and starvation. It is not Israel which faces shortages in medicine and fuel.
This inability to affirm the basic rights of Palestinians has many newer professionals questioning the commitment that the health and medical fields have made to health equity and serving marginalized populations in recent years. The pandemic has made public health and medicine targets of right-wing authoritarians. Should another right-wing authoritarian get into power again, how will healthcare professionals react? The present response to the Palestinian people’s plight does not inspire confidence.
While the world has abandoned them, the Palestinian people have been showing us what collective care is about. I have been simultaneously horrified and moved by images of Palestinians taking care of each other in these dire circumstances. Wheeling the elderly in wheelchairs and carrying the wounded as they are forced to evacuate. People, including a child, holding premature babies in their hands, as they transfer them to another part of the hospital. This is what healthcare should be about – refusing to leave anybody behind.
In a few years, when this massacre, which scholars have warned may become a genocide, is widely condemned, some people may feel shame, others may offer tepid apologies to the Palestinian people. To my health colleagues who are on the sidelines right now, debating whether they should take the risk of saying anything – do not risk being one of those people who carries regret with them in the future. Join with us, the growing number of medical and public health professionals, who are raising our voices in support of our Palestinian colleagues.